Uganda Spine Mission November 2017 - Day 6

With all the surgeries being done under incredulous circumstances the team ventured to the wards to round on the post op patients. Most nurses and caregivers were on strike, so our challenges continued.  The general wards were divided into a male, female, and pediatric section.  When we entered the building, the concrete floors were covered with water with the morning cleaning crew sweeping the water across the surface to make them as clean as possible.  Blankets and food containers from overnight stays of the families lined the room surrounding the patient beds, which were about 18 inches apart.  Families were our biggest allies when rounding on their loved ones.  Whether a father, sister, or cousin, the family members took ownership of their loved ones lying in the hospital beds.  The language barrier was surpassed by Benon, the orthopaedic officer with us.  For the families, he translated post-op instructions, wound care instructions, follow-up plans, and answers to their questions.
Dr. Perry was the first one to mobilize her patients. We changed dressings and gave instructions to families regarding dressing changes, activity and pain management.  Cindy and Pam instructed the patients and families about wound care and gave them clean tegaderm and gauze we had brought. We passed out ibuprofen and Tylenol pre-packed in little baggies we had prepared. Trying to locate our patients was difficult as there were no patient rosters or room numbers. We continued to the ICU to visit a 12-year-old girl who had undergone a 6-hour spine surgery by Dr. Perry.  She stood up with Dr. Perry’s assistance and her posture was more upright and the kyphotic deformity was gone. As expected she was in pain but am sure she could envision a life of normal activity and posture. 

​   With all the surgeries being done under incredulous circumstances the team ventured to the wards to round on the post op patients. Most nurses and caregivers were on strike, so our challenges continued.  The general wards were divided into a male, female, and pediatric section.  When we entered the building, the concrete floors were covered with water with the morning cleaning crew sweeping the water across the surface to make them as clean as possible.  Blankets and food containers from overnight stays of the families lined the room surrounding the patient beds, which were about 18 inches apart.  Families were our biggest allies when rounding on their loved ones.  Whether a father, sister, or cousin, the family members took ownership of their loved ones lying in the hospital beds.  The language barrier was surpassed by Benon, the orthopaedic officer with us.  For the families, he translated post-op instructions, wound care instructions, follow-up plans, and answers to their questions.
Dr. Perry was the first one to mobilize her patients. We changed dressings and gave instructions to families regarding dressing changes, activity and pain management.  Cindy and Pam instructed the patients and families about wound care and gave them clean tegaderm and gauze we had brought. We passed out ibuprofen and Tylenol pre-packed in little baggies we had prepared. Trying to locate our patients was difficult as there were no patient rosters or room numbers. We continued to the ICU to visit a 12-year-old girl who had undergone a 6-hour spine surgery by Dr. Perry.  She stood up with Dr. Perry’s assistance and her posture was more upright and the kyphotic deformity was gone. As expected she was in pain but am sure she could envision a life of normal activity and posture. 

​We rummaged through the fabrics and shoes and jewelry and wandered in and out of the alley ways.  Almost ready to leave, we heard “Doctor, Doctor” coming from the street.  It was one of our patients who had just received an injection yesterday!  What are the chances??  Dr. Kotton stopped and she said she needed a prescription for physical therapy but had forgotten to get it yesterday.  He wrote the words “referral to physical therapy” on his business card and we bid her ado.
We returned to the hotel and a few people went to Lake Mburo to do some sight-seeing, but most stayed at the hotel to rest.  Dr. Perry had a meeting with the Dean of Mbarara University Professor Gertrude Kiwanuka who is a powerhouse leader for the University.  She also met with the International Health officer Sheila Niinye Olivia, and they brainstormed about ideas to build the program and relationship with the spine teams from the USA and Uganda.  Together we can build on an established relationship to make access to medical care continue beyond the week-long spine camps.
The day closed with everyone retiring to bed relatively early (except me writing this blog) in order to rise early at 3:30 AM to depart for our SAFARI!!!!!