This new mission is a continuation of the one we undertook a year ago, i.e. the training of local doctors in endoscopic prostate surgery, but also the evaluation of the energy needs of this bush hospital, which is constantly growing and whose equipment is now that of a small hospital in our country… hungry for electricity!
The training in urology was carried out by Professor Thomas Gasser.
and Dr Patrick Maurer from Basel.
assisted locally by one of the surgeons on site, Daniel,
the surgeon Balaam Nkunda, whom we will support in his training in urology in Tanzania (two years), and a guest, Dr Nabymania, who works at Mulago University Hospital in Kampala.
A German anaesthetist, who plans to work in the hospital, also attended the camp.
There were 64 consultations leading to 40 operations:
– Twenty-two transurethral prostatectomies (TURP) were performed with and by the local doctors as part of their training in the method.
Two patients had to be re-operated, one for urinary retention and the second, for whom this was a repeat of a previous failed procedure. The latter was not helped and will unfortunately remain dependent on a cystostomy for life.
– Two radical prostatectomies were performed in patients with very large prostates, which could not be treated transurethrally. The six patients known to have prostate cancer also underwent orchiectomy, as testosterone production by the testicles is a factor that aggravates the cancer. No other treatment is currently available locally.
– 6 patients had to be operated on for urethral stenosis: a failure in a young patient, previously operated on for a major pelvic fracture, led to his being sent to Kampala to a specialised centre which has the equipment we lacked locally.
This case is similar to the two young patients sent to this centre a year ago. One of them is cured; the second is on the mend after operations that proved complicated.
These young people have their expenses paid by Africomed
– 4 children were operated on by the local team (cryptorchidism, inguinal hernia and hypospadias).
We bought a dose of antimitotic for an 85 year old patient suffering from bladder cancer.
The two Swiss urologists brought equipment including an optic (was broken) and a new generator which is being donated.
A special acquisition was made in the form of 4 pictures painted by a local artist: these pictures will be part of a flyer to be distributed to prostate cancer patients to help them understand the aftermath of the operation.
There were interruptions on the last day in the theatre and in radiology: the stability of power output was involved!
And this leads us to the other goal of this mission!
For years, the biggest weakness of the hospital has been the instability of the electricity supply, the national grid, being unreliable: the numerous donations of equipment requiring electricity did not help, but there is no other way today to ensure a hospital development. Several projects have been put forward but have not been realised because of the budget required. Since 2013, the hospital depends on a micro-dam built by a German company and supplements the lack of energy with two generators.
We went with a young electrical engineer, Tyler Bacciarini, who works for one of Switzerland’s largest energy providers (Primeo).
He will be helping a young engineer from the Fribourg School of Engineering to support his Masters about how to address the energy shortage and instability at the Bwindi Community Hospital.
Tyler spent a week working on what we now call the “power project”: meeting with an engineer who could develop the dam and with SolarNow who are proposing a photovoltaic panel solution. He took measurements of consumption and consulted the available data (far from always clear!).
Both projects are serious and make sense, but the budget is enormous. $100,000 for the extension and repair of the dam and 120,000 for the solar installation.
Now is the time of prioritising and finding the funds……..the hospital can find about $10,000.
This project is perhaps our greatest challenge! but it is becoming indispensable when faced with the continual breakdown of the equipment used on site.
Other news: The hospital has received the donation of a new fixed X-ray machine and a portable one, both digitised… The great advantage is that we no longer must use expensive film and chemicals to develop the images. The disadvantage is the fragility of the equipment in unstable electrical and high humidity conditions
The conventional machine we brought in 10 years ago is broken down again but probably repairable…it is a matter of preserving it as much as possible.
Fortunately, the C-arm, which allows easier operations in the theatre, is still working.
In preparation for the return of Diana, who is finishing her training, the construction of a physiotherapy room will be completed in May.
and Dr Asaph Owamukama, whose training in orthopaedic surgery we supported, is also returning in May to take on the additional role of hospital director. In Uganda, only a doctor can hold this position!
Our next missions are already scheduled: Orthopaedics from 31 September to 15 October and Urology from 9 to 24 March 2024.
FS March 2023