Ganta City, Liberia. November 2019

Report of Hernia International Mission to Ganta City

November 19- 25, 2019

The team consisted of the following:

Peter Bystricky, surgeon (Czech Republic)

Stepan Matoska, surgeon (Czech Republic)

Paulina Mysliwsky, anesthesiologist (Poland)

Denis Blasquez, pediatric surgeon (France)

Ajaiya Mull, anesthesiologist (Germany)

Iain Muir paediatric surgeon (Scotland)

Bill Cosgrove, pediatrician (United States)

Scott Leckman, surgeon (United States)- Team Leader

We were hosted by Peter George, general surgeon and Chief Medical Officer at the Esther and Jereline Koung Medical Center. We all stayed at Jackie’s Guest House and ate all of meals at the restaurant there. We skipped lunch each day as we were so busy and the heat seemed to suppress one’s appetite.

We operated for six days in four operating rooms. The two rooms with adequate air conditioning had no running water. In the one room that had an anesthesia machine, we did the pediatric cases. The final room had no A/C.

Sterility was challenging. There was one small autoclave heated with charcoal. Power would occasional be lost, but a back up generator (brought from Dr. George’s home for missions) would usually kick in. There was one occasion in which there was no access to water for a few hours.


Items we were glad we brought were: Gloves, suture, headlights, spinal bupivacaine, ketamine, spinal needles, LMA’s and other anesthesia equipment.

In the six days, we did 161 procedures in 133 patients. Most were inguinal hernias, including some recurrent hernias. The vast majority of inguinal hernias were scrotal and were difficult to repair especially since electrocautery was not available. There were 14 umbilical hernias, 14 hydroceles, three femoral hernias and some ventral hernia repairs. We were able to help train at least one young Liberian doctor in hernia repair. After nearly four weeks, there is one known complication, a post-operative hematoma which required evacuation.

 Bill Cosgrove, our pediatrician, had probably the most impactful experience. He trained nurses and midwives in neonatal resuscitation who in turn trained others under his supervision. There was at least one birth he attended with the help of Paulina, in which the baby would not have survived had he and Paulina not been there. Now there more than fifty medical personnel he trained. One can only guess what impact this will have.

We are grateful for our excellent host, Dr. George. He is very committed to the people of Liberia and works under very challenging circumstances. We are also grateful for the enthusiastic help of the anesthesia staff and scrub techs who were always eager to assist us.

Submitted by Scott Leckman MD FACS

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