October Outreach 2019
This fall our medical team consisted of: two general surgeons (Ton v. Engelenburg & Erik Staal) an anesthesiologist (Jan Ammann), gynecologist (Walter Jacques v. Buren), tropical intern (Joost Binnerts), scrub-nurse (Moniek Klein Holkenborg) and a nursing officer (Jiska Staal).
Sunday afternoon/evening we did your first round through the hospital for the new team members that are with us for the 1st time.
As usually it was a quite overwhelming experience. Even for us, who have worked here in the past for years and since then come twice a year for the last 15 years.
Everything is more intense! More patients and family in one room, dogs, cats, insects, and chickens walking around. Colorful clothes hanging everywhere. Nice, friendly and awful penetrating odors. Sounds of laughter and singing. Yet from another corner, screams of pain and moaning. Big tumors, open gaping wounds, patiënts who have been bedridden for months because of neglected traumas….
The 1st day was filled with a very busy outpatient clinic for Erik and Jiska, filled with children that have deformities on the extremities: legs, feet and arms. And of course the every year growing numbers of patients with neglected trauma after an injury or accident.
After that 1st day an operating schedule can be made for the days to come. Experience has learned that this schedule will continue to change daily, due to new patients that come, fresh acute trauma, lack of donor blood, patients that need malaria treatment first, lack of money to pay for the operation, absconding patients because of fear…..
Ton, Joost and Moniek could get started operating on the already preselected patients who were prepared by the local staff.
A growing number of patients find their way to our outreach, suffer from enlarged thyroid glands. These are complex and time-consuming operations. One operation can take up to 3 to 4 hours with quite some blood loss. This outreach we had 2 major complications due to postoperative bleeding. One young man that had to be resuscitated and lay critically ill for 4 days on ICU.
Sadly we lost a 14 year old boy after operating on him two times. It was so frustrating and heartbreaking to realize that this would be less likely to happen in Europe, where he would have gotten the right surgery in the fist place and he would stand a better chance to survive with our high standard of Intensive Care.
In the two weeks Erik operated on more complex and older children with deformities compared to past years. This was a challenge because of the lack of available tools and materials.
It was the first time our team had a gynecologist along. This was greatly appreciated by the hospital staff. With the average of 30 deliveries and 5 caesarean sections each day it can be imaged that the pressure on obstetrics is very high. Walter Jacques was very impressed seeing so many extra uterine pregnancies in just 2 weeks time.
He was able to ease the pressure by doing quite a few specialist operations, consultations, bedside teaching and gave a teaching session for the staff on the monitoring of the fetal condition before and during a delivery.
Next outreach will be in March 2020.
