Cote D’Ivoire 6-13 FEBRUARY 2009

Following some logistical problems with visa application Maciej Smietanski and I arrived to a VIP welcome at the Felix Houphouet-Boigny airport on a humid afternoon with grey tropical rainclouds circling the Ebrie lagoon. To an Anglophone the capital city Abidjan is a big surpise. It has a population of 3.5 million and it is the second largest French speaking city in the world. It is also a cultural hub for a multiethnic population and has a large French community. Although the recent civil war has impacted seriously on economic activity, the business district stands out from all sectors of the city with its gleaming skyscrapers, boutiques and outdoor cafes.

We were provided with a car and chauffeur and hotel accommodation paid for and organised by the protocol of the First Lady. Hotel Ivoire was positioned on the edge of the Ebrie lagoon overlooking several converging peninsulas and islands connected by bridges. Here we enjoyed African style comfort in readiness for the hard work ahead.

The Unite Chirurgicale Yopougon-Attie (UCYA) Hospital was situated approximately 30 minutes drive from the hotel and we travelled there to meet Dr Max Thalmus Director of the Hospital. After a tour of the clinic we attended to preoperative assessment of our first 13 challenging inguino-scrotal hernias. The conditions were basic but softened by the presence of air-conditioning. Cleanliness and surgical protocol were perfect and we worked with a cohesive team of Nurses and anaesthetists who provided many spinal anaesthetists for the patients with larger hernias. Our French was a little rough but our surgical vocabulary increased remarkably during the week. Our schedule included three infant hernias, two incisional hernias and one orchidectomy, for a total of 52 patients with 57 hernias. There were no immediate postoperative complications.

We enjoyed immense hospitality including two late night dinners by the lagoon watching fisherman cast their nets into the murky waters ready for the next days table. Desire Trazo, an old friend from Takoradi and an Ivorian citizen dined us out at a Lebanese restaurant and Jean-Didier Guigrey, the instigator of this mission who is the CEO of EOG Healthcare Limited entertained us at his relatives house in the old Colonial Capital of Bingerville with a traditional repaste. We visited some of the architectural wonders of this exotic city including the dramatic St Paul s Cathedral designed by Aldo Spiritom and the Business district.

The highlight however was a meeting with the First Lady coordinated by Jean-Didier and Dr Eugene Djedje, technical advisor to the First Lady. At this meeting the First Lady confirmed that she would give continuing support to all Operation Hernia missions in Abidjan.

It is hoped that in 2009 two to three further teams will attend. I am asking for French-speaking volunteers.

Andrew Kingsnorth
February 2009