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Reconstructive Surgical Mission Bangladesh

19th Sep 2019

Last Monday, September 18th, our surgical team arrived in Bangladesh for a reconstructive surgical mission. During this mission, we will take you with us in a few blog posts.

The camp is organized by Friendship, a Bangladeshi non-profit organization focusing on healthcare, education, sustainable economic development in inaccessible areas of the country. Surgical missions are performed all year round by different national and international teams. Operations during our mission are performed on one of the Friendship hospital ships, which moves around the Chars in North Bangladesh every three months – a very remote and poor area with almost no access to health care.

The goals of our mission:

  • To treat patients with burn contractures and congenital anomalies (e.g. cleft lip/palate);
  • To explore the possibilities of making surgical missions more sustainable in the future, for example by incorporating training on the job;
  • Knowledge exchange between the local team and the visiting team.

The Dutch team

The Dutch team (from left to right): Matthijs Botman (reconstructive surgeon and general director of GSA), Peter Don Griot (reconstructive surgeon and faculty member of GSA), Swanny Thio (anesthesiologist) and Claire van Hövell (chair of GSA and resident plastic surgery).

Dr. Arif, MD and program manager of the hospital ship

“After graduation in Dhaka in 2017 I joined an organization that treats women with genital fistula. I gave education to government health workers about the topic. I missed doing clinical work, and therefor joined Friendship in 2018. Here I can combine treating patients with management work.” The ship performs as an operating theatre, but also as a clinic for screening and general patient care. Each month around 400 women are screened for breast cancer and cervical cancer, and if needed treated with cryotherapy. There is a pharmacy and a laboratory, and patients can get a consultation and all necessary medication for 5 Taka (€ 0,05). This fee includes surgery, if needed, and transportation.

Dr. Arif is 25 years old. He comes originally from this area. At the ship he works seven days a week and sees his family once every 1,5 months. Dr. Arif believes strongly in the work that Friendship does: “Friendship is the only NGO that works in this part of Bangladesh. It is a very remote and poor area, where people are suffering. The economy of Bangladesh is growing fast, but the money only goes to the rich and the gap between rich and poor is becoming bigger and bigger. Usually, a simple operation will cost around 50.000 Taka, excluding travel costs and other expenses. At the ship, these surgeries are for free.”

Dr. Arif

Dr. Arif

However, there is a downside to the work as well. The surgical camps are usually not longer than a week, and there are many patients that cannot be treated in that week. “Saying no to patients is one of the hardest parts. I wish we would have more camps, with a longer duration, so we could treat all patients.” All teams that come, have the ambition to incorporate teaching in their mission. In reality, this often does not happen. “The camps are short and due to the many surgeries that have to be performed, teaching is not always priority. Since recently, we try to invite Bangladeshi doctors and medical officers from Friendship to join a camp." For the future I hope that it will be possible to train local doctors, like Dr. Alvee, to be make it possible that they will provide affordable and safe surgical care all year around.

The first day we do the screening of the patients together with Dr. Arif, Dr. Alvee and the other team members. There is a big group of patients with severe burn contractures, cleft lips or cleft palates. Some of them have been waiting very long: there is cleft lip patients who is already 17 years old and did not get the chance to be operated before. Dr. Alvee seems very motivated to learn and we are looking forward to work with the team in theatre the coming days.