World Orthopaedic Concern UK

WOC NEWSLETTER 100  May 2007, PAGE 2

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CAMBODIA 

Three years ago this project was stimulated by several factors; much orthopaedic pathology and an increasing number of victims of road accidents required treatment. Dr. Duong Bunn, Head Surgeon of the Unit, and several motivated Cambodian surgeons, had recently return to Pnom Phen, from overseas training.  The orthopaedic ward and theatres and the  nursing staff were in great need of support and assistance. An enthusiastic hospital chief executive, Prof. Teng Soeun, wanted change; an Australian Surgeon, Tim Keenan, was prepared to contribute time and expertise; a nearby NGO hospital, Sihanouk Hospital Center of Hope [SHCH], was prepared to develop a partnership with Tim and Dalton Boot to improve the Unit.

The ethos was to help key Cambodians decide the changes they wanted and then to bring in the finance, expertise and training to make this happen (in collaboration with the Cambodian Ministry of Health - MoH).

In the last three years this approach has born fruit in the following areas;

1. Equipment provision for the wards and theatre – and a system of monitoring usage;

2. Improvements in nurse training in theatre and the wards - Mary Wood, a UK Sister, trained the nurses for nine months, and two senior Cambodian nurses have continued the program.

3. Wards and theatres were refurbished, with funds set aside for maintenance.

4. Funds were also set aside to develop subspecialty training in polio and skeletal reconstruction, for a trainee to attend a course in India.

This “pump priming” initiative has been met by a gratifying response from the MoH, which has increased its financial and general support for the Unit. The Orthopaedic Society has been helped to run monthly Clinical Meetings, and a “Spine Club” has been instituted. The SHCH Hospital has helped with equipment and personnel, from a grant of $60,000 (USAID.) Since then many agencies, including WOC UK, have donated a further $70,000. The use of an experienced fund raiser has been successful in identifying which donors to approach and how to present an application.

With regard to the future, admissions to the ward in the last year have increased by 23% and operations by 68%. There is now a need to expand the size of the ward and the number of theatres, in a sustainable manner. Grant money is being sort for this development. There is much still to do before the unit is independent in a manner that complies with the economic situation, but there has already been a gratifying improvement in morale and confidence, a direct result of the demonstration of continuing outside support. {“e” Dalton.Boot@which.net}

SOUTHERN AFRICA

A good example of sometimes illogical arrangements, is the investment of funded energy in the Eastern Cape, in the Republic of South Africa. A British ”senior” surgeon, Ken Rankin, has settled there in the town of Mpthatha where he practices a priceless, basic orthopaedic service to a grossly impoverished area. He was well known in the UK and so senior trainees visit his unit and benefit as much from the experience, as do the indigenous population of Mpthatha. Now in general, South Africa does not really belong to the Developing World, (except in so far as we all do); but the personal links between, on the one hand, Rankin with the UK, and on the other, Rankin with the Eastern Cape, are extremely valuable. Doubtless when a WOC Region is created in South Africa, generated by and based upon the South African Orthopaedic Association, an even better service will be organised. Every regional group has its favoured connection; sometimes they change hands as it were, but the links are never “cast in stone” and there is no sense of regional “responsibility or ownership”!

BANGLADESH

The Newsletter from the Impact Foundation carries news of the continuing progress of the Lifeline Express and the Boat of Life, which respectively serve Northern India’s Rail Network and the delta South of Dhaka, Bangladesh, on those mobile but parked Hospital Vehicles! David Jameison Evans and John Lourie provide the Orthopaedic aspects of those carriages and boats. {www.impact.org.uk} And between times John has given back-up service at the Sihanouk Hope Hospital in Cambodia (above.)

NIGERIA

Dr. Kabir Abubakar, the Medical Director, writes from the National Orthopaedic Hospital, Dala-Kano, Northern Nigeria, which approaches its fiftieth year. It was set up in 1959, largely at the instigation of Frank Bryson, with regular consultant and registrar rotations from the RNOH in London. Among the visiting staff have been Ginger Wilson, Robin Denham, Chris Colton, Geoffrey Walker and Lorden Trickey. To this day it remains the only source of orthopaedic treatment for 60 million people in the Northern Province. The hospital comprises 180 beds in seven wards, seeing 14,600 patients last year and performing nearly 700 major orthopaedic procedures; it runs a Resident Training scheme and a school for Orthopaedic Nurses and Plaster Technicians. Such success breeds its own problems. The eight consultant surgeons are desperately pressed with demands for modern techniques in back, knee and hand surgery. What the hospital lacks in equipment, it makes up for in care and ingenuity, but they are indeed ready for modern instrumentation. {md@orthopaedicdala.org}

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