Farafenni, The Gambia. November 2018

FARAFENNI GENERAL HOSPITAL

REPORT ON HERNIA INfERNATIONAL MISSION (SLOVEVENIA

& UK TEAM) TO THE GAMBIA

12th – 16th November 2018

Compiled By

Farafenni General Hospital Management Farafenni

North Bank Region The Gambia

20th November 2018
BACKGROUND

The Hernia International Organization a multi – European Humanitarian group started partnership with Farafenni General Hospital in 2007 marking the beginning of the organization’s first Hernia Camp in the Gambia.

Preparations for the November 2018 Mission began in May 2018 with a show of interest contained in an email addressed to Dr Andrew Kingsnorth coordinator for Hernia International from the November 2018 team leader Dr. Tomaz Benedik. The team includes; 3 General Surgeons and a Nurse from the United Kingdom and 1 Surgeons. 3 Anesthetists. 2 Nurses and a Meidical student from Slovenia making up a 11 member team.

OBJECTIVES

The objective of the November 2018 mission were:

1.     To offer surgical services mainly hernia but not limited to hernia alone but patients needing surgical care including children.

         2.     To reduce the backlog of patients on waiting list for surgery at Farafenni and other facilities in                   the Gambia.

PREPARATION

Clearance for the mission was obtained from the Office of the Director of Health Services. Ministry of Health & Social Welfare dated 2nct February 2018 and the necessary formalitirs for temporal registration with the Medical & Dental Concil of the Gambia and the Nurses & Midwives Council of the Gambia. The Hospital Management established a local support team including a Medical Officer; Anesthetist Technician; Theatre Nurses; General Nurses and other support staff to work with the mission. From the success registered in the previous Hernia Misssions. the local team were encouraged to work with the visting team resulting in the establishment of 3 key sub teams.

1. Clinical: assigned with the responsibility of screening and booking (including contact details) of all hernias and related cases seen at the clinic.

2. Communication, responsible for sensitizing the general public including health facilities using the local radio and influential community members.

3. Logistics, Identifying and mobilizing the required resources needed for the mission and these includes; medical supplies. drugs and personnel.

 The units that were fully involved in the preparation process included Administration; Nursing Department; Operating theatre; Laboratory; Laundry; Drug Revolving Fund Unit; Security; Generator Unit and Catering Unit.

SUPPORT FROM MANAGEMENT

To achieve a successful camp. Management ensured that:

1.     The visiting team’s movement was well coordinated with support from the office of the Director of Health Services by providing transportation from the Airport – Hotel and to Farafenni and back to the Coast after the completion of the mission.

2.     The visiting Doctors and Nurses were cleared through the Ministry of Health and the Councils.

3.     Drugs and supplies needed for the camp were made available by the visiting Hernia team and the Hospital.

4.     Staff identified (local team) were available at all time (SAM – 9PM daily) during the course of the surgery.

5.     Food and water was available to avoid interruption of services by providing lunch for the local staff while a hospital cook prepared meals for the visiting team.

OlITCOME

The November 2018 International Hernia Mission operated on 48 patients with 49 conditions with 1 person being operated on for 2 surgical conditions. Of the total cases performed, hernia represents 69.4%; Lipoma 2%; hydrocele 6.1%; and Keloid & Csyst 22.4%. Of the total patients operated on 42 (87.5%) were males and 6 (12.5%) were females. Gambians represents 97.9% of patients and non-Gambians accounted for 2%. Children under the age 5 represents 6.3% of all patients operated on.

SEXNATIONALITYCONDITIONSAGE DISTRIBUTION
 M F Garn Non-Garn Hernia Lipoma Hydrocele Keloid& Cyst < Syrs > Syrs
426471341311345
87.5%12.5%97.9%2%69.4%2%6.1%22.4%6.3%93.7%

Table above shows summary statistics of the November 2018 International Hernia Mission

 CONCLUSION

The Mission was a success despite the drop in the number of cases registered from 51 in March 2018 to 48 in November 2018. However, given that from October 2016 – March 2018, Hernia missions to this hospital have operated on a cumulative number of one hundred and eightyfive

(185) patients mainly hernia, registering 48 for this mission is a significant milestone and thus and indication that hernia cases have drastically reduced in our communities. I must also acknowledged the continuous transfer of skills and knowledge between the visiting team and our local team.

SUMMARY OF HERNIA INI’ERNATIONAL MISSIONS Oct 2016 – Nov 2018

DatesMissionTeam LeaderNo of Patients
22nct _ 29th Oct 2016Slovenian MissionDr. Jurij Gorjanic56
20th _ 25th Nov 2017International MissionDr Leo Mitteregger78
12th – 16th Mar 2018International MissionDr. Antonio Satorras51
12th _ 16th Nov 2018International MissionDr, Tomaz Benedik48
Total233

The Hospital Management would like to register appreciation to the Slovenian and the British team for an excellent job , to Dr. Adrew Kingsnorth for his leadership role in coordinating missions. The local staff must be commended for their dedication and commitment. Equally important. we express gratitude to the Ministry of Health through the Diretor of Health Services (Dr. Mamady Cham) who was with us all through the process for the technical support and encouragement.

 20th November 2018The Mission was a success despite the drop in the number of cases registered from 51 in March 2018 to 48 in November 2018. However, given that from October 2016 – March 2018, Hernia missions to this hospital have operated on a cumulative number of one hundred and eightyfive (185) patients mainly hernia, registering 48 for this mission is a significant milestone and thus and indication that hernia cases have drastically reduced in our communities. I must also acknowledged the continuous transfer of skills and knowledge between the visiting team and our local team. 

SUMMARY OF HERNIA INI’ERNATIONAL MISSIONS Oct 2016 – Nov 2018

DatesMissionTeam LeaderNo of Patients
22nct _ 29th Oct 2016Slovenian MissionDr. Jurij Gorjanic56
20th _ 25th Nov 2017International MissionDr Leo Mitteregger78
12th – 16th Mar 2018International MissionDr. Antonio Satorras51
12th _ 16th Nov 2018International MissionDr, Tomaz Benedik48
Total233

The Hospital Management would like to register appreciation to the Slovenian and the British team for an excellent job , to Dr. Andrew Kingsnorth for his leadership role in coordinating missions. The local staff must be commended for their dedication and commitment. Equally important. we express gratitude to the Ministry of Health through the Diretor of Health Services (Dr. Mamady Cham) who was with us all through the process for the technical support and encouragement…

20th November 2018