With the hospital’s entrustment, advices of my relatives and friends, I, as a member of the 17th batch of Chinese Medical Team Assisting Seychelles, followed the footsteps of my predecessors and arrived in Seychelles safely after 15 hours of flying on September 15, 2018. As a 50-year-old orthopedic surgeon and a communist of many years’ standing, I have been sticking to the belief of “keeping our mission in mind and never forget our original intention”. We started our works under scattered living and unsafe conditions, without a translator and cook. Our practice demonstrated the friendly spirit and superb skills of Chinese doctors, as well as the demeanor of the people in the Second Hospital of Shandong University.
Arrival of the 17th Batch of Medical Team Assisting Seychelles in Seychelles on September 15, 2018
On September 26, 2020, we overcame various difficulties under the epidemic, and successfully completed the foreign aid tasks assigned by our nation. As the leader of the foreign aid medical team and temporary party branch secretary, I led the medical team back to China by a chartered plane of Hunan NO.6 Engineering. In the past two years, under the leadership of the Chinese Embassy in Seychelles, the National Health Commission and the Health Commission of Shandong Province, we have inherited and carried forward the boundless love spirit of Chinese foreign aid medical care in Seychelles, an island country in the Indian Ocean. With active working, pioneering and innovating and selfless dedication, we have made significant progress in political and ideological work, foreign aid medical care, diplomatic propaganda, anti-epidemic and life.
1. Political and Ideological Work
In the days of foreign aid, I always set strict demands on myself according to the communist standards, strengthened my political and ideological study, worked hard to adapt my ideological level and knowledge accomplishment to the requirements of the development of the new era, and kept consistent with the Central Committee of the Communist Party of China in thinking and actions. I worked conscientiously and proactively, and devoted to my duty by keeping a clear mind in dealing with matters of great importance, never being perfunctory in minor matters, and strictly abiding by disciplines for foreign affairs as well as all rules of the medical team. We kept in mind the great trust of the Communist Party of China and the motherland, assumed our mission and responsibilities, served the people of the countries receiving our assistance wholeheartedly, and interpreted the spirit of the Chinese foreign aid medical team of “being fearless of hardships, willing to contribute, healing the wounded and rescuing the dying, and showing the boundless love” with practical actions.
2. Healthcare Work
Our medical team consists of 6 people, with Cardiologist Li Zhiyuan and Radiologist Yang Yuhai working at the Victoria Hospital, Seychelles, and the other 3 acupuncturists worked at the Northeast Branch. The Victoria Hospital is the largest hospital in Seychelles, with eighty to ninety percent of its doctors and nurses from foreign countries, mainly Cuba, India, Sri Lanka and others. Total 6 orthopedists, one from Morocco, one from Cuba, one from Russia and two local junior doctors, are responsible for the whole orthopedic work across the country, including on-duty, outpatient, surgery, and ward rounds, which is a huge amount of work. Since doctors come from different countries and the professional quality of the personnel varies, I have been continuously improving the surgical methods and treatment ideas of local doctors, which earned unanimous praise from patients and local doctors at all levels., and adopting improvement suggestions, with various types of surgery taking the lead in Seychelles. Meanwhile, I have also updated the plaster fixation concept that has been adopted in Seychelles for many years. Seychelles people like sports, and because as an island country, local people drink rainwater, they are prone to suffer from osteoporosis. There are many patients with limb fracture, especially in forearms and ankles. They used to be treated with over-articulation plaster external fixation with relatively long time of fixation. Considering the common skin problems caused by local hot weather, as well as worse swelling and dysfunction after plaster removal, neither such overarticular fixation nor the plaster cast is necessary to this kind of distal fracture, and the simple plaster slab can meet the need. After observation of many cases, the simple plaster slab has been widely adopted at present, which reduces the disability rate and other complications. I had advocated minimally invasive surgery to reduce tissue trauma, especially in areas with poor blood supply, such as the rupture of achilles tendon. If the tissue is damaged during surgery, the achilles tendon may not heal well and skin tissue necrosis may easily occur. A national-level female badminton player in Seychelles completely ruptured her achilles tendon during the training. I arranged surgery as soon as possible, and performed minimally invasive achilles tendon anastomosis. Combined with rapid rehabilitation techniques, the wounded player could walk on the ground on the same day after the operation, and almost recovered to normal 2 months after the operation. The patient was very grateful.
Every Monday, Tuesday, and Wednesday are orthopedic surgery days, and generally, 4 to 5 surgeries will be arranged each time. Most surgeries are trauma and joint replacement surgeries, combined with several spinal surgeries, which is no more than 10 a year. Orthopedic surgeries are also rare. Compared with China, the efficiency in Seychelles is extremely low. The first operation may get started until being delayed to 10 o’clock, and with unsmooth cooperation and communication during the operation, overtime is the norm trend. Many orthopedic instruments in Seychelles have been abandoned in China more than ten years ago; meanwhile, we face the lack of supporting instruments, models, especially steel plates and intramedullary nails. The most dangerous thing is that AIDS, hepatitis and syphilis are not routine examination items, while it is inevitable to injury fingers considering the application of electric drills, electric saws and bone knives required for orthopedic surgeries, coupled with the unskilled cooperation between doctors and the gap in operation level. During a joint replacement surgery after I arrived in Seychelles for half a year, my right thumb was injured by a doctor’s hammer in the surgery, and the veins on the back of my finger were pierced by the sharp edges of the hammer. Seeing the blood gushing out of the broken glove, the first thought crossing my head was “how can I just die for the country under such circumstance, and it still remains a year and a half before I complete the task.” Finally, after a week of anxiety, I was relieved when the patient’s HIV test came out to be negative. However, there is no guarantee that I’m totally clear, long-term observation is required. After nearly a year of work, I have won the praise of my peers with my excellent technique, especially the only severed finger reunion in Seychelles in the whole year.
The Seychelles Hospital only accepts patients referred by the community. Usually, I worked in outpatient clinics on Thursday mornings, with 30 to 40 patients at a time. All the patients have made reservations in advance. The outpatient nurses and auxiliary staff there wear work clothes, while instead the doctors wear their usual formal clothes, which may aim to narrow their distance with patients. It is very difficult for patients to see the outpatient clinic of specialist physicians, in which case, they may have to wait for one month. However, they trust doctors very much, and get treatment directly after the diagnosis, without further explanations. Although the whole treatment is free, they may fail to get timely treatment for many diseases due to 1-3-month in-queue time for CT or MRI examinations.
Taking a Small Plane to Make a Round of Medical Visits to the Outer Islands
It is a hard and unprofitable job to make a round of medical visits to outer islands, so it is inevitable that local doctors are reluctant to do this work, while, we are here for assistance, and we take no remuneration for all works, so this work is basically undertaken by Chinese doctors. As a 50-year-old doctor who doesn’t speak English in China, it is also a challenge for me to travel alone for a round of medical visits in outer islands of a foreign country. There are two rounds of medical visits per month, with one day in the middle of the month, and two days at the end of the month. In order to take the earliest small plane, at 5:40 or 6:55 in the morning, we need to get up shortly after four o’clock, and then take the car dispatched by the hospital to the airport one hour in advance. We will fly to Praslin Island first, and then go to La Digue by boat. There are a lot of outpatients, usually being more than 30, most having made an appointment in advance, as well as some patients who came under emergency cases. In the afternoon, we will return to Praslin by boat. After completing the work of the outpatient clinic in the next day, we will take a small plane to return, which is really drudgery. The first time when I went to Praslin for a round of medical visits, I missed the return flight because there were too many patients. I waited for 4 hours at the airport, and finally took the last return flight under the help of the airport. In Seychelles, I could fully appreciate the slow pace. It is common to wait for a transfer vehicle in the airport for two or three hours. Many people may never take this kind of small planes. It just likes a tractor in the countryside, rumbling with a loud noise and flying at very low altitude. When the plane flies across the clouds, I always get nervous, and my ears were still singing even after getting off the plane. Although this work is a hard one, it is an easier way for the Chinese medical team to spread the Chinese voice and show our selfless dedication. Whether in the airport, docks, hospitals, hotels, or islands, you can feel the local residents’ warmth to us. I can always hear the lousy greeting of “Hello, Doctor!” I have fully experienced the confidence and cultural self-confidence brought by the strength of China when we are abroad.
Skin Traction for Pediatric Fracture of Femoral Shaft in Emergency
In the medical team, only Yang Yuhai and I needed to work on night shifts, namely, only one Chinese doctor, he or me, worked at night. Every month, we had to work on duty for 7 to 9 24-hour shifts, and even more than 10 such shifts when other doctors took a vacation. During the Christmas Holiday in December 2019, two doctors left on vacation, and I worked for 5 24-hour shifts in 10 days. The on-duty phone received calls from all over the country, the deluge of various accents sometimes made me feel confused. On weekends, most patients in the clinic would be referred to the hospital, resulting in a busy shift. My colleagues often told me that these patients should go back to the local clinic for treatment. However, when we saw they had been transferred to our hospital, we couldn’t bear to refuse them, but gave them treatment. Different from China, where treatment will be carried out according to detailed sub-specialties, the orthopedist in Seychelles needs to be versatile, even including treatment for children, which is a huge test on the basic skills of the orthopedist. In case of challenging pediatric patients with very complicated diseases, I often sought advice from Wang Ruoyi, an expert in the Pediatric Surgery at the Second Hospital of Shandong University.
Giving Lectures on Safety and Disease Prevention at Chinese-funded Companies
For the Chinese abroad, instead of any hardships, illness is the most horrible thing. Therefore, we frequently offered free clinical treatment, conducted health examinations, and provided guidance for them at the aid project department during their vacation. All foreign aid medical teams that ever dispatched overseas have undertaken the health care work for Chinese personnel abroad. At present, besides the Chinese Embassy, the Economic and Commercial Counselor’s Office, the Confucius Institute, the medical team and other foreign-related institutions in Seychelles, there are also branches or project departments of companies such as CNQC International, Shenyang Construction, Sinohydro Corporation, Huashan Construction, Hunan NO.6 Engineering, most of which are undertaking the construction projects in Seychelles aided by China. We conducted free clinical treatment for Chinese construction companies in Seychelles one by one in their off-duty hours. Such free clinical treatment aimed to get a preliminary understanding of the health status of the Chinese staff of the construction company and provide corresponding health guidance, medication, acupuncture and other treatments based on their own health conditions, thus ensuring their physical and mental health during their work in Seychelles. Meanwhile, we provided detailed answers to some health problems and doubts raised by the workers. Seychelles has a typical tropical climate, and most of staff coming to Seychelles can adapt to such hot and humid climate only after a period of time. In view of these existing situations, coupled with our own experience and professional knowledge, we would give them corresponding guidance on life and health, so that they can get through the adaptation period quickly, devote themselves to work, and contribute to the friendship between China and Seychelles.
In order to well protect the health and life of Chinese in Seychelles, our medical team members are accessible in 24 hours without turning off our phones. For construction companies, trauma is part of their daily work. In Victoria Hospital, where the efficiency is very low, it’s normal for patients, who suffer from no life-threatening symptoms, to wait 2 to 3 hours even asking for the emergency treatment. With our medical team in Seychelles, they can see a doctor and receive treatment at any time. At around 6:30 on the morning of February 20, 2019, a truck, registered to a Chinese construction company, with 21 construction workers and 1 driver mainly from China and Bangladesh on board, rolled over on a road near the Seychelles Industrial Zone when the truck driver tried to dodge a Seychelles private car that suddenly lost control in front of it. All people on the truck were injured to different degree at this car accident. I rushed to the hospital to assist in the treatment of the injured people, and performed operations urgently on two patients with clavicle fractures and one patient with tibia fracture. Two months later, at 6 o’clock in the evening, a worker from the same company had his right hand damaged while cleaning the mixer. I came to the hospital in haste for debridement and repair. After more than 4h operation, I successfully saved 3 fingers of him. At 8 o’clock on the night of August 21, 2020, a famous patriotic overseas Chinese fell accidentally and caused severe pain in his left hand and upper limb. Considering his donation of 5 million yuan in cash and a large amount of epidemic prevention supplies to Wuhan during the anti-epidemic period, as well as his frequent help to the medical team, we still gathered urgently and rushed to the hospital even though all members of the medical team were in vacation that week. After Yang Yuhai carried out radiography for him personally, he was diagnosed as an unstable comminuted fracture, displacement, and compression of the left radius. Taking into account the medical conditions of the Seychelles Hospital, as well as the lack of suitable steel plates, we decided to perform manipulative reduction and external fixation, in which case, the bone defect cannot achieve anatomical reduction like a surgery can do due to bone compression. However, it is the most suitable treatment method under the limited conditions. Therefore, under the traction of Doctor Cheng Bin, we performed the reconstructive surgery, and the final effect was almost same to anatomical reduction according to the postoperative X-rays re-examination results.
3. Diplomatic Friendship
Spreading the Chinese voice, promoting diplomacy activities, and building a bridge of China-Africa friendship are also important tasks for the medical team. When I just arrived in Seychelles, colleagues in the department did not believe in the medical treatment level of Chinese doctors. I found that Dr. CHETTY went to the court two or three times a month, which turned out to be a medical lawsuit of orthopedic treatment. In Seychelles, patients will go to the court to initiate legal proceedings if they believe that the treatment results are not as good as they expected. Although the patients have basically never won the lawsuit, such lawsuits really put doctors in a more worried situation. Given such dilemma, I proposed the consultation system to them for patients with odd and difficult symptoms. For patients with difficult problems, we would save their contact information, and re-examine them in 1 week after collective discussion. One year after this system was applied, the amount of lawsuits was greatly reduced.
In the first week after arriving in Seychelles, I was greeted with skepticism due to language barriers, but my professional skills cleared all of such voice of doubt. For example, during a microendoscopic discectomy and fixation operation performed by the CEO of the Hospital and I, he tore the dural sac under the microscope, while I helped him to suture it. Such help reassured him that although we had just arrived in Seychelles and cannot communicate well, our excellent technology could also make up for it. When a surgeon major in joint replacement firstly started to conduct total hip replacement at this hospital after 11-years study in Cuba, he mistakenly installed the cemented femoral prosthesis as a biological prosthesis, which caused a fracture during the reduction, and it was me who assisted him in correcting it. Furthermore, the Cuban doctor used to perform reconstruction of anterior cruciate ligament under arthroscopy through open operation, while I instructed him to conduct closed reconstruction. Given the above-mentioned assistance, he was very grateful and gave me a thumbs-up. In another case, when I receive the request for reduction of broken forearms of a 3-year-old daughter of a general surgeon at 9 o’clock in the evening, although I was not on duty, I rushed to the hospital for reduction immediately after receiving the call, and the treatment effect was very good. Later, many relatives and friends of hospital staff, as well as staff from national departments, who had orthopedic diseases, also wanted to see me for treatment.
In April 2020, the traction bed slipped and hit my foot when I was treating a senile intertrochanteric fracture, leaving a hole on the surgical shoe, and I insisted on finishing the operation before taking an X-ray. The examination result showed a fracture on the fifth toe. Such kind of injury is normally classified as work injury in Seychelles, and the injured can have at least one month’s sick leave. Considering that the shortage of doctors in the Orthopedics Department, I limped to work after only 4 days of rest. Such selfless spirit further refreshed the image of our Chinese doctors.
VLADIMIR, an orthopedic surgeon practicing medicine at Seychelles Hospital for 1 year, is a junior orthopedic surgeon from Russia. Under my guidance, he felt that he had made great progress in performing orthopedic surgeries, and applied to study in the Orthopedics Department of the Second Hospital of Shandong University on his own initiative. Our department arranged Yin Qingfeng, a surgeon major in joint replacement with good English communication skills, to contact him and help him complete all procedures. Although his trip to China has been cancelled due to the epidemic, his action also increased the popularity of our hospital.
4. Image Promotion
On the afternoon of October 25, 2018, a 16-member CPPCC delegation led by Liu Qibao, the Vice Chairman of the National Committee of the Chinese People’s Political Consultative Conference, arrived in Seychelles for a four-day visit to the Republic of Seychelles. Officers of Seychelles Government introduced the history and current situation of the hospital to the delegation, as well as doctor training, foreign academic exchanges. Mr. Jean-Paul Adam, the Minister of Health of the Republic of Seychelles, said that Seychelles had the best medical level in Africa, and such level was inseparable from the outstanding contributions made by the Chinese medical team to Seychelles’ health cause over the past 30 years.
Liu Qibao Visited Members of the 17th Batch of Chinese Medical Team Assisting Seychelles, Accompanied by the Minister of Health of Seychelles, Chinese Ambassador to Seychelles and the Head of the Economic and Commercial Counselor’s Office,
Report on the Chinese Medical Team by Seychelles Nation Newspaper on October 1, 2019
Report on the Chinese Medical Team by Seychelles Nation Newspaper on October 1, 2019
During the National Day holidays of 2019 and 2020, Seychelles’ national mainstream newspapers published articles about the Chinese medical team on the NATION page. Since the Chinese government sent the first batch of medical teams to assist Seychelles in 1986, total 17 batches of medical teams have been dispatched to Seychelles for assistance, which has played a pivotal role in the local medical and health cause. The Chinese medical team, which has enjoyed certain reputation in the local area, is more valued by the local government and people.
Chinese Medical Team Participating in the Mountain-climbing Competition Held by the Ministry of Health of Seychelles
The locals are great fans of Chinese food, so I cooked delicious Chinese food at home regularly and brought it to my department for sharing with local colleagues and Cuban doctors, which was a good way to promote our friendship. In December 2019, we formed a team together with locals to participate in the round-island marathon relay. In February 2020, I participated in the mountain-climbing competition organized by the Ministry of Sports of Seychelles, showing the new look of contemporary Chinese doctors. Rich and colorful activities can bring the medical team closer with local people, and offer a more effective channel to popularize our medical team via all types of activities and local media.
5. Epidemic Prevention and Anti-epidemic Actions
Since the outbreak of the COVID-19 epidemic, I kept on working, and reminded my team members ceaselessly to pay attention to epidemic prevention and ensure personal safety first. Under the leadership of the Economic and Commercial Counselor’s Office and the Chinese Embassy, we worked closely with the Ministry of Health of Seychelles to face difficulties, and acted proactively by assisting Chinese-funded enterprises in Seychelles doing a good job in the prevention and control of the epidemic, organizing training of Chinese in Seychelles, and popularizing knowledge of COVID-19 prevention. We made every effort to build a solid barrier against COVID-19 for all compatriots in Seychelles.
In May 2020, during the epidemic, an important Chinese diplomat developed symptoms of pneumonia, with a high fever of over 39°C every day, suffocated breath, and failure of lying on his back. By virtue of all auxiliary examinations completed by the medical team, he was diagnosed as pneumonia, was admitted to the medical isolation ward urgently and treated as a suspected case of COVID-19. Thanks to the active communication and coordination between the medical team, the Chinese embassy and the Seychelles Government, he was excluded from the diagnosis of COVID-19 as soon as possible, and confirmed as mycobacterial pneumonia. Even though this case is out of the specialty scope of Doctor Li Zhiyuan and me, we insisted on make the rounds of his ward and contacted actively with relevant Chinese experts. After more than ten days of meticulous treatment, the patient got fully recovered.
Work Exchanges with Officials from the Ministry of Health of Seychelles at Chinese Ambassador’s Residence
Summary of the Work of the 17th Batch of Medical Team and Arrangement of Handover to the 18thBatch of Medical Team
After successfully completing two years of foreign aid work, I have been tempered in all aspects, with broadened horizons, improved English communication level, and proved ideological cultivation. After returning to my original job position, I will continue to carry forward the spirit of dedication, serve the people wholeheartedly, and make extraordinary contributions in ordinary positions.
{Author: Liu Zhonghao; Source: Human Resources Department; Editor: Publicity Department/News Center}