Lusaka, Zambia, September 6 – 17, 2023
From September 6 to 17, 2023, we participated in a business trip as part of the MEDEVAC program at the University Teaching Hospital (UTH) in Lusaka, Zambia. This marked the first mission at this hospital organized by doctors from Motol University Hospital. The selection of this hospital followed a reconnaissance visit a year prior, where the alternative was a regional hospital in Mongu, which lacks sufficient equipment. The mission schedule was prepared in advance in cooperation with the doctors from UTH, particularly Dr. Alex Malambo, who meticulously and rationally prepared the patients, operating rooms, and staff facilities.
The mission was coordinated by Dr. Zdeněk Čada, Ph.D., Prof. Jan Klozar, Ph.D., Dr. Zuzana Balatková, Ph.D., Dr. Šárka Havelková, and operating room nurse Hana Soprová. The team also included MEDEVAC representative Mgr. Michaela Bezděková and photographer Jan Mihalíček. The mission began on Friday, September 8, with an introduction to the hospital leadership, followed by a tour of the operating rooms and patient facilities for the coming week.
During the surgical week, two operating rooms were available. Surgeries were only performed on adult patients. The surgical procedures mainly focused on oncology of the neck, with Prof. Klozar and Dr. Čada performing most of these, as well as procedures related to the nose and paranasal sinuses, carried out by Dr. Balatková, and ear surgeries performed by Dr. Čada. The list of procedures included chronic middle ear infections, nasal polyps, tumors of the nasal cavity, salivary gland carcinomas, laryngeal tumors, and thyroid pathology. The surgeries were made more difficult by the lack of some essential equipment, such as nerve monitoring. Another complicating factor was the high incidence of HIV among the patients. A major benefit was the presence of our anesthesiologist Dr. Havelková, who substituted for the long-standing shortage of anesthesiologists at the hospital.
In total, 23 patients aged 24 to 71 were operated on during the mission. Eight ear surgeries were performed on adult patients (ages 24-71). The most common finding was chronic mesotympanic otitis in the context of Eustachian tube dysfunction. In addition to myringoplasties, primary and revision reconstructive surgeries were also carried out. The ear surgeries were demonstrated to local doctors.
Seven neck surgeries were performed on adult patients aged 40-71, mainly focusing on thyroid surgery, malignant tumors of the neck, larynx, and salivary glands.
Eight nasal surgeries were carried out by Dr. Balatková, treating patients aged 24-57, with the most common diagnoses being nasal polyps and inverted papilloma.
All surgeries were completed without serious complications. Postoperative checks were regularly conducted both during hospitalization and as outpatient visits after the patients were discharged, with patient and staff education on postoperative care. The surgeries began at 8:30 AM and concluded around 4:00 PM.
In support of ongoing operations, medical supplies were handed over to the ORL department at UTH, including surgical attire, gloves, protective glasses, surgical footwear, suture materials, sterile compresses, face masks, medications (antibiotics, ointments, vasoconstrictors, etc.).
The ORL department is equipped with basic instruments but completely lacks adequate equipment such as an operating microscope, bipolar forceps, drills, neuromonitoring, irrigation systems, and others. A financial donation for this department would be very meaningful.
The MEDEVAC humanitarian mission at UTH in Lusaka, Zambia, can be considered a success, and the pre-set objectives were achieved. The organization of the mission was very well managed, both by MEDEVAC and the Embassy of the Czech Republic, as well as by the head of the ORL department in Lusaka, Dr. Alex Malambo.
Doc. MUDr. Zdeněk Čada, Ph.D.
Prof. MUDr. Jan Klozar, CSc.
As. MUDr. Zuzana Balatková, Ph.D.
MUDr. Mgr. Šárka Havelková
Hana Soprová
