In the operating theatre

Spanish, Puerto Rican and Andorran Team, Eruwa 18-27 MARCH 2010

It was incredible! is all we can say. We began our project when I first came to Eruwa, in June 2009, when we decided to undertake part of our work after talking with Dr. Awojobi. The Foundation Dr. Ramon Vilallonga has been involved in many projects, but since we met Dr. Awojobi, we cleary decided to continue this colaboration. On this ocasion, we met, a group of five people, from three different countries, Puerto Rico (Dr. Vangie Teixidor), Andorra (Mr. Josep Maria Puy) and Spain (Dr. Candy Semeraro, Miss Cristina Andreu and myself, Dr. Ramon Vilallonga), at the airpot of Lagos.

Spanish, Puerto Rican and Andorran team

Spanish, Puerto Rican and Andorran team

We arrived late in the evening and we were met at the airport by the team from the Clinic who took us in the clinic’s bus to Eruwa the next morning after spending the night in Lagos. The same day of our arrival, we began surgeries. Hernias of course. Baba, the person in charge of the theater and assistant for us, has been working a lot, and in a very efficient way. Accommodation was very changed since the last time. We did not stay at the town s hotel anymore, but at the clinic. Two houses were fixed for us. Perfect! We have repaired many hernias. Cristina, our scrub nurse, has taught Shakira, a local nurse who helps with the surgeries. Candy and I have taught some trainee residents and specially Daso, who is now perfectly able to perform a hernia repair with mesh. We were very pleased about that. The Awojobi familiy, as usual, has been very helpful and kind. No need to say that again. We have been treated like kings. Vangie even wanted to taste the local food we did.

Laying the foundation stone

Laying the foundation stone

 

“Sweets, pencils and a ball were offered to the kids. We can still hear the shouts of happiness.”

“Sweets, pencils and a ball were offered to the kids. We can still hear the shouts of happiness.”

As usual, we did a nice visit to the neighbourhood school. All the kids were so happy and excited. It was a great experience and we enjoyed it a lot. Sweets, pencils and a ball were offered to the kids. We can still hear the shouts of happiness.

We have continued treating Kundus, the little boy who got burnt almost one year ago. With material from our hospital, we changed the dressing every two days and he is improving but it is going to be very slow, as the burns are so extensive. Candy made a fantastic doll for him and Joe, an ambulance.

We also had the opportunity to assist Dr. Awojobi in his elective and emergency surgeries: testicular torsions, recurrent laparotomy hernia repairs, humerus realignment, thyroidectomies an experience.

Finally, we also laid the first stone of the future Ramon Vilallonga Puy Ibarapa Hernia Center. An incredible experience. We wish to continue in this way, trying to improve heath care in Nigeria. We hope to come back soon.

Dr. Ramon Vilallonga

In the operating theatre

In the operating theatre

Adhoc Team – Eruwa, Nigeria 27 JUNE – 3 JULY 2009

Servaise de Kock; South Africa, Ramon Vilallonga; Spain, Andrew Kingsnorth; UK

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Operation Hernia’s first outreach to Awojobi Clinic Eruwa (ACE), Oyo State in Nigeria (26 June 3 July) has been a remarkable experience. The outreach followed Professor Andrew Kingsnorth’s site visit to Eruwa earlier this year (see report). Nigerian visa complications at the eleventh hour unfortunately prevented Dr Dave Sanders (from Plymouth, UK, but at the time doing voluntary work in South Africa) from joining the project. The final team consisted of team leader and very able teacher Prof Kingsnorth, charismatic Spanish surgeon Dr Ramon Villalonga and myself from South Africa.

On arrival at Murtala Mohammed International Airport in Lagos on Friday evening I was met by Prof Kingsnorth and our Nigerian host, Dr Yombo Awojobi. We stayed over at the Lasos Hotel where we could discuss the week s programme over supper. Breakfast the next morning was had amidst at least five power cuts. Later we learned that the power has been off in Eruwa for 2 months and most houses have their own generators. Coming from South Africa, the Nigerian environment was not that much different from home. The lack of proper infrastructure for such a rich country as Nigeria came as a shock though!

Traffic in Nigeria is simply chaotic and I was extremely thankful that I did not have to drive myself. Motorbikes carried up to six people and South African potholes suddenly seemed very small to me. Dr Awojobi kindly took us on a sight seeing trip to his alma mater school, Lagos University (where a monument was put up for his late brother, Prof Ayodele O Awojobi, a distinguished lecturer in Engineering). We also visited the Olabisi Onabanjo University Teaching Hospital. We then headed to Eruwa where Mrs Tinu Awojobi and the rest of the family welcomed us and cared for our needs in a very special way throughout the week, including cooking special meals for us.

That evening we unpacked the new Codman surgical instruments donated by Atrium, the mesh donated by Atrium, the Valley Lab diathermy machines from Covidien and the suture material donated by BBraun. Thanks also to Ethicon SA and other sponsors for having made this project possible.

Over the next few days we operated happily using the AM Eye Clinic Theatre on the ACE premises (where beds, gowns and theatre lights are locally made!). Forty-four patients underwent surgery and 52 hernias were repaired, including bilateral femoral hernias in a male patient and a lumbar hernia. We also trained 24 local surgeons, resident surgeons and family practitioners in performing the Lichtenstein Mesh Repair. Most of them still do a modified Basinni repair for lack of mesh availability at a reasonable cost. Most of the trainees could get hands-on experience. We were kindly assisted by Dr Awojobi s staff and his clinic supplied most of the reusable equipment.

We were most impressed with Dr Awojobi s ingenuity in his hospital. His cleverly devised inventions include an autoclave machine, locally produced intravenous fluids, a self-made washing machine, a bicycle wheel driven centrifuge, etc. He is also producing interlocking bricks that are used for building an auditorium to host the 2011 Rural Surgeons World Congress. Rural surgery at ACE is practiced at its best. Much can be learnt from Dr Awojobi s resourcefulness. One gets the impression that patients are cared for in a special way.

Special events included a visit to the local king, an evening party with a live band and neighbours attending in their typical Nigerian attire, visiting a local school and just walking around the village streets. Nigerians are very hospitable and we were always greeted with a You’re welcome!

ADVICE to future teams:

1. Do take operative protective clothing (theatre shoes, plastic aprons and eye protection).

2. Take Malaria prophylaxis and Yellow Fever immunisation.

3. Make sure you have enough memory/batteries for your camera.

4. You will need lots of energy the working days can be long.

In conclusion, taking part in Operation Hernia was an enriching experience for me. I found Prof Kingsnorth’s input especially inspiring. Ramon Villalonga also proved to be a particularly pleasant team mate. I wish Dr Awojobi and the ACE all the best for the future. May Operation Hernia continue to contribute meaningfully to rural surgery.

Servaise de Kock
Surgeon, Ngwelezane Hospital, Empangeni, KwaZulu-Natal, South Africa.

Team Ghana 2009

Hispano-Belgian Team, Takoradi, Ghana 14-22 FEBRUARY 2009

The Hispano-Belgian team consisting of Ramon Vilallonga (consultant from Spain), Pina Orlando (experienced nurse from Belgium) operated at in Takoradi from February 14-22. Unfortunately, Dr. Casper Sommeling, Dr. Martin Ruppert and the rest of the Belgian team couldn’t come and we had a very busy time in the theatre. We personally finished exhausted every day.

Team Ghana 2009

Team Ghana 2009

After arrival we drove to Takoradi in a raining night. We were welcomed at the guest house by Grace, Lillian and Kate, our hosts for the week who had a lot of pleasure in meeting again Pina because it was her second year.

Sunday we met Dr. Bernhard Boateng and discussed the surgical week . He had planned about 29 patients; 22 in the hernia wing and 7 in the Ghana Ports and Harbour Authority hospital. We underwent for incisional hernias, mango, pineapple and one watermelon hernia repair. Also we had two cases of testicular hydrocoele and a testicular tumour. We performed also and emergency surgery in a patient with a strangulated hernia.

We had a very nice time with all the team there. The operation nurses helped a lot that everything was well organised, especially at the GPHA hospital. Everybody treated us very well and we danced even a lot, sandwiches were very nice

Dr. Bernhard Boateng spend a lot of precious time for us, in keeping us with some activities, even in the late afternoon. However we had time for visiting the harbour, play a game of golf with Georgina (The best golf player in Ghana) and some other activities. We even plan to organize a Golf tournament the next time we will go.

Local Children

Local Children

 

Part of the Team

Part of the Team

The last day in the hospital we were gratefully thanked by the team of nurses for the good works we did with presents. We got a special T-shirt of the hospital and lovely team pictures where taken. We also got one for our own album.

Also Dr Boateng and his team did think about our curves! Special Ghanaian chocolates where given to us by hart. We both were very touched with these gifts !

On Sunday after our arrival, we were taken to the beach and the last Saturday we visited the National Park of Kakum with the lovely guide Rebecca. Finally we went to Cape Coast and Accra where I was dropped to fly back to Spain and Pina picked up her whole family for another nice vacation trip around Ghana.

The Foundation Dr. Vilallonga www.fundacioramonvilallonga.org had taken material for 40 patients, including meshes, 200 bottles of local anaesthesia and Pina took plenty of presents for the kids but also for the friends. So our suitcases were empty at the end of the week. Everything went very well.

Dr Frank and Dr Bernhard deserved and received our deep respect for their work in Takoradi for treating all patients (children and adult) with all diseases (as surgeon, obstetrician etc) with relatively little is an immense responsibility. Also the nurses who we cannot forget because without their organisation we were able to operate. We hope we will be able to support them again.

We are keeping in touch with everybody, and all patients are going fine and will be followed up thru next teams and the local doctors .

The Hernia Wing and GPHA are well equipped but in the Ghana Ports and Harbour Authority hospital theatre we ran out of electricity for 30 minutes and we performed the surgery with a lamp. The nurse asked me Aren t you going to continue, doctor?, I answered after some reflection Of Course . Than we used the flashy glasses whit led lights on who Pina took with her. We, the young surgeons have grown with the electrical cut. The nursing staff are well trained and fun to work with. They work very hard without complaining and put the well-being of their patients first. Dr Frank and Dr Bernard deserved and received our deep respect for their work in Takoradi. Running a hospital and being a generalist physician who treats all patients (children and adult) with all diseases (as surgeon, obstetrician etc) with relatively little is an immense responsibility. They deserve as much support as we can give.

We had a wonderful time thoroughly enjoying performing the operations, meeting Ghanaians and visiting parts of the country.

We will be back!

Ramon Vilallonga
Pina Orlando

Operating Ghana 2009

Operating Ghana 2009