Mansoura Egypt Cleft Lip & Palate Surgical Volunteers International October 2012

This year my path to Egypt took me through Zurich. 

I flew Swiss International from Zurich to Cairo (here’s a picture of the flight over the Alps). They hand out chocolate bars in economy, a big improvement over the pretzel bits you get on US carriers. 

After arrival in Cairo we waited for a second wave of team members and then loaded up and headed for Mansoura. We had a good turn out for clinic the next morning. Here’s a video of the waiting room, fairly early in the morning. The man in the hat was a character; I saw him later that week when his relative had surgery. The waiting room in Mansoura

 The evening after clinic we went to dinner at a club along the Nile. On the way back we passed a circus, but were too tired to go in.

 I can’t say enough good things about the medical students in Mansoura. They were helpful in clinic, well prepared in basic science and eager to get some clinical experience. Dr. Laura Monson is an excellent plastic surgeon with cranio-facial experience and there was always a crowd around her table. I didn’t have much of a view but I could watch the bag move up and down.

I talked about the technique of direct laryngoscopy and tracheal intubation all week and on our last day I let one of the students go after it without me beside him. This is how we did it: an inhalational induction with oxygen and volatile anesthetic, followed by an IV under deep inhalation anesthesia. I do my own laryngoscopy, to make sure there are no surprises, and spray lidocaine on the vocal cords. 

Then I gently control ventilation until the patient is apneic. At that point I hand the laryngoscope to the student and walk to the end of the table. Holding tightly onto the table, I breathe slowly and don’t let go until the pulse oximeter reading falls below 94%.

Here are some photos of the students at work. I gained a new understanding of co-operative learning. And, yes, they got the child intubated.