262 stones
Gallstone disease seems to be less common in Nigeria than the USA but we do see some cases. The incidence seems to be increasing. This may be because the obesity epidemic is coming to Nigeria.

On this trip, I have performed 3 cholecystectomies. On my last trip we performed several as well, including one woman who had 262 stones! I have been quite surprised how beautiful the stones are from Nigerian patients. 

Beautiful stones
A new team member has arrived, Charles Nwajei, MD,  a Urologist. Charles went to medical school at the University of Calabar and did urology training at University of Benin. I first met Charles when he came to NCH in 2006. Uche brought him for extra training. He has just finished all his training and is looking to get some additional general surgery training. He is a kind, quiet man. He is a good surgeon and an asset to to the team.

We have discussed cassava previously. It is a dietary staple in Nigeria. Today on the way to work we learned some more. The young man in the picture has a mobile millstone for grinding cassava. The mash is then made into gari. His machine runs on gasoline. He charges 200 Naira ($1.33) to grind 2 large bags.

Cassava in....

                                                                 Gari out!