A final visit to Tanzania this year saw Mark and Greg return to the Arusha Hub at the beginning of November. They were joined by Dr Mugisha Nkoronko, a Specialist Surgeon and the TSA project lead. He is also the President-Elect of the Tanzania Medical Association and brought with him an incredible charisma, which greatly enhanced our efforts. This also represented an important landmark for the project – as the first official bi-partisan AMHSI faculty (although we must remember the support from the Muheza team; when we trialled our first induction in Korogwe back in 2020).
Starting at Mt Meru Regional Referral Hospital they were warmly welcomed by Drs Heri & Hanson and their team. With a definite sense of unfinished business for us, it was incredibly satisfying to finally get an AMHSI service properly established. Originally a Phase 1 site, there were initially issues in getting a suitable autoclave to the hospital, followed by the chaos that COVID caused. We have stayed in touch with the team and in June managed to provide a small supply of mesh for Dr Heri to use.
On our return, the local team elected for a complete re-run of the induction process. Presentations / discussions were followed by some simulation and hands on autoclave training (we brought one with us this time) on the first day. A further two days of high-quality live operating followed through which we were well looked after.
It perhaps reflects our approach to this work, that despite the various challenges encountered, commitments made have been honoured and persistence all round has ultimately led to another high-quality sustainable service being established. It is in very good hands here in Mount Meru.
Also within this Hub, we re-visited ALMC hospital. It was fantastic to re-connect with Drs Lema and Benson and pleasing to hear that the AHMSI service continues to run well. They have now performed over 90 mesh hernia repairs in project without issue. Our next goal here is to get the eRegistry established and the historical data uploaded.
Our final hub destination was Selian Hospital. Slightly further out of the centre, it was a bumpy ride in a Bajaj (Tanzanian Tuk-Tuk). The excitement of this adventure was further heightened by the variable weather, with torrential rain temporarily turning roads and hospital walkways to rivers and streams! As previously noted, Dr Elbariki and his team have been persistent and very resourceful in getting this AMHSI service established. 23 mesh repairs have now been performed here so far this year and without issue. On this visit, we were able to provide a further 4 months supply of mesh and set up access to the eRegistry with a patient from that morning added.
We also maintained our relationship with Dr Kondo and the team by a visit to KCMC in Moshi. One of the biggest centres in Tanzania, they have many established collaborations. One of these is with Northumbria Hospital in the UK who helped establish a flourishing mesh hernia service several years ago using a slightly different model to ours. Early on in the conception of the AMHSI (nee TNMHP) we collaborated with Northumbria and were also grateful for Dr Kondo’s expertise and guidance. This time we were returning to discuss the adoption of our eRegistry at KCMC, a hope that their data could provide useful benchmarking for the rest of the project. We were also able to provide enough AMHSI mesh for 32 repairs to cover an unexpected shortfall before the next Northumbria visit.