Facing Africa Surgical Mission 2017
Posted by Samantha Andrades on Wednesday 20th September 2017
Mr Hiroshi Nishikawa recently travelled to Ethiopia, with our partner Facing Africa, to take on complex surgical work not available in the country. He tells us about his experience with two Noma cases.
Recently I have returned from my eighth Facing Africa surgical mission to Addis Ababa in Ethiopia. As always, I come back older, slightly wiser but also humbled by what we see and do there.
Facing Africa is a charity that deals with the treatment of a devastating disease called Noma. It affects poorly nourished children and those who survive often have terrible facial deformities as well as difficulties eating and drinking.
The charity organises and funds all the equipment and hospital conditions needed for an experienced surgical team to treat these very challenging patients in the middle of a poor developing country.
This year we were faced with both technical and ethical dilemmas. Our mixed skill set often means that we are asked to help with non-Noma cases too. This year we were presented with a total of twenty patients, all who had facial deformities. I personally dealt with two young women called Hulu and Zinash, who were both suffering from a condition known as ossifying fibroma.
Both women’s lower jaws had been replaced by a solid, rock-hard bony tumour that had invaded the surrounding tissue. They had been suffering from this slowly growing benign tumour for several years and now the size of them was equivalent to a large melon. Unless we could treat the women, they would die as it was becoming almost impossible to eat, drink or breathe.
It took two surgical teams ten hours respectively to remove the tumours and replace the resected lower jaws with new ones made from the skin and fibula bone taken from one of their legs. The operations had been planned weeks in advance, in the UK, to allow for the precise fit of the bone and reconstruction plates by my Maxillofacial colleague Kelvin Mizen. Microsurgical techniques were also needed to allow blood to flow to the new jaw.
Zinash recovered brilliantly and her fighting spirt was inspirational. She now has a fantastic future ahead of her and it was wonderful to see her true beauty emerge now that the mass had been removed.
Prior to her surgery Zinash’s loving and totally dedicated father had tried everything to cure his daughter. He had even sold his cattle to help fund her treatment in the past but it came to no avail. Luckily however, myself and the team at Facing Africa were able to not only save Zinash but also help to fund his cataract surgery to allow him to see properly again.
Unfortunately, the reconstruction for Hulu failed, but thankfully a salvage operation helped to ensure that she would have a functional lower jaw. Despite this however, she will still require future surgery in order to live a normal life.
While Zinash came from a very supporting home, the same could not be said for Hulu, who had been rejected by her family after her disease lead to the demise of the family laundry business (locals feared they might catch the same disease as Hulu). As a result, Hulu was left living on the streets and it’s only due to the persistence of Facing Africa front line workers, Tihitna and Kidist, that she was saved.
The sadness in Hulu's eyes reflected the desperation to be accepted by her family again, but sadly, when her mother did eventually come to visit her in hospital Hulu received a slap instead of a hug. However, in spite of this, Hulu did eventually return to her family home but unfortunately, we have no idea how she’s now being treated or whether her family have now accepted her.
Obviously, a two-week surgical mission only allows for me to skim the surface of this vast country, but I’m so thankful to say that I could assist in saving not one but two lives. Furthermore, I am so proud of the Facing Africa team as it is rare to find total harmony between skills and aims.
Mr Hiroshi Nishikawa
Consultant Plastic, Reconstructive and Aesthetic Surgeon