​What kinds of symptoms do patients experience before receiving treatment?

A bulge and pain in the affected area are the most common symptoms. The symptoms may get worse with straining. The pain may be severe enough to affect the patient’s ability to work and perform daily activities.

​What is the impact on patients’ lives of living with these conditions?

Because they can’t afford the cost of surgery, many patients wait years before having their hernias repaired. They live with chronic pain. In addition, the economic impact on families can be profound. Patients with hernias are often unable to work full-time, reducing their ability to grow or purchase food and to pay school fees for their children. If surgery for children is delayed, the hernia may become incarcerated or strangulated, cutting off blood supply to the intestine.

What cultural or regional factors affect the treatment of these conditions?

There is no historical, regional, or cultural significance to this condition. Surgery is often delayed because of poverty.

What does the treatment process look like?

The patient is typically admitted to the hospital one day prior to the surgery to be assessed by the surgeon and anesthetist. At Bwindi Community Hospital, surgery for hernias is conducted under general anesthesia. The Bassini hernia surgical technique is used for inguinal hernias. An incision is made in the area of the hernia, and the defect in the abdominal wall is identified. The edges of the defect are brought together and sutured. The skin incision is then sutured, the wound is dressed, and the patient is taken to the recovery area until stable. The patient will typically remain in the hospital for two days post-surgery. The patient will be discharged on the third day and return for followup after two weeks.

What is the impact of this treatment on the patient’s life?

After rest and healing, the patient will be able to resume normal activities. Long-term complications in children may be avoided.

What potential side effects or risks come with this treatment?

There are always risks with anesthesia, especially in children. The surgical repair procedure is simple and effective, and the risk of complications is very low.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Hernia surgery is only available at hospitals. The nearest alternative hospital is more than two hours away. Patients may live anywhere from 2 to 50+ kilometers away from Bwindi Community Hospital. They may walk or take a taxi to the hospital. Normally, they learn about Watsi from the community health nurses.

What are the alternatives to this treatment?

Adult patients may wait years before seeking treatment because they cannot afford the cost of surgery. Alternatives may include pain management medicine or abdominal support. Some patients may use herbal medicines or treat themselves with ash to relieve pain and reduce swelling.