July 27, 2014

I must admit, the last three weeks I was “on edge”.  This is the 10th mission. By now I assumed it would be auto pilot. Yet this is the most ambitious Uganda Mission endeavor since its inception.  Five teams (3 spine, 1 trauma/joint & 1 plastics team), 28 volunteers, 3 shipments, and shipping containers that I can’t keep count of.  This morning came and a new realization came with it, I can’t prepare any more.  The mission is now.

After a week of packing, sorting, collecting and re-packing, Lance and his wife came with their minivan to my house to pick up the containers and myself.    The rest of the team from Dallas, Skylar, Anthony & Sherri met us at the British Airways check in kiosk.  Immediately Anthony set the “smooth” tone for the trip. During the check in process, I think he is hitting on the ticket agent, by claiming to have a tattoo of her name “Lydia” on his arm.  To my astonishment he scores the team an extra baggage waiver by lifting his Dr Pepper t-shirt to show the name Lydia tattooed on his arm.  It remains to be seen how smooth he is when faced with the overwhelming spine pathology he is soon to witness.

The flight to Heathrow was uneventful, and Heathrow security as non-compliant as ever.  We persevered and made it to the rendezvous at Huxley’s pub in terminal 5.  There we were joined by Liz, then Tom S., Tom G. & Erica, closely followed by Nur.  As security delayed us we really had no time to reacquaint or even meet the new team members.

Just as Heathrow security was unwavering in its reputation, Zvi was too in his arrival.  He strolled into Huxley’s, with his duty free bag, with his ever calming demeanor, about 30 seconds after I had made the decision that we can’t wait for him any longer and need to proceed to the boarding gate.

With all team members accounted for, I was no longer on edge and ready for the second nine hour flight.

The arrival at Entebbe was uneventful and on time.  As predictable was the fact that one shipping container with the total joint equipment did not show up.  Tom S. hustled to the baggage claim attendant while we began loading collecting the bags and containers to load onto the bus.  As we exited the terminal I was very much relieved seeing the Mbarara Health Services bus and the remaining team member Joseph.  Joseph even had the bottled water and ground nuts I had asked him to procure for the trip to Mbarara.  Those nuts were even more flavorful now that the team was intact and we were on our way.

For those following this blog, stay tuned, visit often and send messages. We thank you all for your support to date.

- Dr. Isador Lieberman

Day 1
Annnnd we’re off! The 2013 Uganda Spine Surgery Mission officially began on Thursday, August 8 at London Heathrow Airport. This year’s team of six– the smallest team yet– gathered from a smattering of departure cities, including Dallas, Toronto and Tel Aviv. Flying in from Dallas were team lead Dr. Izzy Lieberman, his daughter (and chef extraordinaire) Danielle, and two veteran spine surgery missioners, scrub nurse Sherri LaCivita and medical equipment sales rep Rob Davis. Dr. Zvi Gorlick, a family physician in Toronto, joined the team for the first time, as did I (Jennifer Teichman), a medical student from the University of Toronto.

After a quick caffeine boost at the airport, we dumped our luggage at airport storage and scurried into London for the day. When a two-hour line thwarted our attempt to visit the Sherlock Holmes Museum, we hopped into a cab and found ourselves at Trafalgar Square after a quick drive-by of Buckingham Palace. All six of us clambered up the gigantic lion statues for our first team photo.

We met Ros Eisen, secretary of the Putti Village Assistance Organization for delectably crispy fish and chips at The Seashell, where Zvi insisted on ordering every dish on the menu that happened to be unavailable that day. Re-energized, we made our way to Big Ben, which several of us were surprised to learn referred to the bells rather than the clock tower itself. Dr. Lieberman surprised us with tickets for the London Eye, which proved to be the highlight of the day. We sipped champagne 40-something stories atop London and congratulated ourselves for a day well-spent. Then, it was back to Heathrow for our 9:00pm flight to Entebbe.

Quote of the day: "No time for dresses."- Dr. Lieberman, after Danielle expressed a desire to change out of her yoga pants and into a dress for our day in London. We mean business! 

Day 2

We touched down in a rainy Entebbe around 7:30am, sleepy-eyed yet itching to get started on the mission! Our collective enthusiasm met its first challenge when my laptop was stolen from the airplane. As a newcomer to the mission, I learned my first lesson of the trip: keep your valuables on you at all times, no exceptions. Our first driver, Eric, then appeared not with the 40-seat bus we thought was to be provided by the Mbrara University of Science and Technology (MUST), but with a small pickup truck and a 6-person van. This was my first hint that things don't always go as planned in Uganda. We loaded the truck with our bags, piled ourselves into the van and started the bumpy 60 minute drive into Kampala, the capital and largest city in Uganda. Our first stop was Case Medical Centre, a private hospital that served as a base for the mission in previous years. This year, however, we were only there to pick up the medical equipment they had stored for us from last year.  Danielle and I held down the fort by the luggage-laden truck while the rest of the team retrieved the equipment. Rumour has it that while hoisting a big bag of surgical equipment, Zvi lamented Izzy's choice of profession, and graciously provided us with our first quote of the day: "Why couldn't you have been an ophthalmologist!?"

After a true feat of space-maximization, the equipment was loaded into the truck and sent off to Mbarara to await our arrival the next day. Meanwhile, we headed to our Kampala accommodations, the Speke Hotel, for a much needed shower and change of clothes. With the whole afternoon still ahead of us, we paid a visit to the Galilee Community General Hospital, a Jewish Hospital in Kampala interested in future collaboration with the Uganda Spine Surgery Mission. We toured the facilities, including the new hospital building currently under construction. It was particularly interesting to learn about some of the considerations given to building and maintaining a small hospital on philanthropic support; the constraints of space, funds, resources and expertise were evident throughout our tour of the main hospital and construction site. Nevertheless, the team agreed that the new hospital promised to be a valuable addition to the community. 

The team returned to the hotel to rest before dinner, a good idea since dinner turned out to be a marathon for the stomach and palate. We feasted on delicious Indian cuisine at Khyber Pass, one of two kitchens at the hotel and a favourite of previous incarnations of the Spine Surgery Mission. By the end of the night, several pants buttons were unbuttoned (mine included), and our droopy-eyed procession made its way to bed. 

Quote of the day (#2): "I'm so full, I don't even have room for a tic tac"

Day 3

Move in day! We awoke to a beautiful morning in Kampala, and hit the road after a hearty breakfast at the hotel. First stop: The Nakumatt Oasis, the Zeus of all department stores. There, amongst the impeccably clean and organized isles, one can find everything from toothpaste and vodka to washing machines and power tools. It puts Walmart to shame. After stocking up on what is reportedly the world's best coffee beans, we piled back into the van and continued the five hour trek to Mbarara. Newly paved, the road to Mbarara traverses a landscape of rolling green hills, flat valleys of cultivated land and dirt paths dotted with shacks selling local fruit, meat, fish and potatoes. There was a collective cringe as we passed trailer after trailer of live bulls packed tighter than sardines, their ferocious horns piercing the air above them. Every half hour or so, the serene landscape was broken by the bustle and dirt of a small village with decrepit store fronts ironically painted in advertisements for Coca Cola and Nokia. Within an hour of the ride, our clothes were covered in a thin film of copper-red dirt kicked up by fellow drivers and boda-boda cyclists. 

local artisan crafts. Like school kids watching their first science experiment, Zvi, Rob and I oo-ed and aw-ed at a demonstration of water spinning in opposite directions in funnels placed on either side of the equator. Cooler still, water placed in a funnel centered on the equator didn't spin at all as it drained! Call me a nerd....

We arrived at our hotel in Mbarara, the Lakeview, and were pleased to find large, comfortable rooms. Anxious to start our work, we gathered our medical equipment and drove to the Mbarara Regional Referral Hospital, our base for this year's mission. We were met there by a spectacular surprise: last year, the hospital had opened an entirely new wing including an Intensive Care Unit, Emergency Department and operating theatres. We set to work right away, unloading the equipment from the truck and transporting it to a temporary storage room in the Emergency Department. 

Unloaded and eager to explore, we began a tour of the new building. The Emergency Department is a bustling continuum of corridors and open spaces filled with beds and curtains, each bed occupied by a patient and surrounded by family members. The spill-over of family members sit quietly on benches lining the hallways, many of whom carry infants. It seemed many of these families had not been home for days. Passed the Emergency Department, we found the ICU, a stark contrast to the crowded hallways of the ER. The ICU is a quiet space with each bed contained in a separate glass room. Computer monitors displaying patients' vital signs hang over the beds, much like one would find in any hospital in North America. Already impressed, we then proceeded to the surgical wing. Dr. Lieberman's expression was that of a kid in a candy shop when he first laid eyes on the operating rooms. Big, bright, clean, well-equipped and windowed... we hadn't expected anything close to this! The team's excitement was palpable.    

We left the hospital elated and even more motivated to kick off a great week at Mbarare. After an "edible" dinner at the hotel, we headed to bed for a good sleep before our first big day at the hospital.

Quote of the day:

"It's ok, you can take your skirt off here.. we're all medical professionals"

"The food is.... edible...."