Plastic Surgery Camp March 2012 (Nigeria)

Report by Hanneke Tielemans

Members of the team:
Drs. Cees Spronk – leader of the team and plastic surgeon
Drs. Ina Groustra – anaesthesiologist
Drs. Jan Hochtritt – plastic surgeon
Aafke Lautenbach – assistant anaesthetist
Annet Brouwer – operation assistant
Femke Annema – operation assistant
Drs. Hanneke Tielemans – doctor preparing to become a specialist in plastic surgery

After a quiet flight we arrive in Abudja on Wednesday 7 March. The African heat, odours and chaos are irrefutably present. The first night we stay at the “Sisters of Devine Love”, an excellent place as the name suggests. The next morning we leave quite early: in two buses we drive to Mangu. After some breakdowns and a nice stop with fresh Coca-Cola under a mango tree, we arrive in Mangu at four o’clock. Even our underwear contains dust by now, so therefore it is great to freshen up. The temperature in Mangu is agreeably warm, but definitely not sultry. There is only electricity at night and in the evening between 7 o’clock and half past ten. There is no running water. The water basins in our homes are filled daily by hand.

Lots of luggage! Materials are brought from the Netherlands. On Friday we rise early, have breakfast and at eight o’clock we go by bus to the hospital where we see a large number of patients. Again African chaos… Scores of people are waiting for the screening. During the entire mission the people’s cordiality is remarkable. People greet us, laugh and ask us if the job goes well. When one of the plastic surgeons returns from the toilet he is asked if he managed… On Friday we unpack the material, install our materials in the operating theatre and screen the patients. We see a great variety of indications that need operations: contractures caused by burns, scars and deformities after traffic accidents, cleft palates, tumours, hypospadias, etc. etc. When planning the operations we realise that there are many patients. That is why we decide to start operating on Saturday.

Breakfast is substantial and is different from what our Dutch stomachs are used to early in the morning: fries, donuts, French toast, pan-cakes, etc. A good start indeed! Saturday afternoon it is time to relax and acclimatise. Sunday morning we attend a lively sermon in church. The Interplast-group is introduced to the locals and we join the dancing! Because of the troubles (i.e. the bomb attacks) in Jos we decide to stay near the hospital and guesthouse in our leisure time. Next morning we are told that this Sunday there were troubles again. The little leisure time is spent near the guesthouse.

Weekdays generally look like this: breakfast at 7.30. At 8.00 we leave for the hospital, 8.15 the first plastic surgeon starts in the operation room and the second plastic surgeon sees patients. Lunch is at 13.30. Somewhere between 17.00 and 19.30 the operation programme ends and then we return to the guesthouse. On Saturday morning we check patients and on Sunday morning we go to church. The numbers of operations are: cleft lips and palates 6, urogenital problems 7, fresh burns 1, post burn contractures 53, ulcers 1, others 30. Total 98.
For all the children that need operations the anaesthesiologists brought a small present and ‘Bravery Certificates’. After one day it turns out that adults appreciate such a certificate as well… Nurses are told when somebody has not received one! This means that from now on everybody will receive a ‘Bravery Certificate’. The team cooperates well and the atmosphere is good. The operations are successful and one case will not be forgotten easily: an eleven-year-old child with a large ulcer-tumour on the head. We see her in the policlinic and have to choose between doing nothing, which probably means that she will soon die, or operating upon her with the limited means we have. We decide to operate. During the operation we are faced with a reanimation-setting, but because of our good cooperation and the excellent leadership of anaesthesiologist Ina it turns out well. Next day we see the girl’s mother breastfeed her again.

The last day we have some nice activities: Annet will teach hygiene and prevention of infections and we will hand out the certificates. Those who have to step forward are very proud to receive their Interplast Certificate! This mission is very informative for all of us. Fortunately we have a great deal of laughs as well! On the last evening we have a farewell dinner with invitees, during which we are extensively thanked for our efforts. We are happy and satisfied when we board the bus next morning on our way to the plane. A fantastic mission! And we hope that many missions are to follow!

Hanneke Tielemans
doctor preparing to become a specialist in plastic surgery