Urological mission March 2024

When you go with a small team, the impression is that organization will be easier, and that the person whose main task is to make sure the camp runs smoothly will be bored… and this is never the case.

There was the urology camp, but also the follow-up of the installation of the solar panels, and the usual headache of finding patients whose names change with each intervention (consultation, X-ray, operation, laboratory…) and the non-user-friendliness of the PACS (radiology archiving system).

As for urology, the pleasant surprise was that the equipment brought along years ago was still functional. The urologists, Prof. Thomas Gasser and Dr. Patrick Maurer, had also brought along a few necessary accessories.

Our disappointment was the absence of Dr Balaam Nkunda who, at the last minute, informed us that he was undergoing examinations in Tanzania, where he is continuing the urology training we sponsor. He promised to be present in February 2025,for the next urology camp.
Failing that, the young surgeon on site, Dr Daniel Izimba, benefited from the urologists’ training, the aim being to continue these operations in our absence.

We had the company of a young doctor, Andrew Kizito, who had just graduated, and who proved to be not only helpful but also brilliant and perfectly at ease in this new work context. He was referred to us by Mrs Eva Winizki, who chairs a foundation that helps young Ugandans for their education .(UECD : Uganda Empowerment and Career Development).

There were over 60 consultations and 43 procedures: 20 TURPs (endoscopic prostatectomies), including 2 with orchidectomy (castration because of prostate cancer), 3 open prostatectomies (prostates too large), 10 endoscopic urethrotomies for urethral strictures, including a young man sent to Kampala during the 2022 mission. Furthermore, 3 orchidectomies, a urethroplasty, a posterior valve repair in a 5-month-old child, a hypospadias operated on in a 15-year-old adolescent by the local surgeon, a bladder neck incision were also performed .
Priority was given to all patients with urinary catheters, whether bladder catheters (suprapubic) or urethral catheters.
Three biopsies were performed because of the doubt as to the presence of prostate cancer, and in radiology, 11 urethrogramms confirmed the need for intervention in 6
patients. One patient presented with bladder carcinoma and benefited from chemotherapy instillation (Mitomycin).

There were two failures: a 73-year-old patient with a stenosis of the urethra that was too proximal, and a 55-year-old quadriplegic patient with a skin fistula from his membranous urethra (below the prostate).

The urologists also benefited from the presence of a German anaesthetist who accompanies our camps, Dr Dieter Braun. He’s still frustrated by the state of the monitors, but seems to have come to accept the working conditions !!!!

And the explanatory post-operative flyers were particularly appreciated.

Daniel, Patrick Maurer, Thomas Gasser, David et Andrew

On our return, we had an appointment with Professor Frank Asiimwe, head of the department of Urology at Kampala University Hospital, Mulago Hospital: his main activity at present is the initiation of kidney transplants : The demand for dialysis is exploding. He is ready to collaborate with the Bwindi community hospital by sending young doctors there and accepting trainees into his team.
We were lucky because he studied in Tanzania, at the hospital where Dr. Balaam Nkunda now works.

On three occasions, the operations were interrupted by power cuts. Now, more than ever, with three rain-free days and unprecedented high temperatures, we know that our project for solar panel installation is justified.

Of course, there were some pitfalls: these panels had to be functional when we arrived and we were accompanied, for control purposes, by Mr. Tyler Bacciarini, the electrical engineer who helped us set up this project and had accompanied us a year ago.
As it turned out, not all the designated roofs could support the weight of the panels, and the waterproofing of some would be put to the test. So a location had to be found that would allow the residual panels to be installed on the ground, much to everyone’s dismay: this turned out to be a green space beloved by patients. What’s more, there was a delay in the delivery of the panels.

As of today, installation is finally complete and about to become functional.
We’ll be keeping a close eye on this, especially as our generous donors expect this follow-up.

In physiotherapy, everything’s going well! The premises provided for this purpose were stiflingly hot because they were built from containers… but that will be taken care of.. There’s a lot of work to be done there: disabled patients, post-operative treatments, retarded children… Diana and Jackie, whom we’re also going to sponsor, are much appreciated!

Jackie & Diana

Last but not least, there have been colloquia between radiology, IT and the installers of digital radiology in the USA…via WhatsApp, Zoom and TeamViewer (with schedules difficult to reconcile!) The aim was to install a more user-friendly archiving system…which has finally been achieved.

We still have to solve the problem of patient names…a symposium on the subject should motivate those concerned not to write names phonetically!!!!!

The next camp is scheduled for 2025, at the beginning of February.

The next orthopaedic camp is scheduled for October 2024…and we’ll miss Dr. Kohut!

FS April 2024