Anesthesia in Developing Countries: The Road to Entebbe

After a leisurely morning packing and a quick trip to Target (bless the Daytons, they stock insect repellant in December for people like me), I showed up at the Delta counter two hours before departure. The airport was nearly empty. Once the counter agent and I came to an agreement: Kevin Healy's bag to Uganda, Daniel Healy's bag to India, the rest of the check-in and security screen was a breeze. I'm going to spend a week in Kampala at a course entitled Anesthesia in Developing Countries. Grant Maxted, one of my anesthesiologist friends from Toronto, recommended the course very highly so I am keen to get started.

TERRAMOTO!!!

Wednesday is a market day in Nuevo Progreso, so clinic was busier than usual. There was a crowd waiting to register and Sor Veronica was at the head of the line, calling names and giving direction.We had three operating room cases today: removal of a scalp lesion, tonsillectomy and cholecystectomy. The list was completed by 10:05. 

Line up for registration on Wednesday morning

Sor Veronica calling names for clinic patients

On the way back to the dorm I worked up the courage to try a bit of ice cream from the street vendor. Small serving but tasty, and for Q2 you can't beat the price. 

 I like the pictures on his cart at least as much as the ice cream.

 The earthquake struck about ten minutes later. It was a pretty vigorous shake, lasting about fifteen seconds. I kept expecting the quaking to diminish but it got stronger until the walls were perceptibly moving and a couple of the big terra cotta flower pots on the sun deck tipped over. 

As I type, this plant is being watered by our afternoon down pour.

 No structural damage, no injuries for patients or staff. Tara Starr, one of our ophthalmologists, had to complete a blepharoplasty by flashlight. No one was undergoing cataract surgery at the time.

Tara looks pretty relaxed (and just plain pretty!) after performing surgery under trying conditions.

A couple of bottles broke in PACU and a package of Beaver blades fell on the floor in the operating room. At the behest of the local authorities we spent two hours at the soccer field, a precaution against after shocks. We felt pretty silly when we came back to find that the Guatemalan doctors had been seeing patients all along. It's been quiet all afternoon so I hope the excitement is over. 

A member of the Hospital de la Familia board of directors accompanies each team. Bill Stewart is our board member. He's a great guy, neither as old or as rich as Montgomery Burns. Their political views do align pretty closely,

http://www.youtube.com/watch?v=ltCIEbLMaQg

so it was a bit of a sad morning for Bill. Better luck next time, Bill! (Not really).

First Report from Nuevo Progreso

I had major misgivings in the days prior to our departure on November 1. Recruiting for the 2012 team was difficult. Mark Taylor, general surgeon from Ames and a stalwart member of the team since 2002, could not attend. Three of the four ophthalmologists from 2010 were not returning. None of the optometrists from 2010 returned. A plastic surgeon who was referred by a friend played cat-and-mouse with me through the summer and fall. In October he declared his commitment to the team and intention to join us, and cancelled 24 hours later saying he had an open house in his new office on November 7. I wasn’t mad; who hasn’t had an open house pop up at the last minute? To top it all off, our medical repair engineer cancelled the day before we were scheduled to leave USA.

The morning of departure didn’t look any better. I couldn’t find my shoes and had to sneak away in a pair of trainers I found in the bowels of the hall closet. My apologies to Kyle, Matt or Luke (they were last seen in a trash can in Coatapeque).  In Chicago I found out that one of the volunteers overslept and missed her flight from SFO.

  

After that last bit of pain the trip has gone very well. We got our twenty-one pieces of luggage checked in at Des Moines airport and they arrived intact in Guatemala. The customs people were a little confused. They had a waiver for another team and couldn’t find any of our drugs on it. Sr. Veronica saved the day and we were in the hotel by 11:30.

Enough about travel. Here’s a photo of Debbie Wise RN, Lloyd Smith MD and Amanda Poppe: all from Ontario. Amanda is studying kinesiology at Thunder Bay; Debbie and Lloyd are from Toronto. I hope no one in Iowa will tell Mark Taylor how good a surgeon, and fast, Lloyd is. Amanda is applying to medical school.

This is the view from the dining area, looking over Nuevo Progreso. On a very clear day you can see the ocean

This is a partial view of the open-air kitchen, newly remodeled since my last visit in 2010.

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Amanda is the head of the kitchen ladies. She oversees food preparation. She and Rosanne  hit it off while Rosanne was working on the Cooks' Dinner in 2008.

And these are the roasted peppers that we had for Monday lunch.