Africa Surgery Report for 2015

TOM’S TRIP REPORT FROM SIERRA LEONE – MAY 6 TO AUG. 8, 2015

The Ebola epidemic which devastated Sierra Leone, Guinea, and Liberia made it dangerous for me to visit Sierra Leone in October 2014 as I had planned. A visit then would have been unproductive because the hospitals and clinics I work with stopped functioning normally, either because the fear of Ebola shut them down, or they turned their attention entirely toward treating that one disease. When I did arrive in Sierra Leone on May 6, 2015, the country had not recorded a new Ebola case in almost one week, but soon isolated cases arose; and when I left the country on August 9, 2015, they were continuing to show up. While I often worked in or traveled through Ebola hot spots, I was very careful not to have physical contact with anyone; and I followed all precautions such as frequent hand washing with bleach solutions provided at police checkpoints and hospital entrances. Because Ebola’s maximum incubation period is 21-days, after leaving Sierra Leone, I stayed with friends in Holland and returned to my residence at the Assumption Church in Morristown on August 30, 2015 which is 21-days after I left Sierra Leone.

When I first saw Aminata Kamara in May, she was in obvious discomfort, standing stiffly and constantly fanning herself. Months before, an infection originating from a decayed tooth had spread down onto her neck and chest. At some point Aminata had employed native healers who applied local herbs which probably made her problem worse. By the time she sought help at the Connaught Government Hospital in Freetown in February 2015, Aminata’s left breast and half of her right breast were eaten away by infection. The tissue and much surrounding skin were surgically removed by a Sierra Leonean surgeon with funds provided by Africa Surgery. There is no qualified Sierra Leonean reconstructive-plastic surgeon who can do skin grafts to quicken the healing of Aminata’s torso, and foreign surgical teams are no longer coming in because of the Ebola virus. Fortunately, we had previously shipped in our container a large quantity of donated non-stick bandage pads. These have greatly reduced Aminata’s physical pain. She is still an in-patient at the hospital and is being fed and treated at Africa Surgery’s expense. On one of my later visits to Connaught Hospital, I met Aminata who was crying, her body bent forward so that the tears hit the floor and not her bandaged chest. I then learned that three months before being admitted in February, Aminata, who is 22, had given birth to a baby girl. She has not been able to see nor hold her baby since being admitted to the hospital because, with the Ebola virus still keeping restrictions high at the hospital, the baby could not be brought to her. Without skin grafts, her healing will take a very long time.
Mohamed Turay’s right foot was bandaged, but was bent at an unnatural angle, when I was first brought to his ward at the Connaught Hospital. His cousin, who smelled of alcohol, told me that Mohamed had been brought there by members of a medical team from one of the large international organizations that had come to fight Ebola. Our team of Africa Surgery field workers and I learned that Mohamed had been provided with a motorcycle and was working as a volunteer contact tracer for a chiefdom in a remote part of the country, when he fell with the bike on a bad road. Contact tracers are the workers who follow up on all persons reported to have had contact with a confirmed Ebola victim. They monitor the suspect person for any Ebola symptoms for 21 days, the disease’s maximum incubation period. We observed two doctors from the international organization moving around the hospital and helping to triage non-Ebola patients, so we did not doubt this story. Mohammed’s cousin complained that he and Mohamed had been there for two-weeks with no treatment being done beyond the changing of bandages. We had our doubts and did not want to intervene with the large, prestigious organization’s patient; but on a visit back about ten days later, it became apparent that the cousin was not lying. We added Mohamed to the growing list of patients we were paying to have treated by Dr. Ibrahim Bundu, the very competent and only orthopedic surgeon attached to the hospital. Dr. Bundu inserted an implant to correct the angle of Mohamed’s foot and ankle. Mohamed has been discharged but will have to be re-admitted to the hospital in one month to have the implant removed. Meanwhile we have provided him with crutches.

On June 16, we started to isolate 20 patients and 2 caretakers for 21 days before we could send them to the FOCOS (Foundation of Orthopedics and Complex Spine) Hospital in Ghana. Eleven of these were in need of spinal surgery. Five were children whose spines had been deformed by tuberculosis infections. Two were post-operative spinal surgery patients requiring revision surgery because their implants had broken, something which had only happened to one Africa Surgery/FOCOS patient before. Three women and one young man were in need of hip replacement, and four were post-operative spinal surgery patients being flown back at FOCOS’s expense to participate as subjects in a research study.
We flew them to Ghana on three different days. On each day we were required to cross the large Freetown harbor on a ferry and keep the quarantined patients inside our vehicle to prevent them from having physical contact with anyone not in their group. On the airport side of the harbor we parked and provided them with a lunch of bread and canned sardines under the shade of a large mango tree in the yard of a woman who is also in need of spinal surgery due to a tuberculosis infection, but whose passport had not been issued before the Ebola crisis shut down normal operations at the immigration office.

On our first day eating in the yard I went with one of our team members to record in my log book information about a girl, age 8, whose spine had also been damaged by TB. When asked if anyone in the area had the “dry cough”, as they call pulmonary tuberculosis in Sierra Leone, the father and family members told us that they knew of no one. We always ask about this because TB can only be spread by a victim’s coughing. Therefore, the girl must have been exposed to someone with pulmonary TB who is likely to spread it further.

On our second time having lunch there a neighboring man came to us for help. Salifu Kamara’s arm had been broken about one year before, when he was struck by a door being carried by a passenger on a motorcycle. Salifu looked older than the 50 years he claimed to be, and his right arm hung limply from his thin body with a slight bend above the elbow, but he could still move his fingers. On our last trip back from the airport we collected Salifu and his nephew, Suliman, who was to serve as a caretaker in the event that Dr. Bundu would be able to do surgery on the fractured arm. The first night the two were staying at our isolation quarters, Salifu coughed a great deal. We had his lungs X-rayed, and the radiologist made the diagnosis of pulmonary TB. We immediately had Salifu started on an eight-month-long regimen of anti-tuberculosis medications. He is staying at our facility for now so that our team can assure that he complies with the treatment. He does not mind this, probably because he is already feeling much better and has regained his appetite. We are feeding him well and include two boiled eggs a day in his diet. Once he is built up and has finished the initial intensive stage of medications, the team will take him to be seen by Dr. Bundu. Meanwhile Suliman, who is about 14-years-old and who does not attended school, is getting daily instruction from a tailor. Suliman is a member of the first class of young people to attend our Freetown sewing workshop which uses antique, treadle-style sewing machines donated by Assumption Parish parishioners and others. Suliman learns quickly, so one day we might be able to provide him with his own machine to use to earn his living as a tailor back in his village, or wherever he wants to.
Surgeries have been scheduled and some have already been done for our patients now

During the three-months I was in-country, thanks to Africa Surgery, over 60 persons have had hernias surgically repaired; over 60 have been treated for vision-threatening eye diseases, including cataracts, glaucoma and infections; 12 have started orthopedic-surgical and medical treatment, most for injuries caused by falls or accidents; five men have had surgery to relieve urine blockages; scores have been medically treated for conditions such as malaria and typhoid; about 200 people have had one-to-three decayed teeth extracted; and 12 have started medical and surgical treatment for swollen, abscessed jaws.

Africa Surgery’s work goes on as our team members continue to find and to bring patients to Sierra Leonean surgeons and facilities for treatment. We currently also have ten people with tumors on their faces and/or their necks whose surgeries cannot be done in Sierra Leone because of limited surgical equipment and the lack of specialized surgeons. The fear of Ebola as well as a nationwide doctors’ strike in Ghana are frustrating our efforts to send them to Accra, Ghana where we are hoping their tumors can be removed and, in some cases, their faces rebuilt. Included among these patients are two young boys with almost identical tumors growing from their upper jaws, pushing out their noses and threatening to crush their right eye sockets.

Thank you for your prayers and the support that enable us to continue this work. The patients, whose recoveries depend on your help, deeply appreciate it. A special thanks goes to the George Washington Council 359 of the Knights of Columbus and to the Friendly Sons of St. Patrick of Morris County for their support amounting to a total of $3,000 which covered the cost of my airfare and in-country, personal expenses, making it possible for 100 percent of all other donations to go to helping our patients and students in Sierra Leone.

On behalf of the many people here benefiting from your help, I want to thank you for your continued generosity and prayers.

The Ebola virus is still ravaging Sierra Leone, where the number of reported cases as of December 20 is almost 9,000 and the number of deaths from Ebola infection might be as high as 400 per week. This is leaving thousands of children as “Ebola orphans,” having lost one or both parents and some having lost many members of their families. Many of these children have themselves survived Ebola infection. Because of the fear of contracting Ebola from these children, many are not even taken in by members of their own extended families, and are left on their own to survive in the streets.

Since 2004, the St. George Foundation has been caring for street children, many orphaned by Sierra Leone’s civil war. The St. George staff recently identified over 100 “Ebola orphans.” Africa Surgery is teaming up with the St. George Foundation to provide care to as many of these abandoned young children as possible. Using funds provided primarily by Africa Surgery, these children are now being brought into the St. George orphanage near the capital city of Freetown. They are given any additional medical care needed, as well as all basic needs of food, shelter, clothing, and emotional support. Most will stay at the St. George facility for three-to-six weeks until their extended families can be contacted and convinced and trained to take them in, or until foster parents can be found and trained.

TOM’S UPDATE REPORT – SEP. 24, 2014

September 30, 2014 / Africa Surgery / Make A Comment / Uncategorized

THE SITUATION
An outbreak of Ebola Hemorrhagic Fever occurred in Guinea in March 2014. One theory is that it moved from an animal host, such as a fruit bat or monkey, to humans, when someone butchered an infected animal or consumed fruit contaminated by animal feces or saliva. Ebola is spread by contact with infected victims’ body fluids, including blood, sweat, and tears. Because it was not contained, Ebola began to spread among these people who traditionally greet each other, often with long hand-shakes, and who wash the corpses of deceased loved ones and often touch and embrace the deceased during funeral ceremonies. A corpse of a victim is highly contagious for weeks. Ebola has by now spread in Guinea and into neighboring Sierra Leone and Liberia and has infected over 5,800 people, killing 2,800 of them. The actual numbers are probably much higher because infected people are afraid to go, or bring infected loved ones, to isolation centers, preferring to have them die at home. This causes many more people, especially caregivers, to become infected. Many professional caregivers, including nurses working in hospitals, have also become infected. Four medical doctors in Sierra Leone have died of the disease. About 60 percent of Ebola victims admitted into the centers do die, and the bodies are not returned to the families but are enclosed in plastic bags and buried in common graves.

This Ebola epidemic, the largest in history, has become a catastrophe. But unlike an earthquake or flood, it is slow moving. It is like the civil wars that overran Sierra Leone and Liberia, where the enemy is brutal and capable of striking almost anywhere. But at least in the wars, the people could see and hear the enemy, have some ideas of where they were striking, and could at times run away.

WE ARE TOUCHING THE LIFE OF SO MANY PEOPLE
February 4, 2014 / Africa Surgery / Make A Comment / Life Story, Trip Reports

Almost every day, people come to my door in the village or go to find me at the hospital where they request help for various problems. Most are medically treated at the Holy Spirit Hospital at Africa Surgery’s expense for conditions like typhoid and malaria. Some, including two small boys, are being scheduled for surgical treatment of hernias; two men have undergone emergency surgery for strangulating hernias. Others are having surgery by visiting teams of reconstructive plastic surgeons for burns or certain tumors and growths, and at least three babies are being treated for cleft lips and pallets. Others, whom we are referring to specialists in the capital city of Freetown for treatment at our expense, include a teenage girl needing a tonsillectomy, and another with what appears to be a fast-growing-bony tumor on her lower jaw that we hope the oral surgeon can remove. One man, age about 50, who was diagnosed with cancer and admitted for pain control, died about three weeks later.

So far, our helper, Foday, has taken 39 patients to the Baptist Eye Hospital, five having their sight restored with cataract surgery, some being treated for various infections, but most receiving follow-up medications for cataract or pterygium surgeries previously made available by Africa Surgery.

Tom Johnson, Jr.

Dec. 5, 2013

Kumba Thonor, before, IMG_0725 - kopie

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