University Teaching Hospital comes of age

THE twins, Bupe and Mapalo before their separation. PICTURE: JACK ZIMBA

‘INVESTMENT in health is wealth,” says University Teaching Hospital (UTH) senior medical superintendent Clarence Chiluba. This is the stance the hospital has taken in its quest to create a healthy and wealthy nation.
The country’s largest referral hospital is building its capacity to cross uncharted waters, resulting in better services to the Zambian people, including the provision of major surgical operations. One recent example is the separation of conjoined twins – Bupe and Mapalo by a team of local medical experts.
UTH was established in 1934 at its present site and was run by expatriate doctors. The vision was to have local doctors run the institution.
In 1967, a medical school was established to train students in medicine and paramedics. Professors Elwyn Chomba and Evaristo Njelesani were among the first intake of medical students enrolled.
The medical school has grown in capacity capable of training undergraduate and postgraduate students as well as doctors of philosophy (PhD).
The institution has experienced major expansion in most clinical disciplines and has continued to grow in meeting the needs of the country.
“By the late 1980s, most of the work at the hospital was in the hands of Zambians, with a few expatriates involved,” Dr Chiluba said.
With Zambians at the helm of the institution, a need arose in 2016 to unbundle the institution, modernise its services and bring about efficiency in its operations.
The unbundling of the institution has seen a lot of changes at the institution, including expansion of infrastructure and refurbishment of units, bringing the facility to speed with what is obtaining in other countries.
State-of-the-art equipment has been purchased to allow doctors and other medical personnel operate efficiently.
“It is envisaged that if people are kept well from any sort of disease, they will be productive resulting in economic growth of the country,” Dr Chiluba said.
He said as UTH remains the flagship of health services in Zambia, it should demonstrate its potential of ensuring good health.
Five different specialised hospitals within UTH have been established as a result of the unbundling of the institution.
These are Cancer Diseases Hospital, Paediatric, Adult Hospital, Eye Hospital, Women and New Born Hospital.
Under the Adult Hospital, headed by Dr Robert Zulu, are various departments including internal medicine, surgery, accidents and emergency.
Dr Chiluba explained that the Adult Hospital has been doing a number of operations since its establishment in 2017. Some operations were done with the support of expatriate doctors, mainly from India and Japan.
“Over 20 open-heart surgeries have been conducted under the Adult Hospital, mainly by local doctors,” he said.
In addition, there is a local team of neurosurgeons led by Dr Kachinga Sichizya who have also been conducting operations of the brain.
While, different teams of local doctors are offering service in their respective fields, the institution has continued to train locals and foreigners in cardiology, neurology and orthopaedics.
There was an air of anxiety on February 2 in Zambia among people who ardently followed the separation of the conjoined twins, Bupe and Mapalo. The eight-months-old twins, born from a Kawambwa couple, Moses and Lydia Mwape, were joined at the abdomen, with their livers attached.
The twins were separated by a team of local doctors led by a paediatric surgeon, Bruce Bvulani and a general surgeon, Robert Zulu.
The two doctors were supported by senior doctors, including Prof Tackson Lambart (neurosurgeon) and Prof Lupando Munkonge (paediatrician).
Women and New Born Hospital senior medical superintendent Maureen Chisembele told journalists that the babies were separated at 16.58.
Briefing journalists during the moment of anxiety around the nation, Dr Chisembele noted that there was still a lot to be done in terms of closing up the wounds and anticipated that the surgery would continue for an hour-and-a-half or two hours.
The operation, which started at 10:00 hours, ended at about 16:00 hours. About 30 medical experts took part.
Soon after the operation, UTH public relations officer Natalie Mashikolo said the twins were in a stable condition and were closely being monitored by a team of experts.
Mr Mwape, the twins’ father, said “We feel good that the operation was successful”.
The twins are currently recuperating in hospital – Mapalo was weaned from oxygen a few days after the operation, while Bupe is slowly being weaned off.
UTH Head clinical care Dr Zulu explained that initially when the Siamese twins arrived from Kawambwa, they were under the Women and New Born Hospital.
A multi-disciplinary team of local medical experts was set up with the objective of separating the girls.
The team worked up a time table with a checklist which was followed to the day of the operation.
“There was a team from the Anesthesia Department [which was] tasked with sending the twins to sleep. This is because you cannot operate unless the patient is given anesthesia,” Dr Zulu said.
Before February 2, the nursing, laboratory services and pharmacy teams were all in place and ready for the operation.
“When all things were set for the operation, we set the date after informing the parents who understood and were agreeable for the surgery to go on,” Dr Zulu said.
The first team to go in the operation room was the anesthesia one led by Dr Christopher Chanda.
When they were done, the surgical team followed, led by Dr Bvulani and Dr Zulu who combined efforts.
There were more than 20 doctors around who were giving moral support and advice as required.
The operation started around 10:30 hours and proceeded to 16:58 when the twins were separated.
After separating the girls, the medical team had to close their abdomens by bringing together the two edges of the skin without putting anything artificial.
The babies have been in the ICU since February 2 and are recovering well.
Dr Zulu said Bupe recovering slowly compared to her sister Mapalo. “We are checking on Bupe more frequently and she is being supported by machines.”
He said the Siamese twins’ case was unique because the operation was conducted by a local team of doctors.
“The university hospital is able to carry out complicated operations. All we require is support and teamwork,” he said.
The medical team is humbled by the goodwill messages that have continued pouring in following the successful operation of Bupe and Mapalo.
“We had a lot goodwill messages from all over the world which we are grateful of. Messages of goodwill from within make us humble because it means we have been part of the team that saves lives,” he said.
“As a teaching hospital we are flying the Zambian flag high. We want to fly it higher so that we make every Zambian proud of our contribution to the health system.”
When Angolan minister of Health Silvia Lutucuta visited the twins in the ICT, she said she was proud of what the medical team had done.
Dr Lutucuta also commended Government for giving priority to healthcare service delivery by investing in medical equipment and human resources.
She said the successful separation of Bupe and Mapala demonstrated that it is possible for African health facilities to conduct complicated surgical operations.
Ministry of Health Permanent Secretary for administration Kennedy Malama said Government had provided the necessary support for the operation of the twins.
Dr Malama said the nation should continue praying for the recovery of the babies who are still receiving treatment.
He stated that UTH will be conducting most of the operations locally in a bid to minimise expenses on medical evacuations.
“Over 80 percent of the [medical] problems UTH sends out of the country have to do with heart and kidney. This is why the institution has narrowed down to focus mainly on the two challenges,” he said.
Dr Chiluba said the UTH will soon embark on a kidney transplant project.

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