Report of the Belgian/Italo team
In March 2011 a team of three Belgian surgeons (Stefaan Poelmans, Marc Huyghe and Casper Sommeling) accompanied by an Italian registrar (Cecilia Ceribelli) visited Takoradi in Ghana.
We again flew with Lufthansa/SN Airlines, which company we have to thank for giving us the opportunity to bring 15 kg of extra luggage each, so that we could take enough medical material with us. We brought meshes (kindly donated by BBraun Medical NV Belgium, Covidien Belgium, Bard Italy and Assut Europe), gloves (Cardinal Health), disposable drapes (M?lnlycke Belgium), suture material (Johnson & Johnson), local anesthetics (Astra Zeneca and BBraun), analgesics, syringes and needles. After a wearing drive from Accra to Takoradi through some heavy thunderstorms, we arrived very late Saturday night at 'the Villa' were we had a good night sleep.
Sunday morning we took a cab to Green Turtle Beach Lodge, were we had a nice and relaxing day. Returning to Takoradi we made a stop in Dixcove were we observed and admired the return of a local fishing boat. In the evening we met Bernard Boateng, who again did the selection of the patients on forehand.The living circumstances in 'the Villa' are good. 'The girls' (Kate, Lilian and Benedicte) took good care of us. The food they prepared was fine and far better than the Western food served in the local restaurants.
During the week the three surgeons rotated in the three different hospitals (Hernia Wing, GPHA and also for the first time Dixcove), accompanied by Cecilia. We operated on 74 patients, of which seven were children. Most of the adult patients, presented with groin hernias (61, in seven bilateral), in some accompanied by a hydrocele. In most of these patients a Lichtensteinrepair (with standard middle weight polypropylene) was performed. We did not use mosquito nets. Three other patients only had hydroceles.
Most patients were operated under local anaesthesia, but loco-regional anaesthesia was used as a standard in all three locations in the more demanding scrotal hernias, contributing to a better comfort of the patients. The children ofcourse were operated under general anesthesia; in Dixcove the induction was done by the child relaxing on the back of the headnurse walking around.
Again this year there were some challenging scrotal hernias, and also the age of the patients we operated on is increasing. The oldest patient was 90 years of age and in good condition!The presence of a registrar is useful; firstly, because she could assist us, but secondly and more important, we could assist her in performing operations, that will lead to more experience for her. She performed ten operations. The motivation of the local hospital teams is good and the level of care of the nurse-anesthetics in the three hospitals is high. The equipment in the hospitals (also in Dixcove) is of a reasonable level, but although we were convinced that we brought enough material, again at the end of the week there was a shortage of drapes, gloves and sutures. As can be understood by the total of operations performed we individually made long days, but it was rewarding. Even the last Friday we operated in the Hernia Wing until after eight o'clock in the evening.
After a long week hard work we had dinner at the Planters Lodge Friday night. On Saturday we made a trip to Bushua beach, were we had a nice day at the beach. Sunday-morning we said goodbye to the girls and were brought to the Kakum National Park, were we made a quick trip to the forest and made the Canopy Walk. Entrance prices were threefold from last year and it starts to look like a 'tourist trap'. Much more pleasure we had from a visit to the 'Monkey Forest Resort' near the Kakum National Park. This resort was founded by a couple from the Netherlands. They try to save left-alone animals, that are brought to them by the locals. A visit is worthwhile (at the right side of the road when you drive to Kakum). After that we had (like last year) a nice meal at the Birawa Beach Restaurant. After a challenging drive to Accra (we were getting a little late) we arrived at Kotoka Airport just in time.
Conclusion: a rewarding mission; due to the fact, that we were with three surgeons, we could operate in Dixcove Hospital, where there is a nice atmosphere and were patients are taking good care of. For this moment we think a mission to Takoradi should consist of three surgeons and one or two registrars. The participation of trainees should be encouraged. Also the presence of a nurse is valuable; a nurse can discuss and control some matters of sterility with the local staff. The presence of an anesthesist in the team seems not so important, because of the qualifications of the local nurse-anesthesists.