Case study: Medevac of three-year-old for lifesaving surgery
Ojiya from Juba, South Sudan, underwent a lifesaving operation to repair a gastroschisis in Nairobi, Kenya, after a transfer by MAF. MAF’s Jenny Davies reports on her case
Ojiya underwent a nine-hour operation to correct her condition where her bowel had formed outside of her abdomen during gestation in the womb, known as gastroschisis.
Following the successful reconstructive surgery, Ojiya is now recovering well.
Mission Aviation Fellowship’s (MAF’s) three-and-a-half-hour flight from Juba to Nairobi enabled the little girl to arrive swiftly and safely, ready for the surgery.
The alternative? A dangerous and exhausting four-day inter-country overland trip on inadequate roads, which would have been out of the question in Ojiya’s fragile condition.
According to Forbes, South Sudan has the highest rate of poverty in the world and does not have the advanced medical capabilities to accommodate such a complicated procedure, unlike its neighboring country Kenya.
Ojiya’s parents – Boniface and Charity – do not have the financial means to pay for a private air medical transfer. For them, a humanitarian air operator like MAF is the only way to access lifesaving medical treatment for their little girl. Boniface, Ojiya’s father, said: “I would like to thank MAF and the AMI Clinic for the genuine support that they gave me in the transportation of my daughter from Juba to Aga Khan University Hospital in Nairobi. I thank everyone who participated.”
Fighting to survive
Soon after she was born, Ojiya had some surgery to address her condition, but it was unsuccessful.
Nearly three years later, she was admitted to the AMI Clinic in Juba after her health began to deteriorate. AMI’s Emergency Medical Technician Cole Tideswell was amazed: “It was an extraordinary and unique situation that she survived up until this point and didn’t catch severe septicemia.”
Since the AMI Clinic was unable to carry out such advanced surgery, AMI’s Clinical Lead Dr Ilirjan Bashllari approached Aga Khan University Hospital in Nairobi, which has specialist pediatric surgeons who would be able to undertake Ojiya’s operation: “Aga Khan University Hospital agreed to do the operation and from our side, everything was in place, but the transport proved challenging. We had to work out, how do we connect this place with that place? We were stuck!”
That way, the risk of infection – which would otherwise be much higher on a busy commercial flight – would be mitigated
Dr Bashllari’s colleague, Advanced Support Paramedic Ingo Müller had a friend who worked for MAF South Sudan: MAF Pilot Tobias Meyer. MAF’s small planes are the perfect solution to connect the two healthcare institutions.
This door-to-door service meant that Ojiya would be picked up from home by ambulance and get transported to MAF’s plane (a Cessna 208B Grand Caravan) at a local airfield in Juba. Another ambulance at the other end would meet her at Nairobi Wilson Airport for a final direct transfer to Aga Khan University Hospital.
That way, the risk of infection – which would otherwise be much higher on a busy commercial flight – would be mitigated.
The transfer of Ojiya by Cessna Grand Caravan C208B to Nairobi – three-and-a-half hours – was a fraction of the time that it would have taken by road.
Dr Bashllari explained about the first phase of the surgical operation in Nairobi, which took five hours: “They had to reconstruct the guts to close the fistula (hole) and repair the abdominal wall. It was a long, complicated and difficult surgery, but at least Ojiya would have a fighting chance.”
It was a long, complicated and difficult surgery, but at least Ojiya would have a fighting chance
Tideswell said it was Ojiya’s initial care in Juba that made a big difference: “Credit to the AMI nurses in Juba who first cared for her and dressed the wound to prevent sepsis. If they hadn’t done that, the risk of sepsis and death within the next year would be quite high.”
Access to surgery impossible without MAF
After the first phase of surgery, Ojiya received specialist aftercare in the pediatric intensive care unit at Aga Khan University Hospital until she was strong enough to be discharged.
Ojiya and Boniface then boarded MAF’s return flight to Juba to be reunited with the rest of the family and, a few days later, Boniface reported that his daughter was recovering well: “Her operation was a success and she’s getting better and better every day.”
Dr Bashllari offered his sincere thanks to MAF: “Ojiya is one step closer to a full recovery. MAF offered the possibility of surgery to that family. [Its] services are extremely valuable and without [it], the surgery would not have become a reality. MAF gave Ojiya the opportunity to have the best treatment around.”
Dr Bashllari continues to provide advice and support to Ojiya in Juba to help her establish normal bowel function post-surgery.