We are hoping to be able to broadcast live that morning back to the telemedicine center at UCSD. That was my major assignment for this trip to make the tele broadcast work. Upon arrival and unpacking I figured out that I did not have the hdmi to dvi adapter that is required to hook up the unit to the monitor. Without that I cannot see what I am doing in order to get things up and going. When I realized that this peace of equipment was missing my heart sank. How could I have forgotten this? I double checked that all the wires and cables we needed were in the box more than once. I took the equipment out multiple times also but not once did I think of looking for that adapter. The adapter screws into the back of the monitor and the last few times I broke it down I just left it screwed into the monitor. I started to run through my head how on earth I could have left that at home and where it could have been. I took a deep breath and looked through all our boxes once more. I was not expecting to find it but had to make doubly sure it was not there. Yet another lesson even two to be learned here. Always make a packing list and tape it to the inside of the box so that I can ensure this will never happen again. Lesson two letting go. I wanted to cry for a brief moment when I realized we would not be able to run the show without this. Breathing in and out I let go of these thoughts and the new thought that entered was “The Magic of India”. I went right to the tech support people that were here to help us and told them I needed this piece and asked them if the knew where we could find one. Then I also relayed that if we could not find one any flat panel hi definition television would work. The set out to try and find this for me. Another issue for the broadcast was the internet connection. When we first arrived it was getting 28megabits per second down and 03 up. It was also dropping the connection every few minutes. When I first looked at the computer set up here I had to reconfigure the network wetting because there was no working internet connection. Once I reconfigured it I was able to test the speed. It is hooked up through a dsl modem. After figuring this out I once again went to the IT crew and asked them if it was possible to get the internet running any faster. They told me they would work on this but it would probably take 3 days to make it happen. Without a faster speed we would not be able to live stream with our equipment. Once more I breath in and think “The Magic of India” and left them to figure out their work.
I set out on my task at hand, I had to find someone who would interpret for me and translate so I could find the families with the 3 patients. I found Sanjay and communicated to him my needs and he told me we would go over to the other building where they had a pa system set up he would make an announcement so we could find the families. I went back in the breakroom and got C. to come take the photos while I did the interviews. We set out to the other building and the calls on the pa were made. It took a few minutes but the first two families appeared in the reception area where we were standing. I intereviewed and this is the information I came up with.
- 1. Pawan Patel is 8 months old 9 kg male, Left Cleft lip repair. He and his family live in a town called Rithi. It is a 3 hour bus ride into Damoh. He is here with his 25 year old Mother, Raina, and maternal Grandmother. They heard about the surgery clinic at a fair festival celebration in their town. They got a handout from a booth. They say this surgery is going to change his life for the better and are very thankful to have the opportunity for the surgery because they could not afford a surgery like this. The father is a laborer and could not come because he was at home working. They have one other son who is 3 years old.
- 2. Mantri Kushwahar is a 9 year old 19kg male, Palate repair case. He and his family are from Fatehpur which is a 6 hour bus ride into Damoh. HE is here with his father, who has one other son. He is a Vegetable Vender but does not grow the vegetables only sells them. They came here for a previous surgery in 2007 with leap and during that time the fixed the cleft lip and also his right forefinger was burned and contracted so they fixed that also. He is in his second year of school studies and brought his books so he could study for his tests when he gets back home. His favorite food is Apple and his favorite game is pulling a tractor around on a rope, he drags it behind him. When he grows up he wants to become a doctor. When I asked him how he feels about the upcoming surgery he said he is happy about it and very thankful that he will be better.
- 3. Sibendra Patel is eleven months 20 days old 8 kg female. She is here with Father and Mother who are 26 and 24 and have been married for 4 1/2 years. This is their first child. They live in Rewa which is 4 hours to Damoh by bus. The Fathers younger brothers wife is here with them and they are staying at their house. Father works at HeroHonda the motorbike company as a packer. They expect that this will change their child’s life forever and make it better than ever before. There are no other children with clefts in their village and this is the first one in their village and all the surrounding area. They have no worries or questions about the surgery as they are putting their child in the hands of the surgeons.
We had a lunch of what they called fajitas. It was the flatbread they make with chicken and vegetables inside. Also there was a chicken broth and a little dumpling place in a cup for us to drink. I am really enjoying the food here. Everything I have eaten has been good. I love the curry potatoes and spinach stuff they make.
Throughout the day the hospital staff are really great about offering us tea and drinks. There is a fridge stocked with bottled waters (Aquafina) and bottles of Pepsi, Mountain Dew and a few others. The Masal Chaia tea is so great.
The day continued on and it was getting rather warm outside. We had air conditioning and a fan running in the medical hospital. The break room managed to stay at a fairly nice temperature. As the day went on I started giving should and neck massages to the crew. By this point everyone was getting pretty sore. Doing multiple surgeries one on top of another with limited amounts of supplies and equipment is really draining. They were all so appreciative of the massages. After that I returned to editing pictures.
Next thing I know Doc comes in and says to me, come in here I need your help. I drop what I am doing and go into the OR3 room. There is a patient on the table and she says to me scrub in I need your help. I had to pee and should have gone before coming into the room but when she called me it sounded urgent so I didn’t dawdle I just rushed over. I scrubbed up and got my gown on and prepared to assist. Patient was a 22 year old male with a major burn. He was deaf and could not hear, I think if I remember correctly there may have been some sort of explosion and that is how he was injured. His burns happened two years ago. I am not sure if he lost his hearing due to the accident or he had hearing loss before that. The portion we were working on was trying to free up his shoulder so he could lift his arm. Doc made the incisions and started to free up the arm. I was pulling on his arm and using a great amount of force to stretch his arm up. eventually she got down to the ligaments and then went to work on the skin graft. She had to cut across his lower abdomen almost form hip to hip in order to get enough skin to close the wound under his arm. Eventually Dr. R came in to assist in sewing up the skin graft while Doc worked on the abdomen. Once the patient was closed up they put a cast on his arm and he was ready to be woken up. The next obstacle was that he needed to be in an upright position and they didn’t have a medical bed that could do that here. So we had to improvise and quickly. In comes Mr. Sony! Mr. Sony is super fantastic he is so creative and handy. He came in and then tied a stool up on the gurney and put pillows behind it to make it a functional upright spot they could transfer the patient to. Eventually the patient was slowly becoming awake. It was very difficult not being able to talk to him as he came to because they wanted him to be still and not thrash about so he didn’t rip open his stomach sutures. They got him transferred and into the recovery room and then the nurses from the hospital staff said they would stay with him because they could not safely transfer him to the other building where the rest of the post op patients were.
The rest of our crew cleaned up and loaded on the bus to go home. Word was that G had been throwing up and was increasingly more sick. She is also diabetic which can create additional issues. Everyone was in a hurry to get back and check on her and see how they could help her. Doc ended up staying with the patient as well as the two anesthesiologist N and L. Everyone else traveled back home on the bus for dinner. It was just after midnight by the time we got home. We ate and the doctors went to check on G. They ended up draining the abscess and hooking up IV fluids. After eating we al went to bed. By the time I got to bed it was after 1 and I hadn’t seen Doc so I have no idea when she got home.
We woke up in the morning to find out that another of our team was ill and had diarrhea and vomiting. J had been sick since 2am and so they started an IV drip on her and gave her some Zofran and anti-biotics. While everyone was organizing the plan for the morning I went to find someone to open the office so I could get schedules printed up for the day. I got that taken care of and Doc was working on the powerpoint presentation. I had to email it off to the people back in the USA she was arranging the conference with. The power goes out here at least once every morning when everyone gets up and starts using appliances and turning on lights and such. That kicks the router off and I have to get them to open up another locked door to reset the switch for the router. Every door here still uses skeleton keys and its quite funny watching them try each key to figure out which one works. I am sure the ones who use the office know which key it its but I usually find anyone I can grab to open it for me. While I was working on this a plan was created to move G to the OR in order to clean out the abscess. J was going to be staying here and would need someone to look after her and change out the IV fluids. I was designated that person because S. had done it the day before. S told me she would come relieve me at noon so that I could go out on the trip outside the hospital compound to take photos. We, C, J and myself were supposed to be taken out into the town to take photos because it was going to be an active day at the market. Tuesday is the day that everyone takes off here which is why we didn’t go yesterday. Anyway sitting here has given me the ability to update the blog and type this out. Now I am going to go find the wifi connection so I can send it to you all:-) So far I am feeling great and doing wonderfully, lets hope I stay a part of the group that doesn’t get sick!
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