MEMORY OF THE MISSION CARRIED OUT FROM 19 TO 28 APRIL 2018 BY “CIRUJANOS EN ACCIÓN” IN THE “ESTHER & JERELINE MEDICAL CENTER”OF GANTA CITY (LIBERIA)
The Ganta City (Liberia) mission was proposed several months in advance, and from the start it was a wonderful challenge: for the majority of the members of the team (except the lady anaesthetists) that was our first visit to Africa. The team was finally made up by 9 members:
César Ramírez (surgeon and team coordinator), Javier Moreno (surgeon), Elena González (surgeon in residence, 5th year), José Pradillos (paedriatric surgeon), Inma Giménez (anaesthetist), Ana López (anaesthetist) plus Paco Gomez, Sara Corredera and Verónica Fernandez. On April 19 we started each from his or her city (Málaga, León, Valencia and Murcia) and we met in the Casablanca airport to take our Air Maroc flight and its 23 hours to Monrovia. Then after a 4 hours flight in a commercial plane with unbearable heat, we reached Monrovia at 2.25 a.m.
We found waiting for us the Medical Director of the Esther and Jereline (E&J) Medical Center and alma mater of the local mission, Dr. George, and the highest authorities of that center. The Monrovia airport is small, all up-and-down, and lacking even the minimal conveniences of safety and luggage control, with a single customs with works with utter laziness. In this mission we’ve had no problem with our luggage (10 bags 30 Kg each, including a generator for electrical scalpel) thanks to the help we got at the Málaga airport from an Air Europa pilot, Nacho Ballesteros, personal friend of Dr. Javier Moreno, who worked hard to get everything properly done. For Verónica, Sara and Elena this was their first mission with “Cirujanos en acción“; the rest of us had already taken part in previous campaigns.
The way from Monrovia to Ganta City takes almost 4’30 hours along a rudimentary commercial road, and we occupied 3 local lorries that Dr. George books for us for all our stay in Liberia. Our lodgings in Ganta City are in a small guesthouse called Jackie’s Guest House where we have been able to choose either individual or shared room; that is the best available in the city and we have hot water, air-condition and a “tex-mex” meal, more than acceptable, which does for breakfast and supper “in situ”, and is taken along to the E&J Medical Center at lunch time.
There is absolutely nothing worth seen in Ganta City and no possibility for any excursion to touristic places, so that our days had been intense and very repetitive. Every morning we met at 7.30 a.m for breakfast, and half an hour later they took us to the Medical Center. On arrival we found a group of patients (children and adults) who had been called by the local doctors so that we would evaluate them.
Daily one of the surgeons of our team and the paedriatic surgeon had a small room in which we saw the patients, examined them selected them for surgery. No pre-operation information has been asked by us, and the patients (children and adults) have been operated after the surgical evaluation.
The E&J-MC is something similar to what in Spain could be a small ambulatory with two operation theaters whose sterility conditions are just basic, and then a small room for patients had been arranged for a third operation theater. We have practically no material as it is a medical center in which only caesarians are performed, and now they are just beginning to carry out some caesarians as acute appendicitis.
Though there are respirators in the operation rooms they cannot be used because there is no oxygen; thus when general anaesthetic with breading help is required for some patient, this has to be ventilated by hand by the anaesthesist.
We had brought 3 whole sets of surgical material to operate hernias and one for paediatric surgery which we donated to the E&J-MC when the mission was over. We have fully utilized the more than the 300 Kg of surgical material we had brought with us, as they hardly have any gloves, gauze, antiseptics, sterilized gowns, sterilized fields, dressings (in fact since our coming, they have made use of our material for their surgical needs). Similarly we have taken their and the donated to them more than 200 boxes of omeprazole, paracetamol and analgesics for their use in Ganta City.
During the mission a total of 175 patients have been operated upon (83 children and 112 adults) with 249 surgical interventions. In 74 patients (almost a 40%) several 2 or 3 processes have been carried out. We have been struck by the amount of patients with inguinal hernia who associated umbilical hernias of at least 1.5-2 cm, and all the more as the majority were young, thin and with apparently good mussels. We have utilized 80 mosquito net gauzes donated by Hernia International and about 100 large opening and low molecular wait which had been donated by BBraun; we had enough and to spare. The patients remained for a night (the hospital has some common rooms for 3-4 patients and then one large common hall for men and another for women, were at least 20 patients could be accommodated. They were revised by us early each day to be able to release them and realize that there was no problem. A patient operated upon for an epigastric hernia had to be operated again for an important hematoma on the first day after the operations, and 4 patients have presented minor postoperation scrota hematomas which have needed no intervention. For a personal petition of Dr George we operated upon two young women with evident symptoms, who otherwise they wound have never been healed.
The medical and administrative authorities of the E&J Medical Centre have been most help from the start. We have received all kind of help, and all have tried to make us happy. On our arrival and farewell we were received with local songs and prayers by the local people, and as a special thanksgiving they have gifted us clothes with local motives which we’ll keep with all love. They have repeatedly asked us to come again as soon as possible because they are very much in need, and we surely will do it as it has been an unforgettable mission.