Portuguese physicians of Gastroenterology travelled for the first time to Sao Tome and Prince, in a mission that allowed the diagnosis, the therapeutic orientation of patients and the realization of specialized workshops meant to Sao-Tome physicians and nurses.

The mission was organized by Instituto Marquês de Valle Flôr (IMVF) under the Programme Health to All: Specialities, in partnership with the Gastroenterology Service of Centro Hospitalar e Universitário de Coimbra (CHUC). In a country where there are no specialists in Gastroenterology, the team of Portuguese physicians, coordinated by Dr. José Eduardo Pina Cabral, doctor in CHUC, was composed by the physician Dr.ª Sara Campos and the nurse Enf.ª Marisa Melo, and had activities during a week (from 11th to 16th January 2016), at the  Dr. Ayres de Menezes Hospital, in Sao Tome.

This was the first speciality mission, however it is expected its continuity in the scope of the programme Health to All: Specialities, a project which comprises 23 medical specialities, and that has been applied by IMVF in partnership with the Ministry of Health and Social Matters of Sao Tome and Prince, being co-funded by Camões – Instituto da Cooperação e da Língua I.P.,  Calouste Gulbenkian Foundation and General Health  Directorate.

Technical Activity:

  • Evaluation of material and human resources in the country regarding Gastroenterology and Digestive Endoscopy areas;
  • Improvement of the Endoscopy Unit with several equipments and instruments (thanks to the support of Portuguese companies such as:  Higiplus, Endowork and Laboratório Norgine);
  • Achievement of 55 endoscopic exams;
  • Realization of the first high digestive endoscopy under sedation, with the support of anaesthesia, in the operating room, in a 12 years old patient, inpatient with high digestive bleeding.

Care activity:

  • Evaluation of 12 patients during extern consults, internment and urgency service.
  • Diagnostics of Hirschprung’s disease, which was possible thanks to the collaboration with Dra. Celeste Alves (leader of the IMVF Imagology mission), with the realisation of the first opaque clyster in the country.

Evacuation of patients to Portugal:

  • It was recommended the evacuation of 5 patients to Portugal because of the severity of the cases and the necessity of a complementary therapeutic, currently not available in Sao Tome and Prince.

Formative activity:

  • Formation on the job to Sao-Tome physicians and nurses during the clinical activity at the Dr. Ayres de Menezes Hospital;
  • Participation in the first Course of Medical Emergency (12th to 15th January 2016): one session about gastroenterology emergencies, focused on High Digestive Bleeding (Dr. José Eduardo Pina Cabral) and another one about System of Manchester triage, especially on emergency gastroenterological pathology (Dra. Sara Campos);
  • Transmission of information through media (TVS) to the Sao-Tome population about the importance of digestive health, the risks of chronic alcoholism and the need of preventing infectious diseases as viral hepatitis B and C. – video TVS (21.35) available here.

Mission’s report: “With the mission finished, our opinion is that it was held in a very positive way. The main purpose was accomplished: the patients of Sao Tome and Prince with digestive symptomatology were unsorted as priorities, evaluated and oriented, in terms of therapeutic and monitoring”, (source: report of the mission written by the medical team headed by Dr. José Eduardo Pina Cabral, from which were part of Dr.ª Sara Campos and the nurse Enf.ª Marisa Melo).

Targets for the future: This was the first step of an operation that is expected to be frequent. Hence, the Gastroenterology mission’s goals to the triennium of 2016-2018 are the following:

  • Reaching a protocol of evacuation of Sao-Tome patients in Gastroenterology with the service of Gastroenterology of Centro Hospitalar e Universitário de Coimbra;
  • Extension of Telemedicine to Gastroenterology;
  • Continuation of the realisation of short-term missions to Sao Tome and Prince;
  • Creation of the Unit of Gastroenterology at Dr. Ayres de Menezes Hospital;
  • Complementary specialized workshops in Gastroenterology for the physicians and the nurses who ensure the activity of the Endoscopy Unit at the Dr. Ayres de Menezes Hospital;
  • Course in Gastroenterology to the Sao-Tome physicians and nurses;
  • Realisation of screenings (viral hepatitis and helicobacter pylori) and further development of studies.
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