The orthopaedic part of Daktari Project is one of the original sub-projects that were set up in 2010. This is due to the nature of the hospital, a district hospital that serves as a referral center for more than 2 million people. Dr. Benard Balyana serves as the orthopaedic surgeon at Kilembe Mines Hospital and is a dear friend of Daktari Project.

TRAFFIC ACCIDENTS

Today, after Ethiopia, Uganda has the second highest number of traffic accidents in Africa. According to the World Health Organisation's Global Status Report on Road Safety 2013, Uganda is mentioned as one of the countries with an alarmingly high number of road accidents. If this trend of road accidents continues to increase, the health loss due to traffic injuries could be ranked second compared to HIV/AIDS by 2020.

These road accidents often lead to terrible public injuries. Open fractures are complex injuries to bone and soft tissue. They are orthopaedic emergencies due to the risk of infection due to contamination and impairment of the soft tissue and sometimes also of the supply of blood vessels and the associated healing problems. Any wound occurring on the same limb must be suspected as a result of an open fracture until proven wrong.

The principles for the treatment of open fractures are an initial evaluation and exclusion of life-threatening injuries, prevention of infections, healing of the fracture and restoration of the function of the injured extremity.

The local doctors are very experienced in this and have developed a way to help themselves out with limited resources. With Daktari Project we try to supply them with osteosynthesis material as well as to set up and maintain together a project that minimizes the risk of osteomyelitis (bone infection). We have already started a scientific study to look at the effect of calcium sulphate pellets impregnated with gentamycin/tobramycin (an antibiotic) on the development and treatment of osteomyelitis. The results have already been presented at various international conferences (BVOT and ISTA). Project orthopaedics is of course very closely related to the wound care project and the infection prevention project.

FUTURE PROJECT: OUTREACH PROGRAMME

At the moment brainstorming is going on about setting up an 'outreach' programme to treat certain orthopaedic disorders (end-grade hip/knee osteoarthritis, major stiff posture abnormalities, clog feet, ...) on the spot in cooperation with the local doctors. More information will follow soon.