radio

Here on the ship, silly videos are regularly made for general announcements.  We have a video reminding us to take just two-minute showers and a video reminding us to keep the reception area quiet, and so forth.  Last year in Sierra Leone, I was in a video about knowing how to use the Land Rover radios.  So, without further ado:

o pos

A few days back, I had the opportunity to be a blood donor (again!) here on the ship.  You can read about my first time donating by reading (and watching the video!) on this post entitled "blood."    Last time, my blood was for a patient in our Intensive Care Unit, but this time it was needed in the OR for a patient that was undergoing surgery right then and there!  As I've mentioned before, we have a living, breathing "blood bank" on the ship since we don't have storage space for blood.  If a unit is needed, the donor is called, the blood is drawn, and then it goes almost immediately into the recipient. 

 One of our lab techs/vampires Polly drawing my blood.

Moments later in the OR with Dr. Iain (an anaesthestist).  Yep, that's my blood being hooked up.

A gift from some of the OR nurses.  My number was supposed to be 15 (my hemaglobin/iron level), but the 5 was accidentally made into a 2. 

thumbs up

hope

Wednesday morning.  I wake up at 5am.  I don't even remember the last time my alarm went off that early.  Brush teeth.  Put on blue scrubs.  Fill water bottles.  Breakfast service started at 3:30 this morning--the first vehicle left around 4.  It's going to be a good, albeit long, day.

Around 6:00am, my caravan leaves for Kégué Stadium.  Security teams have been there since yesterday afternoon, to help the line stay in order.  3,500 people show up. 

 

The hazy morning soon gives way to ray of sunlight.  Underneath the brightly colored, patterned fabric typical of West Africa are moms, dads, children, elderly...all with ailments, maladies, deformities, disfigurements...seeking relief.

Pre-screeners work through the line, identifying potential patients.  As the heat picks up, volunteers distribute water, peanut butter sandwiches, and laughter.

Inside the stadium are several stations.  Registration, history, physicals.  Exam rooms for max fax, plastics, and general surgeries.  X-ray, lab, pharmacy, data entry, scheduling, communications, infant feeding program, children's ministry.  Final check.  Prayer.

 

1,600 people enter the gates and proceed through the screening process. Tumors, cleft lips, goiters, hernias, burns.  People are weighed, masses are biopsied, x-rays are scheduled.

I'm working at Data Entry.  Over 1600 patients, about 550 make it to this station, after their exams.  We enter their information into a database and print ID cards.  The patients are then directed to either scheduling, lab, x-ray, or pharmacy.  Over the course of the day, I enter information for about 180 people.

Just shy of a 12-hour day, I head back to the ship in another caravan, tired and sweaty.  This is just the beginning of the outreach.  The beginning of new stories of lives transformed.  

open house

This past Monday was the annual Hospital Open House.  Before the hospital opens at the beginning of an outreach, the hospital opens up for all the crew to visit and play games.  Each ward and OR, as well as the lab and x-ray, has a different activity.  In our department, we had practice suturing, intubation on dummies, and my station: dress-up and play surgeon.  Despite all of our gowns and gloves being way too big, our room was definitely popular with the kids on board!

Kylie gets ready to begin surgery.

Xavier receives assistance with his too-big gloves before operating on Theo's "broken" arm.

Practicing my scrub nurse skills with Laura and Malachi as they operate on Tracy's arm lipoma.

revisiting eyes

Monday morning I woke up thinking it would be a normal day down in the OR office, getting some things ready for the start of surgery (which is this coming Monday!).  As I was about to leave my cabin, the phone rang (around 0745).  On the other end was Innocent, our Assistant Eye Team Coordinator, explaining that two of the current four eye team members were sick, and they were about to head out to screening.  Knowing that I had previously been on the eye team, he asked if I could help them out.  "We'll be back by two," he reassured me.  I said I'd check with Missy (the OR supervisor) and get back to him.  After getting the okay, I hopped in a Land Rover...right after our big all-hospital photo shoot.

All of the Hospital staff (as of 30 January 2012).  I'm sitting on the hood of the center Land Rover, with sunglasses on.

The OR Staff!  

We are a little short right now because we are getting 12 new staff this coming weekend.

As I was saying, we headed off for our eye screening site of the day, the International Chapel at the West African Advanced School of Theology.  If you're like me, you probably think of a small house of worship when you hear the word "chapel."  Emphasis on the word small.  But, just when you think you have West Africa figured out, it turns around and calls this a "chapel":

Yes, this behemoth of a building is the International Chapel.  As we unloaded our equipment, I couldn't help but compare this site to our places in Sierra Leone.  Usually when we went to a church in Sierra Leone for screening, we would end up clearing out all the pews and still being a little on the cramped side.  But here, oh my.  The whole eye screening operation was set up right inside those front doors with ample space left over...we didn't have to move a single one of the 100+ pews.

A quick look at our set-up.

An unfortunately dark photo taken from the pulpit area.  The huge balcony was about half of the main floor. 

I was put in charge of pre-screening and was told to expect about 200 patients.  No big deal.  Pre-screening involves looking in each person's eyes with a flashlight to determine quickly if they have cataracts, a pterygium, or another something else we can help.  "Yes" people then proceed into the church to be seen by our optometrist.  When I took my place to begin pre-screening, Innocent explained (in French) what would be happening and the crowd immediately began clapping!  It was really overwhelming--I mean, I'm not a doctor, but I think that these people were just so happy that someone was there to care for them, regardless of what the "care" would look like.  My cursory exams proceeded well and I got to polish my slightly rusty French skills ("Pas de cataractes!  C'est bon!")  Hours later, I find that I'm still working on this group of what I thought was 200 people.  Eventually, a day volunteer comes out and tells me that Nancy, our sole ophthalmic tech, says we need to stop--there are too many patients!  I look at the click-counter my translator is holding and we are at 368 patients!  I quickly pre-screen the remaining few, telling the "yes" patients to return in two weeks and that puts us up to 408 total patients.  I guess when you're on a roll, then you are on a roll.  Eventually, we manage to get everything packed up by 3:45pm and back to the ship at 4:15pm.  The day was longer than expected but definitely well worth it, as we scheduled 57 patients for a secondary screening at the ship (a yield of about 14%, which is great!).  I did get a little sunburned, but my great conversations with the day volunteers made up for it (topics included churches and how one votes in the U.S.).  All of them were crucial in making the day run smoothly and what was really a pleasure to work with them.  

On Tuesday morning, the ship held a Hospital Evacuation Drill.  It starts at as a regular fire drill, with most people mustering on the dock and the hospital folks staying in there respective areas.  Then the captain announced that the "fire" was out of control and the hospital would need to be evacuated.  Despite not having any actual patients on board, the ward was filled up with crew volunteers, acting as blind, injured, recovering, and unconscious patients.  We also had two intubated dummies in the OR and three "recovering" patients in the PACU.  The whole thing was pretty exciting.  You never really think about "Okay, what do we do if we have to evacuate the ship while we are cutting apart this person's jaw?"  After getting our OR patients outside, we proceeded to one of our four dockside tents, which operated as our makeshift OR.  The whole drill went very smoothly and it was great to see how everyone worked together to clear the ship safely. 

Tuesday afternoon, the OR nurses began bleaching the department.  As the completed individual rooms, my job was to go around and swab pre-determined surfaces (unknown to the nurses).  I then sent the swabs to the lab to be cultured, in order to see if our bleaching was effective.  I just got the results back and let's just say that we will be doing some rebleaching tomorrow :(