Invitation to develop adult and adult congenital heart surgery in Benin City, Nigeria October 1-14, 2018 We have pleasure in announcing the first historic mission to The University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Volunteers will be enlisted from previous waiting list files, and on a first come, first served basis. You are encouraged to apply, and if there is insufficient room on one particular mission, your name will be held forward for the next available mission. The Republic of Nigeria is in West Africa. It has a southern coastline on the Gulf of Guinea, and has Benin to the west, Cameroon to the East, Chad to the Northeast, and Niger to the North. Nigeria is the most populous country in Africa and the seventh most populous country in the world. It is the largest African oil producer and, since April 2014, the largest economy in Africa. On 1 October 1960, Nigeria gained its independence from the United Kingdom. Nigeria, like many African countries, was formed to benefit its colonial power - the United Kingdom, providing a source of raw materials for the factories in Europe. Civil war broke out in 1967 but ended in January 1970. Benin City lies 155 miles east of Lagos, and 230 miles south of Abuja, the capital. It is historic, once the capital of the Benin Empire and one of the oldest cities in Nigeria, dating back to pre-colonial times (Benin formerly Dahomey, is a separate country west of Nigeria). The Benin Empire boasted one of the most advanced and organized kingdoms before the arrival of the British. Benin City, well inside Nigeria continues to serve as an important cultural center of the people. Although the city was almost destroyed over a century ago by the British, modern Benin City has a large community, good cultural center and museum. One of the official languages in Nigeria is 1
English. Only upper and middle-class people in the largest cities actually speak it, though most citizens have an understanding of English. The national lingua franca is Nigerian pidgin, an English-based creole language spoken by 75 million people as a second language. Climate: It varies: it is equatorial in the south, tropical in the center, arid in the north. Natural hazards include periodic droughts and flooding. Getting there: Benin City is about a 4 hour drive from Lagos, but travel should be undertaken during the day, as the roads are bad and poorly lit. Local flights from Lagos into Benin City are run by Peace and Arik airlines. Cardiac Surgery Status in Benin City Currently, the University of Benin Teaching Hospital (UBTH) is only able to offer thoracic surgery and the need for cardiac surgery development is dire. As the most populous country in Africa, there are very few centers doing cardiac surgery and at the minimal volume level. This Teaching Hospital serves a regionally severely deprived population exceeding 10 million people. CardioStart s role will be to initiate and develop a comprehensive adult cardiac surgery program in October. CardioStart's first two containers were sent on 14th April, and another is likely to be sent later this year to provide the essential equipment needed to start the program. OUR MISSION: ADULT CARDIAC SURGERY PHASE ONE: The team will inspect, unload and distribute the contents of the containers, and check equipment installation. They will then prepare the OR and ICU to develop the operation program to be carried out in the hospital. Before surgery begins, a full review of patients and a dry Run rehearsal will be carried out, testing equipment and staff educational in-servicing. PHASE TWO: The team will follow midweek CardioStart will work with the local team to further establish the essential features required for cardiac surgery at the Hospital and help set the necessary benchmarks for the Hospital to become a regional tertiary referral center. Part of this mission will be to assist development of the rhythm of regular operating. Our first series of cases will follow preparation of the entire program with nursing, biomedical, perfusion, ICU equipment preparation and teaching. The commencement of simple heart cases will follow according to the discretion of the heart surgeons, in collaboration with the Nigerian team and will likely be adult congenital presentations or valvular pathology, subject to cardiology review and recommendation. There is currently no catheter suite but pacing assistance will be possible during this time period. 2
Recommended Cardiac surgery team requirements: 2 adult cardiac surgeons 2 adult anesthesiologists 1 intensivist 1 Laboratory medicine /physician/hematologist 2 Cardiologists (One, interventional trained) 2 perfusionists 6 ICU nurses 1 biomed engineer 1 respiratory therapist 2 educational instructors 2 OR Nurses/Techs (1 circulating, 1 scrub) Airfare: Airfare costs will be self-funded by each volunteer. Popular flight corridors are through Frankfurt, Amsterdam or London to Lagos. In selecting your airfare, first select the most convenient international embarkation point from your home state, as domestic travel can be negotiated separately and sometimes, much cheaper. Lodging: This will be provided for by our hosts. Volunteers should expect that they may be asked to agree to same-sex room sharing in order to help reduce the costs incurred by our hosts. CardioStart will assure minimum standards to ensure volunteer safety and comfort, but we will try to be sensitive to the financial burden borne by the local officials. Meals: During the day, meals will be available and provided for by the hospital. Evening meals/snacks, etc. are available in the hotel or local restaurants in Benin City, at volunteer s own expense. They are generally of a high standard and inexpensive. Medical issues: (Full details will be sent to those volunteers joining this mission). All volunteer activity will be carried out with full HIV precautionary measures. You should have a routine check before travel of your HIV and Hepatitis a/b/c status. Vaccinations must include a current Yellow Fever, and tetanus protection (within 10 years) with certification. Volunteers will be advised to take malaria prophylaxis just before the mission and those with serious medical conditions should obtain consultation and approval from their doctor prior to the mission. Please see the CDC website for international travel guidelines. Applying to join the team: 3
Simply contact us soon by going in to our website and registering your interest at www.cardiostart.org. If accepted, you will then receive a Selection letter listing all the required documents. There is a $40.00 (USD) registration fee to be paid on the website as a donation. This helps us in our preparation and mailing of documents to Nigeria s Ministry of Health. Selection will be on a first come first served basis and according to positions needed for the team. All pre-mission information will be sent by e-mail from our Tampa office. Therefore, we request you give us your personal e-mail address (not employment address) so that you can receive electronically derived information and attachments about the mission. (Volunteers using hospital or company web servers sometimes find that their institution s spam filters block attachments and group mailings). Helping us to Prepare: We need help with Cardio/Vascular/Thoracic OR instruments, ICU disposables, central lines, oxygenators for heart surgery bypass, and general medical equipment and disposables to donate to the Hospital. If you hear of any equipment to donate, please contact our Tampa office. (Info@cardiostart.org). Please ALWAYS obtain written consent from your department Head, when receiving donations. We can provide a disclaimer to the donating institution and tax information. Travel/touring: Coastal trips and other adventures are worth considering. CardioStart mission leaders cannot directly help you make internal tourist travel arrangements but you can usually obtain cheap travel packages during the week you arrive. Any tour arrangements should be made after the mission ends. This time is considered a personal vacation and is not part of the mission; therefore, CardioStart assumes no responsibility. 4
Benin has a zoo with lions and some other animals. Nigeria has eight large national jungle parks and game reserves spread throughout the country. The parks make up about 3 percent of Nigeria's total land area. Collectively they contain an abundant diversity of fauna, (buffaloes, roan antelopes, chimpanzees, crocodiles, hippopotamuses, hyenas, giant forest hogs, lions and leopards, as well as flora. The closest National park in the Edo region is Ekomo and is the second largest rainforest in Nigeria. If you are planning to return through Lagos there are offers of excellent tours of the Lekki region, near Lagos, with the longest jungle tree walk in Africa. A bustling market, the museum and the Nike Art center are also well worth seeing. Security Note: Some foreign governments advise against travel to Northern and Central Nigeria due to ethnic tension, lawlessness and the current activities of terrorist groups such as Boko Haram. Benin City and local region is not a security concern. Our hosts will be very careful to ensure our security at all times, and any travel arrangements beyond the mission you wish to take are best pre-discussed with the local coordinators. Safety-conscious official tours are available Aubyn Marath MBBS MS FRCSEd ATLS +1 503 887 5333 Aubyn.marath@me.com 5