Rural surgery in Guinea Bissau: An experience of Doctors Worldwide Turkey

INTRODUCTION: In Africa, there is critical shortage of surgeons. Majority of the surgeons work in urban centers, there is almost none working in the rural side. This study documents surgical interventions performed in Guinea-Bissau by Doctors Worldwide Turkey.
METHODS: A group of surgeons from the Doctors Worldwide Turkey performed various procedures in the Simao Mendes, Gabu and Bafata community hospitals. Demographics, surgical methods, anesthesia techniques, and complications were recorded.
RESULTS: Sixty four procedures were undertaken between 5-16 february 2010 and 6-11 may 2011. Mean age was 44,5 (range: 6-81) for 47 male (85,5%) and 10 female (17.5%) patients. Five cases were emergency. Hartmann procedure for rectal carcinoma; modified radical mastectomy for breast carcinoma; 2 right total thyroidectomy, 1 bilateral subtotal thyroidectomy; 2 incisionel hernia repairs with mesh, 1 breast lumpectomy, 3 mass excisions, and 2 keloidectomies, various techniques of hernia repair for 35 inguinal hernias (4 bilateral, 3 strangulated and 2 coexisting with hydrocele), Winkelman procedure for 5 hydroceles (1 bilateral), and unilateral orchiectomy for 1 bilateral hydrocele were recorded. Sixteen patients (28,1%) had general, 24 (42,1%) spinal, l5 (8,8%) epidural, 10 (17,5%) local, and 2 patients (3,5%) had IM ketalar anesthesia. There was no mortality.
DISCUSSION AND CONCLUSION: Surgical diseases, majority of which are hernias, are threatening public health in underdeveloped regions of Africa. Blitz surgery may be an efficient temporary solution.