It felt good to be back at work today. We have quite a few more children to treat before we leave.
Today, Dr. Kirchner and I did three cleft lip procedures. All happened to be left sided, but each is different. I think that is one of the most challenging aspects of this surgery, it seems that each case is a bit different and requires thoughtful planning. One of the patients today was the little Maasai child that I wrote about recently. I hope to get a nice photo to post tomorrow. He looks very good and it is quite satisfying to see the physical change in his face, but also to imagine the difference this improvement will make in his life.
I’d like to share a couple of observations about working in a mission hospital in Africa.
One, you get used to sudden blackouts in the OR. There seem to be roving power outages several times each day. There is a brief period of total darkness in the operating room before the emergency generator switches on. For certain procedures, we wear headlights and so we can continue the procedure, albeit without suction or electrocautery. However, when we aren’t using a headlight, we just sit and wait. Most often, it only takes thirty seconds, though sometimes it goes on for longer, and always it seems like an eternity. I’m sure the pioneering missionary surgeons can tell better stories, about operating without electricity at all, etc. I just thought you might find this interesting and the photo below interesting as well. And, please note, I am not complaining about this hospital–it is fantastic. Everyone here has to deal with the power outages and the emergency generator does a great job.
Operating in the dark, only a headlight illuminates the operative field. This patient has a mouth gag or retractor in place and is having a cleft palate operation. Of course the retractor is only placed after the patient is completely asleep and the lips and cheeks are carefully retracted so as not to injure the patient.
Two, the mothers stay with their children, in the same beds. Now, this can happen in the US also, but typically US moms have packed their own clothes. In mission hospitals, the moms are seen wearing hospital gowns, as their only set of clothing is hanging to dry on the clothesline outside. After seeing the Maasai village this weekend, I completely understand. For many of these families, coming to this hospital is akin to a middle class American staying in a five star hotel–with food, clean water, clean clothing, indoor plumbing and a mattress. These are dedicated mothers who love their children, have traveled long distances and are often brought to tears when they see their darling babies after surgery. It is a privilege to care for these children and work with their mothers.
Three, there are multiple languages being spoken all around. Frequently we’ll have one translator going from the mother (who speaks a tribal language) to another translator (who speaks Swahili), to me (who speaks only English). In the OR, the staff speaks English when talking to us but Swahili when speaking with each other. And so, of course, we wonder what they are saying…maybe Swahili lessons are in my future…