Missions

REPORT FROM HO MISSION NOVEMBER 14-21, 2015

This was the third Operation Hernia mission to Ho Hospital. The first mission was in 2012.

The team comprised the following members:

Coordinator: Miriam Adedibe Surgical Registrar;

Consultant Surgeons: David deFriend, Prof Guido Schuermann, Prof Odd Mjaland,

Surgical Registrars: Naami MCaddy and Sebastian Galler

Travel to Ho

Following arrival in Accra the team stayed overnight at the Baptist Guest House in Accra on November 14. All team members met with Chris Oppong for a briefing. The team travelled to Ho hospital the following day. They were met by Dr Geoff Nyamuameh, senior surgeon who took the team on tour of the hospital.

Accommodation and food

We enjoyed very good accommodation. We were hosted at Chances Hotel. This was specially arranged by Dr Ben Gbeve, a retired Plymouth Orthopaedic Surgeon whose nephew owns the hotel.

Theatre Sessions

We occupied three theatres for 4.5 days. One consultant and one junior were assigned to each – this allowed for maximum teaching. The 4th theatre was left for Ho Hospital to fulfil their emergency commitments.

It could not have been used as an extra theatre because it was impractical for us to do so due to:

1) A paucity of simple cases

2) Equipment/sterilised packs – Sister Lucy was struggling to equip the three theatres already running

3) Low staffing – again, Sister Lucy and the nursing staff pulled together and worked beyond their usual hours to complete this mission.

Outcomes

The total number of procedures performed was 80 and there were no early complications.

Post-operative patient reviews on the ward were performed by one of the visiting team when time allowed, otherwise the home team managed the patients.

Home Visit

As a first by the Operation Hernia team, 3 patients were visited over Friday afternoon and Saturday morning at their homes. The patients were happy to see the team and it was a wonderful opportunity for Operation Hernia to see the patients in their home environments.

This excellent idea had been suggested by Prof Guido Schuermann.

Debrief

1. Safety issues highlighted by team members included: sharps handling (scalpels should be handed over in a dish), swab count (not rigorously performed for each operation)

2. Worn-out needle holders

3. Diathermy: worn out accessories

This first section of the report was coordinated by Miriam Adedibe. Individual Team Members have provided their own additional comments and these are detailed below:

1. Prof Guido Schuermann

The Ho mission was a great success. The team was just perfect and it was very helpful that Naami and Miriam were with us. The hospital was well equipped and we could run three operating theatres for the whole week. We did more than 80 cases – most of them with huge hernias – without any major complication perioperatively.

The staff were excellent, highly motivated and very well trained. The hotel was the best I have ever seen in Ghana, all making it a very enjoyable and successful mission.

I thank the whole team for taking Sebastian and myself, for the friendly atmosphere and for the collegial and friendly exchange of ideas. It was just a great week!!

2. Miriam Adedibe

I fully echo Guido’s sentiment. The mission was a success in every way.

We completed the list of hernia repairs, totalling 81 cases, and most of these were relatively complex H3 cases. Many thanks for supporting me as the administrator/team leader. It was an unexpected opportunity from which I learned much. The team worked well together and were very helpful with suggestions on how to increase our efficiency in theatre. A special thanks to David (whose seniority and expertise was invaluable in many situations) and Naami (my co-pilot).

3. David deFriend

I can only say what a privilege it was to be part of such a great team and to have the chance to work with wonderful local staff and patients. Thanks to Miriam and Naami for organising us so well and for the report. I can’t think of anything to add except to say that I very much intend to go on another mission and would be honoured to work with all or any of you again. It went by so quickly that it almost feels like I never went away now that I’m back to the day job!

Chris, thanks again for the opportunity and it was great to see you.

4. Odd Mjaland

I am filled with great memories of a fun an interesting mission and happy to have made such nice friendships at my mature!!!! age. I felt young and revitalized when getting back to the frozen lakes and minus 7 in Norway. The cases were challenging but as I see it, the quality of our work could not have been much better. Working close with Naami was inspiring, the trailblazing energy of Miriam gave the group an energy boost that lasted long beyond the flight back home. I shall be back!! Miriam’s report covers our mission well and I would echo the comments about the problems with worn-out needle holders and diathermy equipment, areas for potential improvement.