On Sunday, November 12, Peer Poelmann (orthopedic surgeon), Wouter Jurgens (plastic surgeon), and Pieter-Stijn Haen (orthopedic surgeon) departed for Tanzania. After an overnight stay in Zanzibar, we flew on the next morning, November 13, to Arusha, where we were picked up and taken to Selian Hospital. We were warmly welcomed by Dr. Robert Maise and his colleagues. After confirming and collecting our registration, we were given a tour of the hospital, where we saw the wards, operating theaters, radiology department, and outpatient clinic.

It was time to get the outpatient clinic started. We were supported by the surgeon and two medical residents who helped with translation and the use of the electronic patient record (EPR). The outpatient clinic was initially quiet, but that soon changed. A notice had been published in the local newspaper, and two child rehabilitation centers were informed of our visit. Many children came from The Plaster House, which allowed us to efficiently run consultations and select many children for surgery. There were a striking number of children with skeletal fluorosis, a condition caused by excessive fluoride in the local groundwater, which is not recommended for drinking. This leads to deformities and rotation, particularly in the legs, making it difficult for these children to walk. One girl had broken something eight years ago and had since been in a wheelchair, causing her knees to be bent at about 90 degrees and preventing her from straightening her legs, as she hadn’t done so for years. There were also a number of young children with clubfoot. Additionally, there were many children with old fractures that had healed incorrectly. For the plastic surgeon, Dr. Jurgens, there were many patients with contractures after burns, as well as children with cleft lips. After a warm lunch and a full day of work, we had filled three operating days across three operating rooms. Unfortunately, due to a lack of time and resources, we couldn’t help everyone. Once a patient was selected for surgery, admission was arranged, and they were referred to the anesthetist for further examination and blood tests.

Every day at the hospital began with a service for the staff at the local church. On November 14, we attended the service and were welcomed and introduced to everyone. We then went to the operating complex, where we were welcomed again. Dr. Jurgens operated alongside the surgeon, performing many cleft lip repairs as well as extensive skin grafts and contracture corrections. Dr. Poelmann and Dr. Haen operated in two other operating rooms, handling complex cases together. In Selian, we mainly performed corrective osteotomies (realignment surgeries) on children’s legs, which were then placed in plaster. In some cases, the plaster had to be reinforced with a stick. The date and the number of weeks the plaster was needed were written on it, making it clear for the local doctors and nurses how long it should remain on and when it should be removed. Afterward, we visited the operated patients.

We repeated this on November 15 and 16.

After a weekend to recover from work, we traveled to Mwanza, a city of millions on Lake Victoria. We were picked up and taken to Sumve, a small town outside Mwanza, to a small local hospital. In Sumve, we were received by Dr. Charles Petro. The hospital in Sumve was significantly smaller. It had announced our visit in the local newspaper, and patients were informed of our arrival. The waiting room was packed, and we immediately got to work. In Sumve, there were notably more children with untreated clubfoot. Again, many children had cleft lips, untreated fractures, infections, and burn injuries. After a day of consultations, we had filled three full operating days again. We even performed some combined surgeries (plastic and orthopedic surgery), which was highly valuable and improved the quality of care. This allowed us to help some children we otherwise wouldn’t have been able to assist.

In total, we were able to help just under 50 children at Selian and Sumve Hospitals. The patients and local colleagues were all very friendly, cheerful, and helpful. We felt incredibly welcomed, and it was immensely rewarding work to do. We would love to return again.

Peer Poelmann, orthopedic surgeon
Wouter Jurgens, plastic surgeon
Pieter-Stijn Haen, orthopedic surgeon