GUIDO-CORDULA FELLOW (TRAINEE) REPORT FROM NALERIGU MISSION NOVEMBER 2015
November 2015

GUIDO-CORDULA FELLOW (TRAINEE) REPORT FROM NALERIGU MISSION NOVEMBER 2015

A. Introduction by Chris Oppong

Operation Hernia established a Training Fellowship for Ghanaian doctors in 2013 (Guido-Cordula Fellowship). The purpose is to provide a period of intensive training in mesh repair of hernias. The trained doctors then return to their hospitals to use and transfer their acquired skills to more junior colleagues.

The Fellowship is funded by Prof Guido and Mrs Cordula Scheurmann. The first Ghanaian doctor to benefit from the award was Dr Zainab Alhassan, a surgical trainee from Komfo Anokye Teaching Hospital at Kumasi in the Ashanti Region. Although no cases of Ebola were recorded in Ghana there was a perceived risk of the disease and hence award was made in 2014. Dr Mohammed Bukari is therefore the second Ghanaian doctor to benefit from the award. He is also a surgical trainee at the same Teaching Hospital.

The doctors are selected by the Ghana Hernia Society. They have basic skills in hernia repair and are given intensive hands-on training in mesh repair during a mission. The training team ensures that the Fellows are able to independently perform mesh repair safely and employ correct techniques by the end of their training. The report by Dr Bukari documents the success of the training programme.

Chris Oppong

Consultant Surgeon

Chairman, Operation Hernia

Dr Mohammed Bukari

Dr Mohammed Bukari

B. Report by Dr Mohammed Bukari, Guido-Cordula Fellow 2015

Team

The team to Nalerigu was led by Dr Chris Oppong and included Dr Nazzia Mirza a colorectal surgeon and Mrs Sandra Stanton an emergency theatre scrub nurse.

Venue

The Baptist Medical Center is located in the North-eastern part of Ghana. Its location puts it in a unique position to offer much needed medical care not only to people in that part of Ghana but also people from neighboring countries of Burkina Faso, Togo and Benin. The catchment area has some of the worst access roads and poorest people in Ghana; hence most patients present with late complications of their ailments. Operation Hernia’s mission for the year 2015 was from the 7th to the 14th of November. The mission couldn’t have chosen a better location and I felt very privileged to part of it.

The team members arrived at the selected venue a bit tired; the enthusiasm however was palpable. Everyone was beaming with adventure; I being the novice looked on with great interest as members shared previous experiences. Everyone but Dr Oppong and I was new to Ghana and I was soon the focus of the discussion when the conversation centered on my opinion on the health-seeking behavior of patients with hernias in Ghana, the ease of access to surgical care and the options readily available. It was interesting to note it was quite similar in other parts of the world with somewhat similar socio-economic characteristics.

Travel

The travel arrangements to Nalerigu were relaxed and we made it to the airport in good time. The journey however wasn’t, with team members trying to acclimatize to the heat and the not so familiar bumpy route. Fortunately we had an experienced driver and we got to Nalerigu in good time on evening of 8th November. The team took a quick tour of the hospital and met briefly with the theatre staff available at the time. A meeting was scheduled for the morning of the next day to get acquainted with members of staff, draw up a schedule and decide on how work was expected to progress.

Operating theatre sessions

Work started fully on the morning of 9th November after the scheduled meeting. Members were encouraged to wear a name tag to facilitate familiarization. Patients were initially screened by the surgeons and passed on to the anesthetic team and nursing staff who prepared them for surgery. The team used the recommended WHO protocol and checklist before the start of every surgical procedure. Work however progressed slowly partly because the influx of patients out patients, records were somewhat slow and also the coordination between operating room and pre-anaesthetic assessment area was less than ideal. Christina, an intensive care nurse volunteer at the facility, gladly offered to be the intermediary for this process and made a huge difference. Turn over time between cases was cut to about fifteen minutes on subsequent days and no properly prepared patient had their surgery rescheduled.
The cases managed were very varied and included adult and pediatric groin hernias, incisional hernias and hydrocoeles.

My personal training and experience

I assisted both surgeons doing three cases each and they in turn assisted me with five cases.
I went on to do 15 cases on my own assisted by the very experienced Mrs Sandra Stanton but supervised by the surgeons who were in theatre but not scrubbed.
Work on Friday 13th ended with a final meeting with the entire operating team including resident medical officers. Everyone was satisfied with the work done and suggestions were made on how to improve the efficiency of future missions. The team said a big thank you to the staff of Nalerigu and everyone posed for a final photo shot. The return trip to Accra offered no surprises and we arrived on time the morning of 14th November.

Gratitude

I will always be grateful to Operation Hernia for giving me this opportunity. The discipline of Dr Oppong, the constant caution of Dr Nazzia and the encouragement of Mrs Stanton have in one week giving me a new challenge. Thank you very much.

Dr Mohammed Bukari, Surgical Resident

Komfo Anokye Hospital, Kumasi, Ghana