Dr. Michael Ohene-Yeboah can still recall the seemingly mysterious ailment that afflicted so many people in his Ghanaian village.
He'd often see the local Catholic priest as he ran around trying to treat those who'd fallen victim to this strange abdominal sickness.
He remembers the howls of pain, how the protrusions in their bodies swelled to the point where they could no longer work, and how, all the while, herbalists and other healers warned them that surgery was too expensive and wouldn't help them even if they could afford it.
Photo by oneVillage Initiative/Flickr.
He never had a name for it until he became a district medical officer: inguinal hernia. And cases of it kept him busy day and night.
More than 200 million people across the world suffer from inguinal hernias — a condition where an organ or other piece of tissue breaches the muscle wall in the groin, causing swelling, infection, and blockages. The bulge that results can sometimes descend as far down as the knees, causing even more discomfort. Often, the sufferer is unable to work or even move around.
The mortality rate from hernias is particularly high in Africa, where it's estimated that only 30 out of every 100,000 cases get repaired. The surgery is a simple outpatient procedure, but it still requires more money and surgical skill than most West Africans can afford.
"Non-surgeon physicians already perform the repair of inguinal hernias in the rural district hospitals," Ohene-Yeboah says via email.
"However ... the outcomes were not very satisfactory," he continues. "Now, if the skills of these non-surgeons can be improved then we could expect better outcomes."
Ohene-Yeboah has been teaching the easy-to-learn mesh repair technique to non-surgeon doctors for years. It requires just a few supplies, such as sutures and anesthetics, along with standard surgical monitoring equipment. But the mesh itself, which holds the breached organs back until the muscle wall heals, can often be too expensive for some rural hospitals.
Ohene-Yeboah and his fellow surgeons must also contend with the lack of education around treatment for inguinal hernia, especially in remote areas. "Many patients with long-standing inguinal hernia have been told by the herbalists and other traditional healers that an operation will lead to death," he says.
Some of them will eventually accept the surgery, after much convincing, but not all.
Photo by Shane T. McCoy/Wikimedia Commons.
Ohene-Yeboah was still committed to saving as many lives as possible, but he always knew there had to be a better way. Then, one day, it found him.
In 2011, Ohene-Yeboah published a paper in the West African Journal of Medicine about the hernia epidemic in Ghana, explaining how low-cost mesh and basic training for non-surgeons could make a massive difference for the country. It attracted the attention of Dr. Jessica Beard.
A U.S.-born surgeon, Beard had spent time in Ghana as part of a high-school exchange program and continued to return to the African continent because she was interested in the intersections of surgery and public health.
In an email, she explains that "in Ghana, we have hernia surgeons interested in training doctors to perform hernia surgery and doctors who want to learn. But physicians in low- and middle-income countries (LMICs) face many competing interests and need to be compensated for the training and care they provide."
Photo by Nora Morgan/Flickr.
So Ohene-Yeboah and Beard worked together to create a "toolkit" to help non-surgeon doctors in Ghana address the hernia problem themselves.
The toolkit includes a series of step-by-step instructions and pre-recorded lectures to help prepare doctors for the very basic hernial repair procedure called the Lichtenstein technique. It also provides a breakdown of the necessary surgical supplies, incentives, and guidance for how to fund and provide the training (like transportation, food, accommodations, and a small honorarium for trainers).
Beard handles research and logistics in the U.S., including gathering financial support from their partner organizations such as the Americas Hernia Society and the Swedish Research Council.
But other than that, she says, "It's all locally driven by Michael's leadership, vision, and tenacity."
And that's how the Ghana Hernia Society was born, with the mission to "reduce the burden of disease from inguinal hernia through increasing access to high quality care."
The inaugural class of 12 non-surgeon doctors trained in the mesh repair procedure "graduated" in 2013. The society has continued to expand and grow since then.
But there's still a lot of work to do — and not enough funding.
In addition to toolkits and training programs, Ohene-Yeboah and Beard also use the Ghana Hernia Society as a vessel to secure surgery funding and low-cost supplies. "We hope to use data from the study on our program to show the Ghanaian government that investing in surgery can be effective and cost-effective," Beard explains. "Our training program and toolkit implementation are the first step in this process."
Over the next 5 to 10 years, they hope to triple the number of Ghanians treated for hernias. And if their dataset is large enough to prove the value of the program, Ohene-Yeboah hopes to eventually build a factory where they can produce their own commercial mesh, making this simple surgical process easily available in hospitals across West Africa, including Ghana.
Photo by USAID Africa/Flickr.
In 2018, the Ghana Hernia Society received a $50,000 Gen H Challenge grant. It's a huge step forward — but they still need more support as they move into the future.
You can help them out as well by donating cash or supplies to the Ghana Hernia Society.
As Sir Cecil Wakeley of the Royal College of Surgeons once said, "A surgeon can do more for the community by operating on hernia cases and seeing that his recurrence rate is low than he can by operating on cases of malignant disease."
That was 70 years ago, and it remains true today.
It's people like Ohene-Yeboah and Beard who are doing the work to keep those recurrence rates low, helping communities across Ghana and the rest of West Africa.
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An Irish woman went to the doctor for a routine eye exam. She left with bright neon green eyes.
It's not easy seeing green.
Did she get superpowers?
Going to the eye doctor can be a hassle and a pain. It's not just the routine issues and inconveniences that come along when making a doctor appointment, but sometimes the various devices being used to check your eyes' health feel invasive and uncomfortable. But at least at the end of the appointment, most of us don't look like we're turning into The Incredible Hulk. That wasn't the case for one Irish woman.
Photographer Margerita B. Wargola was just going in for a routine eye exam at the hospital but ended up leaving with her eyes a shocking, bright neon green.
At the doctor's office, the nurse practitioner was prepping Wargola for a test with a machine that Wargola had experienced before. Before the test started, Wargola presumed the nurse had dropped some saline into her eyes, as they were feeling dry. After she blinked, everything went yellow.
Wargola and the nurse initially panicked. Neither knew what was going on as Wargola suddenly had yellow vision and radioactive-looking green eyes. After the initial shock, both realized the issue: the nurse forgot to ask Wargola to remove her contact lenses before putting contrast drops in her eyes for the exam. Wargola and the nurse quickly removed the lenses from her eyes and washed them thoroughly with saline. Fortunately, Wargola's eyes were unharmed. Unfortunately, her contacts were permanently stained and she didn't bring a spare pair.
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Since she has poor vision, Wargola was forced to drive herself home after the eye exam wearing the neon-green contact lenses that make her look like a member of the Green Lantern Corps. She couldn't help but laugh at her predicament and recorded a video explaining it all on social media. Since then, her video has sparked a couple Reddit threads and collected a bunch of comments on Instagram:
“But the REAL question is: do you now have X-Ray vision?”
“You can just say you're a superhero.”
“I would make a few stops on the way home just to freak some people out!”
“I would have lived it up! Grab a coffee, do grocery shopping, walk around a shopping center.”
“This one would pair well with that girl who ate something with turmeric with her invisalign on and walked around Paris smiling at people with seemingly BRIGHT YELLOW TEETH.”
“I would save those for fancy special occasions! WOW!”
“Every time I'd stop I'd turn slowly and stare at the person in the car next to me.”
“Keep them. Tell people what to do. They’ll do your bidding.”
In a follow-up Instagram video, Wargola showed her followers that she was safe at home with normal eyes, showing that the damaged contact lenses were so stained that they turned the saline solution in her contacts case into a bright Gatorade yellow. She wasn't mad at the nurse and, in fact, plans on keeping the lenses to wear on St. Patrick's Day or some other special occasion.
While no harm was done and a good laugh was had, it's still best for doctors, nurses, and patients alike to double-check and ask or tell if contact lenses are being worn before each eye test. If not, there might be more than ultra-green eyes to worry about.