Comprehensive Report on the Outreach by Liberia Physicians and Surgeons Without Borders (LPSWB) in Collaboration with Hernia International UK at Bongmiles Hospital, Bong County, Republic of Liberia (26th–29th September 2024)
Introduction
From 26th to 29th September 2024, a team from the Liberia Physicians and Surgeons Without Borders (LPSWB), in collaboration with Hernia International UK, conducted a medical outreach at Bongmiles Hospital, Bong County, Republic of Liberia. The mission aimed to provide essential surgical care, focusing on hernia repairs and other general surgeries pathology to underserved rural communities. The outreach was facilitated by a team of highly skilled professionals from diverse specialties, committed to addressing the health needs of rural Liberia.
Team Composition
The outreach team included the following professionals:
- Dr. M. Peter George – Consultant Emergency, Rural, and General Surgeon
- Dr. Ayun Cassell III – Consultant Urology Surgeon
- Dr. Michael Kempeh – Specialist General Surgeon
- Dr. Onyekachi C. Subah – Specialist Transfusion Medicine & Public Health
- Dr. Seanan Subah – Specialist General Surgeon
- Dr. Arthur Wouh – Specialist General Surgeon
- Dr. Liveah Koheneh – Specialist Anesthetics Physician
- Dr. Ambrous Fawenel – Medical Officer in Surgical Training
- Dr. Younda – Medical Officer on Rural Surgical Rotation
- Dr. Alexandra Tokpah – Medical Officer/Medical Director of Bong miles Hospital
- Mr. Eric Cassell – Strategist and Financial Adviser
- Roger Corcor – Certified Scrub Nurse
- Momoh Sonnie – Certified Nurse Anesthetist
Objectives:
The primary objective of the outreach was to provide life-saving surgical interventions, primarily focusing on hernia repairs and other general surgical procedures, in a rural setting. Additionally, the team sought to:
- Alleviate the backlog of surgical cases in the region.
- Provide postoperative care and education.
- Train local medical staff to enhance surgical capacity in rural Liberia.
Arrival and Preparation
The team arrived at Bongmiles Hospital on the 26th of September 2024 and immediately began preparations for the surgeries, including patient evaluation, resource allocation, and surgical setup. The surgeries commenced on the 27th of September and continued through to the 29th.
Dr. Alexandra Tokpah and Dr. Younda were responsible for patient recruitment, ensuring all candidates for surgery were appropriately screened and diagnosed. They worked in collaboration with the local hospital staff to ensure seamless coordination.
Data Collection and Analysis
Throughout the mission, patient data was meticulously collected for later analysis. The following parameters were documented:
- Patient Diagnosis
- Gender Distribution
- Type of Procedures Performed
- Surgical Outcomes
- Postoperative Care
- Anesthesia Given
- Diagnosis Percentage Breakdown
- Procedures Performed by Each Surgeon
Analysis of Findings
- Patient Diagnosis
Patients were screened and diagnosed for various conditions, primarily focused on hernia repairs. Other diagnoses included hydrocele, lipoma, and soft tissue masses.
2. Gender Distribution
- Male: 81%
- Female: 19%
The significant gender disparity reflects the prevalence of hernias in male patients.
3. Type of Procedures Performed
The majority of surgeries were hernia repairs. Other surgeries included:
- Hydrocele repairs
- Lipoma excisions
- Soft tissue mass removals
4. Surgical Outcomes
- Successful Surgeries: 100% of all surgeries had a positive outcome with no complications reported.
- Complications: No complications were noted.
5. Postoperative Care
The postoperative care team, led by Dr. Liveah Koheneh and Momoh Sonnie, ensured that patients received appropriate pain management, wound care, and follow-up consultations. No cases of postoperative infection were reported after 2 weeks.
6. Anaesthesia Given
Dr. Liveah Koheneh, the Physician Anesthetists, was responsible for administering anesthesia. The procedures were carried out under:
- Local anesthesia: 11%
- Spinal anesthesia: 76%
- General anesthesia: 11%
- Unknown: 2%
The choice of anesthesia was based on the type of procedure and the patient’s condition.
7. Procedures Percentage
9. Procedures by Doctors
The above distribution highlights the contribution of each surgeon to the success of the outreach.
10. Nurse Anaesthetics
Conclusion
The medical outreach at Bongmiles Hospital was a resounding success. The collaboration between Liberia Physicians and Surgeons Without Borders and Hernia International UK resulted in the successful treatment of numerous patients, many of whom had been waiting for surgical intervention for months. The outreach not only alleviated the surgical backlog in Bong County but also provided valuable training and experience for local medical personnel.
Recommendations
- Continuous Outreach: There is a need for ongoing surgical missions to rural areas to address the unmet surgical needs.
- Capacity Building: Training local healthcare providers will enhance their ability to handle such cases independently.
- Data Utilization: The collected data should be used to plan future outreaches and improve resource allocation.
- Post-Operative Follow-Up: Future outreaches should incorporate long-term follow-up plans to monitor patient recovery.
The outreach team would like to extend their gratitude to Hernia International UK, Bongmiles Hospital,Ministry of Health ,Liberia Medical and Dental Association LMDA and the local community for their support in making the mission a success.
Prepared By
Dr. M. Peter George (MD, FACS)- Team Lead