CAMEROON CAMPAIGN REPORT 4-13 JULY 2024- Report
Dates of the campaign: departure on 4/7/2024 at 12 noon and return on Saturday
13/7/2024 at 5 p.m.
Members of the team: César Ramírez, Pablo Muriel, Jaume Ortega and Marta
Roldón (surgeons); Javier Mora, Beatriz Fort and Sandra Casares
(anaesthesiologists); Francisco
Gómez, Azahara Giraldo and Carlota Gómez (nurses) and Virginia León (4th year
dental student). All of them are volunteers from the Cirujanos en Acción
Foundation.
Origin and destination: César, Francisco, Marta, Azahara, Carlota and Virginia
(Málaga); Pablo, Jaume and Beatriz (Barcelona); Sandra (Madrid); and Javier (Gran
Canaria). From the airports of Malaga, Madrid and Barcelona we left to join in
Istanbul, from where we flew together to Yaounde on a flight that left at 17.40 local
time on 4/7/2024 and arrived at 00.05 h on 5/7/2024 local time in Yaounde (one
hour less than in Spain). We flew with Turkish Airlines and each of the 11 members
of the expedition travelled with two 23 kg packages, and the airline was kind
enough to allow us to take 3 extra packages at no extra cost (a total of 575 kg). In
our luggage we have carried and stamped with our ATA notebook a Ligasure, an
Ultracision generators and a diathermy generator. The only incident during the trip
was that all the luggage we took on board from Malaga did not arrive with us in
Yaounde, and we were able to recover it 24 hours later. Because of this, to operate
on the first day (5/7/2024) we had to buy meshes and suture materials, which
William Ngatchou has found for us as always and whose cost we have assumed.
Workplace in Cameroon: the Hospital Gynecologique-Obstetrique et Pediatric de
Yaoundé (HGOPY) is a relatively recently built centre located inside the General
Hospital of Yaoundé, which is usually used for the medical and surgical care of
children and women. It is a public hospital that belongs to the Ministry of Health
but provides health care only to the population that can pay at the entrance (where
the ‘Caisse’ is located) for any type of service. The HGOPY was the physical space chosen for this campaign by the André Onana Foundation to carry out the
Dates of the campaign: departure on 4/7/2024 at 12 noon and return on Saturday
13/7/2024 at 5 p.m.
Members of the team: César Ramírez, Pablo Muriel, Jaume Ortega and Marta
Roldón (surgeons); Javier Mora, Beatriz Fort and Sandra Casares
(anaesthesiologists); Francisco
Gómez, Azahara Giraldo and Carlota Gómez (nurses) and Virginia León (4th year
dental student). All of them are volunteers from the Cirujanos en Acción
Foundation.
Origin and destination: César, Francisco, Marta, Azahara, Carlota and Virginia
(Málaga); Pablo, Jaume and Beatriz (Barcelona); Sandra (Madrid); and Javier (Gran
Canaria). From the airports of Malaga, Madrid and Barcelona we left to join in
Istanbul, from where we flew together to Yaounde on a flight that left at 17.40 local
time on 4/7/2024 and arrived at 00.05 h on 5/7/2024 local time in Yaounde (one
hour less than in Spain). We flew with Turkish Airlines and each of the 11 members
of the expedition travelled with two 23 kg packages, and the airline was kind
enough to allow us to take 3 extra packages at no extra cost (a total of 575 kg). In
our luggage we have carried and stamped with our ATA notebook a Ligasure, an
Ultracision generators and a diathermy generator. The only incident during the trip
was that all the luggage we took on board from Malaga did not arrive with us in
Yaounde, and we were able to recover it 24 hours later. Because of this, to operate
on the first day (5/7/2024) we had to buy meshes and suture materials, which
William Ngatchou has found for us as always and whose cost we have assumed.
Workplace in Cameroon: the Hospital Gynecologique-Obstetrique et Pediatric de
Yaoundé (HGOPY) is a relatively recently built centre located inside the General
Hospital of Yaoundé, which is usually used for the medical and surgical care of
children and women. It is a public hospital that belongs to the Ministry of Health
but provides health care only to the population that can pay at the entrance (where
the ‘Caisse’ is located) for any type of service. The HGOPY was the physical space chosen for this campaign by the André Onana Foundation to carry out the
campaign, on the basis of a compromise that the Ministry of Health had sent in
writing for the use of the HGOPY. It is important to remember that the minimum
wage in Cameroon accepted by the government is the equivalent of 80 euros.
From the very moment of our arrival at the Hospital on Friday 5/07/2024 at 10 a.m.,
the collaboration with our work and the facilities we have received have been null
and void, namely:
- No person responsible for the HGOPY (director manager or medical
director) has had the courtesy to welcome us and at least say ‘Hello’; only
one hour before our departure on 12/07/2024 at 7 p.m. the medical director
came to thank us and to excuse the manager who had had a meeting that
had prevented him from saying goodbye to us.
- The very morning of our arrival and before the surgeries began, we began
to receive letters from the Hospital management with payment
commitments to sign for the use of oxygen, the use of physiological saline
solution, the use of antiseptics to sterilise the material and the use of
sanitisers to clean the floor and operating theatres, on pain of not being
paid, we would not continue operating. The most tense situation occurred
on Sunday morning, 7/7/2024, when two administrative staff from the
Hospital addressed me in a rude tone, forbidding us access to the
operating theatres if the Hospital did not pay them the amount demanded
for all the items demanded (1,800,000 frCA, about 2,600 euros). We were
unable to work for 4 hours and were treated like poachers until the FAO
executives in Yaounde, Justin Lamouchi and Stephanie Longtchi, came to
the hospital and paid the full amount demanded in cash to these two
people.
- Throughout our stay and work in the Hospital, we have not had the
professional collaboration of any doctor, nurse, auxiliary or responsible person
in the Hospital. We have only met people from the Hospital on occasions when
they wanted to ask for money or make objections through third persons.
Our operational structure at the HGOPY in Yaoundé was therefore the same as
the one we had at the Centre de Medecin et Sport (CMS) last year but in a
different physical space:
1.- The patients had been recruited by the communication campaign carried
out by FAO and the patients registered by the medical staff of the CMS.
According to the list sent to me by William Ngachou, a total of more than 300
goitres and more than 300 hernias had been recruited for the campaign.
2.- The patients were moved around the Hospital, brought and changed for the
operating theatre by the FAO volunteers (Prince, Khumalo, Benjy…, up to 12
people) who are essential elements and of great value for the logistics of the
mission (they also act as orderlies), as they always bring joy and positivity.
3.- Our equipment was cleaned between patients by CMS sterile staff and the
operating theatres were also cleaned and sanitised by CMS cleaners, never by
hospital staff.
writing for the use of the HGOPY. It is important to remember that the minimum
wage in Cameroon accepted by the government is the equivalent of 80 euros.
From the very moment of our arrival at the Hospital on Friday 5/07/2024 at 10 a.m.,
the collaboration with our work and the facilities we have received have been null
and void, namely:
- No person responsible for the HGOPY (director manager or medical
director) has had the courtesy to welcome us and at least say ‘Hello’; only
one hour before our departure on 12/07/2024 at 7 p.m. the medical director
came to thank us and to excuse the manager who had had a meeting that
had prevented him from saying goodbye to us.
- The very morning of our arrival and before the surgeries began, we began
to receive letters from the Hospital management with payment
commitments to sign for the use of oxygen, the use of physiological saline
solution, the use of antiseptics to sterilise the material and the use of
sanitisers to clean the floor and operating theatres, on pain of not being
paid, we would not continue operating. The most tense situation occurred
on Sunday morning, 7/7/2024, when two administrative staff from the
Hospital addressed me in a rude tone, forbidding us access to the
operating theatres if the Hospital did not pay them the amount demanded
for all the items demanded (1,800,000 frCA, about 2,600 euros). We were
unable to work for 4 hours and were treated like poachers until the FAO
executives in Yaounde, Justin Lamouchi and Stephanie Longtchi, came to
the hospital and paid the full amount demanded in cash to these two
people.
- Throughout our stay and work in the Hospital, we have not had the
professional collaboration of any doctor, nurse, auxiliary or responsible person
in the Hospital. We have only met people from the Hospital on occasions when
they wanted to ask for money or make objections through third persons.
Our operational structure at the HGOPY in Yaoundé was therefore the same as
the one we had at the Centre de Medecin et Sport (CMS) last year but in a
different physical space:
1.- The patients had been recruited by the communication campaign carried
out by FAO and the patients registered by the medical staff of the CMS.
According to the list sent to me by William Ngachou, a total of more than 300
goitres and more than 300 hernias had been recruited for the campaign.
2.- The patients were moved around the Hospital, brought and changed for the
operating theatre by the FAO volunteers (Prince, Khumalo, Benjy…, up to 12
people) who are essential elements and of great value for the logistics of the
mission (they also act as orderlies), as they always bring joy and positivity.
3.- Our equipment was cleaned between patients by CMS sterile staff and the
operating theatres were also cleaned and sanitised by CMS cleaners, never by
hospital staff.
4.- The doctors who took care of our patients on the ward as well as the nurses
who helped with the next day’s treatments were also CMS staff.
Therefore, all our support was provided by the FAO volunteers and all the CMS
staff who went to the HGOPY to do their work, given that, according to what we
were told, the FAO had agreed with the Ministry of Health to use the
physical structure of the operating theatres and nothing else, anything
else would have to be paid for.
A total of 180 patients were operated on during the campaign, which can be
broken down as follows:
- 53 thyroidectomies, of which 31 were subtotal and 22 total. All patients
were discharged the following day except for two who suffered
complications. The first, an asphyxial haematoma that required immediate
drainage, haemostasis and tracheostomy due to stridor in relation to
compressive neuroapraxia, with both recurrent nerves perfectly preserved,
and was discharged on the third postoperative day. The second was a 75
year old patient with a giant goitre which turned out to be an infiltrating
cancer of the left recurrent nerve with massive ipsilateral macroscopic
lymph node disease; complete exeresis surgery of the tumour was
performed with preservation of the healthy right thyroid lobe and isthmic
section. Postoperatively, the patient developed progressive respiratory
insufficiency and deterioration of the level of consciousness, which led us,
in desperation on the second postoperative day, to perform a tracheostomy
as a last resort, without managing to overcome the situation, so that the
patient died after applying comfort measures and talking to the family.
- 114 patients with abdominal wall hernias, distributed as follows: 95
inguino- crural hernias (19 bilateral, 20% of the total, and in 9 cases
recurrence, 9%), 18 midline hernias (epigastric / umbilical). Only one
patient operated on a giant inguino-scrotal hernia required re-surgery due
to residual haematoma which was drained.
- Other surgeries performed were 13 surgical treatments of hydrocele (6 as a
single diagnosis and 7 associated with another inguinal pathology
cryptorchidism +/- inguinal hernia), 4 cryptorchidism (2 as a single
diagnosis and 2 associated with hydrocele +/- inguinal hernia), a young
woman with purulent peritonitis after foreign body perforation, a keloid, an
orchiectomy for a tumour and a giant lipoma.
Special mention should be made of Prof. Dr. William Ngatchou, Managing
Director of CMS, who spent three days with us morning, noon and night helping
us to solve structural and bureaucratic problems. Given that the suitcases
arrived 24 hours late because Turkish Airlines left them in Istanbul, we had no
meshes and William bought them for us the same morning so that we could
save that day and also in the bad moments of pressure from the administrative
leaders on Sunday 7th July he also came to the Hospital to turn the situation
around.
An essential figure in the development of our campaigns in Cameroon (and one
that I believe should never be missing) is Sylvain Abueme, a specialist in electro-medicine, ‘fix-all’ and liaison between the team, the FAO volunteers
Therefore, all our support was provided by the FAO volunteers and all the CMS
staff who went to the HGOPY to do their work, given that, according to what we
were told, the FAO had agreed with the Ministry of Health to use the
physical structure of the operating theatres and nothing else, anything
else would have to be paid for.
A total of 180 patients were operated on during the campaign, which can be
broken down as follows:
- 53 thyroidectomies, of which 31 were subtotal and 22 total. All patients
were discharged the following day except for two who suffered
complications. The first, an asphyxial haematoma that required immediate
drainage, haemostasis and tracheostomy due to stridor in relation to
compressive neuroapraxia, with both recurrent nerves perfectly preserved,
and was discharged on the third postoperative day. The second was a 75
year old patient with a giant goitre which turned out to be an infiltrating
cancer of the left recurrent nerve with massive ipsilateral macroscopic
lymph node disease; complete exeresis surgery of the tumour was
performed with preservation of the healthy right thyroid lobe and isthmic
section. Postoperatively, the patient developed progressive respiratory
insufficiency and deterioration of the level of consciousness, which led us,
in desperation on the second postoperative day, to perform a tracheostomy
as a last resort, without managing to overcome the situation, so that the
patient died after applying comfort measures and talking to the family.
- 114 patients with abdominal wall hernias, distributed as follows: 95
inguino- crural hernias (19 bilateral, 20% of the total, and in 9 cases
recurrence, 9%), 18 midline hernias (epigastric / umbilical). Only one
patient operated on a giant inguino-scrotal hernia required re-surgery due
to residual haematoma which was drained.
- Other surgeries performed were 13 surgical treatments of hydrocele (6 as a
single diagnosis and 7 associated with another inguinal pathology
cryptorchidism +/- inguinal hernia), 4 cryptorchidism (2 as a single
diagnosis and 2 associated with hydrocele +/- inguinal hernia), a young
woman with purulent peritonitis after foreign body perforation, a keloid, an
orchiectomy for a tumour and a giant lipoma.
Special mention should be made of Prof. Dr. William Ngatchou, Managing
Director of CMS, who spent three days with us morning, noon and night helping
us to solve structural and bureaucratic problems. Given that the suitcases
arrived 24 hours late because Turkish Airlines left them in Istanbul, we had no
meshes and William bought them for us the same morning so that we could
save that day and also in the bad moments of pressure from the administrative
leaders on Sunday 7th July he also came to the Hospital to turn the situation
around.
An essential figure in the development of our campaigns in Cameroon (and one
that I believe should never be missing) is Sylvain Abueme, a specialist in electro-medicine, ‘fix-all’ and liaison between the team, the FAO volunteers
and the CMS staff. Sylvain is a Cameroonian who studied in Madrid and La
Coruña, speaks perfect Spanish, and although he lives and works in Brussels
(as does William Ngatchou), he comes to Yaoundé to support the campaigns.
Finally, it has been a real honour to be able to count on the support and
backing throughout the week of the Spanish Embassy in Cameroon, which
through the chancellor Ms. Paula Ruiz Samanes has always been aware of our
needs and problems, has given trips to the airport in her free time to recover
our lost material and has made us feel that Spain had a little piece in
Cameroon. Infinite thanks also to our ambassador, Mr. Ignacio García
Lumbreras for his closeness and affection, for having received us at his home
on 12/07/2024 before we left and for having comforted us by identifying us as
the authentic Spain brand, the one that makes our country the most supportive
in the world.
Given what happened and the good experiences that have always meant the
campaigns in the CMS that have been carried out by Cirujanos en Acción, I
recommend never to work again in this public Hospital HGOPY and to continue
betting on the CMS.
With a total of 178 patients and 215 procedures performed, the campaign has
been by any standards a success.
S.D.: Dr César Ramírez
Campaign Coordinator
Patron of the Cirujanos en Acción Foundation
Director of the CR Bisturí Solidario Foundation
Coruña, speaks perfect Spanish, and although he lives and works in Brussels
(as does William Ngatchou), he comes to Yaoundé to support the campaigns.
Finally, it has been a real honour to be able to count on the support and
backing throughout the week of the Spanish Embassy in Cameroon, which
through the chancellor Ms. Paula Ruiz Samanes has always been aware of our
needs and problems, has given trips to the airport in her free time to recover
our lost material and has made us feel that Spain had a little piece in
Cameroon. Infinite thanks also to our ambassador, Mr. Ignacio García
Lumbreras for his closeness and affection, for having received us at his home
on 12/07/2024 before we left and for having comforted us by identifying us as
the authentic Spain brand, the one that makes our country the most supportive
in the world.
Given what happened and the good experiences that have always meant the
campaigns in the CMS that have been carried out by Cirujanos en Acción, I
recommend never to work again in this public Hospital HGOPY and to continue
betting on the CMS.
With a total of 178 patients and 215 procedures performed, the campaign has
been by any standards a success.
S.D.: Dr César Ramírez
Campaign Coordinator
Patron of the Cirujanos en Acción Foundation
Director of the CR Bisturí Solidario Foundation