Reflection and Rejuvenation.

A much-needed weekend. We ended up going on day trips to Tanga on both Saturday and Sunday. I dutifully saw my recovering laparotomy patients on both days, but I must confess that there was a definite urgency to my step as I left the wards each morning, wanting to minimise the risk of ‘being caught’ and ending up involved in any more patients. Putting a bit of physical distance in place by heading to Tanga also felt quite therapeutic!

On the Saturday we travelled with one of the O&G surgeons and went for the first time to The Tanga Beach Resort (a complete misnomer as it is not by the beach, but does have a lovely pool!). It was lovely to share such things with her and lunch was our treat. We returned there on the Sunday with the three Australian medical students who were such fun and great with the chidlers. It also gave me a chance to catch up on some paperwork, which may sound boring, but you can’t seem to escape such things even in Africa! One such task was to write a progress report for the Hospital Superintendent, something both he and I thought was important (he wanted it for a newsletter to send to the Bishop I think). It became a very therapeutic exercise as I started to list and unpick all the things we have done and achieved in the surgical department since my arrival. Once I started, it flowed, and I was pleasantly surprised by quite how much that needed inclusion. In brief: 

Ø  Cleaner, more organised theatres.

Ø  262 ‘new’ instruments.

Ø  The introduction of mesh surgery with a sustainable vision, a procedure for sterilisation (with new autoclave), 16 cases all successfully performed so far and 7 of these with the local doctors as primary surgeon.

Ø  Audit and mesh registry established (to enable follow up and ensure the safety of what we are doing).

Ø  A new technique for hydrocele surgery established.

Ø  The use of diathermy now established.

Ø  Some new suturing techniques established (and in conjunction with diathermy have significantly reduced wound infection rates).

Ø  WHO checks & swab counts established, ensuring safer surgery.

Ø  New drugs sourced (eg for prostate trouble and anaesthesia).

Ø  The continuous development of safer anaesthesia through experience.

Ø  Considerable shared surgical experience on the wards, in outpatients and in theatres. Boosting the quality of surgical decision making and services provided in Muheza.

Ø  Several laparotomies (which I am told have saved a number of lives – probably down to the decision making) and a number of other surgical operations not routinely performed here (eg paediatric hernia surgery which builds on their occasional paediatric practice of a visiting tonsil & adenoid surgeon).

Ø  Networking with the regional hospital and the exciting developments of potential wider collaboration.

Ø  Established departmental meetings incorporating elements of education, patient safety and audit.

So, for all the challenge being faced (and hopefully overcome), when considering what is contained above, I find myself with a broad smile on my face, a sense of deep satisfaction and certainly an element of pride in what we are doing together as a team here.

There is, of course, still so much more to do.