This time, we were four: Dr Inès Raabe, paediatric orthopaedist, Dr Véronique Erard, specialized in infectious diseases, Samuel Grenier, radiology technician, and myself.

The trip from Entebbe to the hospital by car gave us the chance to see the tropical landscapes again, the animals on the edge of Elizabeth Park (lots of elephants this time) and to bring three suitcases of equipment for physiotherapy and occupational therapy, as well as some donated clothes for the toddlers.

The physiotherapy equipment, obtained thanks to Marie Jordan, occupational therapist (mission 2021), was enthusiastically received and motivated Dianah, the physiotherapist we had sponsored, to put her shelves back in order. She has sent us a report on her activities (see Report from Dianah, physiotherapist at BCH).

Clearing shelves in physiotherapy with new equipment

Enormous progress was made in orthopaedics: screening took place in a much more spacious room than before, patient visits were better organised with a dressing trolley available, and the operating theatre was no longer recognisable: it was tidy, there were no meetings and meals in the reception room, and no one was sleeping in the changing rooms!

There were fewer operations than previously, partly because the Ministry of Health organised free surgery camps at the same time and at short notice: the hospital expects a resurgence of patients after these camps because public hospitals are always short of equipment and medicines…

Many of the cases presented were inoperable after discussion between Inès and Asaph, notably because of the age of the lesions, with no possible benefit from an operation! and sometimes because the appropriate equipment was lacking. Several patients were also referred for physiotherapy. The operations carried out were difficult: one patient was reassessed twice before the very difficult decision to amputate). Some operations were unknown to the team on site.

Three patients returned after the 2023 camp: one was considered cured, a second presented the complicated problem of insufficient treatment of two varus knees and will have to be presented to one of the participants in the 2025 orthopaedic camp, and the last was reviewed for persistent osteomyelitis and returned home with a smile.

All the operations were supervised by Dr Dieter Braun, an anaesthetist from Germany, who has been regularly taken part in the bwindi camps.

and we were able to use the radiology room thanks to a C-arm that is still operational.

C-arm still functional and essential in orthopaedics

Fixing a complex fracture thanks to radioscopy

One positive point is that the presence of an orthopaedic surgeon on site (Dr Asaph, whom we sponsored): most acute cases can be treated quickly. Fewer patients have to wait months for our camps before being seen!

An added bonus was the involvement of Nickson, a clinical officer specialised in orthopaedics: very conscientious and professional, he was a great help. He also sent us a daily report on camp activity and an overall summary of the mission (see Nickson’s report).

THe orthopaedic clinical officer preparing a cast

The work in the laboratory was a pleasant surprise for Veronique: no samples were misplaced; the analyses were carried out quickly and correctly (except for one glitch that she was able to correct!): the work done with the laboratory technicians during the previous mission (thank you Nathalie and Laetitia) paid off! and there were once again many cases of osteomyelitis.

Progress in the laboratory thanks to Veronique

Radiology gave Samuel and the team a hard time: the cassette reader broke down and could not be used for three days, making it impossible to take X-rays other than with the mobile machine… It came back into service spontaneously, without us understanding the cause of the breakdown. The X-ray monitors are on the way out: two hours of work with a specialist in the United States (through Teams) made it possible to recover only two of the 4 monitors that had been donated with the X-ray equipment. Their lifespan is uncertain.

Samuel trying to repair the X-ray printer

We had the pleasure of welcoming two surgeons specialised in reconstructive surgery, Dr Marie-Christine Matthieu and Dr Marina Barandun, for a few days. Their aim was to assess the resources available for a future mission aimed primarily at treating patients with the after-effects of burns. They performed a skin graft on a badly burned child and we discovered that children’s scalps are ideal for harvesting!

After sampling skin from the scalp for the grafting of severe bosy burns

The solar installation has been in operation since the beginning of July: it’s obvious, when you’re on site, that there are hardly any power interruptions, and it’s great to see that the hospital didn’t have to use the generator during the month of September (diesel consumption of 0 litres!). We still need more time to assess the benefits, with the possibility of automating the dam: at present, it is still managed manually, with the risk of minor power cuts during the hydro and solar transition!

Overall, another success.

Orthopaedic Mission October 2024