Report by Zoe Sun

This was my first time Africa and first time with the mission, led by mission veterans Mr Shina Fawole (Team Leader and Consultant Surgeon) and Melanie Precious (Advanced ODP and Surgery Team Leader), along with my fellow colleagues Miss Rupa Sarkar (Consultant Surgeon), Rajiv Dave (Registrar) and Claire Casey (ODP). The mission was in June, the rainy season, rather than its usual time in November. We carried with us medical supplies for the duration of the mission including medications, local anaesthetic, mesh, syringes, needles, sutures, gloves, gowns and hats. With all these, we met at the airport ready for our mission led by our team leaders.

We arrived in Accra, Ghana on the evening of 6th June and stayed overnight in Accra. The next day, the taxi driver took us on a 4 hour journey to Takoradi. We stayed in a house owned by the local government and used specifically for teams on the mission. Lillian and her team of helpers stayed with us and looked after us during the mission. They did all the hosting, cooking and general maintenance. We visited one of the hospital sites in Dixcove and greeted the local team of nurses and doctors. Next to Dixcove was a tranquil, unspoilt beach where we shared a few drinks and a group photo and Mr Fawole taught us the suture-sparing mesh repair technique for hernias! The same night, Dr Bernard Boateng, Medical Director of GPHA (Ghana Port and Health Authority) Hospital, greeted us at the house. He and his team had assessed the patients locally and planned their operations and their respective hospital sites for their operations. We decided on the order of week and how to split the team along with Dr Boateng.

Monday was the start of the testing week. We based ourselves in two hospitals in Takoradi, Takradi Hernia Centre and GPHA into teams of three. Introduced to the local friendly and very outspoken team of nurses and ODPs, we started on our operations. The caseload consisted of primary and recurrent inguinal hernias, hydroceles, umbilical hernias and children with groin hernias. On average, there would be 8-10 cases per day. Most hernias were operated on under a local anaesthetic; recurrent and larger hernias had spinal anaesthesia, which the local anaesthetic nurses specialised in.

The challenge initially was with the size of the hernias and their chronicity. The rule was not to open the hernia sac if possible, but only Miss Sarkar stuck by this rule, we later found. After the first day, we divided ourselves in teams of two for each of the three sites, with those at Dixcove travelling an extra 2 hours return journey on a daily basis. We were faced with additional challenges, with power cuts and during a longer power cut, we learnt to operate under a torch light. We were also faced with shortage of running water, for which we were provided with water from a tank for scrubbing. At Dixcove, the same theatre was shared between elective and acute cases. Whilst we were carrying out our operation on children, two emergency Caesarean sections came through back to back. The operating tables adjacent to each other, we would be placed in the in stifling conditions when our local colleagues performed the emergency Caesarean sections.

The children were extremely compliant as were the adult patients. The nurses were outgoing and outspoken. Lilian and her helpers were extremely responsive to our needs back at the house. The people in general were very friendly and helpful. One young man, a patient, thanked us profusely as he could now find a wife now that he no longer has a deformity (his hernia). On the last day, we ended the day, altogether at the Hernia Centre with Dr Boateng, and had a group photograph to mark our time there. Many of the staff, were desperate for our return on following missions and explained how much they enjoyed our times together. We were greeted later in the house by politicians who were grateful for our work and wanted to improve the host’s programme for later groups and to include organised sight-seeing. We thanked Lillian and her team for their hospitality before embarking on a return journey to Accra the following day.

I was extremely grateful for this experience, learning not just about operating, but about people and cultures. I learnt that some aspects were not a good mix for my team members…Mel and cockroaches, Mr Fawole and Raj sharing a room, Miss Sarkar and ‘vegetable free’ foods, Claire and any Ghanaian foods. However, the team was fantastic, the experience invaluable. I have learnt a lot about myself, others and the skills I will carry forward in my future training and life thanks to Operation Hernia and my team leaders.

Zoe Sun