Skip to main content
Top
Published in: Hernia 3/2018

01-06-2018 | Original Article

Sustainability in humanitarian surgery during medical short-term trips (MSTs): feasibility of inguinal hernia repair in rural Nigeria over 6 years and 13 missions

Authors: F. Oehme, L. Fourie, F. J-P. Beeres, S. Ogbaji, P. Nussbaumer

Published in: Hernia | Issue 3/2018

Login to get access

Abstract

Purpose

Surgical teaching missions are known to contribute significantly in reducing the local burden of disease. However, the value of short-term medical service trips (MSTs) remains under debate. Humanitarian surgery is highly dependent on funding, and consequently, data evaluation is needed to secure funding for future projects. The aim of this trial is to evaluate the results of 6-year MSTs to rural Nigeria with a specific emphasis on hernia repairs.

Methods

Retrospective series of consecutive operations performed between 2011 and 2016 in rural Nigeria during 13 MSTs. Operations were categorized into type and number of procedures and origin of the surgeon. In terms of inguinal hernia repairs additional data was evaluated such as frequency of local anaesthesia (LA) and the type of hernia. The total amount of disability-adjusted life years (DALYs) averted during each mission are presented and discussed with regard to sustainability of these missions.

Results

From 2011 to 2016, a total of 1674 patients were operated. Of these, 1302 patients were operated for 1481 hernias of which 36.7% accounting as inguinoscrotal hernias. The percentage of operations performed by Nigerian staff increased from 31 to 55%. Overall, eighteen percent of the operations was solely performed by Nigerians. Totally, we averted 8092.83 DALY’s accounting for 5.46 DALY’s per hernia.

Conclusion

The presented missions contribute significantly to an improvement in local healthcare and decrease the burden of disease. We were able to show the sustainable character of these surgical missions. As a next step, we will analyse the cost-effectiveness of MSTs.
Literature
1.
go back to reference Ohene-Yeboah M, Abantanga FA (2011) Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med 30(2):77–83PubMed Ohene-Yeboah M, Abantanga FA (2011) Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med 30(2):77–83PubMed
10.
go back to reference Gourgiotis S, Germanos S, Stratopoulos C, Moustafellos P, Panteli A, Hadjiyannakis E (2006) Lichtenstein tension-free repair of inguinal hernia. Chirurgia (Bucharest, Romania: 1990) 101(5):509–512 Gourgiotis S, Germanos S, Stratopoulos C, Moustafellos P, Panteli A, Hadjiyannakis E (2006) Lichtenstein tension-free repair of inguinal hernia. Chirurgia (Bucharest, Romania: 1990) 101(5):509–512
11.
go back to reference GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet (London, England). 2016;388(10053):1545–1602. https://doi.org/10.1016/s0140-6736(16)31678-6 CrossRef GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet (London, England). 2016;388(10053):1545–1602. https://​doi.​org/​10.​1016/​s0140-6736(16)31678-6 CrossRef
12.
go back to reference Fox-Rushby JA, Hanson K (2001) Calculating and presenting disability adjusted life years (DALYs) in cost-effectiveness analysis. Health Policy Plan 16(3):326–331CrossRefPubMed Fox-Rushby JA, Hanson K (2001) Calculating and presenting disability adjusted life years (DALYs) in cost-effectiveness analysis. Health Policy Plan 16(3):326–331CrossRefPubMed
14.
go back to reference Lopez A, Salomon J, Ahmad O, Murray C, Mafat D (2001) Life tables for 191 countries: data, methods and results. EIP/GPE/EBD World Health Organization Lopez A, Salomon J, Ahmad O, Murray C, Mafat D (2001) Life tables for 191 countries: data, methods and results. EIP/GPE/EBD World Health Organization
18.
go back to reference Ozgediz D, Jamison D, Cherian M, McQueen K (2008) The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 86(8):646–647CrossRefPubMedPubMedCentral Ozgediz D, Jamison D, Cherian M, McQueen K (2008) The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 86(8):646–647CrossRefPubMedPubMedCentral
19.
go back to reference Agbakwuru E, Arigbabu AO, Akinola OD (1995) Local anaesthesia in inguinal herniorrhaphy: our experience in Ile–Ife, Nigeria. Cent Afr J Med 41(12):405–409PubMed Agbakwuru E, Arigbabu AO, Akinola OD (1995) Local anaesthesia in inguinal herniorrhaphy: our experience in Ile–Ife, Nigeria. Cent Afr J Med 41(12):405–409PubMed
20.
go back to reference Mbah N (2007) Morbidity and mortality associated with inguinal hernia in Northwestern Nigeria. West Afr J Med 26(4):288–292PubMed Mbah N (2007) Morbidity and mortality associated with inguinal hernia in Northwestern Nigeria. West Afr J Med 26(4):288–292PubMed
21.
go back to reference Arowolo OA, Agbakwuru EA, Adisa AO, Lawal OO, Ibrahim MH, Afolabi AI (2011) Evaluation of tension-free mesh inguinal hernia repair in Nigeria: a preliminary report. West Afr J Med 30(2):110–113PubMed Arowolo OA, Agbakwuru EA, Adisa AO, Lawal OO, Ibrahim MH, Afolabi AI (2011) Evaluation of tension-free mesh inguinal hernia repair in Nigeria: a preliminary report. West Afr J Med 30(2):110–113PubMed
22.
go back to reference Ohene-Yeboah M (2003) Strangulated external hernias in Kumasi. West Afr J Med 22(4):310–313PubMed Ohene-Yeboah M (2003) Strangulated external hernias in Kumasi. West Afr J Med 22(4):310–313PubMed
24.
go back to reference EACOOTAAAAAEADR A (2015) Groin Hernias at the Wesley Guild Hospital Ilesa, Nigeria: characteristics and emerging patterns of repair. Niger J Surg Sci 25(1):9–14CrossRef EACOOTAAAAAEADR A (2015) Groin Hernias at the Wesley Guild Hospital Ilesa, Nigeria: characteristics and emerging patterns of repair. Niger J Surg Sci 25(1):9–14CrossRef
Metadata
Title
Sustainability in humanitarian surgery during medical short-term trips (MSTs): feasibility of inguinal hernia repair in rural Nigeria over 6 years and 13 missions
Authors
F. Oehme
L. Fourie
F. J-P. Beeres
S. Ogbaji
P. Nussbaumer
Publication date
01-06-2018
Publisher
Springer Paris
Published in
Hernia / Issue 3/2018
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-018-1758-4

Other articles of this Issue 3/2018

Hernia 3/2018 Go to the issue