Report from Christos Dervenis 7-14 SEPTEMBER 2007

It was a really unique experience. We could not imagine how happy all the team were with the hospitality and the kindness of all the people in the hospital and outside of it.

We left Athens on September the 7th, and after a one day stop in Dubai we arrived in Accra on Monday early morning September the 10th. We were 4 surgeons, the chief resident from my department, an anaesthetist and two scrub nurses. We had brought with us three huge packages with all the essential material for the surgical procedures (meshes and sutures, drugs and dressings, lancets and syringes, gloves and masks) thanks to donations from our hospital and the companies Ethicon and Bard. The sponsoring for our trip came from private companies and a small part from Tyco Hellas.

Custom clearance and the trip from Accra to Takoradi ran smoothly and we arrived at our hotel safely. Dr. Dr Boateng-Duah (Medical Director of Takoradi Hospital) was waiting for us and we had our first visit to the hospitals the same day. 60 (3 children) patients were screened and prepared with the necessary pre-op tests for surgery for the next four days. Three different groups were formed to operate using the three available theatres in two hospitals.

We had the basics at the theatres although the second one at Takoradi Hospital, where the Hernia Wing was, was not so good. We did most of the repairs with local anaesthesia although we used general anesthesia for the huge hernias and the children.

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Finally we operated on 53 patients and we did 59 repairs (as some of the patients had bilateral hernias), and with the logistic support from the local people and especially for the chief nurses we did the work under the best possible conditions.

We have some social life in the beautiful tropical environment, although we worked so hard and we were very tired at the end of the day. This did not prevent us to swim and have fun with the big waves in the Atlantic ocean and the beautiful beaches. We were happy with the “official” dinner offered by the metropolitan chief executive (the “mayor”) with very tasty local food. We used this opportunity to ask from him to help with the renewal of the second theater in Takoradi Hopsital. He promised it publicly and the people there were very happy (but you never know with the politicians all over the world!!!)

We left on Friday morning to Accra and on the way to the airport we stopped at the Kakum National Park and the Elmina Castle from where the slaves were sent to the Americas. It was a real experience and we suggest all the following missions to visit this place. We left Ghana with the best possible memories and we encourage everyone to go there and help the people and see a different world.

Christos Dervenis MD FRCS Head, 1st Department of Surgery
Agia Olga Hospital, Athens 14233 Greece

Report from Paddy O’Dwyer 23-29 JUNE 2007

My colleague Dr Chew (Cindy) and I left for Ghana on 23rd June 2007. With us we took mesh donated by Ethicon and Proxy Biomedical, gloves, local anaesthetic and sutures. We arrived in Accra at night, had accommodation pre-arranged and were transported to Takoradi the following day.
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We operated from Monday through to Friday. During that period 37 patients were scheduled for hernia repair, two had to be cancelled, one who had large inguinal lymph nodes and one who developed severe hypertension while awaiting incisional hernia repair. Four children and three adults with incarcerated inguinal hernias had their repair undertaken under general anaesthesia while all the rest were repaired under local anaesthetic. All patients with inguinal hernias were large indirect hernias apart from one which was direct. All patients were discharged on the same day with follow up arranged for one week at the local Hospital.

We finished operating late on Friday evening and returned to Accra on the Saturday when we flew back to Manchester. Unfortunately our flight had to be diverted because of the terrorist attack on Glasgow Airport on the 29th June 2007.

Throughout our stay we had very good hospitality arranged through Brian Dixon. Unfortunately we were not always able to enjoy it as some of the days were long and difficult. In retrospect we should have stayed an extra day and taken a rest day on the Wednesday.

The operating table was too low for someone of my height and resulted in transient backache throughout my stay. The theatre lights worked intermittently and as a result both of us suffered minor needle stick injuries.

The staff in theatre were very friendly and worked hard in difficult circumstances. The patients were excellent and appreciated the efforts of all concerned. We were grateful for the privilege of looking after such patients and would welcome feed back on their outcome.

Report from Giampiero Campanelli

An unused annex of the old hospital in Takoradi was renewed and supplied with all the necessary equipment for a small surgery wing thanks to the help of British High Commission in Ghana, CNR (an oil Canadian company), Plymouth Hospitals, Rotary International and European Hernia Society, under the initiative and the supervision of Prof. Andrew Kingsnorth.
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Giampiero Campanelli, Professor of Surgery of University of Insubria in Varese and General Secretary of European Hernia Society, attended to this beautiful initiative, both during the preparatory and active stage.

During the week, from 27th January to 3rd February, Prof. Campanelli, with the help of his assistant Dr Marta Cavalli, completed 31 procedures including abdominal hernia repairs and urologic operations. He was able to adjust the surgical needs with the local situation and performed all the procedures in conditions that sometimes were not so easy: blackout occurred frequently leaving the operating theatre without light and cauterisation not taking into account the poor surgical instruments: not much, not suitable and damaged by continuous use, but enough for a practiced surgeon.

Thankfully, Prof. Campanelli brought from Milan a baggage full of all the essential material for the surgical procedures (meshes and sutures, drugs and dressings, lancets and syringes, gloves and masks), but it was essential to always pay attention not to waste anything.

But nothing stopped his will or opposed his final end-point: to operate on as many patients as possible.
Most of the cases were performed under local anesthesia: this kind of anesthesia requires a compliant patient, and so the help of the nurses, who could translate and explain the proposed operation to the patient, was absolutely essential and very precious.

However, lack of language didn’t stop Prof. Campanelli: he also tried to speak Fante (the local language), with the consequence that many patients couldn t avoid some laughter during their operation, due to his peculiar pronunciations. This hard working week was possible thanks to Dr Boateng-Duah and Mr Brian Dixon.

Dr Boateng-Duah (Medical Director of Takoradi Hospital) arranged screening of all the hernia patients before their surgery (choosing among 500 people contacted by a television announcement) and provided all necessary requirements to complete the operations.

Mr Brian Dixon, representative of local CNR, provided an excellent logistic support, including an Italian coffee machine.

Everybody who played a role in the organization and running of the Hernia Centre helped our Surgical team to work in a humanitarian and selflessness atmosphere and enable a relationship with each patient, that never should be omitted.

Of course it was a very hard-working week, but also so rich in satisfaction and experiences that when coming back to Italy there was an inevitable sense of loss for all the people that were encountered in Takoradi… so, to the next new humanitarian mission!!