Getting access to an operating room is a recurring problem at many HVO project sites. The high numbers of acute cases that present daily lead to many postponements, and patients often face lengthy waits for minor surgeries.
The Accident and Emergency Center at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana offers a case in point, admitting so many acute cases daily that there is constant demand for surgical care. A patient in need of minor surgery for a fractured finger may face huge delays in receiving that care. Not only is there a lack of operating room time but the high cost of anesthesia, which must be borne by the patient, can also cause delays. In order to address this problem, an HVO volunteer specializing in hand surgery shared skills in “wide awake hand surgery” with his KATH colleagues.
With this new technique, a patient receives local pain inhibitors and physicians can perform the operation in an examining room, rather than the OR. The physician is able to respond quickly and perform the necessary treatment, and the patient is able to regain functional use of the hand in a timely manner and at an affordable cost. Not only has this new technique amplified the services KATH is able to provide, but it also dramatically improves the functional abilities for many patients.
The volunteer reported of his work:
On a very positive note, Dr. Saani and I did his first wide awake hand surgery case (no tourniquet, no sedation) … We did it through two incisions. Good visibility, zero patient pain, one amazed African hand surgeon! This really is a good solution for them. Patients really can’t afford unneeded anesthesia, and it will greatly help the surgeon load. Dr. Saani seemed to fall in love with it.”
The technique was introduced at KATH in 2012 and, as the HVO project director reported at the end of 2013, it remains one of the project’s greatest successes, giving KATH providers the ability to address patient needs more efficiently.
HVO projects aim to provide skills and knowledge that local providers in resource-scarce countries can use to best serve their communities. The success of the wide-awake surgery comes from the HVO volunteer’s consideration of the needs and resource limits in Ghana.
A version of this success story appears in the HVO’s 2012 annual report.