Slovenian team returns

TANZANIA    2 0 1 8

1st Austrian "Hernia International Foundation" Mission

Korogwe, February 24th - March 3rd 2018




Our group was the 10th Hernia International team to Korogwe. It consisted of 6 members: 2 surgeons, 2 anaesthesiologists, 1 radiologist and 1 nurse anaesthetist.

Before our travel, we did not all know each other. Through common friends, a team was assembled , which later showed to be a good one. We travelled separately. Unfortunately, the intended plan to host the first African surgeon on Hernia International Mission (Dr. Peter George from Liberia), had to be abandoned due to problems during his flight. The team met in Triniti Hotel close to Dar es Salaam airport. After breakfast, we travelled to Korogwe on mainly good, but busy roads for the next 6 hours. During this trip, and later on in the hospital, an observation was made that after being here in 2015, Tanzania has been making progress in every sense (roads, traffic rules, infrastructure,...). In Korogwe hospital, we were warmly welcomed by the hospital's medical director and Dr. Avelina Temba as the 10th Hernia International team, after starting in 2013.



 Warm welcome in front of the Korogwe hospital


Immediately after that, we visited the patients and arranged the surgical programme for the first day. We nearly managed to retain all of our equipment with just 1 piece of lost luggage missing. We bought sutures from a local pharmacy. Operations were planned parallel on 3 tables, however this had to be reduced due to the unpredicted absence of 1 surgeon. However, our host, Dr. Temba was willing to operate on table 3 on almost all days. Operations started with 3-4 paediatric cases on table 1, these patients got general anaesthesia and caudal blockage, then we continued with adults, mostly also in general anaesthesia due to large hernias. On table 2, mainly large inguinoscrotals, up to H420 cm-(Kingsnorth classification) were performed mainly in spinal anaesthesia. On table 3, Dr. Temba performed diverse procedures, mostly in local anaesthesia, partly in spinal as well. Table 1 and 3 were sometimes occupied by local surgeons performing emergency procedures. A very well organised, local team was of big help to us. Also, there was a big interest from local surgeons to learn modern hernia procedures.                                                   

   1 OT was well air-conditioned, the other partly (AC was out of order on the second day) so Maria and Marija showed a lot of bravery, working at 37 oC while wearing surgical coats. Strong headlights were a good idea to take with us. Although lighting were working in 2 theatres properly, they were not very bright. The diathermies were working well, despite regular power cuts.


 Maria and Dr Agripina during surgery


 Jurij during teaching retrorectal Rives-Stoppa

In the first three days, the work in all three operating theatres (OTs) ran smoothly from 8 am to 9 pm or even later. Arranging the surgical programme for the following day was the last task every evening. On day 3, after a good dinner in a local grill restaurant on Korogwe main road, we decided to reduce the working hours for next 2 days. This was done partly allowing teambuilding and to enable the local staff to relax and tidy up in the evenings. On the next day, after finishing surgery, we were honoured by visiting the monastery and private hospital of The Sisters of Usumbaya (a catholic order of sisters, to whom surgeons Dr. Avelina, Dr. Archangela and Dr. Dativa belong). Around their monastery various tropic trees with diverse fruits were growing, and considering the peaceful atmosphere of people praying, we almost had the impression of being in the garden of Eden. The private St. Joseph Hospital close to the monastery has just been expanded with a new maternity ward. In this building, a donated ultrasound machine, a gift from Dr. Michael Wutte from Austria, which we brought to Tansania,  will be installed.

On the last day, after finishing surgery, we visited a local market acompanied by surgeon Dr. Ahmad and were in awe of the diversity of groceries and other articles sold by the locals. The final evening party, organised by ourselves and hospital staff in our guest house (Magnificent Korogwe Resort), consisted of speeches thanking the work that had been done, a buffet dinner and some dancing.

Special thanks were given to local surgeons, who performed the early morning rounds every day for all of the patients. This was a big time saving for us, allowing us to start with surgery immediately after arriving to the hospital. The Korogwe hospital has about 15 doctors and 100 beds, making this organisationally possible. We personally checked dressings and removed drainages in incisionals and some large inguinoscrotal hernias Korogwe hospital has about 100 beds, around 15 doctors are working there.