On the occasion of a short visit to St. Mary’s Hospital in Okpoga, Nigeria in February 2010 it was decided to open a new site for future Operation Hernia activities in this place. After some months of preparing everything was set up and the team, predominantly members of the Swiss Surgical Team, was put together. At the same time a second Irish – Swiss – Australian team was getting ready to spend a week in St. Vincent’s Hospital, Aliade.

After a night flight with British Airways we arrived in Abuja early in the morning. The airline had granted us a generous amount of free luggage which we used for bringing along surgical and anaesthesiological material and instruments. Despite the large number of boxes and suitcases we encountered only minor problems at Immigration and soon we could continue our journey. For six hours the two teams bumped in a very full minibus from the airport first to St. Vincent’s hospital where one team was to spend the next week.

Two hours later after a dusty drive and a visit at the bishops place the three Swiss surgeons (Martin Walliser, Hanspeter Notter, Peter Nussbaumer), one English surgical trainee (James Barnes), one Swiss anaesthetist (Warner van Maren) and one Swiss scrub nurse (Claudia Baur) finally arrived at St. Mary’s hospital. A large crowd greeted us with dancing and singing. Posters around the town and announcements in the church had prepared them for our arrival. In order to make the most of the short spell of the mission we decided to set up the operating theatre on the same evening. Boxes of instruments, diathermy machines, gloves and sutures were hoisted onto porter’s heads and taken to the hospital for unpacking and sorting. Fortunately we had electricity 24 hours a day, thanks to a new generator donated by Operation Hernia. So the next morning we started. By dawn patients with hernias started to line up. Following confirmation of a hernia(s) they were put on the list for having surgery the same day or later in the week. The lucky ones put on their colourful nightgowns and sat in front of the theatre where they awaited their turn. Nobody seemed to mind waiting for as long as it took – neither the patients nor their families sitting under a plastic sunshade.

For the next six days we continued operating from 8 a.m to 8 p.m, sometimes even longer. In between two procedures the two tables were vacant just long enough for cleaning. Eighty patients and ninety interventions later we reached full time and still the patients kept coming. Some had travelled for eight hours to reach the hospital and had to be turned down. How distressing to be the bearer of such bad news. Names were taken with the promise that the next hernia team would see to their hernia. Performing up to 18 procedures instead of the usual one operation per day was not only exhausting for the local scrub nurses, but also put the staff working in sterilisation to its limits. However having an experienced expat scrub nurse with the team improved the efficiency and quality of their work and increased the level of hygiene considerably.

One of the aims of Operation Hernia is to teach contemporary surgical techniques to the local staff, but the three Nigerian doctors working in the 100 bed hospital were busy working in the different departments. Since none of them was trained in surgery our intention to teach and train was somewhat limited. In the end we achieved having one of the doctors performing the mesh-repair under supervision.

It goes without saying that our accommodation was excellent and the hospitality of the matron and her team generous. They went out of their way to make our stay relaxed and convenient. And Austin Ella, the local coordinator made a big effort both before and during the mission and has thus contributed substantially to the success of our work. Altogether the team spent a very satisfactory and unforgettable time at St. Mary’s, and we thank everybody involved for their help and support.

Peter Nussbaumer