General Medical Surgical

Upcoming book.

A few years ago I wrote a book, probably better called a booklet, for my students as they began their clinical surgical courses in fourth year of a six year course. It was relevant to their situation with lack of facilities and language difficulties. Their ability to read thick tomes was limited, so I tried to put the very relevant stuff in a compressed form. As I meet a new era of Western students sold on investigations, sometimes seemingly before physical examinations, I’m convinced that it may be of use to them also.

It is due to be published as an ibook on November the 27th.

The introduction reads: –

I am pleased to commend this practical surgery help book written by Associate Professor Barry Hicks. 

Dr Hicks is a surgeon with vast surgical experience in both Australia and Ethiopia, having taught, conducted clinical work, and operated in a number of hospitals throughout Ethiopia over a 50-year period. Dr Hicks has included photos from his extensive collection accumulated over his years in Ethiopia and this is therefore unique as it included many photos of advanced pathology seen in rural Africa. While this is a small book written initially with Arba Minch medical students in mind, it is packed full of practical surgical tips for students and doctors alike and it may be of help to many in training.

The format is that of a very personal but practical description of what information is common and important, as well as other lists and facts covering many areas of surgery. It takes a systematic approach to the human body and surgical conditions. It is small enough to sit in a medical student’s or doctor’s pocket or be loaded on to a phone so that it can act as a ready reference for both elective clinical ward work and the emergency situation. It should be read, memorised, and kept handy for refreshing knowledge as needed. 

As a surgeon working in the DR Congo, who has regarded Barry Hicks as a mentor for many years, I commend this booklet to you.

Dr Neil Wetzig AO; FRACS; FRCS (Eng.); FCS(ECSA)

Consultant and Advisor of Surgical Training Programs, HEAL Africa Hospital, Goma, DR Congo

Barry Hicks

General Medical Surgical trauma Uncategorized

Alternative medicine


Working in Africa you were in competition with other forms of ‘medical practice’. There were witch doctors who sometimes caused us great difficulties. One case that I remember very clearly was a pregnant woman at term who presented in severe shock and bleeding heavily from a placenta praevia. After urgent resuscitation with IV saline as we waited for blood for transfusion her haemoglobin when checked was 3Gm/100mls, about 25% of normal. I have no idea of what her haemoglobin was before she started to bleed but suspect that it was low or she would have been dead. We were very short of blood and there was no blood bank in the area and, using the 2 units available, I quickly did a Caesarean. (She was nowhere nearly fully dilated.) The baby was dead. She survived.

As a first choice she had gone to the witch doctor who sacrificed a goat which she provided. He got the meat, she had to drink the blood to appease the evil spirit causing the problem! It hadn’t helped.

Then there were local healers. I have no doubt that they often did good. A high infant and maternal mortality in the country is a warning that a better system is necessary. But where I mostly met with their failure was in their treatment of fractures. Their major approach was to use external fixation with strips of bamboo tied together very tightly with string. They didn’t have Xrays; they didn’t understand the practice of fixing the joints above and below; they didn’t know how to assess the potential excessive tightness of their fixation with possible nerve, vascular and necrotic problems. They surprisingly didn’t seem to have learned that fractures swell in the early stage of the healing process. We have been ingrained with the 5P principle, watch for – Pain, Pallor, Pulses, Paraesthesia, Paralysis. They do not understand this. They didn’t understand early mobilisation. Therefore we faced initially necrosis with gangrene +/- infection. Then stumps where the limb had dropped off, contracted joints, extreme sepsis etc.

Amputations performed, because of infections, usually had to be of the guillotine type with refashioning when the situation was better controlled. Occasionally on examination of the amputated dead limb we could not find evidence of a fracture. I will show you a few as they presented.  Some of the pictures are a bit nasty. It was rare not to have one or more in the ward every week.


Introducing myself


My name is Barry Hicks. I am a retired surgeon who worked as a surgeon for 50 years – half that time in Australia and half in Africa, mainly Ethiopia. I have thoroughly enjoyed my life as a surgeon. In Ethiopia I was associated with a Christian mission but worked most of the time in a government hospital or as an Associate Professor in two of their Universities. We saw many things not commonly seen in Australia.

I have been married for 57 years to Robin. We have 7 children including 2 ex-Ethiopian, now Australian, young men. I retired from Arba Mintch University at the end of 2017 and we now live in North Queensland on a small farm.