FARAFENNI GENERAL HOSPITAL
REPORT ON HERNIA INTERNATIONAL MISSION
(GERMAN TEAM) TO THE GAMBIA
29th October – 2nd November 2019
Compiled By
Farafenni General Hospital Management
Farafenni
North Bank Region
The Gambia
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 this year’s Mission began in June 2019 with a show of interest contained in an email addressed to Dr Andrew Kingsnorth coordinator for Hernia International 2019 team leader Dr. Meyer Jurgen. The team includes; 2 General Surgeons, 2 Resident Doctors, 1Anaestheologist, 1 Anaesthetist Nurse Technician and 1 Surgical Nurse making up a 7 member team.
OBJECTIVES
The objectives of the 2019 mission were;
- To offer surgical services mainly hernia but not limited to hernia alone but patients needing surgical care including children.
- To expedite access to surgery to patients on waiting list at Farafenni General Hospita and other facilities in the Gambia.
- To provide opportunity for surgery to people with hernia in communities who have limited knowledge on the condition through sensitization using mass media.
PREPARATION
Clearance for the mission was sought from the Office of the Permanent Secretary, Ministry of Health dated 26th August 2019 and the necessary formalitirs for temporal registration with the Medical & Dental Concil of the Gambia and the Nurses & Midwives Council of the Gambia contained in a letter addressed to the Director of Health services dated 25th September 2019. The Hospital Management established a local support team including a Surgeon; 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 through Regional Health Teams; National Broadcasting Radio; Community Radios across the country and influential community members.
3. Logistics: Identifying and mobilizing the required resources needed for the mission and these includes; medical supplies, drugs, personnel and transporatation to ferry visiting taem.
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, Maintenance unit and Catering Unit.
SUPPORT FROM MANAGEMENT
To achieve a successful camp, Management ensured that;
- The visiting team’s movement was well coordinated with support from the office of the Director of Planningand Information by providing transportation from the Airport – Hotel and to Farafenni and back to the Coast after the completion of the mission.
- Drugs and supplies needed for the camp were made available by the visiting Hernia team and the Hospital.
- Staff identified (local team) were available at all time (8AM – 8PM daily) during the course of the surgery.
- Food and water were available to avoid interruption of services by providing lunch for the local staff while a hospital cook prepared meals for the visiting team.
OUTCOME
The 2019 International Hernia Mission operated on 71 patients with 76 conditions meaning more than one person being operated on for more than 1 surgical condition. Of the total cases performed, hernia represents 80.2%; hydrocele 13.1%; lipoma 5.2% and Keloid & Csyst 1.3%.
Of the total patients operated on 66 (92.9%) were males and 5 (7.0%) were females. Gambians represents 84.5% of patients and non-Gambians accounted for 15.5%. Children under the age 5 represents 12.6% of all patients operated on.
| SEX | NATIONALITY | CONDITIONS | AGE DISTRIBUTION | ||||||
| M | F | Gam | Non-Gam | Hernia | Lipoma | Hydrocele | Keloid& Cyst | < 5yrs | > 5yrs |
| 66 | 5 | 60 | 11 | 61 | 4 | 10 | 1 | 9 | 62 |
| 92.9% | 7.0% | 84.5% | 15.5% | 80.2% | 5.2% | 13.1% | 1.3% | 12.6% | 87.3% |
Table above shows summary statistics of the 2019 International Hernia Mission
Table above shows summary statistics of the 2019 Hernia International Mission
CONCLUSION
The Mission was a success as there is an increase in the number of cases registered from 51 in March 2018 and 48 in November 2018 to 76 in 2019. It is important to note there is a documented evidence that from October 2016 – November 2018, Hernia missions to this hospital have operated on a cumulative number of one hundred and eightyfive (233) patients mainly hernia, registering 71 patients for this mission is a significant milestone in our efforts to provide more people access to surgery. I must again repeat and acknowledged the continuous transfer of skills and knowledge between the visiting team and our local team.
SUMMARY OF HERNIA INTERNATIONAL MISSIONS Oct 2016 – Nov 2019
| Dates | Mission | Team Leader | No of Patients |
| 22nd – 29th Oct 2016 | Slovenian Mission | Dr. Jurij Gorjanic | 56 |
| 20th – 25th Nov 2017 | International Mission | Dr Leo Mitteregger | 78 |
| 12th – 16th Mar 2018 | International Mission | Dr. Antonio Satorras | 51 |
| 12th – 16th Nov 2018 | International Mission | Dr, Tomaz Benedik | 48 |
| 29th Oct – 2nd Nov 2019 | German Mission | Dr. Meryer Jurgen | 71 |
| Total | 304 |
The Hospital Management would like to register appreciation to the German 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 Director of Planning and Information Ministry of Health and by extension to Mr. Sang OJ Mendy Transport focal person for the Ministry for providing transportation for the team..