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ANPA & NAPPSA MEDICAL, SURGICAL, OPHTHALMIC, AND DENTAL MISSION
April 2019 | Abuja FCT, Nigeria

Dear colleagues, partners, family, friends, and supporters,

I pray that this report reaches you in good health. 

On April 5-12, 2019, a multidisciplinary team of 70 healthcare volunteers from the Association of Nigerian Physicians in the Americas (ANPA), and the Nigerian Association of Pharmacists and Pharmaceutical Scientists (NAPPSA), under the leadership of their respective Presidents, Drs. Charmaine Emelife and Leo Egbujiobi, sponsored and conducted an extremely successful medical/surgical/ophthalmic/dental mission in the Federal Capital Territory (FCT) area of Nigeria, as part of our annual ANPA week. 

This was the largest of such mission for both organizations and in fact for the country! 

The medical mission was done in collaboration with over 30 local volunteer physicians, surgeons, ophthalmologists, dentists, pharmacists, optometrists, interns, residents, nurses, physical therapists, medical students, interpreters, etc. 

We were strongly supported by our numerous local partner organizations, including Business and Professional Women (BPW), DAGOMO Foundation, Junior Chambers International (JCI), Federal Ministry of Health and it’s Diaspora Division, FCT Ministry of Health, the Emir of Jiwa, the Tungan Kwasuo Medical Administrator, and the CMD of Kubwa General Hospital. 

Our other partners included Bridge of Life (DaVita), SEE International, Americares, Lifebox, MAP International, Supplies Overseas, and Blessings International. 

The opening ceremony at Jiwa featured welcome speeches by some leaders from the aforementioned organizations, as well as the Federal Minister of Health, Prof. Isaac Adewole. Dr. Bola Olowu, head of the Diaspora Desk at FMOH was also in attendance. 

The Emir of Jiwa, Dr. Idris Musa, was so grateful that he spontaneously gave out three chieftaincy to some volunteer leaders titles that day, and would repeat the same act towards the end of the mission. 

He too was a beneficiary of the mission and was personally attended to by our cardiologist, Dr. Osita Onyekwere. 

Dr. Onyekwere performed 12 Lead ECGs and trained local volunteers on how to use them. He also donated 2 ECG and 2 AED Machines to ANPA for future missions. 

The medical team, that included family medicine, internal medicine (nephrology, cardiology, rheumatology, geriatric, gastroenterology, psychiatry), pediatrics, physical medicine pain specialist, pharmacists, residents, nurses, educators, BOL volunteers with their Electronic Medical Records (EMR), and students, attended to about 2,500 patients at the clinic in Government Secondary School Jiwa, and 1,500 patients at the Primary Health Center and Elementary school at Tungwa Kwasuo, totaling 4,000 patients. Over 800 glasses were dispensed, with the Optometry team support. 

The Pharmacy team worked hard to fill the numerous prescriptions at the two primary care clinics, while also supporting the surgical team in the hospital and kept us organized. 

The Gastroenterology team performed 21 upper and lower Endoscopies in 3 days, and helped to equip the endoscopy suite at Kubwa General Hospital. They also trained the local staff on scopes sterilization techniques, and procedures. In the words of Dr. Austin Osemeka, “this was not just a mission but a life changing experience for me, working with colleagues on things they have read about but were unable to do till now.”

The Dental team performed 136 procedures, 330 Screening, 450 Education, and gave away several toothbrushes and pastes. Dr. Philip Igbinadolor saw a 9 year old patient with cleft palate at the end and arranged for the surgery to be done free at University of Benin by Dr. Emeka Odai, who volunteered with us at FCT. 

Our only Ophthalmologist, Dr. Assumpta Madu, along with the CMD of Kubwa General Hospital, Dr. A. M. Lasisi, performed difficult 35 cataract surgeries in 4 days, without using a Phaco machine (none unavailable)!

A special eye case and blessing in Dr. Madu’s words: “My most favorite case….she couldn’t see anything from either eye…lead into clinic by 2 family members…now after bilateral cataract surgery …she is seeing & happy walking by her self.” Picture of this fortunate patient and others are attached below in this report. 

The Anesthesia and Surgical team performed a total of 90 Surgeries (35 Eyes, 55 others – Neuro, Gen, Plastics, Gyn, Pediatric).

Types of cases included meningomyelocele repair, laminectomies, spinal cord decompression, pediatric and adult inguinal hernias, large incisional hernia repairs with mesh, orchipexy, keloidectomy, parotidectomy, lip hemangioma resection, emergency exploratory laparotomy, thyroidectomy for goiter, myomectomies, hysterectomies, C-section, hemorrhoidectomies, abdominal abscess, “lumps and bumps,” modified radical mastectomy, and mastectomy with Sentinel lymph node biopsy, etc. 

The Sentinel lymph node biopsy case provided opportunity for teaching the local surgeons the technique using Isosulfan blue dye, some of which were donated for them to use for future appropriate cases. The procedure minimizes the morbidity of lymphedema post complete node dissections. 

 More Special cases included:

A 7 month old otherwise healthy baby with meningomyelocele, whose family was told to pay N4.5 million (~$12,650) for a needed life saving operation but couldn’t afford it. It was a matter of time before the lesion ruptured or got infected leading to death. 

However, our team of Specialists in pediatrics, NICU, Anesthesia, Neurosurgery, and Plastic surgery (Prof. Ajovi Scott Emuakpor, Drs. Ugonna Chike Obi, Onyeka Nduaguba, Chine Logan, Stanley Okoro, respectively), worked together to perform the successful operation and postoperative care free! The baby is well, thriving, and has a new chance in life. The poor parents were overjoyed. 

Another involved a young woman who developed a very large ventral incisional hernia after a C-section complicated by infection over 5 years ago. It got larger and caused pain, discomfort and interfered with work and activities. Appropriate repair would involve use of a special mesh that costs about $3,000. We brought such mesh to the mission and the free difficult but successful operation was performed by Dr. Iyore James and myself, with expert support by our awesome anesthesia team. The patient is doing well and able to live pain free and provide for her family and community. 

Finally we encountered a unique situation at the Jiwa clinic involving a poor family that has a child with the congenital heart disease, Tetralogy of Fallot, who needs surgery ($13,000), and is so weak that he has to be carried on his Mom’s back. As a result his mom also developed a ventral hernia that needs repair with the special mesh as described above.  Since it was towards the end of the mission we could not do her hernia surgery, but donated the expensive mesh ($3,000) and our local partner, BPW, arranged for her to have the discounted successful surgery performed by a local surgeon last week! She will recover in time to help care for her family, especially her son, Joseph, for whom we are raising funds for his heart surgery soon. 

Katie Chandler, the BOL Director, who has a special interest in this case and saw them in Nigeria along with Pediatric Sickle Cell expert, Dr. Ify Osunkwo, and Cardiologist Osita Onyekwere, describes the situation well in the GoFundMe site she helped us set up. 

“Joseph and his mother, Rosemary, were first in line every morning to receive medical care.  Unfortunately, our team was not able to treat Joseph.  He suffers from a congenital heart condition called tetralogy of Fallot that requires corrective surgery.  This condition causes oxygen-poor blood to flow out of his heart to the rest of his body, leaving him fatigued and out of breath. Yet, Joseph and Rosemary still returned to the clinic every single day and waited from morning until evening with the hope that he might receive treatment.” 

Because of YOU that hope of receiving free treatment has come true for his mom, and hopefully will come true for him next. Please donate via the link below towards this great cause to get Joseph the care he needs…https://www.gofundme.com/urgent-funding-needed-for-josephs-heart-surgery

Other activities that occurred simultaneously with the medical/surgical/dental mission in Abuja included:

– HBB WKSHP(helping babies breathe) that trained 100 trainers, and has a follow up plan to assure more training and replication throughout Nigeria. This was organized by the efforts of Drs. Chinyere Anyaogu, Obi Maduka, Udo Asonye, Ugonna Chike Obi, Prof. Emuakpor, and many others. 

– Naloxone administration, CPR and AED workshop that trained about 63 people at the workshop and 150 in Abuja.

– We Donated supplies to complete remaining surgeries for free per meeting with CMD: 1 Electrocautery machine, Cuatery pencils, Pulseoximeters, 50 Surgical instruments, Gloves, Sutures, Meshes, Gowns, Gauzes, Tapes, ETTs, bulb suctions, Opthalmology supplies, Medications- antibiotics, anesthesia drugs, etc. 

– Continued Professional Development (CPD) organized with the help of our NAPPSA partner (Drs. Egbujiobi, Anthony Ikeme, and Teresa Pounds, etc), in collaboration with the Pharmaceutical Society of Nigeria (PSN), and the Nigeria Medical Association (NMA). The Opioid Education and Training Workshop held on April 9, 2019 at The Barcelona Hotels, Wuse II, Abuja. The achieved goal of this timely Workshop was to equip the Nigerian Healthcare Professionals with the knowledge and tools for meeting the challenges of the Opioid abuse Epidemic.

– ANPA Advocacy events included meetings with strategic governmental agencies, stakeholders in healthcare, Medical and Dental Council of Nigeria (MDCN), Nigeria CDC, and the Federal Ministry of Health with discussion focused on the imminent launching of the Diaspora Professionals Healthcare Initiative. More details at a later date. 

On April 11, 2019 we had a fantastic Farewell Dinner hosted by our friend and partner, Dr. Ibrahim Wada. 

Dr. Wada was not only instrumental in the planning of the mission at FCT, but volunteered himself, his hospital and staff, and even allowed our Gynecologists to move and perform some operations in his hospital when Kubwa operating theaters were fully occupied, in the face of overwhelming surgical needs. 

During the farewell dinner ANPA and NAPPSA leaders thanked all volunteers and partners, and recognized each with a certificate of participation and appreciation. 

Thanks to Fidelity Bank and our friend, Dr.  Biodun Ogungbo, who hosted team dinners on separate nights. Dr. Ogungbo also performed a discounted emergency spine surgery on a relative after the mission ended, aided by financial donations from Dr. Chine & Mrs. Kaylene Logan, Drs. Chris & Mercy Isichie (of Faith Alive Jos, site of our mission in 2016), Dr. Onyeka Nduaguba, and Dr. Iyore & Grant James. For that I am very grateful. 

Finally, on April 13, 2019, as part of our ANPA week tradition (courtesy of Mr. John Momoh, owner of Channels TV), President Charmaine Emelife, Dr. Jide Bamigboye, and yours truly me, appeared and discussed our activities on Channels TV SUNRISE show hosted by Neota Otaigwe and Alero Edu. Unfortunately, NAPPSA President Dr. Leo Egbujiobi could not join us due to prior commitment. You can watch the video on the following link:

– 2019 ANPA Week  https://m.youtube.com/watch?v=rzW69JWEsCg

On the same day many of us attended and enjoyed the elegant wedding of a onetime “ANPA baby,” Adanna Kpaduwa, daughter of our own Drs. Julius & Stella Kpaduwa. Wishing them a happy marriage. 

Although we had lots of difficult challenges during this massive mission, we have a lot of accomplishments to be proud of. 

  1. The largest medical mission ever in Nigeria!
  2. Working with NAPPSA, dentists, and nurses, showed our health colleagues in Nigeria that physicians and other healthcare workers can work together successfully to take care of patients. Hopefully, it will promote more harmonious relationship between them. 
  3. Over 4,000 medical and 90 surgical patients were positively touched as enumerated above. There were gifts of vision and lives. To them we are heroes and heroines, although we just did our jobs. We still continue to find ways to help patients like Joseph and Rosemary after mission ended. 
  4. We volunteers also benefited from new partners (BOL, BPW, DAGOMO), and old ones (JCI, FMOH), networking with colleagues, developing skills and innovation (that we didn’t realize we had), in resource scarce environment, appreciation of what we have in the US/UK and inspiration to improve healthcare in Nigeria, plus the four unexpected chieftaincy honors!
  5. Skills and knowledge transfer between diaspora and local colleagues, plus capacity building. Challenge is sustainability. 
  6. Health education on hypertension, diabetes, and chronic kidney disease prevention, HBB Training to improve infant mortality, CPD Seminar to combat the Opioid crisis. 
  7. The introduction of EMR to our field activities for the first time by our new partner, BOL, helped us stay organized, get real time lab results to guide therapy, and will be valuable for follow ups and even provide data for future publication and health policies. ANPA should welcome these possibilities with EMR. 
  8. Our high school and medical students plus residents got firsthand exposure to clinical circumstances that cannot be taught here. The experience will be invaluable in their future careers, and they are our future. Am sure you can think of more accomplishments. 

On April 14,2019 ANPA leaders had a meeting with CS-DON Director, Ms. Tinuke, and Mrs. Duke to start planning strategies for the 2020 Medical Mission in Calabar, Nigeria. 

On April 16, 2019 I had an ANPA certified medical mission outreach to my village in Owerri, Nigeria with Chima Medical Missions International and volunteers that included Nurse Practitioner Magnus Ihemedu, who was with us in Abuja, and Dr. Okey Duru, a longtime local ANPA volunteers. We saw about 500 patients and dispensed 150 glasses at Durham Baptist church. 

Our ANPA/NAPPSA Team debriefing Teleconference was held on April 28, 2019. Everyone present had a chance to talk. Even our high school student volunteer, Uche Osunkwo, shared her observations and recommendations for improvement. We discussed things that worked well plus suggestions on how to be more effective in the future. 

I would like to mention each Volunteer’s name and accomplishments in this report but space and time cannot permit me. There are so many unsung heroes behind the scenes and we thank y’all. You know that we couldn’t have been successful without your efforts. Please forgive me if I failed to mention your name or missed an important detail. I tried to capture everything concisely, but only human as you know. 

Special thanks to our organizations presidents and officers, all our volunteers from here and in Nigeria, our team leads and champions, our partners here and in Nigeria, our donors, our families that allowed us to travel, and the Almighty God, who kept us safe. 

Be grateful for your health, what you have, and remain blessed. See most of you at the ANPA convention in Washington DC, June 26-30!

Humbly Submitted by 

Cliff Eke, MD, FACS, FICS

Chair, ANPA Medical Mission 

Mission Photos