Before the Hernia International missions started at Korogwe in October 2013, abdominal hernias were the second among the top ten diseases in the surgical department. About 60% of surgical emergencies were obstructed hernias and 10% of deaths were caused by strangulated hernias.  Due to inferior technique (hernia meshes used for 20 years in modern healthcare systems are unaffordable in low-income countries), 40% of operated hernia patients developing recurrent hernias (failed operations).

Since Hernia International missions started 10 years ago, the number of obstructed and strangulated hernias have been gradually decreasing, until now during 2021 there has been no patients with obstructed hernias, >1% recurrent hernias and no death due to obstructed hernia.

Since October 2013 Hernia International teams have visited our hospital, trained us in modern hernia surgery and introduced affordable mosquito net mesh for the repair. A total of over 1200 hernia patients have been operated.

Recent teams have been aware how inferior our surgical instruments have become and how this is impacting on their ability to perform the best surgical operations for our patients. We are therefore requesting six sets of new surgical instruments, specifically for Hernia Surgery and one or two extra instruments that we need for the treatment of road traffic accidents that are becoming more frequent around Korogwe Hospital.

Project title: Renewal of Surgical Instruments for Hernia Surgery, Korogwe District Hospital, Tanzania

Background

Korogwe is a town of just over 60,000 inhabitants located in the Tanga region of northwestern Tanzania. Its communications with the main airport of the country, the Julius Nyerere International Airport located in the populous and old capital of the country, Dar Es Salaam, are by land by means of a road irregularly asphalted along almost 300 km and that becomes interminable in the almost 6 hours of journey that it occupies. The most feasible connections from Europe to Tanzania are via Istanbul and can normally be reached with one stopover. The country has a republican government and the situation there, despite Somalia's proximity to the north, is fairly calm. Korogwe is home to an important Catholic congregation, the Congregation of the Sisters of Our Lady of the Mountain of Usambara, which was established in 1954 and plays an important role in helping local society, including the coordination of medical care through Dr Avelina Temba, who is also a surgeon and a person who gives 24 hours of her life to help those most in need, with a special emphasis on health.

2.0 Economic Conditions of the Hospital

Korogwe Town Hospital is in Magunga, which was founded in 1952 and is a basic hospital typical of developing African countries. It has two spaces that can be used as a consultation room and a waiting room, as well as a bedding area with separate spaces for men, women, children and postpartum women, and a surgical block with two operating theatres. Both operating theatres are equipped with a diathermy generator that works properly and only one of them has a general anaesthesia machine that ism operational, except during power outages. Both operating theatres have air-conditioning systems which are switched on intermittently when it is hot and humid.

Sister Dr Avelina Temba runs the hospital and is widely respected by all the staff. Local doctors and surgeons from the region worke closely with the Hernia International teams, with special mention for Dr. David Siwiti who with Dr Temba supervises the operating theatres every day in and out of the hospital. In the surgical area there are basic changing rooms with a latrine and a third physical space that can be used for emergencies and caesarean sections. Dr Temba coordinates and prepares for the mission via WhatsApp and email in the three months prior to its arrival In Korogwe. All surgical material are registered in a letter of donation to Korogwe Hospital.

3.0 Objectives:

1. To ensure excellence of delivery of surgical operations
2. The acquisition of good quality, durable surgical instruments
3. Specifically for the use of Hernia international Teams and promote sustainability of their missions to our Hospital.

4.0 Actions to achieve the objectives: Purchase of the following: 

Equipment for 6 Hernia Sets

5.0 Sustainability

An implementation plan will be drawn by Dr Temba and Dr Siwiti to oversee the project. Their responsibilities will be to ensure that the instruments are maintained in good condition, specifically for the principal beneficiaries of the project: Hernia International patients.

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