Dangerous ear operations in Zambia sparked an Irish ENT surgeon into action, writes Fiona Tyrrell
An Irish ear, nose and throat (ENT) surgeon is spearheading a campaign to bring modern ENT surgery techniques to Zambia where an estimated 30,000 children in need of treatment are being served by four doctors using early 20th century treatment methods.
In 2003 Kieran O'Driscoll, an ENT surgeon working for the past 10 years in the Regional Hospital at Tullamore, Co Offaly, went on a fact-finding mission to Zambia in Africa to assess ENT services. He says what he found "defied description".
ENT services for a population of 11 million people there were being provided by four doctors with "limited experience". Ear surgery was being performed with hammers and chisels, a far cry from the delicate micro-surgery techniques used in most countries around the world.
In the month prior to his arrival, four children had died as a result of inhaling foreign bodies into their airways. Doctors did not have the basic equipment to remove these foreign bodies.
Two other children presented with brain abscesses, which were complications of infected ear disease. These abscesses went on to cause brain damage. Head and neck cancer patients in the wards were left untreated.
"They were working in the most dilapidated conditions with the most archaic equipment I have ever seen. It was very shocking," explains O'Driscoll.
He decided to set up ear surgery at the University Teaching Hospital in the capital, Lusaka, where the ENT unit was based. In the past two years, he has made four visits. While there, O'Driscoll has been operating as a locum ENT surgeon and, for the first time, ear micro-surgery was undertaken in Zambia.
He has also delivered around €65,000 worth of equipment, including a microscope for ENT microsurgery donated by the Royal Victoria Eye and Ear Hospital in Dublin and basic ENT equipment provided by Alan Kane at Euro Surgical Ltd.
Other organisations which have made donations of basic equipment are Teckno Surgical, St Francis Private Hospital, and the Regional Hospital at Tullamore. Reconditioned hearing aids have been provided by Bill Hennessy of Bonavox and fitted to children with severe to moderate hearing loss.
"One of my most memorable experiences was fitting a hearing aid to a six-year-old child who turned to hear his father calling him for the first time. Something like that is priceless. Fitting a reconditioned hearing aid was like giving a patient a cochlear implant."
O'Driscoll has joined forces with another doctor, Piet Van Haslet, who works for an organisation called Christian Blind Mission (CBM) which has interests in ear surgery around the world. O'Driscoll visits Lusaka twice a year. Both he and Van Haslet have started ear surgery at an eye hospital outside Lusaka.
On his last trip, O'Driscoll operated on five children suffering from chronic ear disease with equipment from Ireland. His next trip - at the end of this month - is the most ambitious. He will be joined by John Lang, ENT surgeon from University College Hospital Galway; Cathal Nolan, an anaesthetist from St Vincent's Hospital; and David Bray, sales executive with Medtronic, which has provided the team with ear surgical equipment. The team hopes to provide life-altering surgery for up to 30 children on this two-week visit.
O'Driscoll's trips have been self-funded and it is only during these trips that ENT micro-surgery is performed in Zambia. He now feels more help is necessary. With this in mind, he has founded a non-government organisation, Ear, Nose and Throat Surgery for Zambia Trust Fund Ltd, which is based in Tullamore, Co Offaly. The company has been supported by the Department of Foreign Affairs.
Ultimately what is required is an education programme for doctors in Lusaka so they can train themselves to be good ENT surgeons, according to O'Driscoll.
While one of the functions of the trips to Lusaka is to educate the present ENT doctors in modern ENT techniques, hospital management in Lusaka is eager for somebody to come and set up a post-graduate training programme for Zambian ENT doctors. Ideally an Irish surgeon considering early retirement could spend two years in Zambia establishing this training programme, O'Driscoll says. This would enable doctors in Lusaka to be trained in ENT and use the donated equipment.
He also hopes to bring a Zambian doctor over to Ireland for a four-month education trip.
"Ultimately, we want to produce an ENT service that would be self-sufficient and would have a number of satellite clinics."
Modern ENT surgery has its origins in Ireland with Sir William Wilde (father of dramatist Oscar Wilde). Ireland is still up there with the best in the international scene, says O'Driscoll.
"It behoves all of us to try to help spread our knowledge and experiences around. Every unit in which I have worked in other countries has done so. I trained in San Diego and staff there used to go to Mexico. In Australia, they go to southeast Asia, and in the UK, medical professionals go to Pakistan and India. The time is right for Ireland to try to get involved in similar ventures."
• Donations can be made to Ear, Nose and Throat Surgery for Zambia Trust Fund Ltd via Bank of Ireland, account number: 16766000; sort code: 90-19-09.