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Support A Facial Surgery...Transform a Life!

by Project Harar
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Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!
Support A Facial Surgery...Transform a Life!

We met 10 year old Zikiya on our 2020 Complex Surgical Mission, she had a large mass on the right side of her face, which had been rapidly growing over 18 months. She had travelled to Addis Ababa with her Grandfather Alleau, from the East Haraghe Zone of Ethiopia, their home village is in a rural area which is hard to reach. her family are farmers, growing maize and keeping cattle, Zikiya has three other siblings, Alleau told us that they attend school while Zikiya stays at home. Before the mass started to grow she had attended school, but she had to drop out because other students were laughing at her, she also was having difficulty breathing.

 Her Grandfather told us they were told about the Project Harar Complex Mission by a health extension worker who was visiting their community. Before this, Zikiya’s family did not think she would be able to receive treatment for the mass, they did not have the financial means to seek the medical care or travel to receive it.

 Zikiya had surgery on the Complex Mission to debulk the mass on her face, although after the surgery the area remained a little swollen, Project Harar Programme Officers have since been in contact with her family back home and the swelling has decreased. Zikiya and her family are so pleased with the outcome of the surgery. The schools in Zikiya’s area are closed due to Covid-19, but when they re-open, she will return.

 On the Complex Mission Zikiya had the opportunity to make friends with other children who had complex facial disfigurements and rebuild her self confidence. 

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Khbane before surgery
Khbane before surgery

           
Khbane is in her early 20’s, she is from the Gimbi zone in Western Ethiopia and lives in a small Kebele (village) called Weyu Mene.

We met Khbane on our 2020 Complex Surgical Mission, she had a huge swelling on the back of her neck. This mass had been growing for a total of four years, she had previously tried to seek medical help in a hospital however no treatment was offered.

Before her surgery Khbane would always use her hair or a scarf to cover the back of her neck.

Khbane’s Surgery was a complete success. There was a little uncertainty prior to the surgery as in some cases similar to this, the growth can invade the bones (vertebrae) in the neck, removing bone as well as the tumour can cause instability in the neck after the procedure and risk damage to the spinal cord. For this reason, the case was carried out jointly with the neurosurgeons from Yekatit 12 Government Hospital in Addis Ababa.

Fortunately, the operation was a success and the tumour could be removed without any compromise to the bones or the tissue around the spinal cord. She will be left with a small scar on the back of her neck.

Khbane was so happy with the result of her surgery, even in the early stages of her recovery she seemed more confident. 

After she is fully recovered Khbane will go back to living with her husband, she hopes she can find a job.

Khbane after surgery
Khbane after surgery
Khbane at the post-op recovery centre
Khbane at the post-op recovery centre
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Project Harar organises one Complex Surgical Mission a year that allows around 50 individuals with facial disfigurements, to access life changing facial surgery in Ethiopia. The treatment for these individuals also includes follow up’s post-surgery. The Project Harar medical volunteer team consists of Head and Neck/Plastic Surgeons, Doctors, Nurses, Anaesthetists and Dietitians, mainly from the NHS. 

 

A hugely important part in supporting complex facial surgery is a follow up phase post operation. Not only do Project Harar provide post operation care for patients but we also provide the opportunity for past patients to come back on the next Complex Surgical Mission, to  check on their progress and to see if any further operations are needed. A patient who we have had the opportunity to catch up with on two occasions Zeynab. 

 

We first met Zeynab in 2017. Zeynab had severe facial deformities due to her Noma. Zeynab’s condition meant that she couldn’t open her mouth and she had difficulty speaking, eating and breathing. Not only this but Zeynab was isolated from her community, she lived with her parents and four other siblings, she had no friends and she had never attended school as her parents feared her being bullied. In 2017 Zeynab told us “I want my face to be beautiful”, she was counselled on these expectations and she also expressed her wish to attend school post-surgery. 

 

 

In 2018 Project Harar was able to perform a two part surgery and dental extraction that dramatically reduced the appearance of her Noma. Zeynab was delighted by the outcome.

 

Zeynab revisited the Project Harar team in 2019 for further surgery. Noma is an extremely difficult condition to rectify, however the results were a complete success! Zeynab is due for another follow in our upcoming 2020 Complex Surgical Mission, she no longer feels alone in her condition and has met many other young people who have faced similar social and physical challenge due to their facial deformities. 

Zeynab Transformation 2017-2019
Zeynab Transformation 2017-2019
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Once a year Project Harar coordinates a Complex Surgical Mission to transform the lives of around 50 individuals with facial disfigurements in Ethiopia. We take a volunteer medical team consisting of Head and Neck/Plastic Surgeons, Doctors, Nurses, Anaesthetists and Dietitians, mainly from the NHS. Abbie, a registered nurse from London, attended our 2018 and 2019 Missions. Here she reflects on her most recent Mission. 

'I was fortunate enough to take part in Project Harar's Complex Mission for the second year running and it was without a doubt my favourite experience so far.

As with all volunteering experiences, the anxiety and fear of the unknown looms, along with the buzz of excitement of what you'll be about to undertake. This year I was to work a different part of the Mission, Pre-Operative as opposed to the Surgical weeks I had previously experienced. I was filled with dread as I had a much smaller team, no safety net of a Lead Nurse until the second week and an entirely new job role. However, my fears were soon to be forgotten.

As soon as we landed it was all hands on deck. Despite the overnight flight and lack of sleep, there was work to be done and the unexpected early arrival of the patients on Saturday afternoon set us to task. Registration, documentation and triage was completed for 30-something patients in a flurry of activity. We identified a few patients we were concerned about, including one elderly gentleman (much older than his reported 45 years) who was in dire need of an emergency trip to A&E with suspected septic shock. All team members attended the unscheduled trip to Yekatit-12, ensuring the gentleman received the urgent care he desperately needed.

As the first week drew on, our team of volunteers (including two dieticians, a dental hygienist, a nurse and two Ambassadors) worked tirelessly assessing, measuring, educating and planning the care required for each patient to ensure they were surgically fit by the end of the two weeks.

We worked together seamlessly, identifying patients that required further assessments before the Surgical Team arrived, to rule out any cases that may be inoperable. By inoperable I mean only those that had likely malignancy or neurological involvement, areas outside of the surgical remit of the Complex Mission. Daily communications and guidance from the UK teams was essential and gave the Senior support we required to feel confidence in our decision making. After all, we were the sole responsibility for approximately 55 people's lives.

Socially, we engaged the patients very well – it was easily done with such a social and accepting groups. Most were from different areas of Ethiopia, most speaking different languages and dialects to each other. Despite this, each day you could see the bonds forming, particular groups becoming tighter and each individual finding their role within the group. Each person slowly starting lowering their barriers, whether it be eating without their guardians, lowering their headscarves or confidently approaching us (the forengies) for help.

This was the power of the Mission I had only experienced in passing before, but this time I was able to see and hear it occurring. Bringing together a large group of people, from all walks of life, with only one similarity; facial disfigurements. 

The Pre-Op Centre soon became a safe place for all patients, one where they didn't have to hide themselves or be ashamed, each person accepting the other for exactly who they were. Each individual having the hope that someday soon, their lives would be changed, their functional challenges would improve as well as their appearances, all thanks to Project Harar.

Even now, a mere week after my return from Ethiopia, names and faces still fill my thoughts. From previous experience, I know this will long continue – a love affair you never expect to participate in, particularly not with 55 people at the same time! Again, this is the power of the Complex Mission. It leaves you yearning to know more about the people's lives you touched, wanting to know the outcome of their surgery and how it will improve their lives. Will that young girl become a lawyer and shun marriage as she claimed she wanted to? Will that young man complete his schooling, be returned to his wife and child and commence his Medicine training? Will that young boy receive lifesaving surgery or be accepted for cancer treatment?

All of these thoughts and more invade my mind daily, it is hard to forget or simply shut out after spending two weeks with such incredibly brave and resilient humans.

After all, as nurses we often touch the lives of others, but it is truly special when the lives of others touch your heart. It is an imprint left for a lifetime.

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In early 2019, our outreach team found 40 year old Negatu in a remote community in Oromia and brought him to our pre-operative centre. Our lead nurse, Raj Mashiana, reflects on Negatu's journey during the 2019 Complex Mission.

When Negatu arrived at our pre-operative centre, we quickly realised that he was very sick. He had a huge lower jaw mass - I'd never seen such a large mass in my life. On arrival to the centre he was immediately taken to A+E as he was very unwell and potentially in septic shock from an infection on his mass. He was admitted on the ward at Yekatit-12 government hospital (where we do our surgeries during the mission) and remained an in-patient there throughout the whole two weeks of pre-op. When our surgeons arrived in Addis and first saw his case, they thought we wouldn't be able to operate on him because he was so sick and his mass was so severe.

Over the next week, he was treated with IV antibiotics to fight the infection and get him better as he was still very weak. Our nurses looked after him 3-4 times a day and our fantastic Dietician, Natasha, supported his progress by building up his strength and optimising his nutrition. After a week of monitoring his progress carefully, I spoke with the medical team about the plan for Negatu's surgery and aftercare. We needed to ensure we were all up to date and the nurses could process and feedback any information they needed to.

We also asked our Ethiopian colleagues to review him and help us make an informed team decision as to whether he was suitable for surgery. They assessed his condition and told us that we should operate. We spent a few days discussing, planning, re-discussing and planning. We finally allocated him a date for surgery. We planned for an Intensive Care bed for after surgery - due to the severity of his mass we thought he would need 1:1 care after surgery and he would need close monitoring.

On the day of his surgery, our International and Ethiopian surgeons worked closely together - the teamwork I saw was amazing! Negatu’s operation took many many hours but it was carefully thought out and we had all the experts on his case. His surgery was a huge success and after the anaesthetists assessed him, he was deemed safe to return to the ward. His transformation was incredible and he did not even need the Intensive Care bed afterwards!

He has gone on to be the most amazing human beings I have ever met. At the post-op centre he has continued working hard on his nutrition, physio and exercises - we can already see his results of consistent wound care from our nurses and he’s even putting on weight!

Negatu’s case shows us how fantastic teamwork, hard work and dedication can change a life.

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Project Harar

Location: London - United Kingdom
Website:
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Twitter: @ProjectHarar1
Project Leader:
Rose Edwards
London, United Kingdom
$415 raised of $5,000 goal
 
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