FOFH General surgical mission

27/09/2012 – 08/10/2012

This was our second general surgical mission and more intense. There were more people in the team and a lot more could be achieved in a short period of time.

OBJECTIVES

Teaching

• formal lectures
• Hands on teaching in theatre
• Teaching during ward rounds and clinics
• Informal teaching based on the cases seen in the wards or being operated on.

Surgical procedures           

Performed both routine as well as complex in nature.

Other procedures such as laparoscopic were done so that the local surgeons can start doing the procedures which will enhance patient outcome.

Respite                        

Local surgeons are overloaded with work and they were appreciative of our input, both in taking patients off the waiting list and teaching them new surgical techniques.

The day usually stared at 07:00 hrs with pre and post op checks on patients and also seeing patients admitted acutely where the local surgeons needed support and opinion regarding the patient’s management. This also included formal hand over of patients admitted overnight.

The day usually finished around 19:00 after finishing the surgery and post op checks.

Over the 5 days the surgical team were able to do 28 operations with included some very complex and others routine procedures. We were fortunate not to have any surgical complications from the operations performed. All 28 patients were pleased to have had their operations done. This could only be appreciated with smiles on their faces the next day.

Meals

We were grateful for Lautoka Hospital to provide lunches – the team organised breakfast and dinner. We were grateful for Amrita to organise this through her sister from Monday to Wednesday and Ranjini on Thursday.

Volunteer group

Avinesh Kumar - general surgeon whose skills and experience was invaluable. His commitment to care of patients made the trip worthwhile.

Rishi Ram – General Surgeon.

Reta McLeod – Anaesthetist who was very experienced and capable. She was able to look after patients as the situations arose. A good example was when we were operating on an undiagnosed pheochromocytoma, which usually is very challenging, and even more so in Fiji, with limited resources, she was able to manage the patient so that the procedure to remove the growth could be done in a safe manner.

Jo Dunstan & Tara Mudgeway, both very experienced theatre nurses were able to work together with the local staff and keep the theatre running smoothly although sometimes very challenging. There was general lack of gear but they were able to improvise and come to a solution. Without them I believe the smooth running of theatre may not have been possible.

Amrita Kumar and Ranjini Ram both GP’s worked equally hard in their own subspecialties. They were able to achieve a lot during the short time especially with Pap smear and general primary care education. They were also instrumental in organising the evening food during the week.

Heather McAlley, neonatal intensive care nurse was able to provide valuable education to the local staff in day to day care of sick or premature babies. She was also able to send some supplies to the hospital which was greatly appreciated.

SUMMARY

Overall the visit was very good which was made better with the good team we had. The experience was very humbling and satisfying especially seeing the patients’ after surgery. The smiles on their faces made other issues insignificant.

Given the limited resources and the organization running on generous donations from people and fund raising we were able to achieve a lot.

I will be keen to do this all over again.

Rishi Ram