We prepared for this mission with some trepidation: we were afraid that there would be problems with the X-Ray equipment that would prevent us from carrying out radiological examinations. At the time of our departure none of the X-Ray equipment was in working order.
The machine that we had taken to Uganda in 2013 and which Phillipe Besson had brought to life, had been banned from use by the Atomic Energy Council, due to erroneous radiation measurements.
The second mobile X-Ray machine, essential for examinations in the operating theatre, had suffered a burn-out of its capacitors in January.
Shortly before our departure, we had two very welcome surprises:
The first surprise came from Dominique Schmid, who had accompanied us on our mission in March 2018. He found an identical discarded mobile X-Ray machine in the basement of the Cantonal Hospital and thanks to Samuel Grenier and a Siemens engineer, we were able to extract its capacitors, and take them with us. (3 x 11 Kg !!!!)
The second surprise was the decision of Philippe Besson to accompany us for 4 days to try a repair the machine that no one in Uganda had been able to fix. With his magic hand, Philippe was able to make both machines work perfectly, and, in addition, he was able to update three mobile ultrasound devices.
X-rays images have now reached a new quality level thanks to the work of Samuel Greiner and the on-site nurse Moses, who acts as a radiographer.
Aside from the problems with the X-Ray equipment, the goal of this mission was to build on the orthopaedic work started in 2017: to consult new cases, to review the progress of patients from previous operations, especially those suffering from osteomyelitis, and to operate on as many patients as possible with the help of local doctors. This work was reinforced by occupational therapy.
Ana had 47 patients undergoing occupational therapy, ranging in age from four months to 83 years and many patients had been spontaneously referred to her without prior orthopaedic consultation. She was seconded by Diana, whom we will now support for a course at the school of physiotherapy. She was able to make use of the previously acquired somewhat modified sewing machine.
We also had an orthopaedic sole made by local craftsmen for a young man with a shortened leg. We also had the chain repaired on an abandoned tricycle in order to use it for the re-education of some children.
Thanks to the work of Dr. Laurence Grueber and an excellent pre-mission organisation by the local staff, we were able to carry out a total of 111 consultations in addition to the examination of patients previously hospitalised and those urgent cases that were admitted during our stay: The “boda boda” (motorcycles) are more and more numerous and serious accidents on public roads have risen markedly.
We were able to increase the number of operations performed by Dr. Grueber and Dr. Kohut to 40, including 17 interventions on children, 8 on young adults and 15 on people over 30.
During these operations anaesthesiology was provided by Dr Katrin Flückiger, and Géraldine Bégué.
Multiple small but vital, repairs to the operating theatre equipment have been carried out by Antonio, who acted as a scrub nurse, and for whom one of whose missions is to find a suitable sterilizer for the operating room.
There are always more and more cases of osteomyelitis, 5 patients returned for a control and they are well ! Unfortunately, Darius the one we were really looking forward to, did not show up!
Six new cases were treated, as well as two cases from 2018. Treatment both pre and postoperative was supervised by Dr. Boscacci. We were able to benefit from laboratory services by sending samples and receiving results from Mbarara so as to ensure correct post-operative treatment.
And there are always axis corrections to be made for small children.
There are patients who arrive, with neglected unconsolidated fractures, and many serious wounds. The acquisition of the dermatome made it possible to perform several skin grafts and the technique was taught to the local doctors.
A number of patients showed up as emergency accident cases and were also treated.
Unfortunately two patients had to undergo leg amputations, one due to gangrene of vascular origin and the other, a paraplegic young woman with an intractable infection.
We again saw patients E. and A., the two badly burned children who benefited from the money received from the “Givengain” crowdfunding program and the money raised from the 80 km of hope from Maxence Reynard and Delphine Grognuz. The patients are well and can move their arms. E. can also move his head.
A. still has his neck blocked but in a position more suitable for daily life, as his head is now upright. The results of ongoing physiotherapy will determine the need for further surgery
Finally, we enjoyed the presence of Nathalie Jaquet, a teacher, who enthusiastically worked in the school for Batwa (Pygmy) children. The school is supported by the Kellerman Foundation.
On the last day, the debriefing meeting led to the identification of some issues that we hope will be partly resolved during our next mission in March 2020.
This camp was a huge success with the number of patients in care, the prior organization of the local team and its active participation in all our activities. Radiology work was efficient thanks to the unexpected arrival of Philippe Besson, whom we all thank.