Today was the day that we could not help. As surgery goes on over in the birthing center, I see patients in the clinic; screening potential surgical cases, seeing patient that the local doctors do not know what else to do for, and seeing women with pelvic complaints as I am the only female doctor in the clinic. Today I saw many patients that I/we could not help. Despite the fact that we are doing more complicated surgical cases this year, we are still working with limited supplies and technology. Several patients presented with very advanced disease making the cases too difficult to perform in the clinic. A woman presented with a thyroid goiter the sized of a large mango. Unfortunately this was too large to safely do in the clinic. Other times the patient requires more workup than can be done at the clinic. We had to turn away a young man with a palpable firm pulsitile mass in his anterior lateral neck, the size of a grapefruit. With only an old ultrasound machine for diagnosis, a neck exploration was beyond our means. And yet others were turned away as we lacked basic equipment such as x-ray, lab, and equipment to do rectal exams. The examples are too numerous to list. All of these cases and more could have been easily treated back home. To look into the patient’s eyes and to tell them that we are unable to help them as the tears well up in their eyes was heart breaking. To them we were their hope. Some had already been seen at the hospital and could not afford care, and others felt that they could get better care at the clinic as the hospital census is 144% and the bed count is over 900. I only pray that they obtain peace with their ailment and that their smiles return to their faces.
JAMBO (hello) from Nyakato where our team has finished the third day of work and is “getting in the groove” with our life here. Each day is more amazing. Just think of us as out camping with lots of friendly people and a great cook named Lucy who makes our meals! Before we tell you some of today’s stories, we’ll fill you in on the surgeries we’ve been doing and those that are planned.
This year we’re privileged to be the first surgical team using new facilities known as the Birthing Center (no actual deliveries there yet.) The building is new and spacious with generator power so that we have constant electricity, as opposed to the more typical sporadic power supply. On Tuesday 3/20 the surgical team cared for 4 inguinal hernia patients and one epigastric hernia patient. Eric Brekke not only performed surgeries but also taught students and killed a wasp in the OR! The next day we also completed 5 surgeries: a 6-year old with a neck mass; a 128 kg woman with a large ventral hernia (I needed to intubate both of those patients); a woman needing a deep axillary lipoma resection; another inguinal hernia; and a breast biopsy.
Today we began our surgical day with Bertha, a 36-year woman with a sizable goiter who needed a left thyroid lobectomy. Everything went flawlessly! She had no complications whatsoever and told Sally she’d been praying for months for people to come help her. Bertha was concerned that she had nothing to pay us with; Sally replied we just wanted her smile, which she readily provided. When Lori got Bertha ready for discharge, she told Lori: “Today I thought God might claim me.” Lori remarked: “It seems like God wants to keep you here now” and Bertha quickly responded, “ I have seen God through you.” After completing another epigastric hernia repair, the surgical team also attended to 3 patients needing keloid excisions — including one 8-year old albino patient.
Tomorrow, Friday 3/23, we have 3 surgeries planned: an open appendectomy, an abdominal hysterectomy, and a deep wound debridement. Two more abdominal hysterectomies are already scheduled for Monday. Kathleen is still wondering what happened to the minor surgeries she expected when she signed on to be scrub nurse! Eric’s excellent surgical expertise is in great demand.
Keith and Kevin kept busy with painting projects today while others (Cheryl, Sally, Sandy, and Hannah) visited a school run by the Compassion organization, where the children sang and counted for them. Cheryl and Hannah have been wonderful helpers in the surgical area: Kristy has been delivering thorough care and education to patients in the Clinic as well as lining up our daily surgical schedule; Rosie, Kathy and Sue keep things humming in the OR; Sandy, Sally, and Lori attend to all the needs in the pre-op/post-op areas; and Jeff is a great help wherever needed.
A daily highlight is our walk into Nyakato after our work is done. On our way to an outdoor place for cold drinks we pass dozens of people at work and play: schoolchildren in uniforms who want to shake our hands and practice English; local young men working at a sawmill and welding shop (all open air businesses); street vendors; pre-school children wanting their pictures taken — the rugged dirt and rock road is filled with people, roosters, mopeds. It’s quite a sight and beyond words to describe: you’ll have to see our pictures!