Following the TSA conference in Morogoro, Mugisha, Mark and Christian travelled by road back to Dar es Salaam, stopping there overnight. It was then a 3am start to fly the 1,100km to Kigoma very early on the Sunday where they were warmly welcomed by Dr Frank Sudai, a specialist surgeon based at Maweni Regional Referral Hospital. Mark had met Dr Sudai at last year’s conference in Dodoma, and it is great to be fulfilling commitments made then.
Kigoma is the most western point of Tanzania. As well as its association with Jane Goodall and the chimpanzees, historically it was an important outpost for the slave trade and is the end of the line for the railway that remains here. It is also where Henry Stanley is reported to have famously spoken the words “Dr Livingstone, I presume” in 1871. So it is rich in history. But, like much of rural Tanzania, it is impoverished with many of the population living off <$2USD/day.
Dr Frank Sudai has been trying to increase the uptake of mesh hernia repair here since 2016. But with the cost of commercial mesh almost double that of the procedure itself, only about 200 have been performed. Uptake has only grown in the past couple of years to include 25-30% of eligible cases (mainly insured patients). Maweni Regional Referral Hospital is a high volume centre, performing 250-300 hernia repairs per year. Furthermore, encouragingly, recent investment was very evident with refurbishment and expansion of the hospital. These considerations make it an excellent venue for the Affordable Mesh Hernia Surgery Initiative.
There are 2 specialist general surgeons here, supported by 6 dynamic registrars (MD doctors who are yet to undergo specialist training (akin to the former SHO grade in the UK). Mugisha kicked off the well attended ‘chalk and talk’ part of the induction programme with a very inspiring introduction. Following the presentations and discussions, we had great fun with our simulation models and mesh preparation / sterilisation stations.
The next few days were live operating. What became very clear was the quality of the services already provided here. There is a high technical proficiency, supported by well organised and run operating theatres. The value that we have added in coming here has fallen on ‘richly fertile soil’. The sterilisation arrangements are also very good and the team rapidly picked up all the nuances needed to provide well prepared and sterilised mesh.
It is again a real privilege for us at SWIFTSS to work with such excellent healthcare professionals, who work tirelessly in difficult circumstances to provide very good care with the limited resources that they have. It is also fantastic to be able to provide the solution to a longstanding problem, that will have a very positive impact on the services provided going forwards. And do this in a way that is sustainable and empowering for the local team.