Dr José Antonio Pascual Montero, 12 Octubre Universitary Hospital, Madrid, Surgeon. Dr Jesús Salvador Torres Jiménez, Infanta Sofía Hospital, Madrid, Surgeon. Dr Jesús Ángel Garijo Ílvarez, Infanta Sofía Hospital, Madrid, Surgeon. Dr Miguel López Vizcayno, Sanitas La Moraleja Hospital, Madrid, Anaesthetist.

We left Madrid on April 23rd at the appointed time without any difficulty in booking the medical material. The flight was normal for some of us and rather exceptional for others who witnessed the landing from the cockpit, courtesy of the pilot. On arrival at the Mariscal Sucre Airport, Carlos Criado (airport commercial director) and Sandra Ocampo were waiting for us and speeded us through customs. The Health Centre staff took directly to La Concordia the parcels with surgical material.

We put up at Sandra Ocampo’s house to be taken later to know Quito’s historical centre, particularly La Ronda, where we saw one of the typical processions of the city, after which we went for dinner to Casa Dami?n, a restaurant owned by one of Dr Pascual’s friends from Segovia. After a night rest at Sandra Ocampo’s house in Quito, we started for La Concordia, where we were received by Dr Kathia Tinizaray and Haydee Caicedo, the three of them essential persons in the organization of the mission. We collected the surgical material to take it to the Alberto Buffoni Hospital in Quinindé where the mission was going to take place and where we were received by the staff very cordially and warmly. We arranged all the material we had with us and left everything ready to begin surgery the next day. Then we came back to the Health Centre where we checked 70 patients in order to programme surgery for the following days. We programmed 50 out of those 70 patients, and we finished work at 18:30 hours.

After some rest we had our supper, a typical barbecued grill from the place, prepared for us by our hosts at La Concordia, Sandra Ocampo and Dr Kathia Tinizaray. After supper we went to our lodgings in the Atos Hotel to gather strength for our mission the following day.

On Monday 25th we got up at 6 a.m. and after taking breakfast we started for Quinindé, at about 40 kms from La Concordia, and we arrived at 7:30 at the Alberto Buffoni Hospital where the staff and the 14 patients in readiness were expecting us. We started operating in the operation theatre they had arranged, but as we were three surgeons and one anaesthetist, we asked for the collaboration of surgeons and nurses of the hospital in order to be able to use the other operation theatre, with the understanding that if an urgency would occur, we would vacate it and would offer our collaboration if necessary.

On that first day we performed 15 interventions on 14 patients (2 eventrations, 6 inguinal hernias, 1 hydrocele, 1 scalp tumoration, 4 umbilical hernias, and 1 epigastrial hernia). One of the eventrations was very large and it required draining and hospitalisation for 48 hours. We want to stress that, besides the help from the hospital staff, two sisters, Carmen Alcibar and Rosa Alcibar, both helping nurses in the infirmary whom we had known in our previous Operation Hernia mission in CSDP in La Independencia, offered their selfless help which, in some moments, was of crucial importance. The work ended at 18:00 hours, and we made our way back to La Concordia in about 40 minutes thanks to the kindness of Sandra Ocampo who lent us her car for coming and going. After a short rest at the Atos Hotel we all had dinner together and got ready for the mission next day.

Tuesday 26: We again arrived at Quinindé Hospital at about 7:30 and started interventions at 8:00 with the collaboration of Dr Zhunala and Dr Preciado, so that we could use both the operation theatres, and we showed them our technique in hernioplastia with mesh, as the use of meshes is not common with them due to the scanty resources at their disposal. On that day we performed 11 interventions (2 eventrations, 2 inguinal hernias, 2 epigastric hernias, 1 criptoquidia, 3 umbilical hernias and 1 abdominal sebaceous cist). One of the eventrations was a huge one and it required drainage and 24 hours hospitalisation. We then left for La Concordia as the previous day in the car Dr Tinazaray had lent us in the morning.

Wednesday 27: Same time of leaving the hotel and arriving at the hospital, beginning our day at 8:00 with the help of the auxiliary staff of the operation theatres, with 12 interventions (2 eventrations, 5 inguinal hernias, 2 epigastric hernias, and 3 umbilical hernias). After finishing work at 16:00 hours we were invited for a meal by the two auxiliary sisters (Rosa and Carmen Alcibar) in their humble house in the outskirts of Quinind?, where we were introduced to their family and we duly appreciated her readiness, selflessness, and the great effort that going to work for the mission entailed. Back at La Concordia we, together with Dr Tinazaray and Haydee Caicedo, were invited for dinner by Sandra Ocampo. With them we planned future missions, and they indicated the possibility of extending such missions to villages in Esmeraldas and Santo Domingo de los Colorados.

Thursday 29: We begin operating at the usual time with 12 interventions (5 inguinal hernias, 4 umbilical hernias, 2 epigastric hernias, and 1 abdominal lipoma). We end at about 15:00 hours and, as a sign of gratitude, we share an aperitif with the operation theatre staff that had collaborated with us. We had a meeting with the director of the Alberto Buffoni Hospital, Dr Saavedra, in which we signed an agreement between Operation Hernia (Dr Pascual signing in the name of professor Kingsnorth), the Hospital and the La Concordia Health Region (Dr Tinazaray) for a three year period. Dr Javier Saavedra thanked us for the work done and urged us to carry out new missions in the Alberto Buffoni Hospital. We collected all the left-over material and we gifted part of it to the same Alberto Buffoni Hospital, and part to the La Concordia Health Centre.

We came back to La Concordia where we were received by the municipality mayor. In a simple act the statement of gratitude for our work was read out, and a copy of it was given to each one of us personally, and one to Operation Hernia. We then started for Santo Domingo de los Colorados, a city of about 200.000 inhabitants, where we were urged to open conversations for the possibility of future missions there. We want to emphasise that out of the 50 interventions carried out, 10 were on children between 2 and 10 years, and 2 on elders over 80. After a night in La Concordia, on Friday 30th we went back to Quito to come back to Madrid on May 1st.

Chris Oppong
Aby Valliatu