The 7th Mission in Ya Wilaya Hospital
November 19th-26th, 2016
Miss Zoe Vlamaki Surgeon, 2nd trip to Korogwe
· Dr Penny Howell anaesthetist.
· Mr John Budd Surgeon with pediatric interest.
· Mr. Alan Cameron Surgeon.
· Mrs Anna Budd theatre nurse, Mr Budd’s wife
Mrs Margaret Cameron NHS retired physiotherapist and Mr Cameron’s wife.
On a hot and sunny afternoon in Tanzanian’s dry season we have arrived at the busy Dar Es Salaam International Airport, the meeting point of the team.
Despite heavy traffic, a member from the hospital staff and the hospital driver, managed to pick us up at the airport waiting area, with a slight delay.
Familiar faces made the foreign country more familiar to meet new people. We had a warm welcome to the country and began the journey, loading the car with all the boxes and baggage.
To avoid driving to Korogwe in the night, we spend the first night at the Bagamoyo, two hours (depends on traffic )drive from Dar Es Salaam a resort on the line of Indian Ocean. We had a very nice relaxing evening before our mission’s work and was a good time to get to know the team members. The hotel in Bagamovo was good value for money and the hotel staff was helpful.
On following day Sunday, Omari drove us to Korogwa. The drive took more than 4h for us to reach our destination.
Our first stop was at White Parrot Hotel where we were welcome by Avelina a local Surgeon and the organizer of those mission trips, to Ya Wilaya Hospital.
We continued our journey with Avelina to our next stop the Ya Wilaya Hospital where we were welcomed by all hospital staff. The hospital has experience working with Hernia International Organization and we were the 7th team who came to work with them .
Avelina took us to her office to brief on patients waiting list. At that moment over 100 patients were awaiting to be seen. The local staff had already made the screening for high risks cases. The ward was crowded with children and elderly placed together.
From start we did the usual practice, identifying patients who needed surgery and discharged home patience that didn’t required surgical intervention. Prior we did visit the operating rooms and meet closer the team to work with us in coming days. All our medical supplies were unloaded from car and we proudly notice our donations fulfill completely the storage space in the stocker site.
Our working week began as usual on Monday, but as tradition goes we had a meeting first with Chief Cancelor and the Mayor of Korogwa before commence our work.
Looking at the cases it was clear to us that some patients will need more than local anesthetics. We put all pediatric surgery under general anesthetic and we allocated all pediatric cases to be performed in most equipped operating room 1. Operating room 2 had an air-condition and basic equipment for Spinal and LA. The operating room 3 was allocated for LA, unfortunately the room didn’t had an air-conditioner.
Hospital staff provided us with full assistance in all aspects of our work. Local doctors took part in provided training and assist us in all ongoing operations. Avelina only managed to join us on our last day, Friday. Her main duty kept her outside of the hospital for the most part of the week.
It is worth to mention the hospital driver Omari who was a great help through out our stay.
We did enjoyed the local food prepared for us every lunch, daily by the hospital.
We stayed at the White Parrot hotel. The rooms were clean, the service was good breakfast was included, the dinner was paid extra also quite good. Sadly, we were the last customers they had to accommodate. After our departure the place was closed down for unpaid tax.
In regards to our mission, we had 91 patients on a waiting list including children. Nevertheless, we managed to perform 97 surgical procedures. Where 27 patients were children, most of them under 5 years old, and 64 were adults.
Pediatric cases of : congenital inguinal hernias, umbilical hernias, undescended testicle, two cases of hypospadias, and hydrocele. All done under general anaesthetic.
The adults operated were 64 patients, of whom the 16 were female. Most of the cases were done under local anaesthetic. We worked out the large scrotal hernias, non reducible inguinal hernias, incisional hernias, selected number for spinal anaesthetic.
We gave general anesthetic/Ketamin with the help of the experienced anesthetic local team in 3 cases with large hernias and one for incisional hernia. In one male case we had non response to any given analgesia and had to administrate general anesthetic with ketamine.
As per routine set, we performed usual postoperative assessment. Furthermore, the assessments were carried out with usual controls in place and we did final reviews for patients on discharge home.
We involve local doctors to participate in all stages of postoperative assessments and we have left necessary recommendations and instructions in place to follow on review assessments. Translated copy with postoperative care instructions was given to each patient on their discharge home.
In addition, we did daily ward rounds every morning reviewing each operated patient and run small daily clinic for new coming outpatients. It was noticeable that establishing good communication between our teams and hospital staff helped us to achieve good results in patients care.
It is important to mention that our medical supplies to the hospital prove yet again, to be an important part in our mission. Providentially, we have had an opportunity to organize our medical supply and it was vital in our work.
Our mission came to the end on Friday, some members of our team have organized a safari trip to finish their stay in Tanzania. I have decided to stay a little longer in the hospital and catch up with the staff, patients and local people. Working thorough the mission didn’t leave much time to do this and I am glad I’ve spent a bit more time with locals before returning back. Following morning I’ve travelled back to UK, after a short stop to Bagamoyo again. The split of the team made early good byes.
I would like to say our team has achieved very good results judging by responds we had from the hospital staff and the patients. Noticeable, the hospital had a rapid improvement with the changes we recommended and training we provide. We are happy to report hospital staff has in progress the implemented all given recommendations. For example: better ceiling in operational room 2, better air-conditioner in operational room 3 and an extra bottle of Oxygen supply, to keep always in stock.
Hospital surgical instruments stock contain large amount of unsuitable operational equipment. We advised hospital Metron to keep only instruments that are possible to use in surgeries, i.e. few selected hernia sets etc.
We understand hospital has a small affordable charge for the surgical procedures they performed; hopefully those funds will help hospital administration to improvements in place.
Considering constant demand for surgical intervention we hope the established improvements in the hospital will help other international teams to work in better settings.
I would like to mention Dr. Alexander Stanek, who helped to have donated new disthermy to hospital. The donation was made by Sister Carol Reid from Tyrone County Hospital and we all send a great Thank You*. Dr Stanek is planning his mission for May 2017.
Also, I would like to say, thank you, to each of you, on behalf of the hospital and myself to John and Ann Budd , Penny Howell, Alan and Margaret Cameron, who helped us to bring donated equipment all the way to the hospital and for the team work we have achieved.
Using this opportunity I also would like to say my gratitude to all my colleagues who helped me collect vital medical supplies for our mission. Especially, I would like to say “Thank You!” to: Dr. Nele Close who helped to cargo boxes of sutures; the staff at St Peter’s & Ashford and Crawley Hospitals NHS Trust for their support.
Medical suppliers, companies Ansell and Swan & Morton who kindly provide supplies of sterile gloves and disposable scalpels.
In addition to above I would like to thank all my Greek friends and families who never stop donating and helping people either here, in UK, or in Greece or far overseas. Your help was absolutely fantastic! Moreover, I would like to say “Thank You” to our Greek Orthodox Church Arche-Bishop in UK, Mr Gregorios who always is happy and ready to support a good cause.
A cordial Thanks You to all
Miss Zoe Vlamaki MD FRCS, team leader.