Stichting Interplast Holland

S T I C H T I N G INTERPLAST HOLLAND
a n n u a l
r e v i e w
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Table of contents
2
General survey of countries and operations
4
From the Chairman
5
Introduction
7
Mission to Guinea-Bissau
10
Mission to Zanzibar
12
Missions to Burundi
15
Joining forces
Thanks to the Dutch Liliane Foundation and Noma
Foundation, an Interplast patient travelled
from Burundi to Nigeria for treatment.
16
Mission to Nigeria
18
Mission to Indonesia
20
Mission to Uganda
21
Follow-up in North Uganda
in cooperation with Trust Fund for Victims
Rein Zeeman and Marjo Aerts review Interplast
Holland’s efforts in Uganda.
22
Let’s stop burns now!
Dutch Burns Foundation gets involved in burn
prevention programme.
23
24
A Dutch ergotherapist in Kampala
Ergotherapist Ilse de Ruijter’s experiences in Uganda.
Discovering Dhaka
Fact-finding mission to Bangladesh with Dokters
van de Wereld (Médecins du Monde, Dutch section).
26
Interplast Holland information leaflet
27
Contact Interplast Holland
28
Special thanks to …
2
General survey
General survey
General survey of countries and operations
O p e ra t i o n t o t al = 10370 w ith 12 8 t eams
Uganda
33 teams
2631 patients
Ye m e n
28 teams
2153 patients
Nigeria
9 teams
683 patients
Rwanda
4 teams
250 patients
Guinea-Bissau
4 teams
267 patients
Burundi
5 teams
511 patients
Zanzibar
4 teams
281 patients
Indonesia
5 teams
498 patients
18 teams
1362 patients
6 teams
976 patients
Ghana
Vi e t n a m
And teams to
Lebanon, Bhutan, Namibia,
Pakistan, India and Burkina Faso.
3
4
From the Chairman
From the Chairman
The 2011 Annual Review of Stichting (Foundation) Interplast
We have seen some changes within our organisation.
organisations we are trying to cut costs. Now the review is
experienced nurse anaesthetist and also a master plaster
Holland is shorter than usual. This year, like many other
only in English, since we use is a lot abroad to promote our
work there. I think most of our followers will not find this a
problem. There are, however, also summaries in Dutch
and French.
As usual in 2011 we have sent teams to Nigeria, GuineaBissau, Burundi and Zanzibar. After four years another
team was invited to Bau-Bau in Indonesia.
As I mentioned earlier, Stichting Interplast Holland is having
to face the financial crisis despite the large number of well-
The nursing committee was joined by Jan van Steen, an
cast technician. In January Marjo Aerts joined our secretarial
staff as a policy maker. She drew up the policy-plan for
2011-2013, advised the board members and drafted the
project proposals.
Unfortunately Annemarie was on sick leave for some time
this year, and the office was less easy to reach. Board
members (Rein and Henk) and Marjo kept up with the daily
activities. No missions had to be cancelled. Luckily she is
back in the office now.
wishers. Gifts are diminishing, and in the end we may have
We started to cooperate with Dokters van de Wereld (Dutch
are continuing with our efforts to give as many children as
project ‘Operatie Glimlach’ (Operation Smile) in Holland.
to reduce the number of missions. Whatever happens, we
possible the chance of a better life.
In Uganda a major step was taken in the burns prevention
programme STOP BURNS. We worked closely together
branch of Médecins du Monde) in connection with their
Our expertise proved very welcome during their first mission
to Bangladesh. In the future we will be working together
more closely on team missions.
with the Dutch Burns Foundation to provide training for
Next year you will probably be able to follow us through
busy in the slum areas around Kampala and recently started
hope this will help to involve you more in our work and to
Burn Prevention Officers. After their training they were very
to visit primary schools. They provide information on how
burns can be prevented.
In Burundi, many patients are still waiting. We made a few
advances with our plans for setting up a Reconstructive
Surgery and Burns Centre. We hope more local initiative
will be forthcoming.
various social media: Facebook, Twitter and LinkedIn. We
help us find more sponsors.
I would like to thank our volunteers and sponsors for their
contribution in the past year. Without your help we would
not have succeeded.
Veel dank, thank you, merci beaucoup, vielen dank,
shukran djazilan, asante sana, webalenyo!
Rein J. Zeeman
This annual review for 2011
has largely been created and
sponsored by volunteers.
Introduction
Introduction
Stichting Interplast Holland is a charitable foundation that
Conakry. The first Interplast team will be sent there in
and adults in developing countries. Each year the
Unfortunately, the spring mission to Nigeria had to be
performs reconstructive surgery on children, young people
organisation sends teams of experienced plastic and
reconstructive surgeons, anaesthetists and operating theatre
assistants on a number of missions to developing countries.
February or March 2012.
cancelled at the last minute because of serious disturbances
in Jos. Missions to Yemen have not yet been resumed
because of the political situation there.
The doctors and assistants, who are assisted by local
Training certificates
their services free of charge. Their assistance includes:
Interplast Holland has been awarding certificates to local
doctors and nurses, work during their holidays and provide
•
performing reconstructive operations free of charge for
children and adults with cleft lips and palates, disfigurements
caused by burns, tumours and other congenital deformities
•
•
training local medical personnel in reconstructive surgery,
anaesthesia and nursing techniques
helping to set up burns and reconstructive surgery units
in hospitals
To secure lasting results Interplast Holland works intensively
with local hospitals, doctors, nurses, universities and NGOs.
In order not to burden local hospitals unduly, almost all
materials required to perform around 100-120 operations are
brought from the Netherlands.
From the beginning of 2011, at the end of each mission
nurses, doctors and staff of the sterilisation department who
have taken part in our courses. In this way they can show
that they have been participating in training. They also have
a certificate that they can put on their CV. In turn Interplast
has an overview of who has taken part and what has been
achieved in terms of training. The names are kept in a
database for each country and a list of names is taken along
on subsequent missions. In 2011, forty-two certificates were
awarded during four Interplast Holland missions. Thirteen
certificates were also awarded to burn prevention officers in
Uganda who had been trained. In 2012 this procedure will
be implemented in every country.
Interplast is an international organisation which was founded
in the United States in 1969. Stichting Interplast Holland was
founded in 1990. By now Interplast is represented in many
other Western countries. As a foundation, Interplast Holland
is fully independent from its fellow Interplast organizations.
They are regarded as sister organisations.
Interplast Holland currently concentrates its activities in
Burundi, Nigeria, Zanzibar, Uganda and Guinea-Bissau.
Missions to these countries take place every year. Interplast
Holland is also active in Indonesia where a mission is sent
every three or four years.
In the past teams have also been sent to Vietnam, Pakistan,
India, Bhutan and Lebanon.
Seven missions
Local staff in Guinea-Bissau posing with their certificates
There were seven Interplast missions in 2011: one to
Uganda
Burundi and one to Indonesia. The seventh mission, in
Burns & Plastic Surgery Institute that was set up in 2004.
Nigeria, one to Guinea-Bissau, one to Zanzibar, two to
conjunction with the Trust Fund for Victims of the
International Criminal Court, was sent to North Uganda for
the fourth time. This time, Interplast worked in Gulu.
Early 2011, there was also a fact finding mission to Guinea-
In 2011 Interplast Holland again gave support to the Uganda
After seven years the focus of burns treatment is now
primarily on preventing burns. A programme for this, called
STOP BURNS, has been developed in conjunction with the
Dutch Burns Foundation.
5
6
Introduction
Training burn prevention officers
Tamara Prinsenberg and Monique Gomez of the Prevention
Mission
visited Uganda twice in 2011 to train burn prevention
give help in developments in reconstructive surgery and
and Research Department of the Dutch Burns Foundation
officers. You can read Tamara’s report on page 22.
Interplast Holland is a charitable foundation that seeks to
treatment in developing countries by participating to
Since February 2011 ergotherapist Ilse de Ruyter has been
achieve the self-reliance of local doctors, nurses and other
about her experiences on page 23 of this annual review.
out operations and providing training and courses during
working in the Burns Unit on a voluntary basis. She writes
Vision
Interplast Holland has a vision of a society in developing
countries in which children and adults with physical
disabilities are given medical treatment so that they can
fully participate physically, mentally and socially in their
community.
staff. The organisation works towards this goal by carrying
team missions, by founding and supporting plastic and
reconstructive surgery units and burn centres, and by setting
up burns prevention programmes. Cooperation with other
organisations in the Netherlands and abroad is high on the
agenda of Stichting Interplast Holland. In the Netherlands
the organisation aims to run its office with the structured,
administrative and policy support of mainly volunteers.
Guinea-Bissau
Guinea-Bissau
Official name
Republic of Guinea-Bissau
Capital
Bissau
Location
West Africa
Surface area
36.152 km²
Number of inhabitants
1.7 million
Climate
tropical
(same as the Netherlands)
28 January - 12 February
Team
Plastic surgeon
Rein Zeeman
First week: without Charlotte but with Dr Lassana
Assistant surgeon
Charlotte Lameijer
During the first week Rein Zeeman had to manage without
Anaesthetist
Gijs Witte
Anaesthetic nurse
Elly Hofstede
Theatre nurse
Karina Heek
Local team
Jan van Maanen
and team leader
(6 -19 February)
Will van Maanen
Intchsso
the assistance of Charlotte Lameijer, who arrived a week
later and stayed on longer than the rest of the team. This
way, she could look after the post-operative care of the
patients. On the first operating day the national television
paid a visit. After broadcasting the whole of Bissau
immediately knew about the team and its members were
greeted on the streets.
Johannes Mooij
Visited hospital
Hospital Nacional Simão
Mendes
GUINEA-BISSAU is a small West African country with an
estimated population of 1.5 million. It is one of the least
developed countries in the world and among the poorest,
listed number 176 out of 187 on the United Nation’s
Human Development Index (2011). The Netherlands, for
instance, is number 3. Average life expectancy is 48 years
and infant mortality in the first year is almost 100 in every
1,000 children.
The country lives primarily from agriculture and has
recently become the biggest exporter of cashew nuts
worldwide.
National television films team at work
This was the fourth Interplast Holland mission to Guinea-
In the first week most operations were mainly on burn
the local organising committee, Consul Jan van Maanen, his
Zeeman was assisted a great deal by Dr Lassana Intchsso,
Bissau. As usual, excellent preparations had been made by
wife Will and Johannes Mooij. The screening on the morning
after arrival was carried out without delay.
contractures, clefts and noma (gangrenous stomatitis). Rein
who will become the director of the new noma hospital that is
being built and sponsored by German Hilfsaktion Noma e.V.
(Noma Aid).
7
8
Guinea-Bissau
Rein and Lassana working together
Second week: doing it the Interplast way
During the second week it was possible to operate on two
tables in one room – the Interplast way – thanks to the
arrival of Charlotte. Cooperation went smoothly, as you can
tell from this passage from Charlotte’s report on working in
the operating theatre.
‘This week we are operating as we did last year: two tables
in one room. Rein operates the complicated burns
contractures, a lot of clefts, this year more noma patients
than last year and even a large lymphangioma (benign
tumour) in the neck. I mainly operate burns contractures,
occasionally a gigantic lipoma (benign tumour), or less
complicated facial reconstructions. The good thing about
two tables is that Rein can look over my shoulder from time
to time and I can make good use of his instructions. The
duo Gijs and Elly again worked in perfect harmony: Elly
coordinates and Gijs injects. And our super-coordinator
Karina keeps her end up well and steers the operating
theatre assistants. It’s marvellous occasionally to go and
stand in the corner of the operating theatre and just watch
how everyone is working, the local staff together with the
Interplast team. We really do work together.’
Positive response from Health secretary
At the end of the first week there was a meeting with the
No treatment available for burns patients
Zeeman wrote about this in his report: ‘A constructive
A happy surprise
training than we do at present. Next year we are going to be
11 February Rein, Gijs, Elly and Karina went back to the cold
state secretary for Health, Augusto Paulo Silvo. Rein
discussion with a positive response to our wishes to do more
allocated young doctors. And the offer of help to treat burns
was welcomed with open arms.’ You can read the full report
of this mission on our website, www.interplastholland.nl.
And finally another extract from Charlotte’s report: ‘on Friday
in the Netherlands. On Monday I saw a lot of operated
patients. It is always a surprise what you see after removing
the dressings. Fortunately, this year there are very few
G u i n e aX- xB xi s
xs
xa
xu
x
wound infections. With my few words of Creole and
during the next mission. On top of the talk with the secretary
brothers and sisters how they should treat the wounds at
forward to the Guinea-Bissau mission 2012!’
Samora’s linguistic skills, we explain to patients, parents,
home. Practically everyone without exception wants to
smear ‘pommade’ on the wounds. Once this has been
emphatically discouraged many patients happily go home.
A well-oiled machine
On Thursday and Friday Fatima (head nurse of theatre
at the hospital) and a number of other nurses and the
physiotherapist are involved in the aftercare. Fatima is
extremely strict in directing her group of nurses which results
in a well-oiled machine to change all the dressings. I look on
of the Ministry of Health, this is hopeful news. Here’s looking
Operations Guinea-Bissau
• • • • • 15 cleft lips and/or palates
36 post burn contractures
8 noma
15 other
10 certificates awarded
Dankzij een uitstekende voorbereiding door het lokale
with contentment – this was the idea. Last year it was very
team o.l.v. Jan van Maanen konden bijna alle patiënten die
seems to be going so smoothly. Have they got more
Een hele prettige samenwerking met de lokale chirurg
difficult to get people involved, and this year everything
confidence in us now because we go year after year? Even
the physiotherapist promises to treat the patients with burn
contractures if Fatima refers them to him. This week I also
had an operating day when I carried out a reconstruction on
the corner of the mouth and other minor surgery.
geselecteerd waren ook geopereerd worden.
dr. Lassano Intschsso. De tweede week kreeg het team
versterking van Charlotte Lameijer. Zij bleef een week
langer om de nazorg van de geopereerde patiënten op
zich te nemen.
Gràce à l’excellente préparation de l’équipe locale
Hope for the future
Jan van Maanen presque tous les patients qui avaient
Johannes phoned me to say that two young enthusiastic
Une collaboration agréable avec le chirurgien locale
On the last day in the hospital one more hopeful encounter.
medical students had turned up to see him. Delwin and Chris
had finished their training in December 2011 and had also
been observers in February 2010 in the operating theatre.
They want to become plastic surgeons and offered to assist
Before and after Cleft Face operation
été sélectionnés ont pu être opérés.
Dr. Lassano Intschsso. La deuxième semaine Charlotte
Lameijer est venue soutenir l’équipe. Elle est restée une
semaine de plus pour prendre en charge le soins
postopératoires des patients opérés.
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10
Zanzibar
Zanzibar
Official name
Zanzibar
Capital
Zanzibar City
Location
island in the Indian Ocean,
Surface area
1554 km²
Number of inhabitants
1 million
Climate
tropical
east of Tanzania
11 - 26 February
was heart-warming, after that the team set down to work in
Team
the operating theatre from early morning till night. This way,
Plastic surgeon
Ed Hartman
all patients could be operated upon. Unfortunately our
Plastic surgeon
Ruth Lester
had to manage from day two onwards without the highly
Anaesthetist
Veronica Evers
Theatre nurse
Agnes Derwa
Anaesthetic nurse
Ingrid Hollander-Mus
Visited hospital
Mnazi Mmoja Hospital
and team leader
anaesthetist, Veronica – taking part in her first mission –
experienced Ingrid Hollander-Mus, who for personal reasons
had to go back home early. Luckily Veronica received help
from two experienced local anaesthesia technicians.This
made it possible for the team to operate on two tables.
Important discussion with the new Health minister
The team met the new Health minister, Mr Juma Duni Haji,
on the first Thursday of their stay. The encounter was filmed
The island of ZANZIBAR lies off the east coast of Africa
and is a semi-autonomous part of Tanzania. The island of
Pemba close by is often considered to be part of Zanzibar.
by a television crew and was broadcast the very next
morning. Also present were the first secretary Dr Mohamed
Jiddawi (Interplast’s contact from the outset), Dr Rama, the
hospital director Dr Jamala and the deputy minister Dr Sira
As in the greater part of the African continent there is no
plastic reconstructive surgery here. Before the arrival of
Interplast Holland, patients were sometimes referred to a
clinic for reconstructive surgery in Dar es Salaam on the
mainland, which is a very expensive exercise. So the
Interplast teams are very welcome on Zanzibar, where they
have been working since 2008 in the Mnazi Mmoja Hospital,
a government hospital with 430 beds.
Fully booked programme
Dr Ramadhan Suleiman had promised the team more than a
Ubwa Mamboya. The new minister was very interested in the
work of Interplast. Again the meeting turned to the
circumcision operations which are often badly performed,
resulting in all kinds of complications. Dr Ruth Lester, who
specialises in operations on hypospadias (birth defect of the
urethra), is a keen advocate of training the local people who
carry out these circumcisions.
Problems with the oxygen cylinders dominated the second
week. They had been ordered, but the connections did not
fit and a standard connection was nowhere to be found.
The director of the hospital said that next year there would
be one overall system and this problem would be solved.
hundred patients and he had not exaggerated. He had
But for now the oxygen cylinders had to come from a clinic
and Zanzibar. Most of them indeed were eligible for an
their operation. Next year they will be the first ones on
selected 118 patients during the pre-screening on Pemba
operation, and in no time the fortnight’s programme was fully
booked. All the patients left the hospital with a date for an
operation. ‘Utopia for many hospitals in the Netherlands’,
team leader Ed Hartman commented in his report.
Meeting the local team members from last year’s mission
close by. Apart from this only two patients missed having
the list.
The full team as they said their farewells. A very hard
working local team ‘that remained enthusiastic, I never ever
experienced such dedicated team members around me’,
said satisfied team leader Ed Hartman.
Zanzibar
Dr Ruth and Dr Rama doing ward rounds
Operations Zanzibar
• • • • 33 cleft lips and/or palates
31 hypospadia or urethral fistula
18 post burn contracture
14 other
Dr. Rama had het goed georganiseerd. Er waren
meer dan 118 patiënten voor de screening. Er werden
lange dagen gemaakt om iedereen te kunnen opereren. In
een gesprek met de minister werd wederom het probleem
van de fistels na circumcisie ter sprake gebracht. Training
van lokaal medisch personeel hoe dit te voorkomen lijkt de
aangewezen weg. De 2de week stond vooral in het teken
van de problemen met de zuurstofaansluitingen (dit zien
we vaker in Afrika!) maar het was een succesvolle missie.
Dr. Rama avait bien organisé. Il y avait plus de
118 patients pour le dépistage. Pour pouvoir opérer tous
les patients il a fallu faire de longues journées. Dans un
entretien avec le Ministre le problème des fistules après
opération de circoncision a été abordé. Il semble que la
solution pour éviter ce problème soit la formation du
personnel médical local. La deuxième semaine le problème
majeur était la connexion d’oxygène (cela arrive souvent en
Afrique !), mais globalement la mission a été un succès.
11
12
Burundi
Burundi
Official name
Republic of Burundi
Capital
Bujumbura
Location
Central Africa
Surface area
27.834 km²
Number of inhabitants
9 million
Climate
tropical
29 April - 14 May
Team
Plastic surgeon
Rein Zeeman
Plastic surgeon
Esther Mesters
Anaesthetist
Rutger van Leersum
Anaesthetic nurse
Jan van Steen
Theatre nurse
Marie-Thérèse de By-
Nurses
Ellen Campagne
Chairman Izere
André Nkeshimana
Visited hospitals
Centre Hopitalo Universitaire
and team leader
de Bakker
Colette Sindahamira
de Kamenge, Bujumbura
Ngozi Hospital, Ngozi
BURUNDI is one of Africa’s smallest and most densely
populated countries The civil war lasting from 1994 to
2005 has meant that it is also one of the world’s poorest.
(It ranks 185 out of 187 on the United Nation’s Human
Development Index of 2011.)
It is located in the great lakes region of Central Africa
and is landlocked. Medical care is accessible to very few.
Sixty-five out of 1,000 children die within their first year.
There are less than 300 doctors for a population of
around nine million.
April - May mission: a rather difficult start
Positive press releases from Brarudi (Heineken Burundi) had
clearly had an impact. There were more than 150 people
waiting for the team on the first screening day in the Centre
Hopitalo Universitaire de Kamenge (CHUK), in the Burundi
capital of Bujumbura.
4 - 18 November
After a chaotic start, again not much cooperation on the part
of the local staff was forthcoming in the first week at CHUK.
Team
They had apparently not been properly informed about the
Plastic surgeon
Andrew Posma
team’s arrival. That made the presentation for the staff and
Plastic surgeon
Rein Zeeman
important and it was extremely well received, but sadly the
and team leader
Assistant plastic surgeon Jarl Tielemans
Anaesthetist
Hans Pöll
Anaesthetic nurses
Vincent van Weerle
Arend Verbaan
Theatre nurses
Elles Loenen
Chairman Izere
André Nkeshimana
Visited hospitals
Centre Hopitalo Universitaire
Ingrid van Ginkel
de Kamenge, Bujumbura
Kibimba Hospital, Gitega
students by the team leader Rein Zeeman all the more
team hardly felt welcome in the first week. Even so, many
patients with clefts and burn contractures were operated on,
though little could be done in the form of training.
Kibimba: a warm welcome
Fortunately, the team received an immediate warm welcome
in this hospital, Kibimba District Hospital in the Gitega
District. Rein and Rutger had visited this hospital a week
earlier to check if it was good and safe to work in. The week
involved a full programme of operations with the local
anaesthetists, the surgeon and even the director joining in
enthusiastically. Skin transplants were new to them. Here
again most of those operated on were children with cleft lips
and/or palates, and burn contractures.
Burundi
Gràce aux bons Communiqués de Presse de
Brarundi (Heineken Burundi) il y a eu un bon nombre de
patients au dépistage du Centre Hopitalo Universitaire de
Kamenge (CHUK). Le personnel local ne semblait pas
toutefois informé de l’arrivée de l’équipe, de ce fait la
collaboration était limitée. Cependant de nombreux patients
avec schisis (bec de lièvre et fente palatine) et contractures
de brûlure ont pu être opérés ! Il y eu beaucoup d’intérêt à
la présentation de Rein Zeeman sur le travail d’Interplast.
La deuxième semaine à Kibimba s’est bien déroulée, des
chirurgiens et anesthésistes enthousiastes qui ont travaillé
toute la semaine. Même le directeur a participé ! La greffe
Before and after cleft lip operation
Rein Zeeman’s presentation in the Gitega regional hospital
de peau était une nouveauté pour eux. Ici aussi beaucoup
de schisis et contractures.
about the work of Interplast in Burundi attracted an audience
November mission: a successful first week
a doctor from the Belgian branch of Doctors without Borders
Interplast team. There was even an enthusiastic, eager-to-
of more than a hundred people: staff members, students and
who were performing fistula operations on women. After an
extremely successful week the team returned to Bujumbura
to see all their patients who had been operated on the
previous week, and changed dressings, some under
anaesthesia.
Would Interplast Burundi be an option?
On the last evening the team visited the Dutch chargé
d’affaires in Burundi Cees Spoel, and his wife Sari. The
discussion turned to the lack of a local organisation. Setting
This time the CHUK was well informed of the arrival of the
learn doctor, Jean Claude, who had been called in and who
arranged everything during the entire week. Within a few
hours of their arrival in Bujumbura the entire team was ready
to screen the long queues of patients. There were far too
many patients and no preparations had been made at the
OPD. Many had cleft lips and/or palates, but there were also
a lot of patients with large tumours, many of which,
unfortunately, were inoperable. The team looked at as many
people as possible and gave advice.
up Interplast Burundi – similar to Interplast Uganda – would
The heavily-loaded operating programme started on Monday,
the next team visit of Interplast Holland.
On Monday night there was a reception at the Dutch
be very welcome! This could help to make preparations for
Operations Burundi, May
• • • • everything went well and fast right from the beginning.
embassy, with some important local officials.
62 cleft lips and/or palates
17 post burn contracture
11 other
12 certificates awarded
Dankzij goede persberichten van Brarudi (Heineken
Burundi) was er een goede opkomst bij de screening in het
Centre Hopitalo Universitaire de Kamenge (CHUK).
Lokale staf bleek echter niet geïnformeerd over de komst
van het team, medewerking was hierdoor matig. Toch veel
patiënten met schisis en brandwondcontracturen kunnen
opere­ren! Voor een presentatie van Rein Zeeman over het
werk van Interplast bestond gelukkig wel veel interesse.
Tweede week in Kibimba verliep prima. Enthousiaste
chirurgen en anesthesioloog die de hele week meewerkten.
Zelfs de directeur deed mee! Huidtransplantatie was iets
nieuws voor ze. Ook hier weer veel schisis en brandwond­
contracturen.
Training on the job at Kibimba Hospital
13
14
Burundi
Dr Elisé operating on a cleft lip
Dr Elisé posing with donated skin graft knife
Fifty operations were carried out in five days’ time. Despite
The director, Dr Elisé, who is himself a surgeon, regularly
though that the team had been working together for years
under Rein Zeeman’s watchful eye. The team left him a skin
a shortage of beds, this was a great result. It has to be said
and were able to anticipate well.
Several film crews stopped by during the week, one of them
from Brarudi (Heineken) that was making a documentary
about Interplast in Burundi. The team also got a lot of
coverage from national television, radio broadcasts and
journalists.
Kibimba: everyone joined in!
Again everything had been well prepared in the Kibimba
district hospital. from the first day of the second week.
Patients had been well screened and documented.
Clearly, from the various reports, the local staff and
employees were extremely enthusiastic and keen to
join in.
Mother takes home her two children following cleft lip operations
assisted and operated on several lips and burns contractures
graft knife to enable him to perform these operations himself.
The operating days went smoothly, also thanks to the good
cooperation with the people from the sterilization
department.
Gitega: possible burns centre?
According to the Health minister, Gitega Regional
Hospital would be the ideal site for setting up a burns
centre as Interplast has done in Uganda. Rein Zeeman
had a discussion about this with the deputy director on
the Wednesday. Together they looked at the possibilities
in terms of the site and the buildings. Apparently Egypt
has shown interest in building a completely new hospital,
but it was uncertain whether this would go ahead. We will
have to wait and see what happens!
Operations went smoothly, thanks also to sterilisation staff
Joining forces
On Friday the team said fond farewells to the staff at
Kibimba Hospital. (See Rein Zeeman’s full report on www.
interplastholland.nl.) Then the team went back to Bujumbura
Joining forces
to change a number of dressings under anaesthesia at
Thanks to the combined efforts of the Dutch Liliane
admitted (mainly reconstructed hypospadias).
Burundi was able to travel to Sokoto in Nigeria for treatment.
CHUK and to do the rounds of patients who were still being
Everyone looked back on a successful mission in Burundi, a
country where there is still a lot to be done.
Operations Burundi, November
• • • • • Everyone looked back on a successful mission in Burundi, a
65 cleft lips and/or palates
country where there is still a lot to be done.
28 post burn contracture
6 hypospadia or urethral fistula
8 other
8 certificates awarded
Foundation and Noma Foundation, Candine Ndayishiy from
One of the Interplast Holand teams that had worked in
Burundi in 2010 saw a noma patient with serious defect
and severe trismus (locked jaw). As a result, she could not
be intubated and the aftercare in the hospital in question
was inadequate. In October 2011, the patient went with an
attendant to the noma hospital in Sokoto in Nigeria where
an experienced Dutch team was operating at the time.
The operation was carried out without complications.
We saw the patient during our November mission in
Burundi, a few weeks after the operation. An early postoperative result. She herself was somewhat affected by
the trip and her expectations had possibly been a little too
Deze keer was het CHUK wel goed op de hoogte
en er was zelf een enthousiaste en leergierige dokter
ingehuurd die de hele week meewerkte en van alles
high. We again told her that she must really practise
opening her mouth properly. We will be able to carry out
further improvements during subsequent missions.
regelde.
This trans-African treatment was sponsored by the Liliane
het begin goed en snel. In vijf dagen 50 operaties verricht!
they organised the trip and funded it. Thanks for this joint
Een overvol operatieprogramma maar alles verliep vanaf
Dit team werkt dan ook al jaren samen en is goed op
elkaar ingespeeld.
In Kibimba was alles prima voorbereid, patiënten
Foundation. They had representatives in both countries and
venture and thanks as well to the Dutch Noma Foundation
for the free treatment.
geregistreerd en de lokale staf was wederom heel
enthousiast! De directeur dr. Elisé werkte regelmatig
mee en kreeg een Watson knife gedoneerd. Nu kan hij
zelf huidtransplantaties verrichten.
Iedereen kijkt terug op een succesvolle missie!
Cette fois ci le CHUK était bien informé, un docteur
appliqué et enthousiaste avait été engagé. Il a organisé
et collaboré toute la semaine. Le programme d’opération
était plus que complet mais tout s’est bien déroulé et ce,
dès le début. 50 opérations en 5 jours ! Cette équipe
travaille depuis des années ensemble et est bien rodée.
A Kibimba tout était bien préparé, les patients enregistrés
et le personnel local très enthousiaste ! Le directeur
Dr. Elisé a travaillé régulièrement avec l’équipe et a reçu
en cadeau un Watson knife. Maintenant il peut effectuer
lui même les greffes de peau. Tout le monde considère
que c’était une mission réussie.
Before and after free radial forearm flap
15
16
Nigeria
Nigeria
Official name
the Federal Republic of Nigeria
Capital
Abuja
Location
West Africa
Surface area
923,768 km²
Number of inhabitants
150 million
Climate
tropical to sub-tropical
8 - 23 October
Team
Plastic surgeon
Cees Spronk
Plastic surgeon
Jan Hochtritt
and team leader
Assistant plastic surgeon Marijn Huijing
Anaesthetist
Rob Niemeijer
Anaesthetic nurse
Geke Hoeksma
Theatre nurse
Fatima van Klaveren
Visited hospital
COCIN Hospital &
Rehabilitation Centre, Mangu
Despite huge oil revenues there is great poverty in the West
African country of Nigeria. Seven hundred babies less than a
month old die every day. The country is far behind others in
terms of health care. The COCIN Hospital & Rehabilitation
Centre is situated in Mangu on the Jos Plateau in Northern
Nigeria. This hospital, formerly belonging to the Nederlandse
Leprastichting (NLR, Netherlands Leprosy Relief), has been
More than 150 people seen, 86 operations
performed in October
Fortunately, Nigeria was again relatively calm in October
and everyday life had resumed its normal course in the
neighbourhood of Mangu. This was just as well, since lots
of patients were on the waiting list. For a start, there were
those who we had had to disappoint in March; they of
course took priority.
The team, led by Cees Spronk, saw more than 150 people
altogether and carried out a total of 86 operations. A good
score, given the fact that the official festive opening of the
new nursing wards happened to take place one afternoon
when the team would normally have carried out operations.
The new wards were completely full by the end of the
mission.
visited twice a year since 2007 by a team mainly comprising
plastic surgeons from the north of the Netherlands.
March mission cancelled
Disturbances in Nigeria are a common occurrence but this
time they were very close to Mangu, which was why only one
mission was sent to Nigeria this year. In fact the team for the
spring mission was already on the verge of departure when
the decision to cancel was taken on the advice of the
Netherlands Embassy in Abuja and the board of Interplast
Holland. It was the sensible thing to do in the circumstances.
The air tickets – always a big item on the budget – could
fortunately be changed to October!
Opening new wards
Nigeria
Old and new wards
Many years of preparation
The opening of the new wards was of course a very special
event. They had taken many years of planning and
fundraising. The official opening was carried out by the
Commissioner of Health of Plateau State under the approving
eye of Annemieke van Soelen of the Netherlands Embassy,
the Mayor of Mangu and COCIN church leaders. Of course,
the initiators Cees and Neeltje Spronk were also present.
Assistant plastic surgeon Marijn Huijing was on her first
Operations Nigeria
• • • • • 6 cleft lips and/or palates
7 hypospadia or urethral fistula
42 post burn contracture
31 other
8 certificates awarded
Dit jaar kon er maar één missie naar Nigeria
the mission. It was an impressive experience for her, as
plaatsvinden. De voorjaarsmissie moest op het laatste
with the most diverse problems. Alongside many burn
geannuleerd worden.
she noted in her report; ‘patients have come from very far
contractures we also saw all kinds of urogenital deformities,
clefts and congenital (hand) deformities. Many children with
burns, particularly on their hands ... the limited care of burns
here is really distressing. And so, bewildered yet brave, they
all turn up to see the white doctors, though from time to time
a cautious tear may fall. Fortunately a lot of hard work has
been done in the past years to set up a new burns centre
with trained personnel. Hopefully, sufficient funding can be
found for this in the near future.’
moment in verband met onlusten in de buurt van Mangu
In oktober was het weer relatief rustig. Het team, o.l.v.
Cees Spronk, opereerde 86 mensen.
Ook hier weer veel brandwondcontracturen.
Tijdens de missie werd het nieuwe gebouw met twee
verpleegafdelingen officieel geopend. Aan het eind van
de missie lagen beide afdelingen helemaal vol. Het
volgende project van Cees en Neeltje Spronk is het
opzetten van een brandwondencentrum!
Nous n’avons pu faire qu’une mission au Nigéria
cette année. La mission prévue au printemps a dû être
annulée au dernier moment à cause des troubles civils
dans la région de Mangu. En Octobre la situation était
relativement calme. L’équipe Cees Spronk a opéré 86
personnes. Ici aussi beaucoup de contractures de
brûlures. Pendant la mission le nouveau bâtiment avec
deux unités de soins a été officiellement ouvert. A la fin
de la mission les deux unités étaient pleines. Le prochain
projet de Cees et Neeltje Spronk est la création d’un
Centre de soins pour Grands Brûlés !
Girl with burns
17
18
Indonesia
Indonesia
Official name
Republic of Indonesia
Capital
Jakarta
Visited island
Buton Island, city of Bau Bau
Surface area
1.910.000 km²
Number of inhabitants
235 million (Buton 500.000)
Climate
tropical
(Buton 4.408 km²)
16 September - 1 October
Team
Plastic surgeon
Rein Zeeman
Anaesthetist
Gijs Witte
Anaesthetic nurse
Elly Hofstede
Theatre nurse
Els Gerritsen
Local team
Sr André Lemmers
and team leader
Dr Arend Donggawa
Dr Magda Hutagalung
Aris Suparman
Ika Kartika
Sister André Lemmers – a Dutch nun with her own charity
foundation Yayasan Sinar Pelangi in Jakarta – devotes
herself to disabled children in Indonesia, which includes
renovation work was still going on and only part of the
consignment of materials and equipment had been set up.
Basically the team ‘simply’ had to set up a small hospital.
Even this experienced team had never had to manage this
before…
From police post to operating theatre
The full team comprised five Interplast members and six
people who had joined the team in Jakarta, as well as two
the island of Buton, located off the southeast peninsula of
Sulawesi. After earlier missions to Kalimantan and Sumba,
Interplast had now been invited to go to Buton, specifically
Bau-Bau which is the main town there.
Fine screening, but ... no clinic!
Sister André had made excellent arrangements for
everything locally; the extra 120 kilogrammes of luggage
were no problem either. The screening of the patients took
place on the veranda of a house belonging to a local
organisation. This was also where all the children were
staying before and after surgery. There were mats
throughout the whole house and outside there were bunk
beds for the adults. All patients present were seen by the
three surgeons, Dr Arend (Indonesian counterpart), Dr Rein
and Dr Floris, and theatre nurse Elsa made a programme for
three operating tables. After the screening the team went to
take a look at the clinic and to their immense surprise – there
was no clinic, just part of a police post with various rooms
giving on to a single corridor and was used as OPD. In fact,
Setting up an operation room
Indonesia
You can read the full report of this exceptional mission on
our website www.interplastholland.nl.
Operations Bau-Bau
• • • 69 cleft lips and/or palates
1 post burn contracture
4 certificates awarded
Op uitnodiging van Zr. André Lemmers, en haar
stichting Yayasan Sinar Pelangi, reisde een team van
Interplast deze keer af naar het eiland Buton. Het Interplast
Opening temporary clinic
surgeons, two anaesthetist assistants from Jakarta and two
Dutch ladies, Tineke and Merel, who happened to be visiting
Sister André. So this was the team that set to work the next
morning ensuring that an operating theatre was created in
no time: the anaesthesia equipment was set up, operating
tables organised, oxygen cylinders brought in, and the
steriliser set to work. Cover sheets were bought on the local
team kreeg in Jakarta versterking van zes mensen; twee
chirurgen en twee anesthesieassistenten uit Jakarta zelf en
twee Nederlandse dames, Tineke en Merel, die bij Zr André
op bezoek waren. In Bau-Bau, de hoofdstad van Buton,
werd een kleine politiepost binnen een dag omgebouwd
tot klein ziekenhuis. In vier dagen werden 70 patiënten
geopereerd. Het was een bijzondere missie!
Sur l’invitation de Sr. André Lemmers et son
market, as well as tea tables which were converted into
association Yayasan Sinar Pelangi une équipe
day of hard work by everybody involved.
A Jakarta l’équipe Interplast a reçu le soutien de six
instrument tables. The team was ready to start after just one
d’Interplast a voyagé cette fois ci vers l’île Buton.
personnes : 2 chirurgiens, 2 assistants anesthésistes
Thanks also to Tineke and Merel!
et 2 dames néerlandaises, Tineke et Merel qui étaient
– not least thanks to the excellent support that Elsa had from
Bau-Bau, la capitale de Buton a été transformé en petit
No less than seventy patients were operated on in four days
Tineke and Merel, who helped to sterilise the instruments,
ironed the sheets and assisted where needed.
Sr André and team
en visite chez Sr. André. Le petit poste de Police de
hôpital ! En quatre jours 70 patients ont été opérés.
Ce fut une mission particulière !
19
20
Uganda
Uganda
10 - 26 June
Team
Plastic surgeon
Rein Zeeman
Plastic surgeon
Floris de Graaf
Anaesthetist
Gijs Witte
Visited hospital
St Mary’s Hospital Lacor, Gulu
and team leader
Post burn contracture before and after operation
Improving anaesthesia techniques
Gijs Witte wrote in his report: ‘it was a special trip because of
the regional techniques we often used, and the eagerness of
For the fourth time, a mission to North Uganda took place in
conjunction with the Trust Fund for Victims of the
International Criminal Court. This time the team went to St
Mary’s Hospital Lacor in Gulu. Prior to arrival some
medicines (Halothane, antibiotics etc.) had to be borrowed
local staff to practise these techniques. They now have a lot
more confidence that they will have a higher success rate
with axillary anaesthesia. That is quite an achievement,
especially given the risks of general anaesthesia in African
conditions.’
from the Burns Unit in Mulago Hospital. The trip from Mulago
to Gulu went well since the road has been improved a lot.
Good screening, highly efficient work
The immediate job on Monday morning was to screen the
patients selected by the AVSI, the Trust Fund’s local partner.
After four years, people now know which operations
Interplast can perform and which they cannot. Most of the
patients therefore could be put on the operating list. Again
there were a lot of burns contractures, mainly of hands.
Forty-five operations were carried out, including 34 on hands
and/or elbow contractures. Strikingly this time there was not
a single patient with cut off lips and/or nose (rebel victims).
The small but extremely experienced team – team leader
Rein Zeeman along with Floris de Graaf and Gijs Witte,
founding Interplast volunteers – were given tremendous
support by the hospital and the local staff. Bosco and Rose,
two experienced anaesthetic technicians, supported Gijs.
Stella, Brenda, Beatrice and Lilian assisted Floris and Rein
during the operations.
Operations Gulu
• • 41 post burn contracture
4 other
In samenwerking met het Trust Fund for Victims van
de ICC vond voor de vierde keer een missie plaats in het
noorden van Oeganda. Deze keer werd er in Lacor
St. Mary’s Hospital gewerkt.
Het team verrichte 45 operaties, waaronder 34 aan
contrac­turen aan hand en/of elleboog.
Sinds 2005 heeft Rein Zeeman zeven keer in Noord-
Oeganda geopereerd en veel slachtoffers van Kony’s
LRA (Lord’s Resistance Army) neuzen en of lippen
kunnen geven. Nu was er geen enkele patiënt met
afgesneden lippen en of neus.
Anesthesioloog Gijs Witte kon dankzij de leergierigheid
van de lokale staf veel aan opleiding doen! Met name
de regionale anesthesietechnieken.
Quatrième mission dans le Nord de l’Ouganda en
collaboration avec le Trust Fund for Victims de ICC. Nous
sommes intervenus dans le Lacor St Mary’s Hospital.
L’équipe a effectué 45 opérations, dont 34 contractures
à la main ou au coude. Depuis 2005 Rein Zeeman a opéré
7 fois en Ouganda du Nord et beaucoup de victimes de
Kony’s LRA (Lord’s Resistance Army) ont pu retrouver un
nez ou des lêvres. Cette fois ci il n’y avait aucun patient
avec des lêvres ou un nez coupé.
Les locaux étaient très réceptifs et l’anesthésiste Gijs
Witte a pu faire de la formation, en particulier les
Gijs teaches Rose how to perform axillary blocks
techniques d’anesthésie régionale (locale).
Uganda
Follow-up in North Uganda
by Rein Zeeman and Marjo Aerts
Rein Zeeman went back again to North Uganda in
December, not to operate this time but to review the work of
the past years and to follow up on patients with post burn
contractures.
Looking for long term improvements
In November 2011, after the visit to the Burns Unit and the
Burn Prevention Project, a small team comprising Rein,
Marjo and Mildred – operating theatre nurse from the Burns
Unit who comes from North Uganda and speaks Acholi, the
local language – set off for North Uganda, to visit patients
who had been operated on in the past. The objective of the
follow-up was to look at the results of the operations on post
burn contractures in the long term. The team looked at:
•
•
•
recovery of function after the operation (medical – Rein)
recovery of functionality within social circumstances after
the operation (public health – Marjo)
the usefulness of Kirschner wires (medical – Rein)
A format for this follow-up was developed. Sixty patients out
of the 130 patients who had had an operation in the
preceding three years came for the follow-up. Pre-operative
photos were available for the majority of them.
The patients had been located by AVSI, an Italian NGO, in
the villages and former internally displaced people camps in
North Uganda. The organisation had tried to find as many
patients as possible without judging the results. Their
names, telephone numbers and villages are now registered
report in the Netherlands which will be published in June
2012. The first impression was that both the patients and the
plastic surgeon were pleased with the results achieved. In
fact, they were unexpectedly good.
An impressive journey
Driving through North Uganda on more or less solely dirt
roads was an impressive experience. The trip from Kalongo
to Lira was certainly a challenge. Even the locals – who had
been born in the vicinity – did not know the road and the
team had to regularly ask where they were. The names of
the villages were not given on the map that Marjo had
brought along. After driving about three hours cries of
recognition came from the back of the car. The names of the
villages were back on the map. Fortunately, it was not
raining, but even so the roads were difficult to pass even in a
four-wheel drive vehicle.
Een klein team bestaande uit Rein, Marjo en Mildred
(een operatieverpleegkundige van de Burns Unit die Acholi,
de lokale taal in Noord-Oeganda, spreekt) bezochten in
november ziekenhuizen in Lacor, Kitgum en Kalongo.
Aanleiding is een evaluatie van de geopereerde patiënten
van de afgelopen drie jaar met brandwondcontracturen.
Zo’n 60 patiënten kwamen voor deze evaluatie naar de
verschillende ziekenhuizen. De resultaten worden in juni
2012 gepubliceerd maar de eerste indruk is dat zowel de
patiënt als de plastisch chirurg zeer tevreden zijn over de
resultaten.
Une petite équipe constituée de Rein, Marjo et
with both the AVSI and Stichting Interplast Holland. Joyce,
Mildred (une infirmière de salle opératoire de Burns Unit
St Mary’s Hospital Lacor together with a physiotherapist who
visite en novembre aux Hôpitaux de Lacor, Kitgum et
the AVSI administrator in Gulu, accompanied the team from
had been involved in the postoperative care of some of the
patients.
The team visited the hospitals in Lacor, Kitgum and Kalongo
where the patients had gathered. The trip had been financed
by the Trust Fund of the International Criminal Court and by
AVSI. The outcome of the survey will be presented in a
Concy in 2008 and 2011, nose reconstruction
qui parle le Acholi, la langue du Nord Ouganda) ont rendu
Kalongo pour le suivi des patients qui ont été opéré les
trois dernières années de contractures de brûlures. Environ
60 patients se sont présentés aux différents hôpitaux. Nous
travaillons encore sur les résultats qui seront publiés en
juin 2012, mais la première impression est que, autant les
patients que le chirugien, sont satisfaits des résultats.
21
22
Let’s stop burns now!
Let’s stop burns now!
by Tamara Prinsenberg from
the Nederlandse Brandwonden Stichting
(Dutch Burns Foundation)
Two training sessions
With plenty of motivation I therefore started to train a group
with the challenging task of starting a burns prevention
the community. I was impressed by their enthusiasm and
In March 2011 I travelled to Mulago Hospital in Kampala,
programme. Before my arrival a lot of work had already been
done: a survey had been undertaken in the slums of
Kampala to find out about cooking habits, experience with
burns and risk perception. The information from this survey,
together with the hospital data gave me an idea of the
problem of burns in Kampala.
I was struck by the large number of burn patients that are
admitted every year to Mulago hospital alone: more than
500 patients received treatment from July 2009 up to July
2010.
The number of burns patients is so much greater than
what we see at home in the Netherlands. Those numbers
alone are enough reason to start a prevention programme,
of nurses from the burns ward to give health promotion to
their knowledge. After two weeks I left behind a burns
prevention team that was ready to go out into the slums of
Kampala.
During my second visit in November we worked together to
expand the prevention programme to schools. We believe
that if the adults as well as the children are educated, the
chances of preventing burn injuries are greater. We did our
first sessions in a public school and the children participated
very well. Many of the children knew someone with a burn or
had sustained a burn themselves. Again, it showed that
burns are a well-known problem that we have to do
something about.
but when I was shown around the Holland Ward and I saw
I enjoyed working with the burns prevention team very much,
even more clear to me. These horrible injuries really have
prevention efforts we can surely decrease the number of
the burn patients with my own eyes the urgency became
to be prevented!
Burn prevention session at public school, Kampala
and I am proud of the job they are doing. With continuous
burns.
A Dutch ergotherapist in Kampala
A Dutch ergotherapist in Kampala
Ergotherapists are therapists who specialize in helping
patients to improve body functions through physical
exercise, enabling them to recover well and fully take part in
society. Ilse de Ruijter went to work at the Burns Unit that
was established by Interplast Holland in Uganda.
In her report, Ilse writes; ‘I had been interested in working
with burns patients since my internship in the burns centre in
arranged for good splint material which I used to make
proper splints. Unfortunately basic materials like gauzes,
bandages, medicines etc. are not always available, which
made caring for wounds properly a real challenge. Patients
are sometimes asked to bring the materials that are needed
themselves, but financial or social problems mean that this is
not always an option.
Helping children to play
My work regularly confronted me with children with serious
burns who are on the ward for several months.
Beverwijk. When I had read about the burns centre in
There was no place for them to play in the ward without
Interplast Holland to see whether there were options for me
bored and most children had no toys to play with. That gave
Mulago Hospital in Uganda I knew I had to get in touch with
there. After a good chat with Dr Rein Zeeman, we agreed
that I would go and work voluntarily as an ergotherapist at
the burns centre in Mulago. That was how I started working
part-time at the Uganda Burns and Plastic Surgery Institute
(UBPSI) in February 2011.
Lack of basic materials
My work in the ward primarily involved doing exercises with
patients, mobilising patients and making splints to reduce or
even prevent contracture formation. I also gave advice to the
getting under people’s feet. The children were stuck in bed
me the idea of appealing to the Dutch children and burns
charity, Stichting Kind en Brandwond to give some financial
help for a children’s play corner. The funding was promised
and I created the play corner. Some people might wonder
why I wanted to put money into toys for children, when
there were not even always enough medicines or bandages.
But people forget how important play is in a child’s
development, but above all in burns treatment for preventing
contractures, which are often caused by lack of movement.
nurses on the best way of dressing wounds, but also on how
Rewarding work
can motivate patients to move. Interplast Holland had
Unit. Often there is no adequate material to work with
they can reduce the chance of contractures and how they
Ilse de Ruijter at work at the Burns Unit
Sometimes it was quite difficult for me to work in the Burns
23
24
Discovering Dhaka
and it is frustrating to see burns caused by assault (acid
Hierdoor krijgen de kinderen spelenderwijs de zo nood­
problems
Hoewel Ilse het niet altijd gemakkelijk vindt om te werken
burns). The care for patients with social and/or financial
zakelijke beweging en vergeten zij hun pijn even.
is also difficult, not to mention the language barrier. But once
onder best wel zware omstandigheden heeft ze nog geen
work is rewarding, you have the chance of caring for people
deze afdeling!
I’d started I never regretted offering to work on the ward. The
who badly need your help. Most of the patients come from
poor backgrounds and they cannot afford to pay for good
moment spijt gehad van haar aanbod om te werken op
Ilse travaille depuis février 2011 comme volontaire
care elsewhere. I would like to thank Interplast Holland,
dans l’Unité Burns Unit de l’Hôpital Mulago. Elle s’occupe
gave me to help others.’
tion. Ilse fabrique aussi des béquilles et donne des conseils
UBPSI and my colleagues in Mulago for the opportunity they
Ilse werkt sinds februari 2011 op vrijwillige basis als
ergotherapeut op de Burns Unit in het Mulago Hospital.
Haar werkzaamheden bestaan uit het doen van oefeningen
en het mobiliseren van patiënten. Ilse maakt zelf ook
spalken en geeft de verpleegkundigen adviezen over de
beste manier van verbinden.
Dankzij een gift van Stichting Kind en Brandwond heeft Ilse
een speelhoek voor de kinderen kunnen realiseren.
de faire faire des exercices aux patients et de leur mobilisa­
aux infirmiers sur la manière de faire les bandages.
Gràce à un don de Stichting Kind en Brandwond Ilse a
réussi à organiser un coin jeu pour les enfants. De cette
façon les enfants bougent de façon ludique et oublient –
pour un moment – leur douleur.
Bien qu’Ilse ne trouve pas toujours aisé de travailler dans
des conditions difficiles, elle n’a jamais eu de regrets de
s’être proposée pour travailler dans cette unité !
Discovering Dhaka
In September, a fact-finding mission to Bangladesh was
undertaken with Dokters van de Wereld (the Dutch section
of Médecins du Monde) for their project ‘Operatie Glimlach’
(Operation Smile). Marjo Aerts took part on behalf of
Interplast Holland, and wrote the following report.
Mutual benefits
assessed properly. Arianne drew up a strict agenda, leaving
branch of Médecins du Monde were arranged after it had
political opposition party that had its office next door, the
The first dicussions on possible cooperation with the Dutch
emerged from a meeting with Mirjam Koppe and Arianne de
Jong that a mission to Bangladesh with a team of plastic
scope for some flexibility. Because of a demonstration by the
team was unable to leave the hotel on Thursday until
five in the afternoon. It proved a good day to catch up
surgeons from the AMC/VU hospitals would take place in
on paperwork.
from the expertise of Interplast Holland. The result was that
In the end all seven hospitals were visited, which meant a
mission to Dhaka, Bangladesh, with the aim of meeting
selected as being the most suitable in terms of operating
November 2011. Dokters van de Wereld was keen to benefit
Marjo Aerts went with Arianne de Jong on a fact finding
contacts, visiting hospitals to see whether they were suitable
and making arrangements with local partners. Before the
mission set off agreements were reached between Dokters
van de Wereld and Interplast Holland and tasks were
divided.
Seven hospital possibilities
Seven hospitals had been identified as possibilities for a
surgical mission by local partners of Dokters van de Wereld.
A standard form was created so that the hospitals could be
busy programme and very long days. Two hospitals were
theatre set-up, bed capacity, availability of the medical
staff etc. One was an NGO hospital and the other one
a government hospital. The team also looked at
accommodation for the team members which had to be
simple, but comfortable. A place where team members
could relax after a hard day’s work. The best option was
somewhere within walking distance of the hospital.
Dhaka is an extremely busy town, traffic-wise, and it would
be unpleasant to have to sit in the car for a long time after
a heavy day’s work.
Discovering Dhaka
Operating room in Munshiganj, Bangladesh
Looking towards the future
Van 18 t/m 24 september vond een oriënterende
Dokters van de Wereld was undertaking its own surgical
missie plaats naar Bangladesh.
for the November mission with a team from the AMC/VU
Arianne de Jong van Dokters van de Wereld (Médecins
mission for the first time. Hence the choice of two hospitals
hospitals. It was important for the team to see the facilities
of the two local hospitals and to decide how and where
future missions would be carried out on the basis of their
own experience. The team would spend a week in each
hospital. Arrangements and task division could then be
agreed on with local partners. The visit went well and the
team was satisfied with the results.
The materials of Interplast Holland were used for this team
mission. Members of the nursing committee discussed
their own experiences with the operating assistants and
anaesthetists of the mission team in great detail. Good
agreements were reached on materials and equipment.
Marjo Aerts van Interplast Holland bezocht samen met
du Monde) de hoofdstad Dhaka. Dit voorafgaand aan een
eerste eigen missie van Dokters van de Wereld met een
plastisch chirurgisch team uit het AMC/VU.
Dokters van de Wereld maakt graag gebruik van de
jarenlange ervaring van Interplast Holland! Er werden in
totaal zeven ziekenhuizen bezocht, en twee uitgezocht
voor de missie.
Materialen zijn beschikbaar gesteld door Interplast, en in
november werden meer dan 100 patiënten geopereerd.
De samenwerking is goed bevallen en zal voortgezet
worden in 2012.
Du 18 au 24 septembre une mission d’orientation
Arianne reported that the mission had gone extremely
a trouvé place au Bangladesh.
operated on.
Dhaka accompagné de Arianne de Jongs de Médecins
well and that more than a hundred patients had been
Marjo and Arianne worked very well together. A sound basis
had been laid for continuing and expanding cooperation
between Dokters van de Wereld and Stichting Interplast
Holland in the years ahead.
Marjo Aerts de Interplast Holland a visité la capitale
du Monde. Un préliminaire à une première mission
combinée de Médecins du Monde et un chirurgien
plastique de l’équipe de AMC/VU.
Médecins du Monde profite de la longue expérience de
Interplast Holland ! En tout sept hopitaux ont été visité
et deux choisis pour la mission.
Le matériel sera mis à la disposition par Interplast en
Novembre et plus de 100 patients seront opérés.
La collaboration s’est bien passée et sera reconduite
en 2012.
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Interplast Holland information leaflet
Stichting Interplast Holland
[ F o u n d a t i o n]
A N O N P ROFIT ORGANISATION
P R OV ID IN G FREE RECONSTRUCTIVE
S U R G E RY AROUND THE W ORLD
Information leaflet
during their holidays. Travel expenses, medical supplies
•
•
from companies as well as the general public.
surgery and special cases beforehand to allow appropriate
Interplast consists of volunteer medical personnel (plastic
surgeons, anaesthesiologists, theatre and anaesthetic
nurses and other specialists), who work free of charge
and instruments are funded by donations raised in Holland
Local staff, i.e. doctors, nurses, interested volunteers
are essential for the smooth running of a mission.
Local doctors should perform the patient pre-selection
during the months before the arrival of an Interplast team.
If possible, they should inform the team about the type of
planning of instruments and supplies for the trip.
Interplast teams provide reconstructive operations that
•
physical disabilities and thereby improve the future of the
setting up the operating room(s).
transform the lives of children and (young) adults with
The first day consists of screening and selecting the
patients for the operating lists, unpacking equipment and
financial, political, racial or religious interest.
•
The aim is to provide (and teach) reconstructive surgery to
etc.) tumours – in children and (young) adults.
whole family of those children as well. Interplast has no
improve function, not to perform cosmetic surgery.
Cooperation with local medical staff and working at existing
hospitals close to the patients’ home is efficient and offers
education in a specialist field for all involved. Apart from
medical staff, local volunteers with social commitment are
essential for the preparation and the smooth running of
a successful Interplast mission.
If you, your town, your hospital, or a charitable organisation
you know think about hosting an Interplast team, here are
some important issues to consider:
•
•
Advance notice for the team should be given at least
Types of operation: burns contractures, congenital
deformities like cleft lip and palate, functional deficits or
disfiguration from injury, infection (polio, leprosy, Noma
•
•
•
Long working hours have to be anticipated by all
involved to make an Interplast mission effective.
Apart from operating, ward rounds and change of
dressing sessions take place every day.
The hospital should offer: two operating tables /
anaesthetic machines, a recovery room, enough beds,
electricity supply, water, normal saline for infusion, sheets
and gowns, if possible oxygen, nitrous oxide, halothane,
some dressing material and plaster of Paris.
The Interplast team will provide: special instruments and
medical equipment, suture material and special drugs
and dressings.
6 months before the intended date.
•
10 operating days. Depending on the severity of cases,
basic, clean accommodation, food and transport for the team.
Duration of the mission is usually 2 weeks, i.e.
about 100 patients can be operated during that time.
•
Size of the team varies depending on the number of
operating tables, anaesthetic facilities and local staff
available. On average, a team will consist of 6 people,
2 surgeons, 1 anaesthesiologist, 2 theatre nurses and
1 anaesthetic nurse, thus being able to run 2 operating
tables (smaller or larger teams possible on request).
You are requested to provide: (if possible, but if you
don’t have the means, other arrangements can be discussed)
Government / Ministry of Health permission for the mission;
assistance with customs, excess baggage clearance etc.
Many years of experience and thousands of
grateful patients are proof of the success
of Interplast activities. YOU can be part of it.
Contact Interplast Holland
Stichting Interplast Holland
Board
Correspondence
Drs. Rutger L. van Leersum, secretary
PO Box 2189
Drs. Rein J. Zeeman, chairman
Henk J.A. Koster, treasurer
Stichting Interplast Holland
2301 CD Leiden
Honorary Member
Visitors’ address
Prof. dr. Bert D. de Jong
Poortgebouw Zuid, room 468
Frank E.I. Schaaf
Els L. Gerritsen
Nursing Committee
Elles Loenen
Paula Ellen
Marie-Thérèse de By-de Bakker
Marjo Aerts
Jan H. van Steen
Policy maker (staff)
Marjo Aerts
Office
Annemarie C. Maas
Committee of Recommendation
Drs. Erica Terpstra
Herman van Veen
Stichting Interplast Holland
Rijnsburgerweg 10
2333 AA Leiden
The Netherlands
T
F
E
I
+31-(0)71-52 10 165
+31-(0)71-52 14 458
[email protected]
http://www.interplastholland.nl
ING bank 15 20 638
ABN AMRO bank 44 88 00 926
This annual review has largely been sponsored
and created thanks to the cooperation of
Annemarie Maas & Sam Pitzalis
editing
final editing Astrid Nagelhout, Leiden
design
Ineke de Graaff, Amsterdam
printing Drukkerij Protocol, Zoetermeer
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With special thanks to...
With special thanks to...
All Interplast volunteers
Stichting Eekhoorn, Leiden
Nederlandse Brandwonden Stichting
Johannes Stichting
Stichting Eureko Achmea Foundation
Stichting Liberty
Diaconie Gereformeerde Kerk, Nieuw Vennep
Mr J.M.G. Huininga, Norg
Euro Tissue Bank, Beverwijk
Stichting Kind en Brandwond
Boudewijn Peters, Zanzibar
Embassy of the Republic of Uganda, Brussels
Stichting Edith Jacoba, Roelofarendsveen
Jan (Honory Consul) and Will van Maanen, Bissau,
Guinea-Bissau
Johannes Mooij, Bissau, Guinea-Bissau
Zonta Club Eindhoven
Johan Krijt / One Creation, Den Haag
Mr and Mrs E.M. Poslawsky-Rutgers, Leiderdorp
Netherlands Embassy, Abuja, Nigeria
Stichting Bron van Leven, Wassenaar
Maatschap plastisch chirurgen, Martini Ziekenhuis
Groningen
With thanks to Stichting Liberty
Dr. E.J.F. Timmenga, Rotterdam
Aerde Bouwmanagement, Tilburg
Dr H.J. Pöll, Den Haag
Netherlands Embassy office, Bujumbura
Prof dr P.P.M. van Zuijlen
Izere, André Nkeshimana
Stichting Pelgrimshoeve
Otto Nelemans, Utrecht
Drukkerij Protocol, Zoetermeer
Sr André Lemmers, Jakarta
SproFit, Genk Belgium
Heineken Burundi
Liliane Foundation
Diaconessenhuis Leiden
Leids Universitair Medisch Centrum
Mrs L.S. Wijnbergen, Rotterdam
... and many others
Postbus 2189
2301 CD Leiden
T
F
E
I
+31-(0)71-52 10 165
+31-(0)71-52 14 458
[email protected]
www.interplastholland.nl
ING 15 20 638
ABN AMRO
44 88 00 926