Knee Replacement in Congo – Part 3

Posted on October 5, 2016 by NHOC Tech under Dr. Hogan, Featured Articles

by: Kathleen A Hogan, MD

I am part of a group of female orthopedic surgeons (WOGO) who travel to third world countries to improve the lives of people by improving mobility through joint replacement. In July, we traveled to the Democratic Republic of Congo (DRC) as guests of the Dikembe Mutombo Foundation to perform knee replacement surgeries. This was an incredibly challenging trip and rewarding trip. This is our story.

Unforeseen Challenges

Nothing went exactly as planned. Our cargo was delayed, resulting in one less surgical day. The sterilizer broke down. Many team members were hit hard by a GI illness. But we had rallied, working late into the evening and finding another nearby hospital to get our equipment autoclaved. We had performed 38 knee replacements. It was the last day for surgery. We knew that even under the best of circumstances there would probably be 6 patients for whom surgery would not happen. But we wanted to try.

Revised Plan

We had a plan to get as many cases done as possible. Two surgeons ran the day-long educational conference for the local surgeons. Everyone else was in the operating room. But after the first cases were completed, the news was grim. The sterilizer was down again. Instruments were gathered up and sent to a nearby hospital to be autoclaved. But the slow down meant 6 patients would not have surgery.

Hearbreaking News for Eight Patients

We had met these patients in May and selected them for surgery. They had been in the hospital for the past 5 days awaiting surgery. They had gone through preoperative teaching and seen other patients recovering from surgery. Telling these 6 patients that their surgeries could not be performed was heartbreaking. Tears were shed – by the nurses, surgeons, and patients. But they all knew how hard we had tried to help them. These patients received steroid injections and braces prior to being discharged.
Later in the day we had to tell 2 more patients their surgery was also cancelled. These 2 patients were in the preoperative holding area when we realized that the equipment sterilized at the other hospital was not sterile and could not be used. It was such an emotional day. All of the surgeons believe that we have to go back to the Congo and finish the job we started. We all made a commitment to these patients that we would not forget them.

42 Knee Replacements in 4 Days

In the end, we were able to complete 42 knee replacements in 4 days of surgery. Our team worked long hours without complaints. The patients did really well after their surgeries. By the time we left, many had already been discharged home. They were walking with walkers or crutches and their pain was well controlled. Our physical therapists taught them exercises to do at home. We spent time with the surgeons who will be following up these patients teaching them about postoperative care for knee replacements. At the 2 week post op visit, all were doing well. We have established a great relationship with the surgeons at the hospital and we are working to help them get a wifi connection at the hospital to help facilitate email and video conferencing.

Benefits to Biamba Marie Mutumbo Hostpital

Not only did we help our patients, but we also helped to make the hospital a little bit better for those who follow in our footsteps. Because our group was coming, improvements had already been made in the operating rooms, including air conditioning. A new sterilizer is needed and will be ordered. After watching us perform a particularly difficult surgery, Rose Mutombo told me that we showed everyone in the operating room who was observing us the importance of getting the surgery done correctly, no matter how long it took. We had the opportunity to work alongside and teach the local surgeons, anesthesiologists, residents and nurses. The people of the Congo have suffered much with recent wars and political dictatorships and corruption. But they are beautiful, resilient people and there are so many good things happening in Congo!