Eruwa June 2013
Operation Hernia Report – Mission to Eruwa, Nigeria, 8th-16th June 2013
Months of preparation and e-mail contact had come to an end when the Operation Hernia (OH) Team for the mission to Eruwa, Nigeria, assembled in London’s Heathrow airport in anticipation of an exciting adventure. After an uneventful flight, and cordial welcome to Nigeria by the vaccination officials, we were delighted to be greeted by Dr Oluyombo Awojobi (Yombo) and his colleagues in Lagos. We continued our journey to Eruwa the following day and were grateful to the driver and our armed escort for avoiding vast amounts of livestock traffic and successfully negotiating large craters in the road. Having reached Eruwa, the impact and effort of the OH teams before us was evident by the warm welcome we received, the prior organisation by Dr Awojobi’s clinic, as well as the recently opened hernia centre. We had a lot of work to do, and a lot to live up to.
It was a pleasure to work with this truly International Team comprising Dr Aleksander Stanek (a Polish surgeon from Northen Ireland), Dr Constancio Marco (Surgeon from Barcelona, Spain), Dr Richard Salam (Anaesthetist from Nigeria now working in the UK), Dr Gregory Wirth (Urologist from Geneva, Switzerland), Miss Sophie Pitt (medical student, UK), and myself Dr Iestyn Shapey (Surgical Registrar from UK). The team gelled immediately and worked closely and very successfully throughout the project. Dr Stanek’s prior experience as consultant surgeon for two years in Abeokuta, the nearest large town to rural Eruwa, was invaluable as he led this international team. We were privileged to have Baba Karim, Yombo’s chief theatre nurse, and his staff working with us throughout the week, and without whom the day to day functioning would not have been possible. Finally, a great debt of gratitude to Yombo and his family, and his five surgical registrars who rotated in and out of the various roles of assisting, operating and anaesthetising.
Seventy patients underwent surgery over 6 days of operating with 100% discharge within 24 hours and no immediate complications. Most had large (Nigerian-sized) inguino-scrotal hernias, many with synchronous testicular pathologies, which demonstrated to us the value of our multi-specialty team. Initially, the days were long as we found our feet, and surgeries were being performed well after dark. However, we soon established a sound working-pattern and slick process by starting with a clinic review of all patients, producing an optimal running order according to anaesthetic requirements and pathology, and getting to work. In addition to providing high quality surgical care, the team also sought to teach and supervise the local surgical registrars in performing tension-free mesh (Mosquito net) repair. By the end of the mission three of the residents could successfully perform the procedures themselves from start to finish.
The distance that patients travelled to receive treatment at Eruwa (some came from Lagos) was testament to years of Yombo’s hard work, the establishement of the OH mission, and the previous teams’ legacy in building the hernia centre. What would be the legacy of the 2013 mission? We were delighted to learn from Yombo that the five surgical registrars were inspired to continue their experience of newly learnt techniques by utilizing the hernia centre facilities on a weekly basis outwith their regular clinical duties.
Surgical Registrar, UK