It’s 11:00 pm Thursday Madagascar time and I’ve been back from the hospital for about half and hour. Isabel, the intensivist and I went over about 6:00 this morning to see the pre-ops, so it’s been a very long day. It’s also been eventful, but I’ll get to that. I’ve been scribbling down notes to myself of things I want to include in my blog, so I’m going to try to get these disjointed observations down before I tell about the day.
The first thing is names. Madagascar names are impossibly long and for someone from the US, unpronounceable. A few examples from my patient list are Haritinatolojanahary, Fahendrena, Tolotriniavo and Voahiranah Judicael. The peoples’ appearance reflects their multinational heritage. They have a blend of Asian, African and Indian features. There was a two year old on the ward post-op for lip repair. I was trying to find out what he usually ate so we could bring him something other than juice. His parents list included meat, cassava, vegetables and rice. We had none of those, so he happily ate yogurt. Parents here, both fathers and mothers, are very nurturing. They wrap their children onto themselves with lengths of woolen cloth, tucking it under to make sort of a seat for the child. As a group, they are calm and soothing and help their children cope post-op. Almost all of the mothers breast feed, so the babies with lip repair can go right back to the breast. Again today we had several young men and women who had primary lip closures. They had great repairs and except for the post operative swelling, their lips look near normal. They certainly will be able to walk down the street without attracting unwanted attention. The young men in particular couldn’t stop looking in the mirrors.
Yesterday the water in the whole hospital dried up mid-afternoon. No one could figure out why. Surgery had to go on, so two five gallon jugs were found for scrubbing and instrument washing. Today the water’s inexplicably back on.
Young children in Madagascar think white people especially those with blond, red or white hair, are ghosts who might drag them off to the spirit world.
I’m trying to post some photos of the pre-op area with kids playing with play-doh, coloring, and today being entertained by the young Mormon elders with pipe cleaners. I may have to try again tomorrow. So on to today. We did 39 surgeries today and have 23 scheduled for our “½ day" tomorrow. We’re on track to complete 165 operations this week. It’s been incredibly busy but also very gratifying, especially with the young men and women. It’s also been very frustrating having to turn away so many. There is another mission here in April, and I hope they restrict it to the people who were left out today.
Today moved smoothly until mid-afternoon and then fell apart completely. First an eight year old came to the ward from the recovery room, and as she came out of her remaining anesthesia, she became completely hysterical. It’s not an unusual reaction, especially with children, but we could not get this girl to stop. Finally, we had to send her back to recovery where the intensivist put her back under anesthesia and brought her back up slowly. Next, a seven year old boy developed airway swelling after he had been on the ward for about 15 minutes. He also had to go back to recovery and ended up with a nasal trumpet, a tube that goes into the nose and keeps it open. He’s back on the ward but also sedated for the night. A baby developed wheezing and needed multiple nebulizer treatments, three other kids started vomiting and needed IV’s that they had previously pulled out re-inserted, and a five year old girl developed arterial bleeding from her adenoid and had to go back to the OR to get it to stop.
Tomorrow is a “half-day.” We have just 23 patients – all lips. We then pack up and the plan is to get to the hotel for the final party around seven. Hmmm.
More later. Off to bed.
The first thing is names. Madagascar names are impossibly long and for someone from the US, unpronounceable. A few examples from my patient list are Haritinatolojanahary, Fahendrena, Tolotriniavo and Voahiranah Judicael. The peoples’ appearance reflects their multinational heritage. They have a blend of Asian, African and Indian features. There was a two year old on the ward post-op for lip repair. I was trying to find out what he usually ate so we could bring him something other than juice. His parents list included meat, cassava, vegetables and rice. We had none of those, so he happily ate yogurt. Parents here, both fathers and mothers, are very nurturing. They wrap their children onto themselves with lengths of woolen cloth, tucking it under to make sort of a seat for the child. As a group, they are calm and soothing and help their children cope post-op. Almost all of the mothers breast feed, so the babies with lip repair can go right back to the breast. Again today we had several young men and women who had primary lip closures. They had great repairs and except for the post operative swelling, their lips look near normal. They certainly will be able to walk down the street without attracting unwanted attention. The young men in particular couldn’t stop looking in the mirrors.
Yesterday the water in the whole hospital dried up mid-afternoon. No one could figure out why. Surgery had to go on, so two five gallon jugs were found for scrubbing and instrument washing. Today the water’s inexplicably back on.
Young children in Madagascar think white people especially those with blond, red or white hair, are ghosts who might drag them off to the spirit world.
I’m trying to post some photos of the pre-op area with kids playing with play-doh, coloring, and today being entertained by the young Mormon elders with pipe cleaners. I may have to try again tomorrow. So on to today. We did 39 surgeries today and have 23 scheduled for our “½ day" tomorrow. We’re on track to complete 165 operations this week. It’s been incredibly busy but also very gratifying, especially with the young men and women. It’s also been very frustrating having to turn away so many. There is another mission here in April, and I hope they restrict it to the people who were left out today.
Today moved smoothly until mid-afternoon and then fell apart completely. First an eight year old came to the ward from the recovery room, and as she came out of her remaining anesthesia, she became completely hysterical. It’s not an unusual reaction, especially with children, but we could not get this girl to stop. Finally, we had to send her back to recovery where the intensivist put her back under anesthesia and brought her back up slowly. Next, a seven year old boy developed airway swelling after he had been on the ward for about 15 minutes. He also had to go back to recovery and ended up with a nasal trumpet, a tube that goes into the nose and keeps it open. He’s back on the ward but also sedated for the night. A baby developed wheezing and needed multiple nebulizer treatments, three other kids started vomiting and needed IV’s that they had previously pulled out re-inserted, and a five year old girl developed arterial bleeding from her adenoid and had to go back to the OR to get it to stop.
Tomorrow is a “half-day.” We have just 23 patients – all lips. We then pack up and the plan is to get to the hotel for the final party around seven. Hmmm.
More later. Off to bed.
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