The Opertaion Hernia Team in Takoradi

OPERATION HERNIA MISSION: OCTOBER 2016 TAKORADI, GHANA

TEAM LEADER – MR SHINA FAWOLE (CONSULTANT SURGEON)

TEAM MEMBERS – MR CHRIS MACKLIN (CONSULTANT SURGEON), MS HANNAH WELBOURN (CONSULTANT SURGEON), MELANIE PRECIOUS (ADVANCED ODP), LISA MACKLIN (RGN), VICKY ARMITAGE (ODP), EMMA UPCHURCH (SURGICAL SpR), MICHAEL KELLY (SURGICAL SpR).

The Opertaion Hernia Team in Takoradi

The Opertaion Hernia Team in Takoradi

On the 8th October 2016 we began our mission to Ghana. I joined a team of three consultant surgeons, three theatre nurses, and two surgical registrars.

We arrived in Accra late on Saturday evening where we met the other teams who were also planning to spend the next week operating across Ghana. The Baptist Guest House was our base in Accra. Right from the get-go the Takoradi team was very welcoming and inclusive of an outsider into their clan. I learned that this team (in some variation) has been traveling to Takoradi to perform Operation Hernia missions for the last eight years.

The following morning in torrential rain, we travelled to Takoradi. After a 4-hour drive we reached our destination, a house owned by the municipal government that has been utilized for visiting surgical teams from UK, Netherlands and Germany. At this residence, Lillian and her team of helpers looked after us fantastically. Their attention to details was remarkable. Every morning, hot water (for showering) and breakfast was ready, and every evening we were treated to diverse and wonderful Ghanaian culinary experiences. Their care and attention to us was extraordinary, and I thank them profoundly.

During the five days operating in Takoradi (Monday to Friday), three surgeons operated in three hospitals/medical centres (The Hernia Centre, Ghana Ports and Harbour Authority Hospital (GPHA) and Dixcove Medical Centre). Screening of suitable cases was already performed by Dr Boateng (Medical Director of GPHA Hospital), who was also always available to help and provide local advice. This planned organization facilitated immediate starting of operating on Monday morning. The majority of cases included primary and recurrent inguinal hernias, ventral/umbilical hernias and some paediatric hernias. On average, each centre operated on 8-10 cases per day. The majority of cases were performed under either spinal or local anaesthesia. Over the 5 days, a total of 103 procedures were performed. The working day was intensive with late finishes, but was filled with an atmosphere of both camaraderie and satisfaction. Both local nursing and anaesthetic staff were always adaptable to rapidly processing patients thus maximizing the impact of the mission.

Our last evening at the Hernia Centre with our celebratory Ghanaian shirts given to us by the medical team

Our last evening at the Hernia Centre with our celebratory Ghanaian shirts given to us by the medical team

Finally, I would like to thank Operation Hernia and ASiT for awarding me the Shorland Hosking Fellowship and the immense experience of participating in this mission.

Michael E. Kelly

Surgical SpR Dublin, Ireland

The team prepare to set off from Accra on the journey to Takoradi

Operation Hernia Report: November 2015 Mission to Takoradi, Ghana.

On the 21st November our team of six began our journey to Ghana. We comprised two consultant surgeons, Shina Fawole and Chris Macklin, a consultant anaesthetist, Josie Brown, a paediatric theatre sister, Lisa Macklin and two surgical registrars, Steve Pengelly and myself. We arrived in Accra on Saturday evening and spent the night at the Baptist Guest House before setting off for Takoradi on the Sunday. We managed to sneak in a trip to the beach on the Sunday and prepare for what turned out to be a very busy week of operating.

The team prepare to set off from Accra on the journey to Takoradi

The team prepare to set off from Accra on the journey to Takoradi

We spent the next five days operating at two hospitals in Takoradi; the Hernia Centre and the Ghana Ports and Harbour Authority (GPHA) Hospital, both of which have hosted Operation Hernia teams many times in the past. The patients had been selected prior to our arrival, coordinated by Dr Boateng, Chief Medical Officer of GPHA Hospital, which meant that there was no hanging around on the Monday and we were able to dive straight into work.

Over the 5 days, across the two hospitals, we operated on a total of 83 patients, including 8 children. In total, as a team we fixed 72 inguinal hernias, 7 other hernias (umbilical, epigastric and incisional) and 4 hydroceles. Needless to say, fitting in these numbers meant long and intensive days, and the local theatre staff and nurse anaesthetists worked incredibly hard to ensure we were able to get through all the patients. There was never any question of not sending for the next patient.

The Operation Hernia team plus the local staff at the Hernia Centre in Takoradi

The Operation Hernia team plus the local staff at the Hernia Centre in Takoradi

As previous volunteers have already attested to, the hernias seen were much larger than those commonly seen in the UK, meaning that the operations themselves were more challenging (and fun), particularly given the variability of the instruments as well as the occasional black out. The main difference was seeing the impact that our service had on the patients. With large hernias, many patients were unable to work and thus, a hernia repair can mean a return to work and the opportunity to provide for their families.

Operation hernia was an amazing and invaluable experience. Aside from the operative experience, it provides an opportunity to see and experience a different culture and provide new insights into our own practise. I am grateful to the other members of the Operation Hernia team and the local staff for making the experience so enjoyable and worthwhile. Special thanks has to go to Shina and Chris for their patience in training which enabled me to operate on large and challenging hernia, and to Lillian and her team who fed us remarkably well (considering the lack of electricity at times) during the trip.

Emma Upchurch, General Surgery Registrar