The charity Facing Africa has assembled a team of medics from West Yorkshire to visit Ethiopia to perform facial surgery on victims of a flesh eating disease. Andrew Robinson reports.
THE hospital in Addis Ababa is a world away from the private Methley Park Hospital where consultant plastic surgeon LeRoux Fourie works.
In a career which has included several years in the South African military, Mr Fourie has performed surgery on gunshot wounds but now most of his time is taken up with cosmetic surgery, from facelifts to breast implants and it couldn't be more different from what he has seen in parts of Africa.
He is now preparing for his second visit to Ethiopia to help people primarily suffering from the condition Noma, an acute gangrenous infection that affects the face and has a very high death rate without treatment.
Last year his team performed 40 operations during two weeks and in October he expects the same heavy workload.
He and his colleague Kelvin Mizen, a consultant surgeon in Leeds who specialises in facial cancers, had a 45kg luggage limit on the plane, most of which was taken up with medical equipment.
They performed the surgery without microscopes – normally considered essential – and instead used magnifying glasses to view the 1mm wide stitches and tiny blood vessels.
"We took all our own kit – stitches, bandages, dental equipment, drills, etc. Each person carried 45kg of baggage. Next time, we want to develop microsurgery so we can treat more people."
Mr Fourie says news of their work spread quickly and desperate patients arrived from across the country. Unfortunately, some of the facial cancers were too advanced and they had to be turned away. But those who are treated go on to lead normal lives, often after years of being shunned.
The life-changing efforts in Africa put his work in the UK into perspective, says Mr Fourie.
"People in the UK might worry about a little bump on their nose, or they might complain to me about an operation scar that is 1mm out of line. I think about the sights I have seen in Ethiopia – the complete disfigurements. Someone may worry about their nose but we have treated people who don't have a nose at all. We have to make them one."
He recalls one seven-year-old lad nicknamed 'hyena boy' by villagers whose face was ripped off by a hyena.
"He was dragged out of a hut and had his face chewed away. He was so stoical, he was fantastic. We really bonded with him, he was wonderful. He had never seen a tap before."
The medical team, which also includes operating theatre nurses Mick and Anthea Etches, also of Methley Park Hospital, want to focus on the risks of post-operation infections during their next trip.
"The infection rate was very high last time", says Mr Fourie. "We are going to take more antibiotics. We assumed the nursing care would be of the standard we are used to. We need to spend more time on the wards, teaching nursing staff about changing dressings and cleaning wounds.
"Technically, the operations went well but 10 days down the line we saw infections that we don't see in the UK. This next time we might have to say no to some of the more complex cases because of the facilities."
Mr Fourie, who was born and trained in South Africa, says the charity Facing Africa provided the funds for the trip and Yorkshire medics had provided some of the expertise, along with medics from London.
"There are only six surgeons in the whole of Ethiopia, compared to seven in Leeds and seven in Wakefield. A little bit of Yorkshire is hopefully having an impact in a small area of Ethiopia."