Table of contents - Interplast Holland · Training certificates From the beginning of 2011, at the...

Table of contents

General survey of countries and operations

From the Chairman

Introduction

Mission to Guinea-Bissau

Mission to Zanzibar

Missions to Burundi

Joining forces Thanks to the Dutch Liliane Foundation and Noma Foundation, an Interplast patient travelled from Burundi to Nigeria for treatment.

Mission to Nigeria

Mission to Indonesia

Mission to Uganda in cooperation with Trust Fund for Victims

Follow-up in North Uganda Rein Zeeman and Marjo Aerts review Interplast Holland’s efforts in Uganda.

Let’s stop burns now! Dutch Burns Foundation gets involved in burn prevention programme.

A Dutch ergotherapist in Kampala Ergotherapist Ilse de Ruijter’s experiences in Uganda.

Discovering Dhaka Fact-finding mission to Bangladesh with Dokters van de Wereld (Médecins du Monde, Dutch section).

Interplast Holland information leaflet

Contact Interplast Holland

Special thanks to …

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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 = 10370 with 128 teams

Uganda 33 teams 2631 patients

Yemen 28 teams 2153 patients

Nigeria 9 teams 683 patients

Rwanda 4 teams 250 patients

Guinea-Bissau 4 teams 267 patients

Burundi 5 teams 511 patients

Zanzibar 4 teams 281 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

This annual review for 2011 has largely been created and sponsored by volunteers.

From the Chairman

The 2011 Annual Review of Stichting (Foundation) Interplast Holland is shorter than usual. This year, like many other organisations we are trying to cut costs. Now the review is only in English, since we use is a lot abroad to promote our work there. I think most of our followers will not find this a problem. There are, however, also summaries in Dutch and French.

As usual in 2011 we have sent teams to Nigeria, Guinea-Bissau, Burundi and Zanzibar. After four years another team was invited to Bau-Bau in Indonesia.As I mentioned earlier, Stichting Interplast Holland is having to face the financial crisis despite the large number of well-wishers. Gifts are diminishing, and in the end we may have to reduce the number of missions. Whatever happens, we are continuing with our efforts to give as many children as possible the chance of a better life.

In Uganda a major step was taken in the burns prevention programme STOP BURNS. We worked closely together with the Dutch Burns Foundation to provide training for Burn Prevention Officers. After their training they were very busy in the slum areas around Kampala and recently started to visit primary schools. They provide information on how burns can be prevented.

In Burundi, many patients are still waiting. We made a few advances with our plans for setting up a Reconstructive Surgery and Burns Centre. We hope more local initiative will be forthcoming.

We have seen some changes within our organisation. The nursing committee was joined by Jan van Steen, an experienced nurse anaesthetist and also a master plaster cast technician. In January Marjo Aerts joined our secretarial staff as a policy maker. She drew up the policy-plan for 2011-2013, advised the board members and drafted the project proposals.Unfortunately Annemarie was on sick leave for some time this year, and the office was less easy to reach. Board members (Rein and Henk) and Marjo kept up with the daily activities. No missions had to be cancelled. Luckily she is back in the office now.

We started to cooperate with Dokters van de Wereld (Dutch branch of Médecins du Monde) in connection with their project ‘Operatie Glimlach’ (Operation Smile) in Holland. Our expertise proved very welcome during their first mission to Bangladesh. In the future we will be working together more closely on team missions.

Next year you will probably be able to follow us through various social media: Facebook, Twitter and LinkedIn. We hope this will help to involve you more in our work and to help us find more sponsors.

I would like to thank our volunteers and sponsors for their contribution in the past year. Without your help we would not have succeeded.

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

Rein J. Zeeman

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

Introduction

Stichting Interplast Holland is a charitable foundation 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 operating 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, disfigurements 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 organizations. They are regarded as sister organisations.

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.

Seven missionsThere were seven Interplast missions in 2011: one to Nigeria, one to Guinea-Bissau, one to Zanzibar, two to Burundi and one to Indonesia. The seventh mission, in conjunction with the Trust Fund for Victims of the International Criminal Court, was sent to North Uganda for the fourth time. This time, Interplast worked in Gulu.Early 2011, there was also a fact finding mission to Guinea-

Conakry. The first Interplast team will be sent there in February or March 2012. Unfortunately, the spring mission to Nigeria had to be cancelled at the last minute because of serious disturbances in Jos. Missions to Yemen have not yet been resumed because of the political situation there.

Training certificatesFrom the beginning of 2011, at the end of each mission Interplast Holland has been awarding certificates to local nurses, doctors and staff of the sterilisation department who have taken part in our courses. In this way they can show that they have been participating in training. They also have a certificate that they can put on their CV. In turn Interplast has an overview of who has taken part and what has been achieved in terms of training. The names are kept in a database for each country and a list of names is taken along on subsequent missions. In 2011, forty-two certificates were awarded during four Interplast Holland missions. Thirteen certificates were also awarded to burn prevention officers in Uganda who had been trained. In 2012 this procedure will be implemented in every country.

Local staff in Guinea-Bissau posing with their certificates

UgandaIn 2011 Interplast Holland again gave support to the Uganda Burns & Plastic Surgery Institute that was set up in 2004. After seven years the focus of burns treatment is now primarily on preventing burns. A programme for this, called STOP BURNS, has been developed in conjunction with the Dutch Burns Foundation.

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

Training burn prevention officers

Tamara Prinsenberg and Monique Gomez of the Prevention and Research Department of the Dutch Burns Foundation visited Uganda twice in 2011 to train burn prevention officers. You can read Tamara’s report on page 22.Since February 2011 ergotherapist Ilse de Ruyter has been working in the Burns Unit on a voluntary basis. She writes about her experiences on page 23 of this annual review.

VisionInterplast 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 foundation 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 reconstructive surgery units and burn centres, and by setting up burns prevention programmes. Cooperation with other organisations in the Netherlands and abroad is high on the agenda of Stichting Interplast Holland. In the Netherlands the organisation aims to run its office with the structured, administrative and policy support of mainly volunteers.

66 I 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 (same as the Netherlands)

Number of inhabitants 1.7 million

Climate tropical

28 January - 12 February

TeamPlastic surgeon and team leader

Rein Zeeman

Assistant surgeon Charlotte Lameijer (6 -19 February)

Anaesthetist Gijs Witte

Anaesthetic nurse Elly Hofstede

Theatre nurse Karina Heek

Local team Jan van MaanenWill van MaanenJohannes Mooij

Visited hospital Hospital Nacional Simão Mendes

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, l isted number 176 out of 187 on the United Nation’s Human Development Index (2011). The Netherlands, for instance, is number 3. 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.

This was the fourth Interplast Holland mission to Guinea-Bissau. As usual, excellent preparations had been made by the local organising committee, Consul Jan van Maanen, his wife Will and Johannes Mooij. The screening on the morning after arrival was carried out without delay.

First week: without Charlotte but with Dr Lassana IntchssoDuring the first week Rein Zeeman had to manage without the assistance of Charlotte Lameijer, who arrived a week later and stayed on longer than the rest of the team. This way, she could look after the post-operative care of the patients. On the first operating day the national television paid a visit. After broadcasting the whole of Bissau immediately knew about the team and its members were greeted on the streets.

National television films team at work

In the first week most operations were mainly on burn contractures, clefts and noma (gangrenous stomatitis). Rein Zeeman was assisted a great deal by Dr Lassana Intchsso, who will become the director of the new noma hospital that is being built and sponsored by German Hilfsaktion Noma e.V. (Noma Aid).

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

Rein and Lassana working together

Second week: doing it the Interplast wayDuring the second week it was possible to operate on two tables in one room – the Interplast way – thanks to the arrival of Charlotte. Cooperation went smoothly, as you can tell from this passage from Charlotte’s report on working in the operating theatre.

‘This week we are operating as we did last year: two tables in one room. Rein operates the complicated burns contractures, a lot of clefts, this year more noma patients than last year and even a large lymphangioma (benign tumour) in the neck. I mainly operate burns contractures, occasionally a gigantic lipoma (benign tumour), or less complicated facial reconstructions. The good thing about two tables is that Rein can look over my shoulder from time to time and I can make good use of his instructions. The duo Gijs and Elly again worked in perfect harmony: Elly coordinates and Gijs injects. And our super-coordinator Karina keeps her end up well and steers the operating theatre assistants. It’s marvellous occasionally to go and stand in the corner of the operating theatre and just watch how everyone is working, the local staff together with the Interplast team. We really do work together.’

Positive response from Health secretaryAt the end of the first week there was a meeting with the state secretary for Health, Augusto Paulo Silvo. Rein Zeeman wrote about this in his report: ‘A constructive discussion with a positive response to our wishes to do more training than we do at present. Next year we are going to be allocated young doctors. And the offer of help to treat burns was welcomed with open arms.’ You can read the full report of this mission on our website, www.interplastholland.nl.

No treatment available for burns patients

A happy surpriseAnd finally another extract from Charlotte’s report: ‘on Friday 11 February Rein, Gijs, Elly and Karina went back to the cold in the Netherlands. On Monday I saw a lot of operated patients. It is always a surprise what you see after removing the dressings. Fortunately, this year there are very few

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

wound infections. With my few words of Creole and Samora’s linguistic skills, we explain to patients, parents, brothers and sisters how they should treat the wounds at home. Practically everyone without exception wants to smear ‘pommade’ on the wounds. Once this has been emphatically discouraged many patients happily go home.

A well-oiled machineOn Thursday and Friday Fatima (head nurse of theatre at the hospital) and a number of other nurses and the physiotherapist are involved in the aftercare. Fatima is extremely strict in directing her group of nurses which results in a well-oiled machine to change all the dressings. I look on with contentment – this was the idea. Last year it was very difficult to get people involved, and this year everything seems to be going so smoothly. Have they got more confidence in us now because we go year after year? Even the physiotherapist promises to treat the patients with burn contractures if Fatima refers them to him. This week I also had an operating day when I carried out a reconstruction on the corner of the mouth and other minor surgery.

Hope for the futureOn the last day in the hospital one more hopeful encounter. Johannes phoned me to say that two young enthusiastic medical students had turned up to see him. Delwin and Chris had finished their training in December 2011 and had also been observers in February 2010 in the operating theatre. They want to become plastic surgeons and offered to assist

Before and after Cleft Face operation

during the next mission. On top of the talk with the secretary of the Ministry of Health, this is hopeful news. Here’s looking forward to the Guinea-Bissau mission 2012!’

Dankzij een uitstekende voorbereiding door het lokale team o.l.v. Jan van Maanen konden bijna alle patiënten die geselecteerd waren ook geopereerd worden.Een hele prettige samenwerking met de lokale chirurg dr. Lassano Intschsso. De tweede week kreeg het team versterking van Charlotte Lameijer. Zij bleef een week langer om de nazorg van de geopereerde patiënten op zich te nemen.

Gràce à l’excellente préparation de l’équipe locale Jan van Maanen presque tous les patients qui avaient été sélectionnés ont pu être opérés.Une collaboration agréable avec le chirurgien locale Dr. Lassano Intschsso. La deuxième semaine Charlotte Lameijer est venue soutenir l’équipe. Elle est restée une semaine de plus pour prendre en charge le soins postopératoires des patients opérés.

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

• 15 cleft lips and/or palates

• 36 post burn contractures

• 8 noma

• 15 other

• 10 certificates awarded

9X x x x x x x 9G u i n e a - B i s s a u

Zanzibar

Official name Zanzibar

Capital Zanzibar City

Location island in the Indian Ocean, east of Tanzania

Surface area 1554 km²

Number of inhabitants 1 million

Climate tropical

11 - 26 February


Ed Hartman

Plastic surgeon Ruth Lester

Anaesthetist Veronica Evers

Theatre nurse Agnes Derwa

Anaesthetic nurse Ingrid Hollander-Mus

Visited hospital Mnazi Mmoja Hospital

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.

As in the greater part of the African continent there is no plastic reconstructive surgery here. Before the arrival of Interplast Holland, patients were sometimes referred to a clinic for reconstructive surgery in Dar es Salaam on the mainland, which is a very expensive exercise. So the Interplast teams are very welcome on Zanzibar, where they have been working since 2008 in the Mnazi Mmoja Hospital, a government hospital with 430 beds.

Fully booked programmeDr Ramadhan Suleiman had promised the team more than a hundred patients and he had not exaggerated. He had selected 118 patients during the pre-screening on Pemba and Zanzibar. Most of them indeed were eligible for an operation, and in no time the fortnight’s programme was fully booked. All the patients left the hospital with a date for an operation. ‘Utopia for many hospitals in the Netherlands’, team leader Ed Hartman commented in his report. Meeting the local team members from last year’s mission

was heart-warming, after that the team set down to work in the operating theatre from early morning till night. This way, all patients could be operated upon. Unfortunately our anaesthetist, Veronica – taking part in her first mission – had to manage from day two onwards without the highly experienced Ingrid Hollander-Mus, who for personal reasons had to go back home early. Luckily Veronica received help from two experienced local anaesthesia technicians.This made it possible for the team to operate on two tables.

Important discussion with the new Health ministerThe team met the new Health minister, Mr Juma Duni Haji, on the first Thursday of their stay. The encounter was filmed by a television crew and was broadcast the very next morning. Also present were the first secretary Dr Mohamed Jiddawi (Interplast’s contact from the outset), Dr Rama, the hospital director Dr Jamala and the deputy minister Dr Sira Ubwa Mamboya. The new minister was very interested in the work of Interplast. Again the meeting turned to the circumcision operations which are often badly performed, resulting in all kinds of complications. Dr Ruth Lester, who specialises in operations on hypospadias (birth defect of the urethra), is a keen advocate of training the local people who carry out these circumcisions. Problems with the oxygen cylinders dominated the second week. They had been ordered, but the connections did not fit and a standard connection was nowhere to be found. The director of the hospital said that next year there would be one overall system and this problem would be solved. But for now the oxygen cylinders had to come from a clinic close by. Apart from this only two patients missed having their operation. Next year they will be the first ones on the list.The full team as they said their farewells. A very hard working local team ‘that remained enthusiastic, I never ever experienced such dedicated team members around me’, said satisfied team leader Ed Hartman.

10 Z 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


• 31 hypospadia or urethral fistula

• 18 post burn contracture

• 14 other

Dr Ruth and Dr Rama doing ward rounds

Dr. Rama had het goed georganiseerd. Er waren meer dan 118 patiënten voor de screening. Er werden lange dagen gemaakt om iedereen te kunnen opereren. In een gesprek met de minister werd wederom het probleem van de fistels na circumcisie ter sprake gebracht. Training van lokaal medisch personeel hoe dit te voorkomen lijkt de aangewezen weg. De 2de week stond vooral in het teken van de problemen met de zuurstofaansluitingen (dit zien we vaker in Afrika!) maar het was een succesvolle missie.

Dr. Rama avait bien organisé. Il y avait plus de 118 patients pour le dépistage. Pour pouvoir opérer tous les patients il a fallu faire de longues journées. Dans un entretien avec le Ministre le problème des fistules après opération de circoncision a été abordé. Il semble que la solution pour éviter ce problème soit la formation du personnel médical local. La deuxième semaine le problème majeur était la connexion d’oxygène (cela arrive souvent en Afrique !), mais globalement la mission a été un succès.

11Z a n z i b a r

Burundi

Official name Republic of Burundi

Capital Bujumbura

Location Central Africa

Surface area 27.834 km²


Climate tropical

29 April - 14 May


Rein Zeeman

Plastic surgeon Esther Mesters

Anaesthetist Rutger van Leersum

Anaesthetic nurse Jan van Steen

Theatre nurse Marie-Thérèse de By- de Bakker

Nurses Ellen CampagneColette Sindahamira

Chairman Izere André Nkeshimana

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

4 - 18 November


Andrew Posma

Plastic surgeon Rein Zeeman

Assistant plastic surgeon Jarl Tielemans

Anaesthetist Hans Pöll

Anaesthetic nurses Vincent van WeerleArend Verbaan

Theatre nurses Elles LoenenIngrid van Ginkel

Chairman Izere André Nkeshimana

Visited hospitals Centre Hopitalo Universitaire de Kamenge, BujumburaKibimba Hospital, Gitega

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 185 out of 187 on the United Nation’s Human Development Index of 2011.)

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 300 doctors for a population of around nine mill ion.

April - May mission: a rather difficult startPositive press releases from Brarudi (Heineken Burundi) had clearly had an impact. There were more than 150 people waiting for the team on the first screening day in the Centre Hopitalo Universitaire de Kamenge (CHUK), in the Burundi capital of Bujumbura.

After a chaotic start, again not much cooperation on the part of the local staff was forthcoming in the first week at CHUK. They had apparently not been properly informed about the team’s arrival. That made the presentation for the staff and students by the team leader Rein Zeeman all the more important and it was extremely well received, but sadly the team hardly felt welcome in the first week. Even so, many patients with clefts and burn contractures were operated on, though little could be done in the form of training.

Kibimba: a warm welcomeFortunately, the team received an immediate warm welcome in this hospital, Kibimba District Hospital in the Gitega District. Rein and Rutger had visited this hospital a week earlier to check if it was good and safe to work in. The week involved a full programme of operations with the local anaesthetists, the surgeon and even the director joining in enthusiastically. Skin transplants were new to them. Here again most of those operated on were children with cleft lips and/or palates, and burn contractures.

12 B u r u n d i

Before and after cleft lip operation

Rein Zeeman’s presentation in the Gitega regional hospital about the work of Interplast in Burundi attracted an audience of more than a hundred people: staff members, students and a doctor from the Belgian branch of Doctors without Borders who were performing fistula operations on women. After an extremely successful week the team returned to Bujumbura to see all their patients who had been operated on the previous week, and changed dressings, some under anaesthesia.

Would Interplast Burundi be an option?On the last evening the team visited the Dutch chargé d’affaires in Burundi Cees Spoel, and his wife Sari. The discussion turned to the lack of a local organisation. Setting up Interplast Burundi – similar to Interplast Uganda – would be very welcome! This could help to make preparations for the next team visit of Interplast Holland.

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



• 11 other


Dankzij goede persberichten van Brarudi (Heineken Burundi) was er een goede opkomst bij de screening in het Centre Hopitalo Universitaire de Kamenge (CHUK). Lokale staf bleek echter niet geïnformeerd over de komst van het team, medewerking was hierdoor matig. Toch veel patiënten met schisis en brandwondcontracturen kunnen opere ren! Voor een presentatie van Rein Zeeman over het werk van Interplast bestond gelukkig wel veel interesse.Tweede week in Kibimba verliep prima. Enthousiaste chirurgen en anesthesioloog die de hele week meewerkten. Zelfs de directeur deed mee! Huidtransplantatie was iets nieuws voor ze. Ook hier weer veel schisis en brandwond-contracturen.

Gràce aux bons Communiqués de Presse de Brarundi (Heineken Burundi) il y a eu un bon nombre de patients au dépistage du Centre Hopitalo Universitaire de Kamenge (CHUK). Le personnel local ne semblait pas toutefois informé de l’arrivée de l’équipe, de ce fait la collaboration était limitée. Cependant de nombreux patients avec schisis (bec de lièvre et fente palatine) et contractures de brûlure ont pu être opérés ! Il y eu beaucoup d’intérêt à la présentation de Rein Zeeman sur le travail d’Interplast.La deuxième semaine à Kibimba s’est bien déroulée, des chirurgiens et anesthésistes enthousiastes qui ont travaillé toute la semaine. Même le directeur a participé ! La greffe de peau était une nouveauté pour eux. Ici aussi beaucoup de schisis et contractures.

November mission: a successful first weekThis time the CHUK was well informed of the arrival of the Interplast team. There was even an enthusiastic, eager-to-learn doctor, Jean Claude, who had been called in and who arranged everything during the entire week. Within a few hours of their arrival in Bujumbura the entire team was ready to screen the long queues of patients. There were far too many patients and no preparations had been made at the OPD. Many had cleft lips and/or palates, but there were also a lot of patients with large tumours, many of which, unfortunately, were inoperable. The team looked at as many people as possible and gave advice.

The heavily-loaded operating programme started on Monday, everything went well and fast right from the beginning. On Monday night there was a reception at the Dutch embassy, with some important local officials.

Training on the job at Kibimba Hospital

13B u r u n d i

Dr Elisé operating on a cleft lip

Fifty operations were carried out in five days’ time. Despite a shortage of beds, this was a great result. It has to be said though that the team had been working together for years and were able to anticipate well.

Several film crews stopped by during the week, one of them from Brarudi (Heineken) that was making a documentary about Interplast in Burundi. The team also got a lot of coverage from national television, radio broadcasts and journalists.

Kibimba: everyone joined in!Again everything had been well prepared in the Kibimba district hospital. from the first day of the second week. Patients had been well screened and documented. Clearly, from the various reports, the local staff and employees were extremely enthusiastic and keen to join in.

Dr Elisé posing with donated skin graft knife

The director, Dr Elisé, who is himself a surgeon, regularly assisted and operated on several lips and burns contractures under Rein Zeeman’s watchful eye. The team left him a skin graft knife to enable him to perform these operations himself.The operating days went smoothly, also thanks to the good cooperation with the people from the sterilization department.

Gitega: possible burns centre?According to the Health minister, Gitega Regional Hospital would be the ideal site for setting up a burns centre as Interplast has done in Uganda. Rein Zeeman had a discussion about this with the deputy director on the Wednesday. Together they looked at the possibilities in terms of the site and the buildings. Apparently Egypt has shown interest in building a completely new hospital, but it was uncertain whether this would go ahead. We will have to wait and see what happens!

Operations went smoothly, thanks also to sterilisation staffMother takes home her two children following cleft lip operations

14 B u r u n d i

Joining forces

Thanks to the combined efforts of the Dutch Liliane Foundation and Noma Foundation, Candine Ndayishiy from Burundi was able to travel to Sokoto in Nigeria for treatment.

One of the Interplast Holand teams that had worked in Burundi in 2010 saw a noma patient with serious defect and severe trismus (locked jaw). As a result, she could not be intubated and the aftercare in the hospital in question was inadequate. In October 2011, the patient went with an attendant to the noma hospital in Sokoto in Nigeria where an experienced Dutch team was operating at the time. The operation was carried out without complications. We saw the patient during our November mission in Burundi, a few weeks after the operation. An early post-operative result. She herself was somewhat affected by the trip and her expectations had possibly been a little too high. We again told her that she must really practise opening her mouth properly. We will be able to carry out further improvements during subsequent missions.

This trans-African treatment was sponsored by the Liliane Foundation. They had representatives in both countries and they organised the trip and funded it. Thanks for this joint venture and thanks as well to the Dutch Noma Foundation for the free treatment.

Before and after free radial forearm flap

On Friday the team said fond farewells to the staff at Kibimba Hospital. (See Rein Zeeman’s full report on www.interplastholland.nl.) Then the team went back to Bujumbura to change a number of dressings under anaesthesia at CHUK and to do the rounds of patients who were still being admitted (mainly reconstructed hypospadias).

Everyone looked back on a successful mission in Burundi, a country where there is still a lot to be done.

Everyone looked back on a successful mission in Burundi, a country where there is still a lot to be done.

O p e r a t i o n s B u r u n d i , N o v e m b e r




• 8 other


Deze keer was het CHUK wel goed op de hoogte en er was zelf een enthousiaste en leergierige dokter ingehuurd die de hele week meewerkte en van alles regelde.Een overvol operatieprogramma maar alles verliep vanaf het begin goed en snel. In vijf dagen 50 operaties verricht! Dit team werkt dan ook al jaren samen en is goed op elkaar ingespeeld.In Kibimba was alles prima voorbereid, patiënten geregistreerd en de lokale staf was wederom heel enthousiast! De directeur dr. Elisé werkte regelmatig mee en kreeg een Watson knife gedoneerd. Nu kan hij zelf huidtransplantaties verrichten.Iedereen kijkt terug op een succesvolle missie!

Cette fois ci le CHUK était bien informé, un docteur appliqué et enthousiaste avait été engagé. Il a organisé et collaboré toute la semaine. Le programme d’opération était plus que complet mais tout s’est bien déroulé et ce, dès le début. 50 opérations en 5 jours ! Cette équipe travaille depuis des années ensemble et est bien rodée.A Kibimba tout était bien préparé, les patients enregistrés et le personnel local très enthousiaste ! Le directeur Dr. Elisé a travaillé régulièrement avec l’équipe et a reçu en cadeau un Watson knife. Maintenant il peut effectuer lui même les greffes de peau. Tout le monde considère que c’était une mission réussie.

15J o i n i n g f o r c e s

Nigeria

Official name the Federal Republic of Nigeria

Capital Abuja

Location West Africa

Surface area 923,768 km²


Climate tropical to sub-tropical

8 - 23 October


Cees Spronk

Plastic surgeon Jan Hochtritt

Assistant plastic surgeon Marijn Huijing

Anaesthetist Rob Niemeijer

Anaesthetic nurse Geke Hoeksma

Theatre nurse Fatima van Klaveren

Visited hospital COCIN Hospital & Rehabilitation Centre, Mangu

Despite huge oil revenues there is great poverty in the West African country of Nigeria. Seven hundred babies less than a month old die every day. The country is far behind others in terms of health care. The COCIN Hospital & Rehabilitation Centre is situated in Mangu on the Jos Plateau in Northern Nigeria. This hospital, formerly belonging to the Nederlandse Leprastichting (NLR, Netherlands Leprosy Relief), has been visited twice a year since 2007 by a team mainly comprising plastic surgeons from the north of the Netherlands.

March mission cancelledDisturbances in Nigeria are a common occurrence but this time they were very close to Mangu, which was why only one mission was sent to Nigeria this year. In fact the team for the spring mission was already on the verge of departure when the decision to cancel was taken on the advice of the Netherlands Embassy in Abuja and the board of Interplast Holland. It was the sensible thing to do in the circumstances. The air tickets – always a big item on the budget – could fortunately be changed to October!

More than 150 people seen, 86 operations performed in OctoberFortunately, Nigeria was again relatively calm in October and everyday life had resumed its normal course in the neighbourhood of Mangu. This was just as well, since lots of patients were on the waiting list. For a start, there were those who we had had to disappoint in March; they of course took priority.

The team, led by Cees Spronk, saw more than 150 people altogether and carried out a total of 86 operations. A good score, given the fact that the official festive opening of the new nursing wards happened to take place one afternoon when the team would normally have carried out operations. The new wards were completely full by the end of the mission.

Opening new wards

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Old and new wards

Many years of preparationThe opening of the new wards was of course a very special event. They had taken many years of planning and fundraising. The official opening was carried out by the Commissioner of Health of Plateau State under the approving eye of Annemieke van Soelen of the Netherlands Embassy, the Mayor of Mangu and COCIN church leaders. Of course, the initiators Cees and Neeltje Spronk were also present.

Assistant plastic surgeon Marijn Huijing was on her first the mission. It was an impressive experience for her, as she noted in her report; ‘patients have come from very far with the most diverse problems. Alongside many burn contractures we also saw all kinds of urogenital deformities, clefts and congenital (hand) deformities. Many children with burns, particularly on their hands ... the limited care of burns here is really distressing. And so, bewildered yet brave, they all turn up to see the white doctors, though from time to time a cautious tear may fall. Fortunately a lot of hard work has been done in the past years to set up a new burns centre with trained personnel. Hopefully, sufficient funding can be found for this in the near future.’

Girl with burns

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




• 31 other


Dit jaar kon er maar één missie naar Nigeria plaatsvinden. De voorjaarsmissie moest op het laatste moment in verband met onlusten in de buurt van Mangu geannuleerd worden. In oktober was het weer relatief rustig. Het team, o.l.v. Cees Spronk, opereerde 86 mensen.Ook hier weer veel brandwondcontracturen. Tijdens de missie werd het nieuwe gebouw met twee verpleegafdelingen officieel geopend. Aan het eind van de missie lagen beide afdelingen helemaal vol. Het volgende project van Cees en Neeltje Spronk is het opzetten van een brandwondencentrum!

Nous n’avons pu faire qu’une mission au Nigéria cette année. La mission prévue au printemps a dû être annulée au dernier moment à cause des troubles civils dans la région de Mangu. En Octobre la situation était relativement calme. L’équipe Cees Spronk a opéré 86 personnes. Ici aussi beaucoup de contractures de brûlures. Pendant la mission le nouveau bâtiment avec deux unités de soins a été officiellement ouvert. A la fin de la mission les deux unités étaient pleines. Le prochain projet de Cees et Neeltje Spronk est la création d’un Centre de soins pour Grands Brûlés !

17N i g e r i a

Setting up an operation room

Indonesia

Official name Republic of Indonesia

Capital Jakarta

Visited island Buton Island, city of Bau Bau

Surface area 1.910.000 km² (Buton 4.408 km²)

Number of inhabitants 235 million (Buton 500.000)

Climate tropical

16 September - 1 October


Rein Zeeman


Anaesthetic nurse Elly Hofstede

Theatre nurse Els Gerritsen

Local team Sr André LemmersDr Arend DonggawaDr Magda HutagalungAris SuparmanIka Kartika

Sister André Lemmers – a Dutch nun with her own charity foundation Yayasan Sinar Pelangi in Jakarta – devotes herself to disabled children in Indonesia, which includes the island of Buton, located off the southeast peninsula of Sulawesi. After earlier missions to Kalimantan and Sumba, Interplast had now been invited to go to Buton, specifically Bau-Bau which is the main town there.

Fine screening, but ... no clinic!Sister André had made excellent arrangements for everything locally; the extra 120 kilogrammes of luggage were no problem either. The screening of the patients took place on the veranda of a house belonging to a local organisation. This was also where all the children were staying before and after surgery. There were mats throughout the whole house and outside there were bunk beds for the adults. All patients present were seen by the three surgeons, Dr Arend (Indonesian counterpart), Dr Rein and Dr Floris, and theatre nurse Elsa made a programme for three operating tables. After the screening the team went to take a look at the clinic and to their immense surprise – there was no clinic, just part of a police post with various rooms giving on to a single corridor and was used as OPD. In fact,

renovation work was still going on and only part of the consignment of materials and equipment had been set up. Basically the team ‘simply’ had to set up a small hospital. Even this experienced team had never had to manage this before…

From police post to operating theatreThe full team comprised five Interplast members and six people who had joined the team in Jakarta, as well as two

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Opening temporary clinic

surgeons, two anaesthetist assistants from Jakarta and two Dutch ladies, Tineke and Merel, who happened to be visiting Sister André. So this was the team that set to work the next morning ensuring that an operating theatre was created in no time: the anaesthesia equipment was set up, operating tables organised, oxygen cylinders brought in, and the steriliser set to work. Cover sheets were bought on the local market, as well as tea tables which were converted into instrument tables. The team was ready to start after just one day of hard work by everybody involved.

Thanks also to Tineke and Merel!No less than seventy patients were operated on in four days – not least thanks to the excellent support that Elsa had from Tineke and Merel, who helped to sterilise the instruments, ironed the sheets and assisted where needed.

Sr André and team

You can read the full report of this exceptional mission on our website www.interplastholland.nl.

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




Op uitnodiging van Zr. André Lemmers, en haar stichting Yayasan Sinar Pelangi, reisde een team van Interplast deze keer af naar het eiland Buton. Het Interplast team kreeg in Jakarta versterking van zes mensen; twee chirurgen en twee anesthesieassistenten uit Jakarta zelf en twee Nederlandse dames, Tineke en Merel, die bij Zr André op bezoek waren. In Bau-Bau, de hoofdstad van Buton, werd een kleine politiepost binnen een dag omgebouwd tot klein ziekenhuis. In vier dagen werden 70 patiënten geopereerd. Het was een bijzondere missie!

Sur l’invitation de Sr. André Lemmers et son association Yayasan Sinar Pelangi une équipe d’Interplast a voyagé cette fois ci vers l’île Buton. A Jakarta l’équipe Interplast a reçu le soutien de six personnes : 2 chirurgiens, 2 assistants anesthésistes et 2 dames néerlandaises, Tineke et Merel qui étaient en visite chez Sr. André. Le petit poste de Police de Bau-Bau, la capitale de Buton a été transformé en petit hôpital ! En quatre jours 70 patients ont été opérés. Ce fut une mission particulière !

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Uganda

10 - 26 June


Rein Zeeman

Plastic surgeon Floris de Graaf


Visited hospital St Mary’s Hospital Lacor, Gulu

For the fourth time, a mission to North Uganda took place in conjunction with the Trust Fund for Victims of the International Criminal Court. This time the team went to St Mary’s Hospital Lacor in Gulu. Prior to arrival some medicines (Halothane, antibiotics etc.) had to be borrowed from the Burns Unit in Mulago Hospital. The trip from Mulago to Gulu went well since the road has been improved a lot.

Good screening, highly efficient workThe immediate job on Monday morning was to screen the patients selected by the AVSI, the Trust Fund’s local partner. After four years, people now know which operations Interplast can perform and which they cannot. Most of the patients therefore could be put on the operating list. Again there were a lot of burns contractures, mainly of hands.

Forty-five operations were carried out, including 34 on hands and/or elbow contractures. Strikingly this time there was not a single patient with cut off lips and/or nose (rebel victims). The small but extremely experienced team – team leader Rein Zeeman along with Floris de Graaf and Gijs Witte, founding Interplast volunteers – were given tremendous support by the hospital and the local staff. Bosco and Rose, two experienced anaesthetic technicians, supported Gijs. Stella, Brenda, Beatrice and Lilian assisted Floris and Rein during the operations.

Gijs teaches Rose how to perform axillary blocks

Post burn contracture before and after operation

Improving anaesthesia techniquesGijs Witte wrote in his report: ‘it was a special trip because of the regional techniques we often used, and the eagerness of local staff to practise these techniques. They now have a lot more confidence that they will have a higher success rate with axillary anaesthesia. That is quite an achievement, especially given the risks of general anaesthesia in African conditions.’

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


• 4 other

In samenwerking met het Trust Fund for Victims van de ICC vond voor de vierde keer een missie plaats in het noorden van Oeganda. Deze keer werd er in Lacor St. Mary’s Hospital gewerkt.Het team verrichte 45 operaties, waaronder 34 aan contrac turen aan hand en/of elleboog.Sinds 2005 heeft Rein Zeeman zeven keer in Noord-Oeganda geopereerd en veel slachtoffers van Kony’s LRA (Lord’s Resistance Army) neuzen en of lippen kunnen geven. Nu was er geen enkele patiënt met afgesneden lippen en of neus.Anesthesioloog Gijs Witte kon dankzij de leergierigheid van de lokale staf veel aan opleiding doen! Met name de regionale anesthesietechnieken.

Quatrième mission dans le Nord de l’Ouganda en collaboration avec le Trust Fund for Victims de ICC. Nous sommes intervenus dans le Lacor St Mary’s Hospital.L’équipe a effectué 45 opérations, dont 34 contractures à la main ou au coude. Depuis 2005 Rein Zeeman a opéré 7 fois en Ouganda du Nord et beaucoup de victimes de Kony’s LRA (Lord’s Resistance Army) ont pu retrouver un nez ou des lêvres. Cette fois ci il n’y avait aucun patient avec des lêvres ou un nez coupé.Les locaux étaient très réceptifs et l’anesthésiste Gijs Witte a pu faire de la formation, en particulier les techniques d’anesthésie régionale (locale).

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Follow-up in North Ugandaby Rein Zeeman and Marjo Aerts

Rein Zeeman went back again to North Uganda in December, not to operate this time but to review the work of the past years and to follow up on patients with post burn contractures.

Looking for long term improvementsIn November 2011, after the visit to the Burns Unit and the Burn Prevention Project, a small team comprising Rein, Marjo and Mildred – operating theatre nurse from the Burns Unit who comes from North Uganda and speaks Acholi, the local language – set off for North Uganda, to visit patients who had been operated on in the past. The objective of the follow-up was to look at the results of the operations on post burn contractures in the long term. The team looked at:

• recovery of function after the operation (medical – Rein)

• recovery of functionality within social circumstances after the operation (public health – Marjo)

• the usefulness of Kirschner wires (medical – Rein)

A format for this follow-up was developed. Sixty patients out of the 130 patients who had had an operation in the preceding three years came for the follow-up. Pre-operative photos were available for the majority of them.

The patients had been located by AVSI, an Italian NGO, in the villages and former internally displaced people camps in North Uganda. The organisation had tried to find as many patients as possible without judging the results. Their names, telephone numbers and villages are now registered with both the AVSI and Stichting Interplast Holland. Joyce, the AVSI administrator in Gulu, accompanied the team from St Mary’s Hospital Lacor together with a physiotherapist who had been involved in the postoperative care of some of the patients. The team visited the hospitals in Lacor, Kitgum and Kalongo where the patients had gathered. The trip had been financed by the Trust Fund of the International Criminal Court and by AVSI. The outcome of the survey will be presented in a

report in the Netherlands which will be published in June 2012. The first impression was that both the patients and the plastic surgeon were pleased with the results achieved. In fact, they were unexpectedly good.

An impressive journeyDriving through North Uganda on more or less solely dirt roads was an impressive experience. The trip from Kalongo to Lira was certainly a challenge. Even the locals – who had been born in the vicinity – did not know the road and the team had to regularly ask where they were. The names of the villages were not given on the map that Marjo had brought along. After driving about three hours cries of recognition came from the back of the car. The names of the villages were back on the map. Fortunately, it was not raining, but even so the roads were difficult to pass even in a four-wheel drive vehicle.

Een klein team bestaande uit Rein, Marjo en Mildred (een operatieverpleegkundige van de Burns Unit die Acholi, de lokale taal in Noord-Oeganda, spreekt) bezochten in november ziekenhuizen in Lacor, Kitgum en Kalongo. Aanleiding is een evaluatie van de geopereerde patiënten van de afgelopen drie jaar met brandwondcontracturen. Zo’n 60 patiënten kwamen voor deze evaluatie naar de verschillende ziekenhuizen. De resultaten worden in juni 2012 gepubliceerd maar de eerste indruk is dat zowel de patiënt als de plastisch chirurg zeer tevreden zijn over de resultaten.

Une petite équipe constituée de Rein, Marjo et Mildred (une infirmière de salle opératoire de Burns Unit qui parle le Acholi, la langue du Nord Ouganda) ont rendu visite en novembre aux Hôpitaux de Lacor, Kitgum et Kalongo pour le suivi des patients qui ont été opéré les trois dernières années de contractures de brûlures. Environ 60 patients se sont présentés aux différents hôpitaux. Nous travaillons encore sur les résultats qui seront publiés en juin 2012, mais la première impression est que, autant les patients que le chirugien, sont satisfaits des résultats.

Concy in 2008 and 2011, nose reconstruction

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Let’s stop burns now! by Tamara Prinsenberg from the Nederlandse Brandwonden Stichting (Dutch Burns Foundation)

Two training sessionsIn March 2011 I travelled to Mulago Hospital in Kampala, with the challenging task of starting a burns prevention programme. Before my arrival a lot of work had already been done: a survey had been undertaken in the slums of Kampala to find out about cooking habits, experience with burns and risk perception. The information from this survey, together with the hospital data gave me an idea of the problem of burns in Kampala.

I was struck by the large number of burn patients that are admitted every year to Mulago hospital alone: more than 500 patients received treatment from July 2009 up to July 2010. The number of burns patients is so much greater than what we see at home in the Netherlands. Those numbers alone are enough reason to start a prevention programme, but when I was shown around the Holland Ward and I saw the burn patients with my own eyes the urgency became even more clear to me. These horrible injuries really have to be prevented!

Burn prevention session at public school, Kampala

With plenty of motivation I therefore started to train a group of nurses from the burns ward to give health promotion to the community. I was impressed by their enthusiasm and their knowledge. After two weeks I left behind a burns prevention team that was ready to go out into the slums of Kampala.

During my second visit in November we worked together to expand the prevention programme to schools. We believe that if the adults as well as the children are educated, the chances of preventing burn injuries are greater. We did our first sessions in a public school and the children participated very well. Many of the children knew someone with a burn or had sustained a burn themselves. Again, it showed that burns are a well-known problem that we have to do something about.

I enjoyed working with the burns prevention team very much, and I am proud of the job they are doing. With continuous prevention efforts we can surely decrease the number of burns.

22 L e t ’ s s t o p b u r n s n o w !

A Dutch ergotherapist in Kampala

Ergotherapists are therapists who specialize in helping patients to improve body functions through physical exercise, enabling them to recover well and fully take part in society. Ilse de Ruijter went to work at the Burns Unit that was established by Interplast Holland in Uganda.

In her report, Ilse writes; ‘I had been interested in working with burns patients since my internship in the burns centre in Beverwijk. When I had read about the burns centre in Mulago Hospital in Uganda I knew I had to get in touch with Interplast Holland to see whether there were options for me there. After a good chat with Dr Rein Zeeman, we agreed that I would go and work voluntarily as an ergotherapist at the burns centre in Mulago. That was how I started working part-time at the Uganda Burns and Plastic Surgery Institute (UBPSI) in February 2011.

Lack of basic materialsMy work in the ward primarily involved doing exercises with patients, mobilising patients and making splints to reduce or even prevent contracture formation. I also gave advice to the nurses on the best way of dressing wounds, but also on how they can reduce the chance of contractures and how they can motivate patients to move. Interplast Holland had

arranged for good splint material which I used to make proper splints. Unfortunately basic materials like gauzes, bandages, medicines etc. are not always available, which made caring for wounds properly a real challenge. Patients are sometimes asked to bring the materials that are needed themselves, but financial or social problems mean that this is not always an option.

Helping children to playMy work regularly confronted me with children with serious burns who are on the ward for several months. There was no place for them to play in the ward without getting under people’s feet. The children were stuck in bed bored and most children had no toys to play with. That gave me the idea of appealing to the Dutch children and burns charity, Stichting Kind en Brandwond to give some financial help for a children’s play corner. The funding was promised and I created the play corner. Some people might wonder why I wanted to put money into toys for children, when there were not even always enough medicines or bandages. But people forget how important play is in a child’s development, but above all in burns treatment for preventing contractures, which are often caused by lack of movement.

Rewarding workSometimes it was quite difficult for me to work in the Burns Unit. Often there is no adequate material to work with

Ilse de Ruijter at work at the Burns Unit

23A D u t c h e r g o t h e r a p i s t i n K a m p a l a

and it is frustrating to see burns caused by assault (acid burns). The care for patients with social and/or financial problems is also difficult, not to mention the language barrier. But once I’d started I never regretted offering to work on the ward. The work is rewarding, you have the chance of caring for people who badly need your help. Most of the patients come from poor backgrounds and they cannot afford to pay for good care elsewhere. I would like to thank Interplast Holland, UBPSI and my colleagues in Mulago for the opportunity they gave me to help others.’

Ilse werkt sinds februari 2011 op vrijwillige basis als ergotherapeut op de Burns Unit in het Mulago Hospital. Haar werkzaamheden bestaan uit het doen van oefeningen en het mobiliseren van patiënten. Ilse maakt zelf ook spalken en geeft de verpleegkundigen adviezen over de beste manier van verbinden.Dankzij een gift van Stichting Kind en Brandwond heeft Ilse een speelhoek voor de kinderen kunnen realiseren.

Hierdoor krijgen de kinderen spelenderwijs de zo nood-zakelijke beweging en vergeten zij hun pijn even.Hoewel Ilse het niet altijd gemakkelijk vindt om te werken onder best wel zware omstandigheden heeft ze nog geen moment spijt gehad van haar aanbod om te werken op deze afdeling!

Ilse travaille depuis février 2011 comme volontaire dans l’Unité Burns Unit de l’Hôpital Mulago. Elle s’occupe de faire faire des exercices aux patients et de leur mobilisa-tion. Ilse fabrique aussi des béquilles et donne des conseils aux infirmiers sur la manière de faire les bandages.Gràce à un don de Stichting Kind en Brandwond Ilse a réussi à organiser un coin jeu pour les enfants. De cette façon les enfants bougent de façon ludique et oublient – pour un moment – leur douleur.Bien qu’Ilse ne trouve pas toujours aisé de travailler dans des conditions difficiles, elle n’a jamais eu de regrets de s’être proposée pour travailler dans cette unité !

Discovering Dhaka

In September, a fact-finding mission to Bangladesh was undertaken with Dokters van de Wereld (the Dutch section of Médecins du Monde) for their project ‘Operatie Glimlach’ (Operation Smile). Marjo Aerts took part on behalf of Interplast Holland, and wrote the following report.

Mutual benefitsThe first dicussions on possible cooperation with the Dutch branch of Médecins du Monde were arranged after it had emerged from a meeting with Mirjam Koppe and Arianne de Jong that a mission to Bangladesh with a team of plastic surgeons from the AMC/VU hospitals would take place in November 2011. Dokters van de Wereld was keen to benefit from the expertise of Interplast Holland. The result was that Marjo Aerts went with Arianne de Jong on a fact finding mission to Dhaka, Bangladesh, with the aim of meeting contacts, visiting hospitals to see whether they were suitable and making arrangements with local partners. Before the mission set off agreements were reached between Dokters van de Wereld and Interplast Holland and tasks were divided.

Seven hospital possibilitiesSeven hospitals had been identified as possibilities for a surgical mission by local partners of Dokters van de Wereld. A standard form was created so that the hospitals could be

assessed properly. Arianne drew up a strict agenda, leaving scope for some flexibility. Because of a demonstration by the political opposition party that had its office next door, the team was unable to leave the hotel on Thursday until five in the afternoon. It proved a good day to catch up on paperwork.

In the end all seven hospitals were visited, which meant a busy programme and very long days. Two hospitals were selected as being the most suitable in terms of operating theatre set-up, bed capacity, availability of the medical staff etc. One was an NGO hospital and the other one a government hospital. The team also looked at accommodation for the team members which had to be simple, but comfortable. A place where team members could relax after a hard day’s work. The best option was somewhere within walking distance of the hospital. Dhaka is an extremely busy town, traffic-wise, and it would be unpleasant to have to sit in the car for a long time after a heavy day’s work.

24 D i s c o v e r i n g D h a k a

Operating room in Munshiganj, Bangladesh

Looking towards the futureDokters van de Wereld was undertaking its own surgical mission for the first time. Hence the choice of two hospitals for the November mission with a team from the AMC/VU hospitals. It was important for the team to see the facilities of the two local hospitals and to decide how and where future missions would be carried out on the basis of their own experience. The team would spend a week in each hospital. Arrangements and task division could then be agreed on with local partners. The visit went well and the team was satisfied with the results.

The materials of Interplast Holland were used for this team mission. Members of the nursing committee discussed their own experiences with the operating assistants and anaesthetists of the mission team in great detail. Good agreements were reached on materials and equipment. Arianne reported that the mission had gone extremely well and that more than a hundred patients had been operated on.

Marjo and Arianne worked very well together. A sound basis had been laid for continuing and expanding cooperation between Dokters van de Wereld and Stichting Interplast Holland in the years ahead.

Van 18 t/m 24 september vond een oriënterende missie plaats naar Bangladesh.Marjo Aerts van Interplast Holland bezocht samen met Arianne de Jong van Dokters van de Wereld (Médecins du Monde) de hoofdstad Dhaka. Dit voorafgaand aan een eerste eigen missie van Dokters van de Wereld met een plastisch chirurgisch team uit het AMC/VU.Dokters van de Wereld maakt graag gebruik van de jarenlange ervaring van Interplast Holland! Er werden in totaal zeven ziekenhuizen bezocht, en twee uitgezocht voor de missie.Materialen zijn beschikbaar gesteld door Interplast, en in november werden meer dan 100 patiënten geopereerd. De samenwerking is goed bevallen en zal voortgezet worden in 2012.

Du 18 au 24 septembre une mission d’orientation a trouvé place au Bangladesh.Marjo Aerts de Interplast Holland a visité la capitale Dhaka accompagné de Arianne de Jongs de Médecins du Monde. Un préliminaire à une première mission combinée de Médecins du Monde et un chirurgien plastique de l’équipe de AMC/VU.Médecins du Monde profite de la longue expérience de Interplast Holland ! En tout sept hopitaux ont été visité et deux choisis pour la mission.Le matériel sera mis à la disposition par Interplast en Novembre et plus de 100 patients seront opérés. La collaboration s’est bien passée et sera reconduite en 2012.

25D i s c o v e r i n g D h a k a

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 financial, 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 efficient and offers education in a specialist field 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 first 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 deficits or disfiguration 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

26 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 & Sam Pitzalis final 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-de BakkerMarjo AertsJan H. van Steen

Policy maker (staff)Marjo Aerts

OfficeAnnemarie C. 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

ING bank 15 20 638ABN AMRO bank 44 88 00 926

27C 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 volunteersStichting Eureko Achmea FoundationNederlandse Brandwonden StichtingStichting LibertyDiaconie Gereformeerde Kerk, Nieuw VennepMr J.M.G. Huininga, NorgEuro Tissue Bank, BeverwijkStichting Kind en BrandwondBoudewijn Peters, ZanzibarEmbassy of the Republic of Uganda, BrusselsStichting Edith Jacoba, RoelofarendsveenJan (Honory Consul) and Will van Maanen, Bissau, Guinea-BissauJohannes Mooij, Bissau, Guinea-BissauZonta Club EindhovenJohan Krijt / One Creation, Den HaagMr and Mrs E.M. Poslawsky-Rutgers, LeiderdorpNetherlands Embassy, Abuja, NigeriaStichting Bron van Leven, WassenaarMaatschap plastisch chirurgen, Martini Ziekenhuis Groningen

Stichting Eekhoorn, LeidenDr. E.J.F. Timmenga, RotterdamJohannes StichtingAerde Bouwmanagement, TilburgDr H.J. Pöll, Den HaagNetherlands Embassy office, BujumburaProf dr P.P.M. van ZuijlenIzere, André NkeshimanaStichting PelgrimshoeveOtto Nelemans, Utrecht Drukkerij Protocol, ZoetermeerSr André Lemmers, JakartaSproFit, Genk BelgiumHeineken BurundiLiliane FoundationDiaconessenhuis LeidenLeids Universitair Medisch CentrumMrs L.S. Wijnbergen, Rotterdam

... and many others

With thanks to Stichting Liberty

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

P o s t b u s 2 1 8 9 2 3 0 1 C D L e i d e n T + 3 1 - ( 0 ) 7 1 - 5 2 1 0 1 6 5 F + 3 1 - ( 0 ) 7 1 - 5 2 1 4 4 5 8 E i n f o @ i n t e r p l a s t h o l l a n d . n l I w w w. i n t e r p l a s t h o l l a n d . n l I N G 1 5 2 0 6 3 8 A B N A M R O 4 4 8 8 0 0 9 2 6

Table of contents - Interplast Holland · Training certificates From the beginning of 2011, at the...

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Transcript of Table of contents - Interplast Holland · Training certificates From the beginning of 2011, at the...