Report of the Belgian - Italo team

3-11 March 2012

In March 2012 a team of four Belgian surgeons (Myriam Bruggeman, Paul Van Acker, Marc Huyghe and Casper Sommeling) accompanied by an Italian surgeon(Cecilia Ceribelli) and a Belgian nurse (Pina Orlando) again visited Takoradi in Ghana.

The Team
The Team

We brought meshes (kindly donated by Medri, Covidien Belgium, Bard Italy and Assut Europe), gloves (Cardinal Health/Medline), disposable drapes (Mölnlycke Belgium and Medline) and suture material (Johnson & Johnson). Resterilized polypropylene meshes and so called “Indian meshes” made part of our overweight luggage. Local anesthetics were donated by Bbraun, only the lidocaine with adrenaline had to be bought by us in Belgium.

This year special thanks to the Ghana Ministry of Health presented by Dr. Kwesi Asabir, Deputy Director Human Resource, who welcomed us Sunday morning in Accra.

After arriving at Accra, late Saturday night, for the first time we stayed at a hotel in Accra. The following Sunday we made the trip to Takoradi, meanwhile visiting Elmina Castle and Kosa Beach.

At arrival Sunday night in “the Villa” a nice meal was ready for us. Again “the girls” (Kate, Linda 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 we organised three teams of two, that rotated in the three different hospitals (Hernia Wing, GPHA and Dixcove). We performed 88 operations on 81 patients, of which eight were children. Most of the adult patients, presented with groin hernias (in six bilateral). In almost all these cases a Lichtensteinrepair was performed. For the first time we did use sterilised mosquitomesh (or Indian meshes, as it sounds less charged) we brought with us, in about half of the Lichtensteinrepairs. The handling is surprisingly good and suturing works fine. Half of the 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. There were four patients operated on recurrent hernia, of which one with an acute strangulated hernia on Sunday-morning just before we were to leave for Accra. The children of course were operated under general anesthesia, as well as one patient with a large upper abdominal incisional hernia.

Again this year there were some challenging scrotal hernias, and also the age of the patients we operated on is still increasing. The oldest patient was 94 years of age and in good condition!

The advantage this year was that we could split up in three teams of two, so that we could assist each other and could share the frustrations in operation another challenging hernia. Even if you think to have seen it all, another situation presents itself.

Operating Takoradi
Operating Takoradi

The motivation of the local hospital teams is excellent 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. There was probably a shortage of heavy marcaine in one of the hospitals, and maybe also of gowns. The operation table in Dixcove is waiting a repair, so that it can be lifted to normal height.

Although with three teams we still made long days, but once again it was rewarding.

After a long week hard work we had dinner at the Planters Lodge Friday night together with Bernard Boateng Duah and his wife.

On Saturday we made a trip to Green Turtle Lodge, the nicest place to be at the Atlantic Coast, were we spent a wonderful day. At Sunday morning we said goodbye to the girls; on arriving at the GPHA-hospital to say goodbye to Bernard he had a little surprise for us. While the rest of the team took a trip to discovery the Takoradi-harbour, Bernard and Casper did perform an emergency operation for a recurrent and now strangulated groin hernia. Luckily for the patient and also for us the strangulated intestine was still vital, so we could preform a Lichtensteinrepair.

After that we drove to Accra, and after a last meal in the Airport View Restaurant we arrived at Kotoka Airport to travel back home again.

Conclusion: again a rewarding mission; due to the fact, that we were with five surgeons and one nurse, we could in teams of two operate in the three hospitals. We know the work we do is a drop on a hot plate, but it is very worthwhile on an individual level. As Belgian-Italo team we will engage us to go back next year to Takoradi.

We once again want to thank Bernard Boateng for the organization at the local level: selecting the patients on forehand; helping us out during the week and operating the people afterwards, that were on the list at GPHA but could not be operated by us.

Casper Sommeling, on behalf of the Belgian - Italo Mission