Author: akingsnorth

Puente Piedre Hospital, Lima, Peru. June 2014

Team members: Dr Arun Baskara (Team Leader, surgeon from USA), Dr Ramon Soliva (surgeon from Spain), Mr Magdi Hanafy (surgeon from UK), Mr Michael Kelly (ST5 registrar from UK), Mr Shahab Khan (ST6 registrar from UK).

The Hernia International trip to Peru was wonderful and it was quite a humbling experience. We (Dr Ramon and myself) were received by Dr Jaime Herrera (who had made all the local arrangements to host the team) late in the night (or early morning) and his hospitality was amazing. We went to his home the next day and spent time with his family. It was so sweet when Dr Herrera’s little kid gave me and Dr Ramon a Father’s day card; I didn’t miss my daughters  on that day.

Our stay at the hostel was comfortable. We were assigned to stay at the 5^th floor. Though there were no elevators, the hotel personnel helped us to get the baggage to our rooms. They were very courteous and helpful. They brought breakfast to our rooms and it was a different experience.

We all were received at the Puente Piedra Hospital by the hospital Chief of Surgery, their CEO, and the surgeons working at the hospital. Every one of them were kind and again their hospitality was immaculate. The cases for the day were on a list and our team divided the cases among us on daily basis. The OR staff were kind, helpful and their enthusiasm in helping us amazed me. I wish I could have learnt more Spanish before landing in Peru. The flow of cases was good and I got the opportunity to teach the Surgical Residents. I could see that they are well ahead of the curve when it comes to hands on while doing the cases. Some of the cases were complex but doable. The lunch at the cafeteria was great and the hospital was kind to provide us lunch free of cost. The Chief of Surgery was there every day with us during lunch hours and made sure we were fed well.

Two weeks flew by in the blink of an eye. I felt a lump in the throat on the last day of our surgery when the thoughts of leaving that place crossed the mind. I appreciate Dr Herrera, Dr Miguel & Miguel (Two Surgeons), the Chief of Surgery and all other Surgeons, Staff, Students, Residents, hotel personnel for all their help and hospitality  which made our stay a pleasant and humbling experience; and thanks to our team as well.

I am looking forward to do more work in Peru during the coming years.

Thanks for arranging this trip, Hernia International.

Arun Baskara

Hernia International in Pakistan, March 2014

Team Members: Andrew Kingsnorth, Alan Cameron, Shambhu Yadav, Vernon Sivarajah, and Penny Howell (anaesthetist)

 As a destination for Hernia International, Pakistan’s reputation for terrorism, corruption, poverty, overpopulation and illiteracy did not seem promising. However my fears were allayed after attendance at a fundraising gala in Birmingham to support the Bewal International Hospital (BIH) in the Punjab – our host hospital. BIH is an extraordinary venture and based on £2m donations from Overseas Pakistanis mostly originating from the Bewal area. A modern, well-equipped facility has been built on the Pothohar plateau on which Bewal is situated. The plateau is fertile being situated between the Jhelum and Indus rivers which spread their muddy waters over the terrain in the monsoons. Wheat, barley and sorghum are grown in abundance. At this time of year the fields are a  green patchwork of terraced plots, which will be ready for harvest (manually) in just one month’s time. Shortly after the harvest the temperatures will rise to 40 degrees until the monsoons arrive in August. 

Our mission was meticulously organised by Atiq Rehman, an ex-patriot Pakistani who had relocated from Bewal about 30 years previously and who currently practices as a vascular surgeon in Dudley. Atiq had been largely responsible for the design, building, equipping and staffing of BIH during the last 3 years, and its coming on-stream as a community hospital, but with 2 operating theatres ready for use when the opportunity arose – enter Hernia International for a 5-day mission during 1-9 March!  

Bewal town is a typically chaotic, unplanned Asian town where street traders line the extravagantly potholed and undrained, metalled road on which traffic rules are absent and the main form of travel is tut-tut or a motorbike-for- four. In early March the mornings are bright and fresh (temperature about 5 degrees) and the atmosphere is bracing. We were housed in Atiq’s uncle’s spacious and vacant house about a mile from BIH. We had the luxury of a cook and housekeeper to energise us for the 10-hour working days. We had the choice of an invigorating walk to the hospital either through fields and past villagers’ houses and livestock, or through the town as it awakened and struggled to work, and children strolled happily to school.

Local members of staff supporting us included a theatre tech (Ashiq), and several nurses and a gynaecologist who doubled up as ward, OR and recovery staff. Surgeons doubled up as operator, scrub nurse and assistant. An exotic mix of supplies was brought by the team and provided by the hospital, all of which proved to be more than adequate for the 59 patients (with 66 hernias) that were treated. Several junior registrars from Rawalpindi Medical College attended during the week for hands-on tuition. Andrew lectured at the College and performed an operation on the Mother-of -all-hernias (4 hour job) at the Benazir Bhutto hospital.

The week was rounded off with a day spent in the capital city of Islamabad – a scenic, green and calm city planned and built in the 1960s, with a backdrop of the Margalla Hills National Park. After visiting the vast Faisal Mosque, we had lunch in a restaurant overlooking the panorama of the city below, before a tour of the Pakistan Monument at its imposing best, at dusk.

It was a great adventure, and no doubt we will be back.

Andrew Kingsnorth