The Tanzania National Mesh Hernia Project
First begun in November 2018, this project is a piece of collaborative work with The Tanzania Surgical Association – under the auspices of Madame President Catherin Mlelwa (specialist surgeon, paediatrics). Colleagues from Hampshire Hospitals, as well as other trusts, alongside researchers at the University of Winchester continue to collaborate on this work as the project progresses.
Primarily, this project involves training surgeons in the technique of mesh hernia repair in their local facility. Part of this training incorporates the preparation of affordable surgical mesh so that they can become autonomous in their delivery of service.
Why is this work so needed?
This project adopts a well-established procedure using mesh for hernia repair, rather than a traditional suture plication technique. Using this approach will bring Tanzanian hernia repair to the same gold standard practiced by the UK. If every hernia was repaired today in Tanzania with mesh, in 5 years there would be 4,000-8,000 recurrences, rather than 160,000-320,000 with a suture repair.
The cost of commercial mesh is prohibitive for most of the population. The costs of inguinal hernia repair in Tanzania ranges from 50k TZS in smaller centres, up to 600k TZS in some of the larger centres. To use a commercial mesh adds a further 250k-350k TZS to the price. Furthermore, as mesh is only rarely used, expertise in this technique is thus also limited.
There is a novel approach to mesh surgery, that was developed and pioneered in India and subsequently adopted and rigorously tested by the UK based charitable organisation Hernia International (they have repaired over 10,000 hernias worldwide with this material). This uses a very particular form of mosquito netting (which has comparable composition to standard commercial mesh) for the prosthesis. This material has been rigorously tested to ensure its comparability, with the results published in the medical literature .
By reducing the cost of the mesh to almost zero (once some basic infrastructure is in place), it thus opens up the opportunity of revolutionising hernia surgery in Tanzania.
This project is supported by 'Surgical teams Working in aFrica Together for Safer Surgery' (SWIFTSS), who help fund and enable work.
For more information on the project, or to get involved in this work, contact: