Thank-you SureFire

Dave Wood was able to obtain 4 LED headlamps donated by SureFire, manufacturer of the world's finest illumination tools and tactical products.  The SureFire system Scott is wearing on the right in the picture below is twice as powerful as the backpacking headlamp Zach is wearing on the left.  Not only is the lighting inherently poor in the operating room, we frequently experience power outages which makes it rather difficult to proceed and usually is in the patient's best interest for us to delay until the field is illuminated once again. 

We are most grateful for SureFire's contribution to our efforts.  You are encouraged to visit SureFire's website and check out their amazing and varied array of products.

Day 5 - It's A God Thing

Yesterday, the post of the day focused on the fact that there are so many wonderful characters passing through Hopital Adventiste d'Haiti on the volunteer trail.  Some come only for a day, others come and stay for weeks on end.  Today, there was an unique set of occurrences that exemplifies how valuable this potpourri of transient skills can be to this institution and its patients.

We started our day ready to perform a hemiarthroplasty on a 54y/o (referred to by the residents as elderly) male with a nonunion of a femoral neck fracture.  Pete astutely picked up a collapsed lung on this gentleman's chest xray with an underlying pleural effusion.  We weren't exactly sure how to manage this problem when in through the ER walked a scrub-wearing volunteer who identified himself as a cardiothoracic surgeon from the Midwest who was randomly assigned to HAH for the day.  He subsequently tapped the patient's chest for us and drew off over 2L of serous fluid which significantly improved the patient's respiratory status.  The patient was administered a spinal anesthetic and Pete and Dave performed the partial hip replacement without complication.

Just as the visiting CT surgeon and his OR team were getting ready to leave for the hour drive back to their home base in Port au Prince, a young lad was rushed into the emergency room with a gunshot wound to the abdomen and chest.

The victim was rushed to the operating room and for  hours  underwent an exploratory laparatomy with bowel resection and repair, repair of a large hole in the stomach, and repair of a lacerated diaphragm.  A complicating factor was the fact that the child had just eaten a large meal and considerable effort was expended washing out the beans and rice from the belly.  Late in the night, the boy was transferred to the Intensive Care Unit for recovery in stable but critical condition.

Was having a chest surgeon with complete support staff present in an hour of need coincidence or serendipitous?  My wife would refer to this string of uncanny events as a "God thing"...maybe she's right.

Day 4 - The Volunteer Experience

One of the advantages of volunteering overseas is the opportunity to rub shoulders with people who hail from different parts of this country and the world.  There is a constant turnover of individuals with unique backgrounds and fascinating histories.  

In the photo below, Zack peforms an excisional biopsy on a large tumor with Dr Tom from Wyoming who has had extensive experience volunteering in Afghanistan.

In the photo below, Pete operates with Dr Seth, and orthopaedic hand surgeon from Vermont.  In the background, Dr Colleen, also from Vermont, provides anesthesia.

Each visitor to this compound has a story worth listening to and another one of the perks associated with the "volunteer experience."

Junk For Jesus

Between cases we all have spent time in the  storage room trying to sort through boxes of donated gear, much of it outdated, incomplete, damaged...essentially worthless and euphamistically referred to as "Junk for Jesus."  

We even got Chad Nelson involved in the organizing of the mountains of gear. 

The take home message is that if you or your hospital are contemplating donating unwanted equipment or supplies to an overseas mission field, please make sure that it is reasonably current, practical, and in good working order before you ship it.

Out Of The Rubble Trailer

Day 3 - Too Tired To Pick A Title

The C-Arm has been a great addition to the orthopaedic surgical program at HAH.  Today, Scott and Pete applied their third Taylor Spatial Frame of the week, a feat that could not have been accomplished without image intensification.  Thanks again to everyone who contributed to this project.

The intraoperative lighting here is marginal at best and coupled with the frequent power outages, we are all thankful that we brought our individual headlamps to wear.

The vast majority of the cases are still earthquake related and we are still engaged in the primary care of acute fractures that occurred on the fateful day of January 12, 2010.  Unfortunately, a significant percentage of our cases are dealing with infections and wound coverage issues.  Here Zack performs an I&D on a patient who had prior hip surgery while Pete irrigates and Kevin manages her pain.

I'm not exactly sure what the circumstances were surrounding the taking of this picture, however I do know that at the end of the day I was pretty wiped out and fell asleep waiting for the boys to finish the case so we could head up to the sleep zone and get some higher quality rest.  We've all been working hard but having a tremendous experience.

Saying Goodbye To New Friends

Today at morning report, the operating room volunteers had a special ceremony honoring a couple of expat volunteers who will be leaving here shortly.  Christa Chandy, Internist and Chief Medical Officer since February 12 will be moving on to private practice as a Hospitalist in Redlands, CA.

Andrew Haglund, Relief Hospital Administrator since January 19, is returning to Loma Linda University as an Assistant Professor of Environmental and Occupational Health in the School of Health.

 They will both be greatly missed and it will be difficult to imagine this place without them.