Following surgery, the lost pallet of supplies to furnish our storeroom had arrived thanks to the unrelenting efforts of Errin Dalzell and the support network back home. While we unpacked the pallet, we continued to care for a friendly young woman, named Sharon, which we met during clinic on our first day. Sharon, a shy-eyed young woman with a beaming smile, visited the clinic with difficulty walking, weakness and loss of sensation in her arms and legs that had started several years ago. At first glance, Sharon's condition had features common to spinal cord damage. Dr. Mimran observed that the cranial nerves that control neck and tongue movement were also abnormal, indicating brainstem compression. The review of the XRAY films revealed an anomaly in the highest cervical segment could account for the neurologic status. Due to the severity of this condition, the surgeons requested a CT films to corroborate their finding definitively and to develop a surgical plan. Sharon and her family did not have the resources to obtain these films, so HVO arranged for the funds and transportation on her behalf. It was also decided that a member of the team 2 should accompany her to ensure that correct films were obtained, expeditiously. J.P. Clark, the neurophysiologist of group 2, escorted Sharon and her sister, Hope, in the team bus, to an offsite private imaging facility in contrast to Mbarara University Hospital where the CT scanner was in a state of disrepair. The CT scan was uneventful but the trip provided the CT scans necessary for Dr. Mimran to confirm that the cervical spine was entering the skull and likely accounted for the brainstem issues. Dr. Burch and Mimran decided that the surgery would require a head and neck surgeon to provide access to the anterior spine through the mouth and would require a transoral approach. Considering the need for this expertise along with the high risk of the spine surgery, they felt that the surgery could not be performed safely in Uganda.
The surgeons met with Hope and Sharon and discussed Sharon's diagnosis.
The news was disappointing for them not only because they could not get the surgical care they had wished for but considering what was required, there was little hope for surgical care in the future. After a moment to digest the news, Sharon beamed again and expressed her gratitude for the diagnosis and the kindness and compassion our group provided.