Schweizerische Sektion
Section Suisse – Sezione Svizzera – Swiss Section
Mission report ICS Training team, Okpoga, Nigeria,
November 2017
From November 4th to 17th the first mission by a training team of the Swiss section of the International College of Surgeons (ICS) was undertaken to St. Mary’s Hospital in Okpoga, Nigeria. Previously the missions were carried out by Swiss Surgical Teams, but this organisation decided to abort the project after 6 years. This years team included two surgeons (Peter Nussbaumer & Florian Oehme), an anaesthetist (Thomas Stoinski) and gynaecologist (Katrin Ochs) and a scrub nurse (Sanne van Rijn).
After an uneventful flight from Zurich to London and Abuja the first challenge was Nigerian Immigration. Thanks to our partners from the hospital and a very helpful note verbal by the Swiss Embassy in Abuja our passing through Immigration and Customs was smooth, despite the multiple boxes filled with medical equipment and consumables. Various medical companies in Switzerland donated the material.
Immediately we continued our journey by minibus. On the road we passed cities, marketplaces, cattle and landscapes with a few huts, some made of stone some made of clay. Due to the bad condition of the usual route we had to take the long road through Lafia. After 8 hours and 450 km of pothole ridden driving we arrived at St. Mary’s hospital just before dusk. There the staff with singing and dancing warmly welcomed us.
To ensure an early start the next morning we decided to unpack our boxes and set up the theatre the same evening. This activity was interrupted by the first emergency case, a 7-year-old girl with a perforated typhoid ulcer. After a successful operation the patient was discharged a week later.
The next morning we started with a lecture* in the meeting hall. About 40 staff joined and participated in the discussion. Afterwards there was a ward round together and then work in theatre started. 60 patients were ready for screening and confirmation of the diagnosis. Some were operated on the same day, others planned for the following days. Everybody agreed to have a short list on Sunday, so we could schedule patients for 10 days. Soon we had adjusted to our day -to-day routine, the only interruption being the many emergency cases. With 6 cases of typhoid perforations we could put a focal point on teaching the concept of emergency laparotomies including staged procedures and the equally important postop care.
Sunday was the only day with some recreation, first by visiting the catholic mass in the village and later in the afternoon the get-together with traditional dancing, singing, speeches and traditional clothes for each team member.
Unfortunately one of our diathermy machines, necessary for haemostasis during surgery, was blown. The second one mal-functioned and so we were left with only one functioning machine. This slowed down work considerably and the operations went on late into the night. Never the less we were able to treat 130 patients and perform 143 operations; including 24 children aged 3 to 7 years. Despite very limited recourses and without the accustomed standard equipment our anaesthetist contributed significantly to the successful outcome of these interventions.
Once again the hospitality of the Matron Sister Christiane and her team was overwhelming. They went out of their way to make our stay relaxed and convenient.
Time flies by and already we had to say farewell. Altogether the team spent an amazing, extraordinary and unforgettable time in St. Mary’s Hospital, and we thank everyone involved for their help and support.
*The following topics were covered during the lectures:
Postpartum haemorrhage
Pre-ecclampsia
Thoracic trauma & drainage (2 parts)
Sutures: material & technique (2 parts)
Hygiene & asepsis
Inguinal hernias
Dr. Peter Nussbaumer, MD
2nd Vice President Swiss section
International College of Surgeons
Project coordinator