Team 3, Day 9 – Wrapping it Up

We had our final breakfast this morning as a whole team and greeted Hasan, our intrepid bus driver, for our ride into Mbarara.  It was foggy this morning having cooled down to the low 60s overnight (weather I would not have associated with Uganda prior to this trip) as we cruised into the Hospital.  The boda boda drivers seemed to have no concept of poor visibility as they often would shut off their engines and lights to coast down hills oblivious to what might be in front of them.  We arrived with a single case this morning – we would be putting on our orthopaedic trauma hats and attempting to adjust an external fixator on the leg of previously treated fracture.  The external fixator is a system of large diameter pins placed on either side of a fracture with metal tubes spanning the fracture connecting to the pins.  The patient this morning needed his fixator adjusted as his fracture was maligned.  Dr. Kip and I (Eric) attempted to accomplish this task but unfortunately the fracture had had 4-5 weeks to heal in this position and though we corrected things slightly he would need an open procedure to reduce the malignment.  

Having given it our best shot we met up with Dr. St Clair and the rest of the team to do group rounds and make sure each patient had a long term plan.  Denise, our ICU scoliosis patient operated on by the previous team, was doing better and we weaned down her ventilator settings with hopes she could come off of it in a few days.  We moved deliberately through rounds, distributing antibiotics straight from the bottle to Gardenisia (our cancer patient earlier this week) for a UTI and reviewing each patient’s plan with the Mbarara staff and physical therapists.  

Our first big case of the week Eziekel looked great and was walking around comfortably.  Mary, our second case was tired but feeling much better.  I paused to give her a finger-knitted necklace my 8 year-old daughter had given me as a good luck charm.  We also handed out Cliff protein bars to many of the children – unfortunately these children don’t seem to get an adequate protein supply which is an essential building block to healing.   They were all excited to try something new and we handed out chewing gum to those that were mildly constipated – again simple bowel meds are in short supply at the hospital and improvisation of treatment was key.  Interestingly, there seemed to universal agreement by the kids that spearmint was by far superior to peppermint.  Our other two patients Shakira and Sarah were resting.  While Sarah was still in quite a bit of post-operative pain and frowning at us, she lit right up when she got her pillow pet and her caregiver expressed his gratitude.

We finished up rounds and discussed all the patients with Marvin and Dr. Deyo (his supervising consultant physician).  With everyone understanding the plan, we made our way back to the hotel for a late lunch and a fairwell to Dr. St Clair.  Dr. St Clair took time to touch base with us each individually to review the week.   We had a last lunch of chicken palaka, a questionable meal at best before 30+ hours of traveling, and we all said goodbye as he headed out.  For the rest of the day we all took time to catch alittle sleep and get ready for our own departure.   We met for a team dinner and marveled at how a group of 8 individuals could come together in a completely foreign environment and accomplish so much.