2007

During this year Operation Hernia became a sustainable project in Takoradi, Ghana, where it is based at the Hernia Treatment Centre which was financed by the British High Commission and constructed by the personal efforts of Mr Brian Dixon. CNR International through their operational base in Takoradi continue to provide much valued logistical support. Three international teams of surgeons from Italy, Scotland and Greece (see the “2007 Missions” webpage) utilised the Centre to treat over 150 hernias during three separate weeks.

The development of this website and the registration of Operation Hernia as a charity in the UK has established Operation Hernia as a definitive provider of healthcare charity work in Africa. It has led to contact with a Nigerian surgeon, with a view to the setting up a Centre for Hernia Excellence in that country and a possible extra mission-location for Operation Hernia. Contact has also been made with a Team of volunteer medics from Canada who were carrying out an ambitious project in an area surrounding the village of Carpenter in Northern Ghana. It is possible that our volunteers could take Operation Hernia to Carpenter in 2008.

The Plymouth Mission, now in it’s third year, followed the pattern of previous visits and treated approximately 130 patients. The mesh used for the hernia repairs was sterilised mosquito net (generously provided by Scotmas), which has negligible costs. In order to evaluate the cost-effectiveness of inguinal hernia repair in Ghana, a research project was undertaken with the help of a health economist who was generously funded by an Educational Grant from Johnson & Johnson Medical (Ethicon). The results of this study will enable politicians and healthcare decision-makers to decide whether hernia repair is cost effective in relation to the number of disability-adjusted life years averted by repairing a hernia in a young man and returning him to employment and the ability to look after his family. This will be an important contribution to healthcare economics and one which will be of interest to the World Health Organisation and the World Bank to advise governments and charitable agencies about the costs of financing inguinal hernia surgery in Africa. Finally, due to the heroic efforts of Brian Dixon, the obsolete theatre light given by Derriford hospital (and transported to Takoradi by CNR International) was installed in December ready for the 2008 Teams.



Our aims for 2008 include a full programme of 10 teams visiting the Hernia Treatment Centre in Takoradi during one week for each of 10 months (see “Volunteer Dates” webpage). We will endeavour to take Operation Hernia on pilot Missions to one or two other African countries in order to utilise volunteers who have registered their interest in Operation Hernia through the website (see “Volunteer Register” webpage). We will publish the results of the health economic analysis of cost effectiveness of inguinal hernia repair in Africa and disseminate it to the relevant governmental bodies. All this we do with the generous help of our (i) cash sponsors: CR Bard, Tissue Science, British Medical Association, Atrium Medical, British Hernia Society, European Hernia Society, and (ii) our sponsors in kind were TycoHealthcare (medical supplies) Ansell (surgical gloves), Cardinal Health (sterile gowns) and British Airways (discounted flights, additional baggage).


2008

We registered another very successful year for Operation Hernia and achieved the aims we set for ourselves at the end of 2007.

Ten teams accomplished missions in Takoradi including five from the UK and teams from Belgium, Poland, Spain, South Africa and Czech Republic. Their reports may be read on the website at “2008 missions”. These teams treated approximately 500 hernia patients and Stan Czudek achieved the first laparoscopic repairs with the assistance of Storz laparoscopic equipment and much logistical support from Brian Dixon.

Perhaps the greatest accomplishment was the joint mission with Jennifer Wilson’s Canadian Medical Team at the Northern Empowerment Association site run by Dr David Mensah and his wife Brenda in Northern Ghana at the village of Carpenter. A huge effort by the Derriford Hospital team in Plymouth with the assistance of the Medical Equipment Maintenance Service (MEMS) provided a full container load of redundant equipment in order to set up two operating theatres on a site where no previous clinic or hospital had existed. This mission will become a permanent feature in the Operation Hernia calendar (se webpage “First Mission to Carpenter”).

In terms of publicising the plight of hernia sufferers in an attempt to raise awareness and enlarge the program through the acquisition of funding, publications were achieved in the journal Hernia and the newsletter of the Association of Surgeons of Great Britain and Ireland.

We can therefore look back with a great deal of satisfaction on this year and thank our sponsors who included the following: cash donations were received from the Oak Foundation, Atrium Medical, Cook, Salts Healthcare, British Hernia Society and European Hernia Society. Hernia meshes were received from Atrium Medical, Baird, BBraun and Ethicon. Atrium Medical donated ten sets of new surgical instruments and a Little Sister autoclave was donated by Collings Park Surgery Plymouth. Ansell and Cardinal Health provided a large supply of surgical gowns and gloves. British Airways donated discounted fares and provided excess luggage space for transportation of medical supplies.

Our aims for 2009 will be to sustain the present level of missions and hernia repairs, to open up additional areas for Operation Hernia in other countries of West Africa including Ivory Coast and Nigeria, and to connect with the larger communities of medical volunteers through the Burden of Surgical Disease working group and the American College of Surgeons Operation Giving Back organisation. To assist our fundraising we will apply for GiftAid and join the Just Giving organisation.

Andrew Kingsnorth





2009

2009 was another very active year in which we achieved all our aims. Twelve teams originated from seven European countries completed missions in three countries of West Africa (Ghana, Nigeria, Ivory Coast), and in five different locations. A total of 65 volunteers treated over 670 patients with hernias and they also taught many local Surgeons modern mesh techniques. At the European Hernia Society in Berlin, the first Humanitarian Hernia Surgery symposium was held which was generously sponsored by Atrium and included wonderful lectures by Bernard Boateng-Duah from Takoradi and David Mensa from Carpenter.

Our sponsors to whom we are extremely grateful were very generous donating £13,800 and surgical supplies as follows: Ansell: surgical gloves; Atrium: £3000; Bard: meshes; Baxter: £500; Bolton Surgical: two sets of surgical instruments; BBraun: sutures; British airways: air tickets to Ghana and Nigeria; British Hernia Society: £2000; Cardinal Health: surgical gowns and drapes; CNR International: computer equipment; Cook: £1000 plus meshes; Covidien: Two diathermy machines; Dr Isabel Mower: Two Little Sister autoclaves; Ethicon: £400; European Hernia Society: £1600; Patient donations: £200; Rotary St Austell: £800; Salts Healthcare: £2000; WL Gore: £2200.

The second mission to Carpenter was again one of the highlights of the year with over 180 patients operated during the two week mission which was combined with the incredible medical team lead by Dr Jennifer Wilson from Uxbridge, Ontario Canada.

Our aims for 2010 include an ambitious expansion outside West Africa in order to accommodate our friends and volunteers in the American Hernia Society. We hope to open a site in South America (in Ecuador or Peru) and to take a team to Mongolia which is a low income country in which rural areas are poorly served by the public hospital system. In addition we will expand our usage of “Affordable Indian Hernia mesh” to all our sites.

Another new aspect of Operation Hernia will be the initiation of a small fee ($25 - $40) to the patients, which will cover extra hospital charges such as laundry, sterilisation of surgical instruments, employing staff to do this work and some of the drugs required for general and regional anaesthesia. This protocol will be applied at all sites on a progressive basis in the expectation that most patients will have some disposal income and will appreciate something that they pay a small charge for rather than getting something given for nothing. Those that cannot afford even the small charge will be provided treatment free of charge.

Finally another bid to receive funding from the Department for International Development will be made.

Andrew Kingsnorth