This morning began with all kinds of men in size super tall white shirts and Arab scarf headgear. It was like an invasion of sorts: TV cameras, people swarming everywhere. It turns out that the King of Qatar had checked into our hotel bc he had been summoned to mediate between the two warring tribes. He mobilized and left right before we did and his motorcade was exactly like the POTUS ones. Black suburbans with flashing lights (except the secret service had on different outfits and looked a little less badass than ours do. Something about a very pressed and starched white shirt that goes to the ankles decreases the awe factor although they were quite something to behold).
The most startling thing for me was not their guns, but the fact that all of the beautiful no smoking signs had been removed from everywhere in the lobby. What is that about? Fortunately they reappeared when he checked out on Friday.
We walked out to Abdur's van to be taken to black lion and he again had trouble cranking the engine. When asked why, he told us it is because they dilute the gas.
We arrived at the hospital around 830 and the first case was not ready. Today the hospital smelled strongly of cabbage and sewage and garlic, not so great for those recovering from dysentery.
The first case went well and the ethiopian operative team got introduced to dermabond (super glue for the skin, I am pretty sure that one small vial costs more than the average annual income here, but it is good stuff). My attending is the Derma King, an international rep the company doesn't even know about.
It was during the first case that we noticed one of the male residents had a big gold ice cream cone necklace (conversation starter? Fashion trend? Foreshadowing of obesity to come in Ethiopia? Maybe it just gets chicks? Nothing like a man with a big gold ice cream cone...minds out of the gutter please.) I would probably strike up a conversation with such a guy.
The second patient of the day was undergoing his 7th surgery. He was 11 years old, about 25 kg, as strong as Chuck Norris and decided when he was turning into the room he was not having it. We corralled him after he jumped from the bed so he couldn't run out of the hospital and then tried to distract him with Angry birds. Man oh man he wanted to play so badly. You could just see it in his eyes, but he was terrorized. I felt so badly for him. They don't provide much if any intraoperative pain control here, but today was going to be different. We had brought an amazing anesthesiologist and he was going to get a nerve block and post op pain medicine.
Ethiopia has many needs and anesthesia providers are a huge one. Our anesthesiologist made a difference with everyone she interacted with and had the students completed captivated as she taught them.
We had the chance to wander into the adult urology room to find them totally violating every tenant of bladder cancer care. They opened a guy's abdomen up as a first step to look for bladder tumor and discovered that they couldn't see it from the outside and then booked him to follow up with a look in with a cystoscope. For those non-medical humans: the cystoscope is the first thing that should be done along with a ct scan not a huge intra-abdominal surgery. Ugh.
Our case went well and then the 3rd one was cancelled because of "no fluid" to clean the instruments. We suspect that it was more to do with it being almost 2 pm which is a super Kate day by their standards
On the way home we attracted several little kids with our roller bags. They helped us push them along and were super adorable as they did. On the walk I bought the weirdest toothbrush ever (pictured below) from a junior pimp/thug for 50 cents. I have no idea how to use this thing without causing myself serious harm via gum splinters (yes that is a straight up stick).
Pics:
Operating at Black Lion
3 views from the OR windows
Dermabond instruction
Anesthesia :)
Angry birds
Ice cream cone
Leaving
Toothbrush pimp
Some of the Qatar guys.
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