Working visit Uganda, jan 2024

Working visit Uganda, jan 2024

From January 24 to 31, a team of plastic surgeons went on a working visit to Uganda. This time it was Margot van Lemmen, Peter Houpt and his daughter Marthe who were committed to do this on volunatary base. You can read their report here below.

On January 22 we flew from Brussels to Entebbe and on January 23 we rented a RAV4 car, silver this time. The air conditioning actually worked and we had no problems along the way. On Wednesday, January 24, we were warmly welcomed by Dr. Pamela. She had lost a lot of weight. That was because of the hard work, she said. There were already many patients waiting for us at the outpatient clinic.
Patients who had been admitted for plastic surgery were also there. They had already been selected by Dr. before our arrival. Steve, the clinical officer orthopedics. In total, we performed 37 consultations at the outpatient clinic in the 6 days, of which we operated on 35 patients in the following days. Unfortunately, we still performed the operations in the emergency operating room, because the building with the new operating room had not yet been furnished. There was not enough money 🙁 

During the operations, sterility was questionable because the patients to be operated on walked directly with dirty feet into the operating room. Peter made a typical comment about the staff (a scrub nurse): “It looks like she was taken straight from the land!” Some had no idea what the intention was, and as far as sterility was concerned, it was better to look away… On the last day, Francy and Daphine got settled in. The anesthesia was well taken care of. The first day Irene was there, very caring, attentive  and thoughtful as always. She currently works 2 weeks in Kitgum and 2 weeks in Kalongo, where her family lives. But unfortunately her mother became seriously ill the next day and she had to go to Kalongo. Her mother died a day later 🙁 For us it was nice that our well-known, cheerful Bishop Peter was available in the following days. We could not operate on 2 tables at the same time, except a few times with spinal anesthesia or local anesthesia. But anyway , better one than none!

The donated items from June 2023 were all in good condition. We again benefited greatly from the diathermy and the Humby knife. It was good that we brought a lot of stitches and bandages with us. We used a lot and left the rest behind. They were also happy with our clogs afterwards.

The operations we have performed on our patients:

4 Cleft palate operations (1 of which was bilateral)
1 AV malformation upper lip
1 PBC entire neck front and left, FTG + Z-plast
1 PBC burnt hand release, Groinflap+FTG
13 PBC fingers hand: release with FTG
3 PBC thumb  Z-plasty
1 PBC wrist, release + FTG
2 PBC elbow Z-plasties
1 PBC foot plantar, release + FTG
4 Amputation of toes/fingers
1 PBC Buttock  Z-plasty
3 Open wound with SSG of ankle, dura and foot
2 Keloid Christmas ball earlobe excision/closure with local anesthesia
1 Hypospadias Duckett repair
1 Meatus stenosis: expansion surgery
1 Tumor (NF?) foot

A baby with a cleft palate was still too young to operate, only 5 weeks old. Marthe (mother of Boris 3.5 years old and Max 1 year old) bought, with Pamela’s permission, a hand-operated breast pump and a can of baby food, so that the baby could be fed with a bottle with a long teat (Habermann). Pamela herself was also confronted with her fourth child with the same problem, so she knew well the importance of this. In Uganda, only breastfeeding is accepted as baby food, even by nurses! If the mother is unable to breastfeed, the baby has a major problem. Marthe, together with Pamela, provided information in the maternity ward about bottle feeding, and explained that it is just as healthy as breastfeeding and that the father can also provide it. Marthe has made a manual with photos about “How to make a bottle of milk” and it is now hanging in the maternity ward.

Pamela and Marthe immediately got along very well. And Marthe wanted to do something for fire prevention, in connection with the many patients we saw with contractures after a burn! Pamela was immediately enthusiastic and gave her the login code for her computer, so that Marthe could get started, resulting in a beautiful poster, both in English and in the local language. Then there are 1000 posters and 1000 flyers by Marthe and a health worker Susan, spread across the many villages around Kitgum. The message is kept very basic and simple. For us it makes perfect sense to cool a burn with water, but not at all for the Ugandans, they urinate on it or put herbs, grass or toothpaste on it! Marthe heard nuns singing somewhere: Cool Cover Call; Cool Cover Call! That’s the slogan on the poster. Amazing, right!

Poster Burn Awareness.pptx

Flyer burn awareness

On January 27 and 28, we first visited all patients. Then we went to Murchinson Falls for the weekend, both during the outward journey from our car and during the boat trip we were lucky: we saw a lot of wildlife, many elephants and giraffes. Beautiful!

On Tuesday, January 30, Peter Houpt gave a very successful presentation about the most common plastic disorders in Uganda: how to close a defect, hand surgery and microsurgery, cleft palate and cleft lip with nutritional advice. And burns were also discussed again, with attention to the required operations and what you can do to prevent these types of operations. It was held in the OPD and all benches were occupied. Pamela had invited all the staff. After singing and prayer, accompanied by piano, Peter could begin. Then there was discussion and words of praise from Pamela.

On Wednesday January 31st during a visit, we were able to unpack many of our patients’ wounds and we were enthusiastic about these early results. Steve will again provide aftercare to our patients, as he did last year in June, with photos and videos so that I can instruct him again via WhatsApp on how to treat and how to get the patient to exercise.

Peter, Marthe and I enjoyed working at the St Joseph Hospital in Kitgum. The Bomah Hotel is also a nice place to settle down in the evening, the chef did his best for us, his pizzas were delicious, as were his curries.

best wishes from
Peter, Marthe and Margot

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