EBOLA IN NIGERIA-MISCONCEPTIONS

Ebola is a terrible disease. Fortunately, Nigeria did a splendid job of eradicating the recent epidemic. Nigeria had 20 cases of ebola with 8 deaths-better mortality than any other country. The last diagnosed case was August 31, 2014.  All people in Nigeria who were sick with Ebola have now either died or recovered. Contacts of these patients have completed their 21-day monitoring period and are no longer at risk for getting sick with Ebola. The country is safe (at least as concerns ebola)

Common misconceptions:

1. There is active ebola in Nigeria.

2. West Africa is one country! Most people I speak with believe this! West Africa, also called Western Africa and the West of Africa, is the westernmost subregion of the African continent. West Africa has been defined in Africa as including the 17 countries Benin, Burkina Faso, island of Cape Verde, Gambia, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, island of Saint Helena, Senegal, Sierra Leone, Sao Tome and Principe and Togo.

Therefore, it is meaningless to discuss "ebola in West Africa". It would be similar to referring to ebola in Southwestern USA. In fact, there is only ebola in Dallas.

3. Obviously, since there is no ebola in Nigeria, restricting travel to this area will do nothing to help the current epidemics.

4. Rejecting Nigerian students from American colleges will not stop ebola

OLD FRIEND

Ameloblastoma

Ameloblastoma is common in Nigeria and West Africa. Despite what you might think, patients tolerate having half their mandible removed  quite well. They can eat and speak normally. This lady had a large ameloblastoma that had destroyed her right jaw. We performed a hemimandibulectomy and pectorals flap reconstruction in 2006. She came to visit us this past September. She is very happy.

Resected jaw

Postop day 3

Postop 1 year

Postop 8 years

Postop 8 years

HAPPINESS

This lady has a big problem, yet, amazingly, like most of my Nigerian patients, she is happy because she is finally getting some care. She has had 3 cycles of chemotherapy and soon we will remove her necrotic, fungating breast. She will probably die relatively soon (who knows?) but at least she will not die with the smell of rotten flesh around her. For an investment of a few weeks, she will be happier for the rest of her life, however long that may be.

Unfortunately, fungating breast cancer is common in Nigeria. For many reasons, such as economics and fear, the ladies come in late. With educational programs, we are trying to change this trend

ALBINO

It is very difficult to be an albino in the tropics. These patients often develop lethal skin cancers. It has been hypothesized that skin cancer prompted the evolution of dark skin.  On every trip to Nigeria, I see albinos with terrible skin cancers. Some patients come early enough that simple cauterization can solve the problem. However, they must come often since new cancers are always developing. This unfortunate patient came in very late. Soon we will perform a big surgery to remove the cancer and cover the site with new tissue.

Albino patients that frequently come for surgery

PATRICK GODET EGLI VINCENT

Making a world class motorcycle is similar to surgery. Every detail must be perfect to get the desired result. Patrick Godet in France makes a beautiful motorcycle that is as beautiful as any surgery I have seen. Every detail is thought out and executed to perfection. What a surgeon he could have been.

ABUJA

This past trip in September, We made a trip to Abuja to do some surgery at Dr. Uche Nkeonye's new hospital. This was Eric Oje's (best nurse anesthetist I have ever worked with) first flight. The surgeries went well and we had a grand time.

Dr. Uche's Hospital

Eric Oje (nurse anesthetist), Ifeanyi Chiekwe (urologist),
and Uche Nkeonye (general surgeon)

BURN CONTRACTURES

This poor lady was involved in a fire and had severe burn contractures, especially from her chin to her chest. She could barely move her head. We excised the scar tissue and placed a pectorals myocutaneous flap. After healing she had normal mobility of her neck. However, we did have to sacrifice most of the right breast. Vicki Jones from the Women's Health Boutique in Longview, TX, kindly supplied her with a bra and silicone breast prosthesis. She is very happy.

Servere burn contracture of the neck

Right pectoralis flap (head to left)

Raising the flap (Head toward bottom)

Postop day 7

Appearance after 3 months

MORE COMING

I have been quiet on the Blog recently since I have been so busy. I spent 3 months this year in Nigeria doing surgery-January, May, and September. I am returning for a shorter trip in November. We have done over 600 cases this year and taught numerous resident surgeons and attendings. The Blog will start again soon.

BTW-my suspicious mole was benign!