The camp, which began last week, will run for 10 operating days. It is the second camp at Kanifing General Hospital by the Dutch team, and part of a yearly outreach that also takes place in Bansang.
According to Ousman Ceesay, Senior Nursing Officer and Head of Operating Theatre at Kanifing General Hospital, the team arrived last Friday and began assessments immediately. Surgeries started the following day.
On the first day of operations, Ceesay said they had successfully conducted seven surgeries on Monday, and had eight surgeries on the list for Tuesday.
The procedures being performed include urethroplasty, trans-urethral resection of the prostate or TURP, open prostatectomy, dilatations, and surgeries for children with undescended testis. The team is also treating hydroceles, varicocelectomies, and conducting cystoscopies to confirm diagnoses.
“Some of the surgeries that they are doing include urethroplasty, which is a very complex surgery that they are actually doing,” Ceesay explained. “It is a very, very expensive surgery that is mostly available at the private facilities.”
Ceesay added that the team does not strictly limit itself to the daily list. After theatre, the consultants also see new patients.
“As you can see, this list already consists of nine new cases that were reported today. He (Dr Kajali Camara will see them before going home. If these patients also need surgeries, they will be included in the subsequent list,” she said.
Dr. Kajali Camara, Consultant Urologist at Kanifing General Hospital, said the camp is targeting conditions that affect thousands of Gambian men and children but often go untreated due to cost and complexity.
“This is a very important surgical camp because there are a lot of Gambians with urological conditions, especially bladder outlet obstruction, which is enlargement of the prostate. This could be cancer or non-cancer, and also patients with disease of the urethra, that means they have urethral stricture, that means their urine pipe is blocked,” Dr Camara said.
Dr Camara explained that many patients live for years with catheters. He said most of them have been with the pipe for five or six years.
The team expects to operate on about 60 to 70 patients by the end of the camp. Procedures already done include open prostatectomy and TURP.
“We have done TURP, that is transurethral resection of the prostate. So, this is a surgery where you remove the prostate without opening the abdomen. So, you go through the penis and then scrape the prostate tissue out,” Dr Camara said.
Other complex cases include urethroplasty, which can take up to four hours, orchidectomy for prostate cancer patients, and surgery for undescended testis in children.
The team also plans a nephrectomy for a 25-year-old woman with a non-functioning kidney, and pyeloplasty for patients with blockages between the kidney and bladder.
Dr Camara said prostate conditions are very common in The Gambia.
“Prostate is very, very common because every man has a prostate. So, it increases in size when you are getting old... As life expectancy is increasing, the incidence of prostate disease will increase. And cancer too, prostate cancer is very common. And most of these diseases are common in black people,” he said.
Cost Relief for Patients
Ceesay said the financial impact of the camp is significant. A urethroplasty in a private facility can cost between D175,000 and D200,000, while an open prostatectomy can go up to D75,000.
“They are very expensive surgeries. Most of them are available in the country anyway. But they are limited. And you know how the take-home in this country is. Having this type of camp is a blessing to the poor ones especially,” he said.
Dr Camara noted that patients are only asked to pay for consumables such as fluids and catheters, which represent less than 10% of what they would pay privately. He said for those who cannot afford it, the hospital has a mechanism of waiving the payment for them.
Dr Camara said the Kanifing General Hospital makes sure everybody who comes for the camp is offered the service.
The Dutch team is on its third visit to The Gambia. The first was an assessment mission to test equipment. This is the second camp at Kanifing and the second this year, following a mission to Bansang in March.
Beyond surgery, the collaboration includes training for Gambian doctors and nurses.
“It is not just about surgery. We are doing what we call transfer of knowledge and skills, not only doctors, but also nurses, theatre nurses, and we transfer skills and knowledge,” Dr Camara said.
Dr Camara said the team also donates consumables. citing that they come with some consumables that when they are going, they leave that with them to continue using them for their patients.
The equipment brought by the team is valued at hundreds of thousands of dollars and allows the hospital to perform procedures it cannot do during normal theatre days.
The camp also includes patient screening. The camp screens all patients they receive. Those who do not need surgery receive medication and follow-up. Those who may need surgery later have their records kept for the next mission.
Dr Camara urged Gambians to seek care early rather than wait until conditions worsen.
“If you come early, your problem will be diagnosed and treated. These urinary problems, if you don't come, you cannot pass urine. By the time you know, your kidneys start failing,” he said.
