Spanish surgeons collaboarte with Hernia International in Kenya

Kenya campaign in Gatundu

(5 to 19 September 2015)

 

We missed one flight, we punctured one wheel, and the all the flamingoes in the lake had disappeared. And yet… let me tell you about it.

We started the campaign, as usual with us, in the Barajas airport, in the early morning of September 5th. Six of us met there, ready to start for Nairobi via Amsterdam. Most of us knew each other from the frustrating campaign we lived through the previous year in India (see memory). We were three general surgeons: Teresa (our leader), David (joint leader) and Sebastian (whom no one knew and who was coming from Mieres), an anaesthesist, the genial Beatriz, a nurse, Nuria (David’s wife), and a man for all jobs, Paco, that is myself. A seventh member of the group, the young and tall woman surgeon from Barcelona, Heura, was missing, as she had to postpone her arrival for a week due to previous engagements. After packing six large bags with surgical material we took the plane to Amsterdam, to link there with the Nairobi flight. But a mischievous bag, as the pilot called it, delayed our departure and the arrival at the Dutch airport, so that, given that our margin was very narrow, we missed our boarding time. Twelve hours waiting and eight flying in the next Kenya Airways plane left us at dawn in the airport of the African capital. We went through customs without any problem, showing the letter we had from the director of the hospital and the Ministry of Health with the list of the surgical material in our new and showy bags. We were expecting to be met on arrival, which actually happened… two hours later. We went to a hotel in Ruiru,a small village half an hour from the Gatundu hospital. The Rainbow Ruiru Resort is a high class hotel with limited and controlled admission, very far from the standard we are used to in these missions. Large individual rooms with a wide bed and starched mosquito net, TV, wifi, bath and water at a whimsical temperature for all of which we had to pay 4.400 shillings, about 38 euros, per day. That place had been chosen by the previous British expedition of International hernia Foundation (to which our own Foundation is associated) as it was the only available lodging next to the hospital, at a distance of about half an hour by car if your driver is Erik, the fast driver of the Toyota Land Cruiser the hospital has for transport.

  

On our first day we received the visit of the director of the hospital, Dr. Patrick Nyaga, in his Sunday best together with a baseball cap and accompanied by his 7 year old child. He greeted us, and as we were having lunch with him at the dining room of the place (an awful meal!) he explained to us in general the planning for our work in the Gatundu district. This is a small village with hardly a handful of shabby buildings along the road that goes through them, at about 70 Km North of Nairobi and belonging to the Thika province. The hospital, at which we arrived at 7 am the next day is an outdated building of British design with several one-plant pavilions along a dusty, yet well-kept with gardens along which we went with the woman head of infirmary, superintendent and factotum at the hospital, the efficient and charming Betty. She showed us the hospital rooms, and she took us to the place for our work and future operation theatre, the only one in the centre. This was a shabby old room, and we settled in it at once. We took out our instruments, and we added a second table while we observed the noisy respirator. We were warned we would have to share it with urgencies, chiefly Gynecology (there were daily 3 or 4 caesareans), another limitation after the one of having only one electric scalpel. Still, those difficulties did not hinder our work at a good rhythm, giving all the possible time to it, since we left the hotel at 6:30 in the morning with the first rays of the sun, and coming back between 20 and 22 hours, in full night, since days and nights have the same length in those latitudes. Sunrise and sunset are fast, as if the sun would go faster, thus taking time away from loving couples in their evening walks.

 

We performed 5 operations on 50 patients, 7 of whom were children between 2 and 10 years. Most of the cases were inguinal and umbilical hernias, some very large, and we had several complicated eventrations which took a long time, someone up to 4 hours. (For more details please see the data base in Exel where all data and tipe of operation for each patient is explained). They brought us our lunch to the waiting room before the operation theatre, and it was always the same: aluminum containers full of rice, green potato sauce and boiled old meat, and we duly eat out of need and courtesy. At the beginning and end we saw the patients to be operated the next day and those already operated upon which needed hospitalization, chiefly those who needed drainage. When we left, we still had to leave two or three without being operated, but we fully trusted our local colleagues and had given them the proper instructions.

 

  

We always felt well accepted, and the medical staff collaborated very well with us. We have to praise specially the commitment of the anaesthetists Veronica and Jennifer who put up with the additional hours we requested, far beyond their timetable, helping Beatriz who, with halothane for the general and the fine needle for the spinal anaesthetised all the patients we operated upon and helped with the urgencies. Our commitment extended itself to formation teaching for students and doctors at the hospital, so that a handful of them helped in the operation theatre and in the waiting halls. I want to single our the work and the enthusiasm of the young surgeon Dr. Abdirashid, a very valuable person with a great interest in learning, who even, under the direct supervision of David the direct supervision, an inguinal hernia. In the same way we have to give special thanks to doctor Makena for her collaboration with the patients and to Janet, head of infirmary, for her patience and skill. We had also prepared a few talks or conferences, but we could not give them for lack of time, as, I have already said, the daily work took up the whole day (and part of the night).

 

This hospital, so out of date and in poor shape, has only a short time to go, as the China government has financed the construction of a new one by the side of the old one still under construction. It is a white building of four stories which will be inaugurated next month. We had the opportunity and the privilege visit it, while none of the doctors there had seen it yet. Betty showed it to us, and we had to go through a side door, fully locked and watched by Chinese guards, as it is the only one of its kind in the place. It is furnished with all advance techniques, and it is said to be a copy of Cantonese model. The operation theaters are computerized. The change to a less toxic gas as the insofluorano for anaesthetic induction, the room for childbirth, the Intensive Vigilance Unit with 14 beds and 2 isolated, the lifts with a memory, and in general all the furniture and materials spoke of the latest technology and implements. We noticed that all titles were written in large Chinese characters with their name in English below. (It’s a pity Swahili, which is the local language spoken by all, has been ignored. Curiously, Swahili has the same vowels as Spanish and is pronounced in the same way. The is very significant as in this way all the natives who share English as official language begin to learn it in the school, so that their pronunciation is very similar to that of a Spaniard when he dabbles in the language of Lord Byron, and that helped our mutual understanding). In this way all future campaigns in Gatundu will have excellent installations in the new hospital.