UK: Welsh paediatrics experts head to Zimbabwe for ‘extraordinary’ week helping local children

By nation.cymru

UNITED KINGDOM: Experts from a Welsh health board have given up their own time to help children with genital abnormalities in Zimbabwe.

The six-strong group from Swansea Bay University Health Board was invited to the Cure International Children’s Hospital in Bulawayo, to work with medics treating young people with hypospadias. This is a malformation of the urethra which means it opens on the underside of the penis.

The trip was intended to help set up a new service for the Cure Hospital, by operating on a variety of individuals with hypospadias and assisting with the training of local surgeons from plastic surgery and urology departments.

The Swansea Bay team also helped to train the ward and outpatient nursing teams in pre and post operative care.

‘Taboo subject’ 

Consultant paediatric plastic surgeon Nick Wilson-Jones said: “As we experience in the UK, hypospadias is a taboo subject, and many families believe their child is the only child with the condition.

“Our training aim was to help the hospital carry out more cases themselves, but also to increase awareness of hypospadias.

“It is an unusual but common condition, including in the UK.

“The nursing team was experienced in managing patients following complex orthopaedic surgery and cleft lip and palate surgery, but had very little urology experience and no hypospadias knowledge.

“We spent time discussing complications and troubleshooting. We also shared the guidelines and protocols we use in Wales.

“The whole nursing team was extremely friendly and worked hard to deliver the best care to patients. Nothing was too much trouble.”

The team first held a day-long clinic with patients having travelled from all over Zimbabwe , some as far as 500 kilometres for their treatment.

Paediatric nurse specialist Louise Scannell discussed with each patient their individual surgery, as well as with their families and hospital staff, and the post-operative care they would need.

Operating theatres

Following the clinic, the team ran two operating theatres for the rest of the week, with Nick working in one and consultant paediatric urologist Selena Curkovic, from Noah’s Ark Children’s Hospital for Wales, in the other.

They were supported by Swansea Bay consultant paediatric anaesthetist Sabello Ndlovu, who was born in Bulawayo and whose local knowledge and language skills proved invaluable.

The team also included senior registrar plastic surgery John Gibson, and trainee plastic surgeon Michaela Paul.

A total of 20 patients, aged from four months to 17 years, received surgery during the trip.

Nick added: “Pre-operatively there was limited access to medical notes which added complexity to those requiring revisional surgery.

“Access to medications proved challenging, and theatre resources were limited. But the combined experience of the team ensured patients received the best possible care and demonstrated the need for a truly multi-disciplinary team approach to hypospadias care.

“It was hard leaving patients because we are used to looking after them post operatively for many years. But we were pleased the local plastic surgery and urology teams have made plans to work together moving forward, with lists planned the week after we left.

“The whole team from South Wales, who used their annual leave to travel out there, also benefitted from such an extraordinary week. The support, friendship, and combined learning will also enhance our team and bring a renewed vigour to supporting and promoting hypospadias surgery in Wales.

“We would love to return and continue the work and training we started. A number of the most complex cases require staged procedures and we would be keen to be involved in their care and further develop the service locally.”