Working visit Tanzania
For the third time Dr Gwen Liu, general surgeon, is flying to Tanzania with Dr Harry de Vries, orthopaedic surgeon. Together they are able to perform more operations, using each others specific knowledge and experience.
This time the journey starts in a small rural hospital in Sumve. Dirk Vink is waiting for them. The children are anxious for the doctors from the Netherlands. Some of them have been waiting for quite a time…but an operation means hope for the future! After all the children underwent their operations, they continued their trip to Arusha. Here Sarah Wallis was coordinating the children for the operations.All in all a meaningful journey for a lot of children. Read below her travel report.
Travel report Sumve and Arusha, 1-11 july 2010.
Our initial travel schedule was April 15th 2010, because of the volcanic eruption in Iceland we have been waiting for 5 days, before we finally cancelled our trip.
Postponing our trip to July 1st, we were flying with Kenia airlines/KLM to Nairobi, Kenia , from where we continued with Precision Air to our destination, Mwanza, Tanzania.
Fortunately our luggage was labelled directly to Mwanza at Schiphol Airport, so we were able to take along our 4 suitcases of 23 kg each, filled with plaster, sutures materials and children clothes for the plaster house. Precision Air would have only allowed us 20 kg each.
After a successful nocturnal flight, we arrived in Mwanza in the morning. At the airport we had some problems with our visa on arrival, because I did not had a receipt for the US dollars. Finally we were able to pay with Euro’s, while having infinite patience.
Dirk Vink drove us to Sumve taking the motorway and unmetalled roads, after 2 hours we arrived in the hospital. It was noon when we met Tineke. Dirk and Tineke are volunteers, not medically educated and are staying in Sumve since 2007. They are returning to The Netherlands in October, but they hope to come back with new fundings from the Rotary.
After a lunch we examined the patients in the out patient department till 18.15. By that time we were expected in the Hospital’s café to join the world cup football match on TV! It was the second half of Brazil against Holland. After the game, we continued our outpatient clinic. Afterwards we went to the ward to see the patients.
Sumve has a collaboration with the Radboud University in Nijmegen in The Netherlands. Two housemen were staying there for 3 months, both called Anne.
On Saturday we were in theatre at exactly 8 am, but it took a while before we could start. The team picked up our speed of calling and changing patients , so in the end we were able to operate 5 patients (tibia and femur osteotomy on a patient with Blounts disease, skin grafting, toe amputation).
On Monday we had the same start-up problem at 8 am in the theatre, despite that, we were able to perform 6 elective operations (Turco, femur osteotomy , achillestendon lengthening, sequestrectomy ellbow ) and 1 acute operation (incarcerated inguinal groin hernia with small bowel resection ). On Tuesday 6th july there were 5 elective patients ( tibia/femur osteotomy, Turco, achillestendon lenghtening, olecranon fracture, zuggertung cerclage with K wires en vicryl because of the lack of metal wires).
There was also a road traffic accident, a cyclist run into a motorbike. The cyclist had a fracture of his left humerus and a ruptured spleen. A laparotomy with splenectomy was performed. Unfortunately the patient passed away.
That evening was the football match between The Netherlands and Uruguay, Dirk had put up a beamer in the café during the world cup. Whenever the Dutch team scored, the local people congratulated us. It was extraordinary to experience this.
On Wednesday July 7th we left for Mwanza by jeep. The airstrip in Sumve was out of use since 2008. It is now being used as the local Sunday market
At the Mwanza international airport we were picked up by Flying Medical Services (FMS). Pilot Esra and trainee pilot TJ had some problems to accomplish the necessary formalities. They had no stamp, no official passengers list, no flight number. In the end, after making up the information, we were allowed to take of.
We made a stop at Endulan airstripe, a Dutch general practitioner Frans was waiting for us with an 11 year old boy with a painful right ankle. He was known with osteomyelitis of his left femur. There was no X ray of his right ankle. We decided to take him and his mother along with us to Arusha for further diagnosis and treatment. We flew over Serengeti, but I was airsick again and could not enjoy the splendid views.
When we arrived in Arusha, we were taken to the FMS base at Olkokola , there were 3 patients with X ray from the Olkokola Handicapped Training Center. After seeing these patients, we were picked up by Sarah (an occupational therapist from New Zealand) and brought to the plaster house. The local Orthopedic surgeon Kibira joined us and we did our clinic. The patients without the necessary X ray would be sent to Arusha Lutheran Medical Centre (ALMC) the next morning. After making the theatre schedule for Thursday we went to the Spiritan House. It had been a long and exhausting day .
Thursday we were ready at 7.15 to be picked up by Sarah for the ALMC, it was our first time in the ALMC. ALMC turned out to be a beautiful hospital. There were even automatic doors at the mean entrance (in a town where the electricity is regularly off)! In the theatre there was a lap top , all the patients operations were put in. There was also a storage room with sterile instruments and equipments. What a difference when compared with Sumve…
We operated on 7 patients ( femur osteotomy, Turco,releasing toe and fingers syndactylie, external fixation of femur/tibia, foot amputation). Between times we also saw new patients.
On Friday 9th july there were 6 operations (abdominal cicatrical hernia, foot/ankle osteomyelitis, osteotomy, tibiapen because of osteomyelitis, shorthening femur stump, and an achillestendon lengthening).
The evening was spend at Sarah and Jack’s house with a lovely meal, together with workers from FMS andcf30. the Jacobson family.
On Saturday we took a cab to the ALMC, the driver didn’t know the hospital, but we could direct him. When we were near the hospital, he said: “ Yes, the new Selian”. That is the name used by the local people.
After visiting the patients, Kibira drove us to the “old Selian”, where 2 patients were waiting for us: a man with an one month old comminucated pertrochanteric fracture and a lady with a 4 months old non union of a patella fracture. There were 2 sets of Dynamic Hips screws with a 4 hole plate and one screw of 90 mm and one of 100mm. There was no traction table available in the theatre, we had to operate the image intensifyer as well.
The lady with the patella fracture was also operated by us.
Around 15.30 there was a new patient with an ankle fracture with a dislocated joint, but we had to call it a day, because our plane back to Holland was leaving at 21.30 from Kilimanjaro airport. Kibira drove us back to Arusha, we collected our empty bags and suitcases. Sarah and Jack drove us to the airport, the trip seemed to take longer then usual. Was it because their baby daughter Kaisha was in the car as well?
All in all it was a valuable experience again. Due to the distance between Sumve and Arusha we were only off for 1 day during this 10 day journey.
Writen by: Gwen Liu