Today I worked with Grady Arnold, an experienced surgeon from Tennessee, who has volunteered for the past 13 out of 15 years. We repaired two cleft lips and one cleft palate. A fourth child had respiratory difficulties in the OR and was rescheduled for Wednesday. All of our patients from yesterday look great. The cleft lip patients went home this morning, typically a 1-2 hour ride in a “matatu,” public minivans that are typically packed with twelve or more people. Some patients travel from Somalia, Ethiopia, Tanzania and other places throughout east Africa.
Our case load is noticeably lighter this year, and we feel less pressure to work into the evening. According to pediatric surgeon and full-time missionary Dan Panero, cleft lip and palate services have become much more accessible to private patients, but we are the only remaining free clinic in East Africa. The availability of missionary otolaryngologist Tom Boeve makes it possible to even follow up the ear diseases which are ubiquitous with cleft palates.
The operating rooms have been improved greatly since 2009. The rooms are as large as US orthopedic rooms, with modern anesthesia machines and good lighting. Central sterile supply and recovery areas are consistent with US standards.
The patients still are housed in open wards. The main ward holds 24 beds divided among four cubicles. I cannot imagine how difficult it must be for the babies and their mothers to sleep in such crowded conditions.
Very little is wasted in Africa. Disposable items like electrosurgical hand pieces and grounding pads, and anesthesia masks and circuits are reused until they fail. Saline is dispensed to the OR table 60 ml at a time. Five sponges are the usual allotment. Sutures are scarce, but I think we will have everything we need. Cleaning and reusing conserves resources, reduces landfill, and creates jobs. We can learn from this.
I found a location higher up the mountain where I have adequate cell coverage to upload my blog and photos. There is still no high speed internet service, and exchanging Emails and Facebook remains touch and go. Electricity has not failed yet this week. I was a little disappointed last night when I was soaped up and ran out of water. Not hot water – the water stopped completely!
Saw our first monkey today – crossing the road outside our house.