Highlights mission trip September 2018


We have grown accustomed to the enormous flow of patients that come to the hospital during the first day of our arrival after hearing the announcement on the regional radio station.

After all these years they know that patients are seen and will get scheduled for surgery. Even though the physiotherapist (Charles) and his assistant (Constancia) work hard to make a pre-selection, the first day is extremely long, hot, chaotic, intense, and confrontational. Patients and their relatives have spent hours, sometimes days travelling, and come with precious saved/collected money and hope to finally get quality treatment. The strong emotional appeal on our compassion to please help their child or relative is often heart breaking.

Again we were confronted with an enormous variety of neglected trauma, injuries, tumors, burns, abdominal problems, infections and deformities. Dr. Susan started off with the first operations that had already been scheduled after receiving a list of operations for the coming 2 weeks. Except for breakfast, all we had that day was time for one coke between the patients.

On Tuesday we started, in collaboration with the enthusiastic theatre team, with the scheduled patients. First the youngest children, so that they didn’t have to be sober for too long.

This trip’s Highlights:

The renovations in the old theatre were finished. It was a joy for dr. Erik to be able to work there again after so many years. The old theatre has more space, sunlight, better functioning doors and a working air-conditioner. The latter was very welcome because orthopaedic and trauma surgeries are physically intensive due to drilling, sawing of bones, screwing, pulling and casting. Unfortunately, the air conditioner starts leaking after 30 minutes and spills water on the theatre floor leading to a hazardous environment with all the electric appliances.

Better hygiene due to the new sterilisation inside the theatre building. Dr. Erik dared to perform more trauma operations with plates/screws.

Paco was able to give regional anaesthesia with the help of a working ultrasound machine! It was exciting to see how much less pain the children had after the surgeries and were able to sleep better at night, alongside with all the other patients in the ward. In the morning we met more happy faces!

Meeting an enthusiastic Tanzanian orthopaedic surgeon Dr. Inyasi from Mwanza, who came to work with Dr. Erik for three days and is eager to collaborate. We were invited to his home for a lovely meal and a get-together with his family.

Meeting the bishop Kassala, chairman of the Hospital Board and discussing future developments.

Gillian was able to train and organize scrub nurses and workers of the central sterilization unit to make standardized surgical instrument packs.

Challenges during this trip:

Lack of sufficient theatre clothes/packs. Due to too few packs and very old industrial washing machine.

Quality of x-ray machine is getting very poor.

Too many goitres, daily we had to send patients away because there was no more room to operate.

This team consisted of:

Susan Lemson (general surgeon),
Paco Heijmans (anaesthesiologist),
Erik Staal (trauma surgeon),
Charissa Rahmee (tropical doctor),
Gullian Reuling (scrub nurse) and
Jiska Staal (nurse).


40 legs were straightened
5 clubfeet corrected
12 goitres removed
3 breast amputations
2 leg amputations
5 stoma closure
2 femur fractures
2 lower arm fracture
1 hip dislocation
Youngest patient to be operated: 3-day old baby with a birth defect to the digestive system.

Nico Nieuwenhuize