Missions

Report of the Belgian – Italian team.

Visit to Takoradi from March 15 – March 23, 2014

In March 2014 a team of four Belgian surgeons (Myriam Bruggeman, Paul Van Acker, Marc Huyghe and Casper Sommeling), one registrar (Stijn Heyman) one nurse (Pina Orlando), accompanied by an Italian surgeon (Cecilia Ceribelli) again visited Takoradi in Ghana. Our main financial sponsor is still the Belgian Section of Abdominal Wall Surgery. We brought meshes (kindly donated by Medri, Covidien Belgium, Bard Italy and Assut Europe), gloves (Medline), disposable drapes (Mölnlycke Belgium and Medline) and suture materials (Johnson & Johnson). Resterilized polypropylene meshes and so called “Indian meshes” were also taken. Local anaesthetics, syringes and needles were donated by Bbraun and BD; this time lidocaine with adrenaline and heavy marcaine were donated by Operation Hernia and bought for us in Ghana.

After arriving at Accra, late Saturday night, for the second time we stayed at the Ghana Baptist Mission. The following day we made the trip to Takoradi, meanwhile visiting Kosa Beach.

This year, thanks to the contacts we have built up in the last years, we stayed in a private house, where we were taken care of by Gina Loupiac. She also owns a very good restaurant in Takoradi and managed to provide us with three meals a day.

During the week we organised three teams

that rotated in the three different hospitals (Hernia Wing, GPHA and Dixcove). In total 81 patients, of which six were children, where operated on. Again most of the patients presented with groin hernias. To our surprise in one patient with bilateral inguinal hernias, a volvulus of the sigmoid was found with necrosis, so a Hartmann’s procedure with a temporary colostomy had to be performed. Reversal of the colostomy is planned in November 2014, when Chris Oppong will visit Takarodi. After our return to Belgium we collected colostomy bags and other materials and sent them to Bernard Boateng to support this patient.

The motivation of the local hospital teams is good and the level of care by the nurse-anesthetists in the three hospitals is high. The equipment in the hospitals is of a reasonable level, but structural changes should be made to the operating theatres. There is still the problem with the lack of running water.

On Friday evening we had our usual dinner with Bernard Boateng Duah and his wife at the the “Gilou” restaurant. Bernard explained to us that also in Takoradi the support of the project is questioned.

On Saturday morning we again visited the Takoradi harbour which is in a phase of new developments. Afterwards we drove to Kosa Beach again and stayed one night at this beach resort. On Sunday afternoon we drove back eastbound to Kotoka airport to leave for Europe again.

Conclusion: again a rewarding mission; the future developments are eagerly awaited.

Casper Sommeling, on behalf of the Belgian – Italian Mission

Home and away team

Takoradi March 2013 Report of the Belgian – Italo – Dutch team. Visit from March 9 – March 17 2013.

Home and away team

Home and away team

In March 2013 a team of four Belgian surgeons (Myriam Bruggeman, Paul Van Acker, Marc Huyghe and Casper Sommeling) accompanied by an Italian surgeon (Cecilia Ceribelli), two registrars (Stijn Heyman from Belgium and Annelien Morks from the Netherlands) and a Belgian nurse (Pina Orlando) again visited Takoradi in Ghana. Our main financial sponsor still is the Belgian Section of Abdominal Wall Surgery. We brought meshes (kindly donated by Medri, Covidien Belgium, Bard Italy and Assut Europe), gloves (Cardinal Health/Medline), disposable drapes (Mölnlycke Belgium and Medline) and suture material (Johnson & Johnson). Resterilized polypropylene meshes and so called “Indian meshes” made part of our luggage. Local anesthetics, syringes and needles were donated by Bbraun an BD; only the lidocaine with adrenaline and heavy Marcain was bought by us in Belgium.

This way for Hernia Operation

This way for Hernia Operation

Recovery

Recovery

After arriving at Accra, late Saturday night, for the first time we stayed at the Ghana Baptist Mission. The following Sunday we made the trip to Takoradi, meanwhile visiting Kosa Beach.

Again “the girls” (Kate, Linda and Benedicte) took good care of us, although they had more difficulties than the years before due to the frequent power cuts. They even proposed us to switch to a hotel, but their “candle light suppers” were much appreciated by us. This year we were lucky to meet Brian Dixon again, who was on “holiday” in Takoradi; however this means trouble shooting for him as a second nature, or as he states it “there are no problems, only challenges”. He contributed again to our mission in several ways, mainly on a logistic level, but also on solving local problems. He even might have solved the problem of running water in Dixcove hospital.

Paul & Brian

Paul & Brian

During the week we organised three teams that rotated in the three different hospitals (Hernia Wing, GPHA and Dixcove). We performed 86 operations in 86 patients, of which nine were children. Again most of the adult patients presented with groin hernias. The total number of operations seems low for the total number of team members but we were plagued by power cuts and interfering caesarean sections. This year in the adult patients two-thirds (51/77) were operated under local anaesthesia, but loco-regional anaesthesia (26/77) was used as a standard in all three locations in the more demanding scrotal hernias, contributing to a better comfort of the patients. The children of course were operated under general anesthesia.

The motivation of the local hospital teams is good and the level of care of the nurse-anesthetics in the three hospitals is high. The equipment in the hospitals is of a reasonable level, but the Dixcove Hospital is in need of sharp scissors and new operation gowns. Although with three teams we still made long days, but once again it was rewarding.

After a long week hard work we had dinner at the the “Gilou” restaurant Friday night together with Bernard Boateng Duah and his wife. On Saturday we made a trip to Green Turtle Lodge, the nicest place to be at the Atlantic Coast, were again we spent a wonderful day. At Sunday morning our group split up. Marc started on a trip of ten days through Ghana. Paul and Myriam stayed another week in Takoradi for holiday; however they were motivated to operate on the patients that were left over from the first week in the GPHA-hospital, so the first two days of their holiday they operated eleven patients (included in the total of 86).

Pina stayed another two weeks in Takoradi to work in the hospital as part of her training to be a specialized nurse. Cecilia, Stijn, Annelien and Casper made the trip back to Accra with a stop at El Mina Castle. Conclusion: again a rewarding mission; if the future team will enclose again as much members as this year we might go to other places in Ghana. We once again want to thank Bernard Boateng for the organization at the local level: selecting the patients on forehand and helping us out during the week.

Special thanks to Brian Dixon, just because being there.

Casper Sommeling, on behalf of the Belgian – Italo – Dutch Mission

In March 2011 a team of three Belgian surgeons (Stefaan Poelmans, Marc Huyghe and Casper Sommeling) accompanied by an Italian registrar (Cecilia Ceribelli) visited Takoradi in Ghana.

Belgian Team, Ghana

Belgian Team, Ghana

We again flew with Lufthansa/SN Airlines, which company we have to thank for giving us the opportunity to bring 15 kg of extra luggage each, so that we could take enough medical material with us. We brought meshes (kindly donated by BBraun Medical NV Belgium, Covidien Belgium, Bard Italy and Assut Europe), gloves (Cardinal Health), disposable drapes (M?lnlycke Belgium), suture material (Johnson & Johnson), local anesthetics (Astra Zeneca and BBraun), analgesics, syringes and needles. After a wearing drive from Accra to Takoradi through some heavy thunderstorms, we arrived very late Saturday night at ‘the Villa’ were we had a good night sleep.

Sunday morning we took a cab to Green Turtle Beach Lodge, were we had a nice and relaxing day. Returning to Takoradi we made a stop in Dixcove were we observed and admired the return of a local fishing boat. In the evening we met Bernard Boateng, who again did the selection of the patients on forehand.The living circumstances in ‘the Villa’ are good. ‘The girls’ (Kate, Lilian and Benedicte) took good care of us. The food they prepared was fine and far better than the Western food served in the local restaurants.

During the week the three surgeons rotated in the three different hospitals (Hernia Wing, GPHA and also for the first time Dixcove), accompanied by Cecilia. We operated on 74 patients, of which seven were children. Most of the adult patients, presented with groin hernias (61, in seven bilateral), in some accompanied by a hydrocele. In most of these patients a Lichtensteinrepair (with standard middle weight polypropylene) was performed. We did not use mosquito nets. Three other patients only had hydroceles.

Most patients were operated under local anaesthesia, but loco-regional anaesthesia was used as a standard in all three locations in the more demanding scrotal hernias, contributing to a better comfort of the patients. The children ofcourse were operated under general anesthesia; in Dixcove the induction was done by the child relaxing on the back of the headnurse walking around.

Casper and patient

Casper and patient

Again this year there were some challenging scrotal hernias, and also the age of the patients we operated on is increasing. The oldest patient was 90 years of age and in good condition!The presence of a registrar is useful; firstly, because she could assist us, but secondly and more important, we could assist her in performing operations, that will lead to more experience for her. She performed ten operations. The motivation of the local hospital teams is good and the level of care of the nurse-anesthetics in the three hospitals is high. The equipment in the hospitals (also in Dixcove) is of a reasonable level, but although we were convinced that we brought enough material, again at the end of the week there was a shortage of drapes, gloves and sutures. As can be understood by the total of operations performed we individually made long days, but it was rewarding. Even the last Friday we operated in the Hernia Wing until after eight o’clock in the evening.

After a long week hard work we had dinner at the Planters Lodge Friday night. On Saturday we made a trip to Bushua beach, were we had a nice day at the beach. Sunday-morning we said goodbye to the girls and were brought to the Kakum National Park, were we made a quick trip to the forest and made the Canopy Walk. Entrance prices were threefold from last year and it starts to look like a ‘tourist trap’. Much more pleasure we had from a visit to the ‘Monkey Forest Resort’ near the Kakum National Park. This resort was founded by a couple from the Netherlands. They try to save left-alone animals, that are brought to them by the locals. A visit is worthwhile (at the right side of the road when you drive to Kakum). After that we had (like last year) a nice meal at the Birawa Beach Restaurant. After a challenging drive to Accra (we were getting a little late) we arrived at Kotoka Airport just in time.

Conclusion: a rewarding mission; due to the fact, that we were with three surgeons, we could operate in Dixcove Hospital, where there is a nice atmosphere and were patients are taking good care of. For this moment we think a mission to Takoradi should consist of three surgeons and one or two registrars. The participation of trainees should be encouraged. Also the presence of a nurse is valuable; a nurse can discuss and control some matters of sterility with the local staff. The presence of an anesthesist in the team seems not so important, because of the qualifications of the local nurse-anesthesists.