This is a two week project focusing on gyn surgical needs of patients who can not afford to have these procedures. We bring all of our own supplies including instruments, suture, gloves, medications etc. I am also going with one of my chief residents and we will be operating together.
Women with gyn problems such as uterine fibroids causing pain, heavy menstrual periods and infertility, ovarian masses and cysts, vaginal prolapse and cervical cancer. As mentioned above these patients can not afford surgical procedures and so they wait until they have an opportunity such as this one.
As women are the main care givers in a family addressing their medical needs then indirectly helps not only them but also their family and their community.
On our first day in clinic we had so many women patiently line up to be seen. Many had come from long distances. They were medically prescreened and came prepared with their medical record books, a recent US and lab work. These women could not afford surgery at the regular hospitals and had saved enough money for the prescreening work up and now hoped that they could receive their surgery here with us. After meeting the patients and taking our own histories and doing our own exams to decide on treatment options, we scheduled almost all of them for surgery the next two weeks. The majority of women had very large fibroids causing heavy menstrual bleeding, anemia and pain but often their main concern was infertility. The ability to be able to conceive can not be underestimated in this country and this culture. It was interesting that many of the Ghanian women we met tend to try to start a family in their thirties. This unfortunately allows the fibroids that many black women have, to grow over these years.
We performed many myomectomies with the warning that they would need a CS in any future pregnancies. Others had hysterectomies for large fibroid masses causing much discomfort. We also had a young woman with bilateral pain and enlarged ovarian masses. The one ovary was torsed three times on itself and completely necrotic, necessitating removal. She had had to deal with the pain for weeks as she had no other place to go.
The surgical cases were challenging but we had great nursing care and it was nice to work with the local anesthesia team. It was also great to work one on one with my chief resident with so many cases back to back and see her skills solidified.
The women and their families were grateful for the care they received. These women are also very strong women and recovered quickly. It was wonderful to see several of them for their one week post op doing so well. Hopefully many will be able to conceive in the future and in the mean time be relieved of their pelvic pain. The other women who had definitive treatment with a hysterectomy will now be able to lead a normal and happier life without heavy bleeding and pain and be able to contribute more to their families, jobs and community.
