Trip to Hospital

We are sitting in Orphanage, waiting to eat lunch. We will go to the hospital and do the pre op interviews. SO I AM UPDATING now in the dark at 4am from my room. The hospital was absolutely amazing. Nothing in my life in the USA could have prepared me for what I was about to witness. We rode in a car over to the hospital and I was in the front seat. I was able to record the 15 minute trip with Avery’s little ipod. There were people of all ages walking, riding bicycles, motorbikes, cars, other buses, trucks, never have I seen 4 people on one motorcycle before. They drive down the middle of the road because the edges of the road are filled with more holes than the middle. Using the horn to navigate and weave through all the traffic. There were cows walking around as well as goats and a few dogs. The driver told us that every cow is owned by someone and at the end of the day each cow knows where it lives and goes back to its owner. We saw one cow with what looked like a log that had been broken and never healed properly. One that had its horns painted green. It was quite an adventure just getting to the place.

Once we arrived we were greeted by a group of five men, There also were men holding flower lei’s not sure what they call them here, waiting to put them over our heads. The bus with the rest of the crew was still in transit so we decided to walk through the new hospital and check out where we would be setting up shop. We walked in and immediately I was taken aback by the smell. I couldn’t pin my finger on what it was exactly but very similar smelling to bug poison. We walked through looking at each room and laying out in our minds where things might be place so to make a functional operating room. There was one room with two operating tables, then a room like an office with a desk a computer a fridge and a couch, the door to the bathroom was also there. Down the hallway some more there was a smaller room to the left that had some equipment and led into another small room which had a sink and some shelves. Behind the room was another longer room with an operating table. Coming out of that room and back down the hallway a bit more and there was a large recovery room with many beds.

After viewing the new hospital we went back outside as everyone else had arrived and the people were anxious to greet us. We walked through a pathway lined with mothers, fathers, grandmothers, grandfathers, some holding babies and young children, some sitting on the ground some in plastic chairs. Hundreds of people. They were all clapping for us as we walked into the old hospital. This was quite a warm welcome.

Once inside everyone starting to set up where they would be seeing the patients. The 3 surgeons were in the front room and as each patient was called in they were weighed and given a file with afew forms. They were then seen by the surgeons and either scheduled for surgery or told they would have to come back for either the dental clinic or the pediatric clinic where they would learn more about how to support healthy feeding and nutrition. They had been given hemoglobin tests which check for anemia, before coming into the interview room with the surgeons. From what I am gathering it needed to be at least 9 for surgery but depending on their age and weight a little below 9 may have been acceptable. They were asked repeatedly if the child had been sick or had a cold or runny nose in the past month. These surgeries are very risky to do on a patient that is not completely healthy, if there is any respiratory illness previous it could lead to an infection that would easily kill them. In the US it would land them in the ICU and still could result in death if not a few weeks stay in the ICU. Not only for the safety of the child but for the safety of the whole operation and all of us who were there we could not have even the slightest doubt about the childs respratory health. In the beginning of the morning the parents seemed pretty honest about if the child was sick or not, by midday you knew that word had probably spread that they would not receive surgery this year if they were sick because everyone kept answering that the child was healthy even though we could plainly see snot or hear coughing. There were interpreters there helping the surgeons to communicate with the families. There were also a few burn patients with what they call contracture, meaning the scar tissue had made it so they could no longer extend or retract their limbs.

After passing through the interview room they were then handed off to anestesia who did a thorough exam, I wasn’t in that room much so I am not sure what all was entailed there. After passing through anestesia they were then handed off once more to more nurses who would advise them of when the surgery would take place and the instructions not to eat anything after midnight before the surgery were given.

A whole schedule of surgeries was made as well as a waiting list for cases that could be done if there was extra time at the end of the day.

In the early part of the day I attempted to set up the camera equipment. I went into the office and found a dsl modem connected to the computer. They had not even gotten it working so I edited the network settings and got the computer online. After testing the connection I found that we were getting 30 megabits per second download speed and 3 megabits per second upload. This would not work if we were going to attempt a live broadcast tele medicine conference. The guys who were working with me told me they would work to see if they could get the connection speed upgraded to a faster speed that would be suitable for working with. The other snag I hit was I was missing an adapter. I needed an HDMI to DVI adapter for the flat panel monitor we had. Coming out of the life size machine is an hdmi output. That is the only output on the new machine we got before we left. The old machine had a VGA output and boy was I wishing we had that back in that moment. I thought I had checked that we had all teh wires and cables and equipment necessary to perform the live broadcast set up, however after retracing I think that what happened was when we went to the College to perform out testing and pick up the new machine for traveling with the guy who was helping us set it all up and test it broke down the equipment when we were done and removed the connector from the back of the monitor. It is possible that I removed it but not as likely because I just left it attached to the monitor knowing I could not use the monitor without it being there. In any case I wanted to kick myself and wondered how the heck I could have over looked that. Needless to say I will be making a packing check list for the equipment box for future use. No sense in dwelling on the mistake but I felt horrible about it for a minute and then moved on to finding a solution. So I found that they have an electronics store in India that would probably carry such a thing however getting one here in time would probably be near impossible. The next line was to try and find a flat panel tv that would accept the hdmi cable. So I have the guy here who updated we that he would do his best to find a monitor that would work by tomorrow evening.

The rest of the day I was in the surgeons interview room where I did manage to get some video recoding done of some of the patients. There is someone else on our trip who is also recording and many of us who are taking pictures so I am sure I will have tons to share eventually.

The day seemed to drag on forever and the surgeons saw every last patient which by estimated count was over 225 of them. The order of patient priority goes from youngest to oldest, then females before the males usually because the females wont be able to be married off or get their dowry if they are not fixed. There was a 24 day old baby we saw who I think may have been the youngest but they cannot do the surgery until they are at least 3 months old here. Many of the kids were soooo small, underweight and probably malnourished, and many of them with anemia.

The nurses set up the OR rooms and then came to help in the interviewing process and then one group was

I am sure I have many more details but time is already running short we will have to get to breakfast at 6:30 and then off the the hospital at 7 to start a long day of surgeries.