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Mission to Ghana: Restoring function through caring & expertise Print E-mail
Written by Alejandro Badia, MD, FACS   
Thursday, 04 May 2017 00:00

In Late March, 2017  I was humbled to share the experience of co-leading a surgical team to Koforidua, inner Ghana, West Africa.

The trip was largely organized by Dr. Philippe Cuenod, of Geneva, Switzerland, and his team, who had been there several times before and developed an effective infrastructure in the St Joseph Orthopedic Hospital  so that our goals could be efficiently met. We were serving under the auspices of GICAM, founded by an Italian colleague and friend some years ago, committed to restoring hand/upper limb function in underserved countries.

The all orthopedic hospital had sparse surgeon coverage and I soon realized that their was essentially no hand/upper limb expertise. I had been to some other missions prior, but this was the first time in deep Africa; a novel culture and region to me. However, I quickly found the commonality of the human spirit and the intense wish to overcome challenges amongst our grateful and well motivated patients.

Our team evaluated most patients while in their hospital beds, essentially making rounds in large open wards where grateful patients lie, awaiting our comments on whether something could be done and when. That night, we made a rough “OR schedule” scribbling names/diagnoses on scrap paper.

Monday morning came, and we worked as a team, intermixed with Ghanian nurses, orderlies and very able anesthesiologists, doling out reconstructive procedures working 3 operating rooms like musical chairs. Philippe and I would tag team the big cases, and work separately on what we called the “little cases”. I assure you, there were actually no minor cases unless you consider a severe elbow burn contracture or a forearm malunion, a jaunt in the orthopedic park. We worked tirelessly, usually till 8 or 9 PM, sometimes midnight, usually eating a quick dinner in a makeshift lounge, besides the recovery room. The brothers from the St. Joseph Orthopedic Hospital would have the food brought to us in 2 large casserole containers, plates/silverware in a baggie.

One case comes to mind that perhaps represents the range and severity of pathology. A young man presented to us without ability to use either arm for over two years. He had broken both humeri (upper arm bones) in a scooter accident and developed non-unions bilaterally. He had no ability to lift his arms since the bones had never healed, and his left hand was largely dysfunctional due to a palsy of the radial nerve. I took the left side, Philippe and his assistant, the right. We simultaneously plated both bones, approximately 10 hole titanium plates/screws and dissected out the scarred nerves. On his side, he used a block of bone graft from the pelvis (iliac crest) and on mine, I performed releases of joint capsules and first webspace of the hand in order to place it in a more functional position. I did not proceed with planned tendons transfers to restore wrist/finger extension since too much scarring was present. That would be for the next surgeon team that comes to Ghana…perhaps us.

However, the cases that struck the deepest cord within us were the children. Whether correcting severe congenital deformities like clubhand, or reversing longstanding contractures from burns, we gave these children their first chance at a functional hand and limb. This would allow them to gain future employment, or perhaps create a family someday, perhaps reversing the rejection they might experience in their communities.

Much like Operation Smile, we give these children and adults a chance to rejoin the mainstream in their cities and villages. They restore smiles and acceptable social appearance, while we restore function and independence. I can hardly wait to go back…
Alejandro Badia, MD, FACS is the Owner and Founder of  Badia Hand to Shoulder Center  and Co-founder, OrthoNOW Orthopedic Urgent Care Centers. Both businesses are headquartered in Doral, FL.

Last Updated on Friday, 05 May 2017 09:37

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