Following the Arusha Hub visit; Greg, Mark and Mugisha then travelled to Mwanza for what was to be an incredibly rewarding and satisfying time in Bugando Medical Centre (BMC). Not only were we welcomed warmly and incredibly well looked after, Dr Ahmed Binde had worked extremely hard to ensure a full and extremely well organised programme.
BMC is one of the largest hospitals in Tanzania. The correspondingly sizeable general surgical team is headed up by the inspiring Dr Vihar Kotecha. With 12 specialist surgeons, 5 residents and 2 registrars, plus theatre, ward teams and students, it was the biggest induction we have run to date. Our initial trepidations around pitching it to the right level were quickly settled as we flexed the programme to accommodate. There was a lot of excellent discussion during the ‘chalk and talk’ elements which were enjoyable and added significant value we were assured. In the operating theatre, the local team’s established expertise with open mesh hernia repair was evident. We were nevertheless able to offer suggestions and refinements which they found useful, particularly around the subtleties of technique and training methods. 
Our overwhelming conclusion was that the AMHSI was in excellent hands in Bugando. Furthermore, as an important specialist surgical training centre it was great to know that we were also supporting and improving the development of the next generation of specialist surgeons – epitomised by Dr Mugisha providing a training masterclass in mesh hernia technique.
BMC is an incredibly impressive institution and also one of the early adopters of laparoscopic surgery in Tanzania. They were very keen to utilise the faculty’s extensive experience as trainers in this regard. As another evolving SWIFTSS workstream that clearly overlaps with the AMHSI, we were delighted to accommodate. We were able to support the team through diagnostic laparoscopy and two different types of laparoscopic hernia repair – both TAPP and TEPP. This was a fantastic achievement and a testimony to the advanced skills that are already present and developing within country. It is incredibly rewarding for us to be involved in such exciting progress which is raising the upper bar of healthcare in Tanzania. It also absolutely compliments the AMHSI, which by contrast is addressing the need for more widespread high quality fundamental surgical skills and services.
Another highlight of this visit was BMCs enthusiasm and sense of responsibility to help drive the spread of the project throughout the Lake Zone. This commitment was repeated and cemented at every level in the hospital, from the Specialist Surgeons themselves, through the Director of Surgical Services all the way to the Hospital Directors office. Such fantastic news; we look forward to embracing BMC as our champions in the Zone and the work we can achieve together. We even managed to scope out the next possible centre for induction (Sekou-Toure Regional Referral Hospital – a high volume hernia centre) by their recommendation and arrangement.
This concluded another excellent and productive visit to Tanzania, epitomising our collaborative approach. The hernia camp in BMC even made the local news. We are incredibly grateful to Dr Mugisha for his sustained enthusiasm and expertise. And to Drs Binde and Kotecha for their incredible hospitality, hard work, excellence and determination. Asante Sana