Luwero, Uganda. September 2016

Hernia International Mission 2016: September 10-17

Luwero, Uganda

After the great success of last years ‘Hernia Camp’ a new team of enthusiastic volunteers embarked on another trip to Luwero, Uganda, once again led by Andy Pilcher along with consultant surgeons Tim Brown and Scott Caplin (Morriston Hospital, Swansea). The second collaboration between Hernia International and Care For Uganda saw the addition of consultant anaesthetist Dave Hepburn, trainees Edward Brown and Charlotte Brown and photographer/videographer/general enthusiast Dan Evans.

We arrived safely at the Care For Uganda Headquarters in Bbowa bright and early on Sunday morning. After a brief rest we made the journey to Bishop Caesar Asiili Hospital where we caught our first glimpse of where we would be working for the next week. We spent time exploring the theatre complex and making introductions with the local staff. It soon became apparent that much like last years trip, the main challenge would surely be the anaesthetic equipment (or rather lack of it)! Still, in Dave’s capable hands, and after the identification of some clean tubing for the anaesthetic machine we were raring to go. We unpacked the supplies we had brought and departed the hospital, eager to return the following morning. On Sunday afternoon we were offered the chance to see some of the other projects co-ordinated by Care For Uganda and meet some of the local children, a truly unforgettable experience.

Monday morning we began the work we came to Uganda for. On our arrival at the hospital there were already plenty of eager faces waiting patiently for us in the courtyard. We devised a makeshift theatre list and began seeing the patients in turn. On identification of a hernia suitable for repair we marked the patient and they were sent immediately to the ward for assessment. All patients had their HIV status checked prior to theatre and signed a consent form. We finished assessing all of the patients before getting started in theatre; a somewhat lengthy process at the Ugandan pace of life! It was a day filled with new experiences, from operating by torchlight to repairing large recurrent hernias venturing up the abdominal sidewall. We repaired 14 hernias on our first day of work, with plenty of inspiration for how to streamline the process in the days to come.

The days that followed just got better and better. We found ways to optimise our time at the hospital, for example being proactive with the autoclave to prevent long delays between cases, and dividing manpower between the clinic and theatre. We enjoyed the daily challenges that faced us and devising means of overcoming them. We took great pleasure in reviewing our post-operative cases and experiencing first-hand the difference we were helping to achieve. We also saw the darker side of such an effort; the swellings that weren’t hernias but most likely malignancy, and even an elderly patient with groin pain that transpired to be a fractured neck of femur. Turning away patients was undoubtedly the hardest part of the trip, especially at the end of the week when we physically couldn’t make theatre space for all those in need of our support.

By the end of 4.5 days of operating we had repaired 72 hernias on 65 patients. In addition we had strengthened relationships with staff at the Bishop Caesar Asiili Hospital and had the chance to take our operating skills back to basics as we performed surgeries using the most basic of equipment. Outside of the hospital the team shared a wonderful week in Uganda, cared for by the fantastic staff employed by Care For Uganda.

For me personally I was delighted to be offered the opportunity to join the Hernia International/Care For Uganda trip to Uganda last September. The skills I developed and experience I gained were invaluable and have already provided great benefit to me as I progress through my surgical training.

Charlotte Brown

ST4 General Surgery

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