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Table of contents

General survey of countries and operations

From the chairman

Introduction

Mission to Guinea-Bissau

Fact-finding mission to Guinea-Conakry

Mission to Zanzibar

Mission to Burundi

Joining forces in Burundi Johanna de Vries of Dokters van de Wereld reports.

Missions to Nigeria

Achieving lasting success in Uganda A follow-up on the Uganda Burns & Plastic Surgery Institute and Burn Prevention programme.

Dr Kuden. K. Deyin and Mr Kefas Tuwan at the Uganda Burns and Plastic Surgery Institute (UBPSI) Dr Kuden reports on their stay at the UBPSI in Kampala.

Sponsors ‘in the picture’

Interplast Holland information leaflet

Contact Interplast Holland

Special thanks to …

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S T I C H T I N G I N T E R P LA S T H O L L A N D

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2 G e n e r a l s u r v e y


General survey of countries and operations

Operation total = 10815 with 134 teams

Uganda 33 teams 2631 patients

Yemen 28 teams 2153 patients

Nigeria 11 teams 861 patients

Rwanda 4 teams 250 patients

Guinea-Bissau 5 teams 340 patients

Guinea-Conakry 1 team 30 patients

Burundi 6 teams 511 patients

Zanzibar 5 teams 364 patients

Indonesia 5 teams 498 patients

Ghana 18 teams 1362 patients

Vietnam 6 teams 976 patients

And teams to Lebanon, Bhutan, Namibia, Pakistan, India and Burkina Faso.

3G e n e r a l s u r v e y


From the chairman

You have in front of you the 2012 Annual Review of Stichting Interplast Holland. The review includes brief reports of our missions and other activities in the course of the year. Detailed mission and financial reports are to be found on our website www.interplastholland.nl.

Five regular missions and one fact-finding visit took place in 2012. Besides the missions to Burundi, Nigeria (twice), Guinea-Bissau and Zanzibar we gave support in the form of equipment and advice to Dokters van de Wereld (the Dutch branch of Médecins du Monde) for its project Operatie Glimlach. Dokters van de Wereld organises missions with Dutch plastic surgeons to Sierra Leone and Bangladesh. A member of staff of Dokters van de Wereld went with Interplast’s Burundi team to look at the way we work and get in touch with local stakeholders. A fact-finding mission was organised to Guinea-Conakry which did not exactly proceed in the way we expect at Interplast.

During the missions we operated on 450 children and (young) adults. Their future is considerably brighter as a result. We saw many happy faces.

Despite the financial crisis, Interplast Holland still managed to do a lot with your support. Only the spring mission to Burundi had to be cancelled. Thanks to our sponsors funds were just sufficient to allow us to meet our commitments to send missions to the various countries.

As for the training local staff, in Guinea-Bissau two young interns worked alongside the Interplast team while in Burundi the team was joined by the enthusiastic staff of the Oral Surgery department of the CHUK hospital in Bujumbura. Two Nigerians, a doctor and a nurse manager, received training at the Burns Centre in Uganda. Preparations for the Burns Centre in Mangu, Nigeria are in full swing thanks to the initiator and plastic surgeon Cees Spronk.

The Burns Centre in Uganda is functioning well by local standards. Unfortunately, the centre can still not manage without our financial support and in late 2012 we were obliged to help out once more. We have been in the process of bowing out financially in the past three years. In the future we will only operate there on occasion. The Burn Prevention

Programme that is being carried out in Uganda with the support of the Dutch Burns Foundation, Cordaid and Stichting Liberty is a big success. Many information sessions were held in the Kampala slum districts, where almost 65,000 people were made aware of unsafe situations and first aid in the event of burns.

We evaluated the project during our last visit to Uganda in November and December. There are visible changes in people’s attitude and behaviour, and thankfully there are even fewer burns injuries as was apparent from visits to different slum districts and interviews with local community leaders.Top level consultations have been held with Unicef Uganda and the Uganda Red Cross with a view to consolidating the gains of this programme, and ensuring their sustainability in the future. Agreements were made to integrate this successful prevention programme with their existing Community Based Programmes.

Without the support of our hardworking volunteers we could not have achieved so much! One of our volunteers from the very start is Marie Thérèse de By-de Bakker, and quite rightly she has been awarded a Dutch decoration, Officer in the Order of Orange Nassau, which was presented to her by the mayor of The Hague. Interplast’s work is greatly appreciated and so is the work of its volunteers!

Cooperation with Dokters van de Wereld on Operatie Glimlach will be expanded in the coming year. Talks on this will be held in early 2013.

We are only able to do all this thanks to our sponsors! Without your support and contributions none of this would be possible. Read all about our work on the following pages or follow us on our website, which provides more detailed information: www.interplastholland.nl.

Veel dank, thank you, merci beaucoup, vielen dank, shukran djazilan, asante sana, webalenyo!

Rein J. ZeemanChairman, Interplast Holland

44 F r o m t h e C h a i r m a n


This annual review for 2012 has largely been created and sponsored by volunteers.

Introduction

Stichting (Foundation) Interplast Holland is a charitable organisation that performs reconstructive surgery on children, young people and adults in developing countries. Each year the organisation sends teams of experienced plastic and reconstructive surgeons, anaesthetists and theatre assistants on a number of missions to developing countries.

The doctors and assistants, who are assisted by local doctors and nurses, work during their holidays and provide their services free of charge. Their assistance includes:

• performing reconstructive operations free of charge for children and adults with cleft lips and palates, disfi gurements caused by burns, tumours and other congenital deformities

• training local medical personnel in reconstructive surgery, anaesthesia and nursing techniques

• helping to set up burns and reconstructive surgery units in hospitals

To secure lasting results Interplast Holland works intensively with local hospitals, doctors, nurses, universities and NGOs. In order not to burden local hospitals unduly, almost all materials required to perform around 100-120 operations are brought from The Netherlands.

Interplast is an international organisation which was founded in the United States in 1969. Stichting Interplast Holland was founded in 1990. By now Interplast is represented in many other Western countries. As a foundation, Interplast Holland is fully independent from its fellow Interplast organisations. They are regarded as sister organisations.

Stichting Interplast Holland currently concentrates its activities in Burundi, Nigeria, Zanzibar, Uganda and Guinea-Bissau. Missions to these countries take place every year. Interplast Holland is also active in Indonesia where a mission is sent every three or four years.

In the past teams have also been sent to Vietnam, Pakistan, India, Bhutan and Lebanon.

There were six Interplast missions in 2012: two to Nigeria, one to Guinea-Bissau, one to Zanzibar, one to Burundi and the sixth one was a fact-fi nding mission to Guinea-Conakry. Missions to Yemen have not yet been resumed because of the political situation there.

Visionary goalInterplast Holland has a vision of a society in developing countries in which children and adults with physical disabilities are given medical treatment so that they can fully participate physically, mentally and socially in their community.

MissionInterplast Holland is a charitable organisation that seeks to give help in developments in reconstructive surgery and treatment in developing countries by participating to achieve the self-reliance of local doctors, nurses and other staff. The organisation works towards this goal by carrying out operations and providing training and courses during team missions, by founding and supporting plastic and recon-structive surgery units and burn centres, and by setting up Burn Prevention Programmes. Cooperation with other organisations in the Netherlands and abroad is high on the agenda of Interplast Holland. In the Netherlands the organisation aims to run its offi ce with the structured, administrative and policy support of mainly volunteers.

Marie-Thérèse de By-de Bakker awarded Order of Officer of Orange Nassau by mayor of The Hague Jozias van Aartsen

55I n t r o d u c t i o n


Guinea-Bissau

Official name Republic of Guinea-Bissau

Capital Bissau

Location West Africa

Surface area 36,152 km²

Number of inhabitants 1.7 million

Climate tropical

27 January - 11 February

TeamPlastic surgeon and team leader

Rein Zeeman

Assistant surgeon Charlotte Lameijer

Anaesthetist Dirk Jan Veldman

Anaesthetic nurse Marjo Aerts

Theatre nurse Toos Bareman

Local team Jan and Will van MaanenDelfi m Cabral and Crisologo MendesJohannes Mooij

Visited hospital Hospital Nacional Simão Mendes

Fifth mission in a row2012 saw the fi fth Interplast Holland mission to Guinea-Bissau since 2008. The local organising committee, Consul Jan van Maanen, his wife Will and Johannes Mooij had again done a marvellous job preparing for the mission. Proper local pre-screening ensures that the team see only few patients who prove ineligible for an operation.Two young doctors, Chris and Delfi m, joined the team at their own request under the auspices of the Health ministry.

Charlotte arrived with the team this time, but was unable to stay on longer for the aftercare. Chris and Delfi m were to take on this task.

First week: just one anaesthetic machineIn the process of setting up the operating theatre it turned out that only one of the anaesthetic machines worked. Luckily, another one could be borrowed at the beginning of the week from the leprosy hospital not far from Bissau.The operating theatre was often very busy, partly because of immense media interest in Interplast’s work. Everything went well and 43 patients were operated on in the fi rst week.

‘Chris and Delfi m are enthusiastic workers. They have had a basic training as doctors but they have a lot to learn before they can ‘operate’ on their own’, writes Rein Zeeman in his mission report. In contrast, Dr Lassana Intchsso performs all the noma (gangrenous stomatitis) operations together with Rein or under his guidance. Dr Lassana is due to become director of the new Noma hospital which will soon be open. He is well-qualifi ed to carry out operations which are not too complicated.

A passage from Charlotte’s report on the fi rst week: ‘The days fl y by. Toos has developed into a real Jill-of-all-trades. The local staff are constantly calling out ‘Toos, Toos, Toos’ to get her attention, but Rein and I don’t lag far behind. She stays calm, makes sure we have the sutures and gauzes we want but occasionally takes an extra stroll round the block to be out of earshot of the cries.Marjo is coaching the local anaesthetic staff as if she’s being doing it all her life, they are loving it. The job of inserting intravenous lines, and handling the doses of Halothane (an anaesthetic) is becoming more streamlined than ever.

GUINEA-BISSAU is a small West African country with an estimated population of 1.5 mill ion. It is one of the least developed countries in the world and among the poorest, ranking 176 out of 187 on the United Nation’s Human Development Index (2012). The Netherlands, for instance, is number 4. Average life expectancy is 48 years and infant mortality in the first year is almost 100 in every 1,000 children. The country l ives primarily from agriculture and has recently become the biggest exporter of cashew nuts worldwide.

66 G u i n e a - B i s s a u


Dirk keeps an eye on both tables throughout the seemingly chaotic process. A simple matter you might think, but it’s quite a challenge when you realise that there are around 15 people milling around two tables in the operating room, along with a local film team in there as well on occasions.’

Second week: screening at the weekendJan van Maanen together with Chris and Delfim screens another 50 people at the weekend. Most of them are eligible for an operation. Altogether 73 patients were operated on, though there were remarkably few children with cleft lips or palates among them. Have they meanwhile all been treated?

Charlotte goes on to write: ‘What is really noticeable this year is that the local population and government are helpful and more positive towards our visit than they have been in the past. The two local doctors (Chris and Delfim) are very much in evidence during the two weeks and also took upon themselves the aftercare of the operated patients after our departure. They want to specialise in plastic surgery but there are few opportunities for this is Guinea-Bissau. They are extremely eager to learn and certainly picked up a great deal from me and Rein.’

Great media coverage‘The government definitely paid us more serious attention and hopeful contacts have been forged for the future. This year, too, the national and international media were keen to keep track of our visit; the Interplast mission was covered on national radio, national television and Portuguese television. The finest sign of the trust that now seems to be placed in Interplast was the farewell organised by the hospital on Thursday evening. A representative of the Health Ministry spoke a word of thanks as did the director of the hospital. It’s good to see that people are keen to get on. It would be great if we, as Interplast, can make a small, but important contribution to this.’

The team posing with some of the patients

Dr Lassana, Sr Fatima and Dr Zeeman after a successful operation

77G u i n e a - B i s s a u


O p e r a t i o n s G u i n e a - B i s s a u

• 7 cleft lips and/or palates

• 34 post burn contractures

• 12 noma

• 20 other

• 21 certificates awarded

Noma patient, before and after surgery with Charlotte Lameijer

Noma patient, before and after surgery

Alweer de vijfde Interplast missie naar Guinee- Bissau sinds 2008. Dat men vertrouwen heeft gekregen in Interplast blijkt o.a. uit het feit dat op verzoek van het Ministerie van Gezondheid twee jonge basisartsen, Chris en Delfim, aan het team zijn toegevoegd. Zij werken twee weken enthousiast mee. Ook lokaal chirurg dr. Lassano Intschsso opereert weer mee. Samen met Rein Zeeman opereert hij voornamelijk de nomapatiënten. Het nieuwe nomaziekenhuis, dat dr. Intschsso gaat leiden, is bijna gereed. Er is tijdens deze missie veel media-aandacht. Ook de Portugese TV kwam langs! Dankzij de inmiddels zeer geroutineerde consul Jan van Maanen en zijn team konden bijna alle van te voren geselecteerde patiënten geopereerd worden.

La cinquième mission d’Interplast depuis 2008 en Guinée-Bissau. La relation de confiance est bien établie avec Interplast et le Ministère de la Santé a adjoint 2 médecins à l’équipe, Chris et Delfim. Ils ont travaillé en équipe avec enthousiasme pendant 2 semaines ainsi que le chirurgien local Dr. Lassano Intschsso. Ce dernier a opéré les patients de l’hôpital Noma avec le Dr. Zeeman. Le nouvel Hôpital Noma est presque opérationnel, il sera dirigé par le Docteur Intschsso. La mission a captivé les médias, même la télévision portugaise était présente ! Grâce a la préparation du Consul Jan van Maanen et son équipe, presque tous les patients sélectionnés ont pu être opérés.

88 G u i n e a - B i s s a u


Guinea-Conakry

Official name Republic of Guinea

Capital Conakry



Number of inhabitants 10 million

Climate tropical

11 - 24 March


Rein Zeeman

Plastic surgeon Etienne Lommen

Anaesthetist Geert Jan Goekoop

Anaesthetic nurse Eddy Hermanus

Theatre nurse Paula Ellen

Local support Idrissa Camara

Visited hospital Trusal Friguia (former Peychine) Hospital, Fria

A new destinationThe initiator of an Interplast programme in Guinea-Conakry is Idrissa Camara (Papingo), Guinean and former Olympic swimmer who has lived in the USA for years but who came into contact with Interplast because he was looking for help for his nephew Naromba who had a cleft lip and suffered terribly. Naromba was operated on in 2006 in Ghana by an Interplast Holland team (see 2006 Annual Review).

After a short visit by Rein Zeeman and Etienne Lommen in 2011, the fi rst team was sent out on a fact-fi nding mission. Papingo had travelled earlier from the USA to Guinea-Conakry to prepare for the arrival of the team. When the team arrived it was soon apparent that many arrangements had unfortunately not been made! The boxes that had been sent on ahead were still at the airport; they had been addressed to the Health Minister, but he was not in the country and could not be reached.

A false start in ConakryThree days and many offi cial bodies later, the boxes were at last collected at the airport by the team. In Conakry, no hospital to work in had been arranged. Our surgeon Professor Saadi, who had promised a lot of help, sadly failed to show up.

Guinea, formerly French Guinea, often called GUINEA-CONAKRY and officially the Republic of Guinea, is constitutionally a presidential republic in West Africa, situated on the Atlantic Ocean between Guinea-Bissau and Sierra Leone. The capital is Conakry. It is one of the least developed countries in the world and has about 10 mill ion inhabitants. (It ranks 178 out of 187 on the United Nation’s Human Development Index of 2012.)

The economy thrives mainly on tropical agriculture, fishing and mining. Guinea-Conakry is the second production country for bauxite, with almost half of the world’s bauxite reserves; besides, there is iron ore, and gold and diamonds are mined. The bauxite production is almost entirely in private hands, 85% of the proceeds go to foreign companies.

Naromba in 2006 and 2011

9X x x x x x x 9G u i n e a - C o n a k r y


Dressing change by Dr Lommen

An attempt was made to find accommodation for surgery elsewhere, but unhappily it was all at short notice. One of the options was Donka University Hospital which had a children’s ward with a small operating theatre complex. Here the team met the plastic surgeon Dr Karamba. It was agreed that some of the team would operate along with him on one morning while the other part of the team were getting the boxes cleared through customs. The operating room was much too small for the whole team! Unfortunately, Dr Karamba had a death in the family the next day and the programme was cancelled altogether.

Better luck in FriaThen on to a second location, the Trusal Friguia hospital in Fria. Here the team was given a warm and friendly welcome!Here are some extracts from Rein Zeeman’s report on the week in Fria: ‘Fria is a special African town. Quite a few things are done for the population and employees by the big bauxite mine. There is 24 hour electricity and water on tap for free. Another special aspect is the three large tower blocks which reminded us of the Bijlmer area in Amsterdam. The roads are in good order and there are even fire hydrants here and there.’

Warm welcome in Fria

10 G u i n e a - C o n a k r y


A mystery; hardly any cleft lips...On Monday 19th March, Rein wrote; ‘Today we were able to operate on six patients and screen some new ones. The operating theatre is fine to work in and the local staff cooperate very enthusiastically. Dr Bengoura (the local surgeon) gave us excellent guidance and helped with the operations. He also arranged for post-operative care. In the end we operated on 30 patients. We were struck how few cases of cleft lips and palates we saw. Did all these patients come from Haute-Guinee perhaps? If so, that would seem to be an excellent location for a future Interplast mission.

One of only 7 cleft lips! Before and after surgery

During this 2012 mission, the number of patients was below what we are used to, but the next time we will see to it that there are many more.’

On the final day of this successful mission, Reins diary read; ‘Our farewell reception was heart-warming and we have been asked to come back next year. Clearing the equipment through customs can be done through a French agency. We left behind a Watson skin graft knife so that the local doctors can cut their own skin grafts to treat patients with burns and contractures’.

Handing over the Watson skin graft knife

11G u i n e a - C o n a k r y


Initiator voor een Interplast-programma in Guinee-Conakry is Idrissa Camara (Papingo), een populaire Guinees en voormalig olympisch zwemmer die al jaren in de VS woont, maar met Interplast in contact kwam doordat hij hulp zocht voor zijn neefje Naromba die een lipspleet had en daar erg onder leed. Naromba werd in 2006 in Ghana geopereerd door een team van Interplast Holland (zie ook Jaarverslag 2006).Na een kort bezoek van Rein Zeeman en Etienne Lommen in 2011 werd nu een team uitgezonden voor een ver-kennende missie. Wat vanuit Nederland allemaal zo goed georganiseerd leek bleek bij aankomst niet het geval. De eerste week kon het team niet veel doen. Er was geen ziekenhuis beschikbaar waar geopereerd kon worden en de materialen stonden nog op het vliegveld.Gelukkig maakte de tweede week in Fria alles goed. Hier een enthousiast en warm welkom, en veel bereidwilligheid om met het team samen te werken.

L’initiateur du programme Interplast est Idrissa Camar (Papingo), un Guinéen médiatique et ancien champion olympique de natation qui vit aux USA. Il est entré en contact avec Interplast pour son neveu Naromba qui souffrait d’un bec de lièvre. Naromba a été opéré par une équipe d’Interplast Holland en 2006 au Ghana (voir le Rapport Annuel 2006).Après une courte visite de Rein Zeeman et Etienne Lommen en 2011, une équipe a été envoyé en mission de reconnaissance. Ce qui semblait bien organisé vu des Pays Bas n’a pas été le cas à l’arrivée. Il n’y avait aucun hôpital disponible où les interventions auraient pu prendre place et le matériel était encore à l’aéroport.Néanmoins la seconde semaine à Fria s’est bien passée. Nous y avons trouvé enthousiasme, chaleureux accueil et volonté de travailler avec l’équipe.

O p e r a t i o n s G u i n e a - C o n a k r y


• 18 post burn contracture

• 5 other

Teaching on the job in Fria

You can read Rein Zeeman’s complete report at www.interplastholland.nl.

Posing with enthusiastic staff in Fria

12 G u i n e a - C o n a k r y


Zanzibar

Official name Zanzibar

Capital Zanzibar City

Location island in the Indian Ocean, east of Tanzania

Surface area 1554 km²


Climate tropical

10 - 24 February


Ed Hartman

Plastic surgeon Ruth Lester

Anaesthetist Gijs Witte

Anaesthetic nurse Ingrid Hollander-Mus

Theatre nurse Jolanda Kooijman-Eskes

Visited hospital Mnazi Mmoja Hospital

A well-prepared missionThe Zanzibar missions are always prepared well by Dr Ramadhan Suleiman at the Mnazi Mmoja Hospital. Dr Rama selects patients in Zanzibar and the nearby island Pemba weeks before the team is due to arrive. Since this was the sixth team to visit Zanzibar since 2009 he knows by now which operations the Interplast surgeons perform. Obviously, the patients have to be healthy and it is the Interplast anaesthetist who has the last word on that. On this mission it was Gijs Witte, an Interplast member from the outset with 20 missions behind him and a wealth of experience.

The fi rst (screening) day in the hospital was a Sunday. The reunion of the team and local staff was a warm occasion. Almost 120 pre-selected patients were waiting. Some of these had to be turned down for the operation, sometimes because they were still too young or because they had a low blood count (HB).

The island of ZANZIBAR l ies off the east coast of Africa and is a semi-autonomous part of Tanzania. The island of Pemba close by is often considered to be part of Zanzibar.

Many patients waiting for screening

13Z a n z i b a r


O p e r a t i o n s Z a n z i b a r


• 46 hypospadia (birth defect of the urethra) or urethral fistula


• 10 other

In the end, the team operated on 83 patients, many of whom again had urogenital problems in which Ruth Lester (UK) specialises. Ed operated on the patients with cleft lips and/or palates, post burn contractures and tumours. There were remarkably few children with cleft lips and/or palates this time.

Sharing knowledgeThe director of the hospital, Dr Jamala, and Dr Rama invited the team to give a presentation of the work of Interplast Holland to local staff. Both Ruth and Ed gave a lecture, Ruth spoke about the problems surrounding badly performed circumcisions and Ed spoke about cleft lips and/or palates and post burn contractures.

The anaesthetic staff Khamis and Mgeni were impressed by Gijs’ techniques, above all the use of a local rather than a general anaesthetic, and they learned a lot.

Excellent cooperationThe days were long but the team had excellent support from the local staff. They are becoming more and more attuned to each other. Practically everyone could be operated on thanks to the sound pre-selection by Dr Rama. The team carried out a total of 83 operations, though anaesthetic was administered 90 times in connection with dressing changes.

Before and after cleft lip operation

Post burn contracture before and after surgery

14 Z a n z i b a r


Il y avait plus de 120 patients sélectionnés. Le Dr Rama a sélectionné en avance à Zanzibar et à l’ile Pemba dans les semaines précédant la mission. C’est la sixième équipe qui se déplace à Zanzibar et les retrouvailles avec l’équipe locale est toujours chaleureuse ! Pour la première fois l’anesthésiste et membre d’Interplast de la première heure Gijs Witte était présent. Il a impressionné par les techniques employées (anesthésie locale, pas d’anesthésie générale nécessaire) et les collaborateurs anesthésistes ont beaucoup appris. L’équipe a fait de longues journées mais a reçu un soutien formidable de l’équipe locale qui s’organise de mieux en mieux !

Er waren meer dan 120 patiënten geselecteerd voor de screening. Dr. Rama selecteert van te voren op Zanzibar en op het nabijgelegen eiland Pemba in de weken voor afgaand aan de missie. Alweer het zesde team dat Zanzibar bezoekt, en het weerzien met de lokale staf is dan ook altijd heel hartelijk! Voor het eerst ging anesthesio-loog, en Interplaster van het eerste uur, Gijs Witte mee. Men was al snel onder de indruk van de technieken (vooral regionale anesthesie, geen narcose nodig) van Gijs en de anesthesie medewerkers hebben veel van hem geleerd. Het team maakte lange dagen maar kreeg voortreffelijke ondersteuning van de lokale staf. Ze raken steeds beter op elkaar ingespeeld!

The entire team posing together

15Z a n z i b a r


Burundi

Official name Republic of Burundi

Capital Bujumbura

Location Central Africa



Climate tropical

21 September - 6 October


Rein Zeeman

Plastic surgeon Esther Mesters

Anaesthetist Rutger van Leersum

Anaesthetic nurse Jan van Steen

Theatre nurses Marie-Thérèse de By- de BakkerEls Gerritsen

Chairman Izere André Nkeshimana

Visited hospitals Centre Hopitalo Universitaire de Kamenge, BujumburaNgozi Hospital, Ngozi

BURUNDI is one of Africa’s smallest and most densely populated countries. The civil war lasting from 1994 to 2005 has meant that it is also one of the world’s poorest. (It ranks 178 out of 187 (shared with Guinea-Conakry) on the United Nation’s Human Development Index of 2012.)

It is located in the great lakes region of Central Africa and is landlocked. Medical care is accessible to very few. Sixty-five out of 1,000 children die within their f irst year. There are less than 0.5 physicians per 10,000 inhabitants.

Only one mission this yearIn early 2012, the deteriorating fi nancial situation of Inter-plast meant that it was sadly impossible to organise two missions to Burundi. The spring mission had to be cancelled.Fortunately, a sponsor was found and the autumn mission to Burundi did take place.

The two chairmen, of Interplast and Izere, Rein Zeeman and André Nkeshimana, departed two days earlier than

the rest of the team. And a good thing, too, because Interplast’s medical supplies were still waiting to be collected at the airfi eld and at the fi rst hospital, CHUK (Centre Hopitalo Universitaire de Kamenge) in Bujumbura nothing had been arranged.

Staff in CHUK

Wonderful local supportIt was fantastic that Brarudi (Heineken) had provided a bus with a driver. The team was really delighted. They were equally happy with a fi nancial contribution from the Dutch Embassy in Bujumbura.

On Friday, the day before the rest of the team arrived, they were allocated the operating theatre for stomatology in the CHUK. Professor Gordien was called out of an operation and was informed on the spot that Interplast Holland was going to be working in his operating theatre.In the end the arrangement worked well and the entire staff, assistants and nurses, as well as professor Gordien himself, enthusiastically cooperated in the team’s work for much of the week.

16 B u r u n d i


Neurofibromatosis (tumour growing from nerve system), partial resection

Unfortunately, there were fewer patients on the screening day this time, and certainly a lot fewer patients with cleft lips and/or palates. The explanation for this was that medical teams from India and Kenya had just been to Bujumbura, and they had mainly focussed on helping patients with these deformities. There were, however, more than enough patients with tumours and post burn contractures.After Dr Jean-Claude (a local doctor engaged by Interplast) had solved the bed problem for our patients, the operating days went well. There were approximately ten operations a day, including a few major operations. Professor Gordien operating on a cleft lip

Before and after bilateral cleft lip operation

17B u r u n d i


A great many patients at NgoziIn contrast to Bujumbura, the number of patients at Ngozi was overwhelming. More than 150 patients were waiting, and all of them wanted to see the Mzungu (white) doctor as is apparent from Rein Zeeman’s report: ‘It turned out that everyone had paid around 500 Bfr, which is approximately 30 euro cents, but it did mean that everybody wanted attention and advice. It was all rather hectic, though fortunately we managed to see them all before it got dark’.

Earlier visits to Ngozi had been memorable because of the enthusiasm of the local staff, but now, in the absence of the only local surgeon Dr Augustin, the organisation in the operating theatre had suffered. Thankfully, Dr Claude was very enthusiastic. The anaesthetic team were given Italian support in the form of Dr Vania, an intensive care anaesthetist from Verona. The operating theatre programmes were full, but in the end the team managed to work through them all without any problems and in four days they performed almost 50 operations!

During the ward round on the first day, the Interplast team found that nothing had been arranged for their patients, no checks had been carried out and none of them were being given anything to eat or drink. Luckily, the team managed to make arrangements for their patients with the hospital kitchen that same evening.

The vaporiser that they had brought with them from The Netherlands fitted exactly onto the anaesthetic apparatus. A stroke of good fortune, for back in 2010, in a different hospital, the Interplast team had had to borrow one because there was no working equipment. Now they could immediately put the apparatus to good and safe use.

The start of the car trip back to Bujumbura, for the post-operative rounds and flight back home on Friday morning, was difficult because of the scarcity of petrol. In the end, after some haggling, and after having paid a somewhat higher price on the black market to get enough petrol for their return trip, the team set off for Bujumbura where they were to carry out the final dressing changes at CHUK with Dr Jean-Claude.

Happily, there were few complications and they could be satisfied with the results. After a slow start at CHUK it was a successful mission, with sincere thanks to their wonderful hostess Esperence (nobody became ill!), Brarudi and our embassy in Bujumbura.

The next mission will be to Kibimba and Ryuigi in the Eastern part of Burundi in March 2013.

In Ngozi; mother with operated child

O p e r a t i o n s B u r u n d i



• 45 other

Adult, before and after cleft lip operation

18 B u r u n d i


Joining forces in Burundi

Theatre nurse Johanna de Vries took part in the Burundi mission on behalf of Dokters van de Wereld; this is her personal report.

‘From 21 September to 5 October 2012 I went on an Interplast mission to Burundi as a representative of Dokters van de Wereld, the Dutch branch of Médecins du Monde. My job was to observe and learn how Interplast worked since Dokters van de Wereld has the same mission as Interplast, namely reconstructive surgery in developing countries with an emphasis on children with cleft lips, cleft palates and burns contractures.

Since 2010, Dokters van de Wereld has been organising surgical team missions and has cooperated well with Interplast from the outset, with the Interplast team supporting our missions with knowhow and materials. The present joint mission therefore also served to assess to what extent the cooperation could be stepped up. Running a joint mission was the best way to fi nd out.

In Burundi we worked in two hospitals, in the capital Bujumbura and to the north in Ngozi. Both missions were a success. Interplast was in Burundi for the sixth time and the pre-screening has been extremely well-organised partly thanks to this. Rein Zeeman, the team leader, made a detailed selection immediately on arrival in the hospital: patients with a cleft lip, a cleft palate and/or contractures arising after burns were fi rst selected and included in the operating programme. All other patients were also seen by the surgeons and if possible put down for surgery.

The impressive aspect of a mission of this kind is the conclusion that common and additional experience are important factors. We see opportunities for setting up and carrying out joint missions in the future.

The mission with Interplast was extremely successful and instructive. The team in which I took part was highly competent, open and friendly. A big thank you for the success we had and the pleasant way we worked together.’

Johanna de VriesMedical Coordinator, Dokters van de Wereld

In 2012 liet de verslechterde fi nanciële situatie

van Interplast het niet toe twee missies naar Burundi te organiseren. Gelukkig werd voor de najaarsmissie een sponsor gevonden!In het Centre Hopitalo Universitaire de Kamenge (CHUK) was niet veel geregeld voor de komst van het team. Professor Gordien van de afdeling Stomatologie kreeg een dag van te voren te horen dat zijn afdeling het Interplast-team moest gaan faciliteren. Uiteindelijk was dit een groot succes want professor Gordien en zijn hele staf werkten enthousiast mee.De tweede week in Ngozi was het aanbod van patiënten weer groot. Door het wegvallen van de enige chirurg, dr. Augustin, was de organisatie op de operatiekamer beduidend minder. De meegebrachte verdamper paste gelukkig precies op het anesthesieapparaat!Hier kon na wat opstartproblemen weer goed gewerkt worden.

En 2012 la situation fi nancière d’Interplast n’a pas permis les 2 missions prévues au Burundi. Heureusement un sponsor a été trouve pour la mission d’automne !L’arrivée de l’équipe n’a pas été bien préparée au Centre Hopitalo Universitaire de Kamenge (CHUK). Le professeur Gordien, unité de stomatologie n’a appris que la veille de l’arrivée de l’équipe qu’il devait mettre à disposition son unité. Mais fi nalement la mission a été un grand succès puisque le Professeur Gordien et son équipe ont travaillé avec enthousiasme.La deuxième semaine à Ngozi les patients étaient nombreux mais l’absence du seul chirurgien Dr Augustin a gêné l’organisation dans la salle d’opération. L’évaporateur que nous avions apporté s’adaptait sur l’appareil d’anesthésie !Après quelques problèmes de départ nous avons pu bien travailler.

Johanna de Vries

19J o i n i n g f o r c e s i n B u r u n d i


Nigeria

Official name the Federal Republic of Nigeria

Capital Abuja




Climate from tropical to sub-tropical

7 - 24 March


Cees Spronk

Plastic surgeon Jan Hochtritt

Assistant plastic surgeon Hanneke Tielemans

Anaesthetist Ina Groustra

Theatre nurses Femke AnnemaAnnette Brouwer

Anaesthetic nurse Aafke Lautenbach

Visited hospital COCIN Hospital & Rehabilitation Centre, Mangu

6 - 21 October


Cees Spronk

Plastic surgeon Jan Willem Kortleve

Assistant plastic surgeon Marije Smitenberg

Anaesthetist Rob Niemeijer

Theatre nurses Fatima van Klaveren Geert Wijnsma

Anaesthetic nurse Geke Hoeksma

Visited hospital COCIN Hospital & Rehabilitation Centre, Mangu

The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in the north. Nigeria is roughly divided in half between Muslims, concentrated mostly in the north, and Christians, who mostly l ive in the South. Nigeria is the most populous country in Africa and despite huge oil revenues there is sti l l great poverty.

March mission able to go aheadAgain it was a tense situation beforehand as to whether the mission would go ahead or not. In Jos the situation is strained because of confl icts between Christians and Muslims. Unfortunately, attacks are a daily occurrence though luckily Mangu is about 80 kilometres away from Jos. Thanks to our people on the ground we know that Mangu itself is fairly unaffected by all the unrest.

Many patients waiting for the team to arriveAfter 12 missions the arrival of a plastic surgery team from the Netherlands is a familiar occurrence in the wider region. There are always a lot of people waiting to see the plastic surgeons, who this time were Cees Spronk, Jan Hochtritt and assistant Hanneke Tielemans. This time the team stayed for two and half weeks and operated on almost 100 patients, half of whom had post burn contractures. It is obvious that care for burns patients is non-existent here. Cees Spronk hopes that with the aid of the Faridpur Foundation and Interplast Holland, for one thing, this lack can be remedied and a burns centre set up.

Courage certificates are highly appreciatedHere is an extract from the report of Hanneke Tielemans who was on a mission for the fi rst time: ‘The anaesthesia team brought with them small gifts and a Courage Certifi cate for all the young children who had to be operated on. After the fi rst day, we noticed that the adults were also extremely keen to have a certifi cate. In fact, we heard through the nurses that somebody had failed to be given one. So from day two onwards every patient was awarded a Courage Certifi cate’.

The team worked well together and the atmosphere was pleasant. The operations went well and there was one case

20 N i g e r i a


that the team will not forget easily; a child of 11 months with a huge tumour on her head. Hanneke; ‘We saw her at the in-patients clinic and had to choose between doing nothing, which meant that we would have to assume that she would die in the not too distant future, or operating on her with the limited means that we had at our disposal. We chose the latter. In the course of the operation she had to be reanimated, but thanks to the team working together well and excellent directions from Ina, the anaesthetist, all went well. When the team visited the wards the next day, the girl was already being breastfed by her mother. Reanimated child the next morning

Patients waiting for screening

21N i g e r i a


On the last day we had the prospect of another nice activity, a teaching session by Annet about hygiene and the prevention of infection and handing out the certificates. Those who are called forward are visibly proud to receive their Interplast certificate.’

‘A fantastic mission’Hanneke thoroughly enjoyed taking part in this mission; ‘Altogether we have learnt a lot during this mission. On the last evening we had a farewell dinner with invited guests, and we were extensively thanked for our efforts. We are happy and satisfied the next morning when we step into the buses on the way to the airfield. A fantastic mission and we hope that many more will follow.’

Ondanks de gespannen situatie in Jos vanwege aanhoudende conflicten tussen Christenen en Moslims kan de missie door gaan. Dankzij de contacten ter plaatse weten we dat er in Mangu niet veel te merken is van alle onlusten.Het team blijft deze keer ruim twee weken, en van de

bijna 100 geopereerde patiënten heeft iets meer dan de helft een brandwondcontractuur. Het is duidelijk dat goede zorg voor brandwondenpatiënten hier nog niet bestaat. Cees Spronk hoopt daar met hulp van o.a. Stichting Faridpur, de Nederlandse Ambassade en Interplast Holland verandering in te brengen door er een brandwonden-centrum op te zetten.

Malgré la situation tendue à Jos concernant les conflits entre chrétiens et musulmans, la mission a pu avoir lieu. Grace à des contacts locaux nous savons qu’à Mangu la situation est relativement calme.L’équipe est restée 2 semaines et demi et plus de la moitie des 100 patients opérés sont des PBC (contractures post brûlure). Il est évident qu’il n’existe pas encore de soins postopératoires adéquats pour les patients brulés. Cees Spronk espère qu’avec l’aide de l’Association Faridpur, l’Ambassade Néerlandaise et Interplast Holland, il sera possible d’apporter un changement et d’ouvrir un centre de soins pour les Grands Brûlés

October mission: tough circumstancesHappily, the second mission to Nigeria went ahead as usual. The fact that Mangu is a remote area is apparent from the following extract from the report on this mission, written by Geke Hoeksma.

‘After having travelled 17 hours and being warmly received by Kefas (manager and head of nursing in Mangu) and the driver Sati at the airport, we arrive late in the evening at the Sisters of Divine Love, a hotel in COCIN (Church of Christ in Nigeria) near Abuja. After a sound night’s sleep we leave the next morning in a truck (borrowed from the leprosy foundation) and a dilapidated bus belonging to the home for disabled children, for a long drive to Mangu.The bus breaks down on the way because of a ‘belt’ that has come loose in part of the engine. The men repair it with a bit of wood from the bush and we proceed further. A little further on, the wedge has to be fixed again and after another 6 hours we arrive safely at our guest house.Like the bus the guest house is in a desperate state of disrepair, there is no running water and electricity only occasionally. Hotels are nowhere to be seen.’

Despite these tough circumstances, both teams, who were led by Cees Spronk and supported by the Faridpur Foundation and the Dutch Embassy, have brought about many changes in Mangu. After the completion of the new nursing ward a lot of work is being done on building a new operation theatre complex.

O p e r a t i o n s N i g e r i a , M a r c h


• 7 hypospadia or urethral fistula


• 32 other


Hanneke Tielemans with patient

22 N i g e r i a


Civil unrest prevents patients from showing upAgain a lot of patients turned up on the screening day. The result after a day’s screening was a full operating schedule. However, altogether 21 of the registered patients failed to turn up. No-shows in such numbers had never occurred before. The riots and unrest in the surroundings areas were probably responsible. People could not travel safely or dared not take the risk. Even so, almost 80 operations were performed covering the familiar spectrum of many post burn contractures, cleft lips and palates, occasional hypospadias and a few keloid reductions (removal of benign tumours).

The medical director, Dr Kuden, and head of nursing and manager, Mr Kefas Tuwan, went to the burns centre in Uganda directly after the mission for a fi ve week training course. You can read Dr Kuden’s report on page 27 and 28.

Na de nieuwe verpleegafdelingen wordt er nu hard gewerkt aan de bouw van een nieuw OK-complex, en medisch directeur dr. Kuden en hoofd verpleging en manager Kefas zijn direct na afl oop van de missie voor een training van vijf weken naar het brandwondencentrum in Kampala, Oeganda gegaan. Deze training is verzorgd door Interplast Holland en het Uganda Burns & Plastic Surgery Institute.

Après la construction du département de soins, la construction du complexe de salle d’opération est en route. Le directeur médical Dr. Kuden et le Chef infi rmier et le manager Kefas sont allés directement après la mission en formation de 6 semaines au Centre pour grands Brulés de Kampala/Ouganda. Cette formation est offerte par Interplast Holland et le Uganda Burns & Plastic Surgery Institute.

O p e r a t i o n s N i g e r i a , O c t o b e r


• 8 hypospadia or urethral fistula


• 25 other


Before and after cleft lip surgery

Young child with post burn contractures; left hand and face

Mother with child, after cleft lip operation

23N i g e r i a


Achieving lasting success in Uganda

Interplast Holland is involved in two long-term projects in Uganda; the UBPSI (Uganda Burns and Plastic Surgery Institute) and theBurn Prevention Programme. Rein Zeeman reports on the current situation.

Work continues at the Burns CentreThe Burns Unit is still functioning well under the management of Dr Christine and Dr Morgan (supervised by Dr Ssentongo). The new steriliser in the operating theatre functions well. A Canadian team has worked at the centre, mainly operating in the burns theatre. There didn’t appear to be that many patients.

The big ward rounds still take place, and often the plastic surgeons are present. Our Nigerian colleagues from Mangu (who are in Uganda to train) joined the team on a temporary basis, working in the operating theatres and changing dressings. They received additional training from Marjo and myself. In any event they have gained enough practical experience. They weren’t very keen on Ugandan food though!

Financial restraintsBandages and gauze are difficult to come by at the moment. In Holland Ward, parts of the ceiling are collapsing here and there. Some renovation will be needed next year. During a talk with the new Mulago hospital director about UBPSI it emerged that he was not really aware of the financial difficulties surrounding the institute. These issues will have to be resolved through the Mulago budget. He was, however, very interested in the results of the Burn Prevention Programme. Mulago will be embarking on renovations next year, and these will include the Burns Unit.

Changes at the BoardDirk ten Brink is retiring as chairman and will be succeeded by the Hon. Tim Lwanga. Astrid de Rooij will also be stepping down as treasurer because of other pressing claims on her time.

Top talksWe have been in touch with Health Minister Dr Christine Ndoa, whom we met in 2005 when we inspected the Arua Hospital for a team mission. She is currently working with advisor Ben Khingi, and we were able to consult with him on the Burns Unit which we did in depth. Besides talking about the contract, we also provided a résumé of Interplast’s history in Uganda for the minister. Altogether we provided him with enough information to lobby for the cause of UBPSI with the minister. We’ll just have to wait and see. In any invent it is clear to everyone that there will no longer be any question of financial support from Interplast Holland. Plans for projects can nevertheless be submitted, and we will try to find donors for them.

Burn Prevention ProjectThe seven Burn Prevention Officers worked hard. In total around 1200 information sessions were carried out in the slums around Kampala and in major markets. An audience of 65,000 was reached. Besides, 53 sessions were also organised at 37 schools.Charles (Community Mobilizer) did a second series of inter views, to follow up on the baseline interviews that were held a year ago. We checked the finances and also the effects on the ground by interviewing a number of community leaders (12), and by looking around for ourselves in the various districts and asking about the sessions and the possibilities for change.

Interview in slum areaWard round Burns Unit

24 A c h i e v i n g l a s t i n g s u c c e s s i n U g a n d a


Protecting children from Some sigiris (metal stoves) have now indeed been screened off with a piece of corrugated metal, while others have been put in a safer place.

Small children are no longer allowed access to a market in Rubaga. The local chairman for Mulago 1 reported that there were no children with burns in his community this year. Last year there had been 15. People watch out for each other and pass the message on if dangerous situations are found.

The Burn Prevention Officers

Protected sigiri

25A c h i e v i n g l a s t i n g s u c c e s s i n U g a n d a


What’s the next step?Unfortunately, we have had to cancel the burns symposium planned for this year because of the financial situation. Unicef Uganda and the Uganda Red Cross Society were contacted with a view to proceeding further with the Burn Prevention Project in Uganda. Both organisations were impressed by the figures, particularly those for the burns victims aged under five (60 to 70% of which are caused by hot water). They occur mostly close to cooking stoves, and can thus be prevented successfully.

Both organisations adopted our view that burn prevention can easily be incorporated into their existing programmes. Marjo gave the Burn Prevention Officers a crash course on how to train the trainers. They will go on to train Red Cross volunteers in providing specific information about burn prevention. Burn prevention will also be included in Unicef’s Child Protection and Adult Education programme. Having held such positive progress talks, contact will be continued by email from now on.

Continuing the Burn Prevention ProgrammeWe must try and ensure that the projects in the slum areas and in the schools continue for another six

months or so for continuity’s sake. No more than 50 to 60 sessions per month can take place within this period. A budget for this will need to be found. Unfortunately, we can no longer count on the Dutch Burns Foundation for this. We were told that Welsly Bhoda had resigned as director in connection with differences of opinion with the Board regarding foreign policy.

Community Based Rehabilitation AllianceWe met Barbara Batesaki, the Executive Director of Community Based Rehabilitation Alliance, an indigenous NGO dedicated to the empowerment of people with disabilities which cooperates closely with the Health ministry. She was also very interested in the Burn Prevention Programme. It would be possible for our discharged burns patients to be tracked and checked by her organisation when they return to their villages. All we need to do is give the name of the village and a short medical record. This would be a welcome solution to the difficult follow-up of burns victims in Uganda.

Information session in slum area

26 A c h i e v i n g l a s t i n g s u c c e s s i n U g a n d a


Dr Kuden. K. Deyin and Mr Kefas Tuwan at the Uganda Burns and Plastic Surgery Institute (UBPSI)by Dr Kuden

The tripMr Stephen Kato, the administrator of the Uganda Burns and Plastic Surgery Institute met us at the airport to convey us to the Modest Inn in Kampala where we stayed for five weeks.

On Monday, 29 October, 2012 the administrator also came to the hotel to take us to the hospital where we met Mr Robert Ssentongo, the Head of the Uganda Burns and Plastic Surgery Institute who welcomed us and briefed us on the activities of the Institute. Afterwards, the administrator took us on a tour of the institute. We later on settled in and familiarised ourselves with the routines of the institute.

The set-up of the Uganda Burns and Plastic Surgery Institute (UBPSI)The Uganda Burns and Plastic Surgery Institute is part of Makerere university teaching hospital Mulago located in Kampala, the capital city of the Republic of Uganda. Though a part of the teaching hospital, it has some degree of autonomy especially when it comes to its relationship with donor partners such as Interplast Holland which is a major stakeholder.The institute is headed by a senior consultant plastic surgeon in the person of Mr Robert Ssentongo. It also has three plastic surgeons, one medical officer, a volunteer senior house officer, interns, nurses and other support staff who have had training in burns management of diverse kinds. The Institute also has two administrative officers who oversee the administrative aspects.In terms of infrastructure, the institute has a burns ward, theatre, an out-patients clinic, intensive care unit, kitchen, a store and a plastic ward.

Clinical workFresh cases of burns are seen in the emergency unit of the hospital by designated medical officers on a daily basis, after which the patients are referred to the burns unit where they are either admitted for further management, treated or treated on out-patient basis.

The burns unit conducts general ward rounds twice a week (Mondays and Wednesdays), out-patients clinic and runs theatre sessions three times a week (Tuesdays, Thursdays and Fridays); however emergencies requiring surgical intervention can be carried out at any time during the week.During my period of stay with the burns unit I carried out the following activities:

• Involved in the admissions of fifteen (15) new cases of burns.

• Performed one cut down and one debridement.

• Eight (8) skin grafts (mesh 1:3) with 7 of them having between 80-90% take, and one graft failure.

• Assisted in 10 skin grafts with Dr Morgan.

• Observed one of the plastic surgeons performing eight (8) cleft lips/palate repairs.

• Participation in ward rounds with the Plastic surgeons and the other medical officers.

Mr Kefas Tuwan was involved in the following activities during the period under review:

• Admissions of ten (10) new cases of burns.

• Monitoring of fluid balance in two patients.

• Change of wound dressings in twenty-five patients, two of which were infected wounds which required using povidone. Most of the dressings involved the use of flamazine cream or normal saline for skin grafts.

• A session with the public health nurse/tutor, Marjo Aerts, on burns prevention.

Finally we also had very useful discussions with Mr Robert Ssentongo, one of the pioneer plastic surgeon of the institute and Dr Rein Zeeman on how to set up a burns unit in resource-scarce settings such as those found in developing countries.

Extracurricular activitiesOutside the hospital routines, we had the opportunity to go to Jinja, where we saw the source of the Nile courtesy of the institute administrator, Mr Stephen Kato.

27 T r a i n i n g a t t h e U B P S I


Dr Kuden en Kefas uit Mangu Nigeria zijn direct na vertrek van het Interplast team in oktober vertrokken naar Oeganda. Zij hebben vijf weken op de Burns Unit gewerkt om zoveel mogelijk te leren, niet alleen over de zorg voor brandwondpatiënten maar ook over het managen van een dergelijke unit. En, zo blijkt uit het verslag van dr. Kuden, ze zijn uitstekend opgevangen en begeleid in Oeganda! Hopelijk kunnen ze het geleerde snel in praktijk brengen in Nigeria.

Dr Kuden en Kefas de Mangu, Nigéria se sont rendus en Ouganda juste après le départ de l’équipe d’Interplast en Octobre. Ils ont travaillé 5 semaines au Burns Unit de façon à apprendre le plus possible, non seulement dans le domaine du soin des patients mais aussi de l’organisation d’un tel département. Il semble, selon le rapport de Dr. Kuden qu’il ont été extrêmement bien reçu et guidé ! Ils pourront rapidement mettre en pratique ce qu’ils ont appris au Nigéria !

Mr Kefas Tuwan and Dr Kuden Deyin

ConclusionOn behalf of our organisation (COCIN hospital and rehabilitation centre and the school for the physically challenged Mangu-Nigeria), I would sincerely like to thank Dr Zeeman, Dr Cees Spronk, Marjo Aerts and the entire Interplast Holland family for giving us the opportunity to take part in this training. I cannot fail to thank either the administrative officer of Interplast Holland, Annemarie Maas, for all the efforts she put into the logistic arrangements for the trip.We are also greatly indebted to Mr Ssentongo and his wonderful team for their warmth and the knowledge they passed on to us. We will never forget the help they gave us.We assure all of you that when we return home, we are going to put everything we have learned into practice as we set up our burns unit, care for the patients and endeavour to create a burns-free generation.Once more thank you all and God bless!

Dr Kuden Kamshak Deyin(Medical Superintendent CHRC Mangu)

28 T r a i n i n g a t t h e U B P S I


Top left: Kringloopwinkels Steenwijk-Vollenhove

Top right: Hans Pleij

Centre: Vlietland Ziekenhuis

Bottom: Distributing clothing (Burns Unit in Uganda) from biennial second-hand clothing market Gouda Noord

Thank you! Big or small, your help can make a difference...

29S p o n s o r s ‘ i n t h e p i c t u r e ’


Interplast consists of volunteer medical personnel (plastic surgeons, anaesthesiologists, theatre and anaesthetic nurses and other specialists), who work free of charge during their holidays. Travel expenses, medical supplies and instruments are funded by donations raised in Holland from companies as well as the general public.

Interplast teams provide reconstructive operations that transform the lives of children and (young) adults with physical disabilities and thereby improve the future of the whole family of those children as well. Interplast has no fi nancial, political, racial or religious interest.

The aim is to provide (and teach) reconstructive surgery to improve function, not to perform cosmetic surgery. Cooperation with local medical staff and working at existing hospitals close to the patients’ home is effi cient and offers education in a specialist fi eld for all involved. Apart from medical staff, local volunteers with social commitment are essential for the preparation and the smooth running of a successful Interplast mission.

If you, your town, your hospital, or a charitable organisation you know think about hosting an Interplast team, here are some important issues to consider:

• Advance notice for the team should be given at least 6 months before the intended date.

• Duration of the mission is usually 2 weeks, i.e. 10 operating days. Depending on the severity of cases, about 100 patients can be operated during that time.

• Size of the team varies depending on the number of operating tables, anaesthetic facilities and local staff available. On average, a team will consist of 6 people, 2 surgeons, 1 anaesthesiologist, 2 theatre nurses and 1 anaesthetic nurse, thus being able to run 2 operating tables (smaller or larger teams possible on request).

• Local staff, i.e. doctors, nurses, interested volunteers are essential for the smooth running of a mission.

• Local doctors should perform the patient pre-selection during the months before the arrival of an Interplast team. If possible, they should inform the team about the type of surgery and special cases beforehand to allow appropriate planning of instruments and supplies for the trip.

• The fi rst day consists of screening and selecting the patients for the operating lists, unpacking equipment and setting up the operating room(s).

• Types of operation: burns contractures, congenital deformities like cleft lip and palate, functional defi cits or disfi guration from injury, infection (polio, leprosy, Noma etc.) tumours – in children and (young) adults.

• Long working hours have to be anticipated by all involved to make an Interplast mission effective.

• Apart from operating, ward rounds and change of dressing sessions take place every day.

• The hospital should offer: two operating tables / anaesthetic machines, a recovery room, enough beds, electricity supply, water, normal saline for infusion, sheets and gowns, if possible oxygen, nitrous oxide, halothane, some dressing material and plaster of Paris.The Interplast team will provide: special instruments and medical equipment, suture material and special drugs and dressings.

• You are requested to provide: (if possible, but if you don’t have the means, other arrangements can be discussed) basic, clean accommodation, food and transport for the team. Government / Ministry of Health permission for the mission; assistance with customs, excess baggage clearance etc.

Many years o f exper ience and thousands o f g ra te fu l pa t ien ts a re proof o f the success o f In te rp las t ac t iv i t i es . YOU can be par t o f i t .

S t i c h t i n g I n t e r p l a s t H o l l a n d [ F o u n d a t i o n]

A NONPROFIT ORGANISATION

PROVIDING FREE RECONSTRUCTIVE

SURGERY AROUND THE WORLD

Information leaflet

30 I n t e r p l a s t H o l l a n d i n f o r m a t i o n l e a f l e t


This annual review has largely been sponsored and created thanks to the cooperation ofediting Annemarie Maas fi nal editing Astrid Nagelhout, Leidendesign Ineke de Graaff, Amsterdam printing Drukkerij Protocol, Zoetermeer

Stichting Interplast Holland

BoardDrs. Rein J. Zeeman, chairmanDrs. Rutger L. van Leersum, secretaryHenk J.A. Koster, treasurer

Honorary MemberFrank E.I. SchaafProf. dr. Bert D. de JongEls L. Gerritsen

Nursing CommitteeElles LoenenPaula EllenMarie-Thérèse de By-BakkerMarjo Aerts MPHJan H. van Steen

Policy maker (staff)Marjo Aerts MPH

OfficeAnnemarie Maas

Committee of RecommendationDrs. Erica TerpstraHerman van Veen

CorrespondenceStichting Interplast HollandPO Box 21892301 CD Leiden

Visitors’ addressStichting Interplast HollandPoortgebouw Zuid, room 468Rijnsburgerweg 102333 AA LeidenThe Netherlands

T +31-(0)71-52 10 165F +31-(0)71-52 14 458E [email protected] I http://www.interplastholland.nl

INGIBAN NL19 INGB 000 152 07 38BIC INGB NL 2A

ABN AMRO IBAN NL76 ABNA 044 880 09 26BIC ABNA NL 2A

31C o n t a c t I n t e r p l a s t H o l l a n d


With special thanks to...

All Interplast volunteersNederlandse Brandwonden StichtingStichting LibertyDhr. en mevr. van Velthoven-Leeuwenberg, HeilooDiaconie Gereformeerde Kerk, Nieuw VennepDhr. J.M.G. Huininga, NorgEuro Tissue Bank, BeverwijkKiwanis NederlandEmbassy of the Republic of Uganda, BrusselsStichting Edith Jacoba, RoelofarendsveenJan (Honorary Consul) en Will van Maanen, Bissau, Guinea-BissauJohannes Mooij, Bissau, Guinea-BissauJohan Krijt / One Creation, Den HaagStichting True BlueNetherlands Embassy, Abuja, NigeriaEmdaplast BV, ZoetermeerStichting Bron van Leven, WassenaarLeids Universitair Medisch Centrum

Stichting Eekhoorn, LeidenDiaconie Protestantse Gemeente, StiensVlietland Ziekenhuis, SchiedamDr. E.J.F. Timmenga, RotterdamJohannes StichtingNetherlands Embassy offi ce, BujumburaDiaconessenhuis LeidenStichting ElsgoedAndrew PosmaIzere, André NkeshimanaStichting PelgrimshoeveDrukkerij Protocol, ZoetermeerBrarudi (Heineken Burundi)Hans Pleij, KatwijkMevr. L.S. Wijnbergen, RotterdamRosalie van Rijn, BeverwijkCliniplast BV, Schilde BE

... and many others

Book on cleft lipand palate surgery in developing countries.

Available on request [email protected] for € 25,–

32 W i t h s p e c i a l t h a n k s t o . . .


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IPH JOZ 2012 binnenwerk DEF - Interplast Holland...IPH_JOZ_2012_binnenwerk_DEF.indd 3 21-05-13 10:56...

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Transcript of IPH JOZ 2012 binnenwerk DEF - Interplast Holland...IPH_JOZ_2012_binnenwerk_DEF.indd 3 21-05-13 10:56...