The Kilembe Mines Hospital is the only hospital in western Uganda that is able to provide orthopedic care due to the presence of 2 qualified orthopaedic surgeons. However, the equipment available to the orthopedic surgeon is often not sufficient to perform the necessary surgeries. That is why we try to collect re-usable and high grade medical equipment. These materials are often discarded before their time in western countries and can be put to good use in a place such as the Kilembe mines hospital. Drills, nails, plates and other similar materials are expensive and are frequently used in Kilembe but are sometimes very difficult to find.

Also newer materials, such as calcium sulfate beads with Tobramycin, are brought to the hospital as part of an infection prevention program. These beads could help to reduce the number of osteomyelitis cases.

Not only do we try to bring to correct equipment with us when we go to Kilembe, but we also try to improve the clinical practice.Discussions between our group and the hospital staff have revealed the difficult problems faced by the hospital, and our aim is now to improve these problems.

One of the major problems are the accidents that happen with the boda-bodas. These are taxi-motorbikes that sometimes transport up to 5 people. When an accident with one of these motorbikes happens, the consequences are terrible. Open tibia and femur fractures are a common challenge for the surgeons, and post-traumatic infections are not seen infrequently. As no c-arm is available in the operating theatre, the surgeons need to be very inventive, and there are a lot of things that we can learn from these surgeons!

A presentation at ISTA 2018 in London, which was normally presented by Dr. Isaac Ojangor Sande, revealed the barriers and drivers of orthopaedic surgery in this district hospital.