I’m going to start with the end of my day since I feel I should explain the last of the photos I uploaded in case any of you have been checking those out. I’m fairly frustrated with Shutterfly – I probably won’t use them again but would like to get through the mission without changing if I can. Every time I post new photos they go through a big to do, acting like it’s a new album, showing only one and then finally posting them all along with a bunch of ads. Of course it’s entirely possible that I just don’t know what I’m doing as my really smart brother uses them successfully all the time.
Anyway, last night, the first night in Antsirabe, I was in a double room but was assured by the desk clerk that when I returned from the hospital today, I would have a single room, “really nice,” (French style air-kiss from his fingertips emphasizing what a great room this would be.) He told me to leave my bags in the old room on the first floor – what we would call the second floor – and they would be magically transported by the hotel staff to my new room. When we arrived back from a long first day of screening around 6:30, I went to the office and was given a key for my new room, this one on the 2nd (3rd) floor. I trudged up the stairs with my backpack and giant bag of baby/kid toys and exam equipment only to have the hallway go pitch black half way to my room. I stumbled along, and after missing it twice, managed to find the right door by feeling the raised numbers. It turns out there are timed switches at the start of each hallway that must be flipped on before you enter if you would like to have your way lighted. Who knew? (not me.) My luggage, of course was not there, but just outside the door was a large red plastic bucket with a medium sized red plastic scoop inside. I assumed it had been left by the cleaning person – HA! – and went down to the office to find my bags. They were, of course, still in my previous room, so I hauled them up one at a time. A few minutes later, the desk clerk knocked on the door to “tell me a few things about the room.” It seems the water pressure is low on the second floor, so if the shower doesn’t work, I can fill the bucket with water from the sink and use the scoop to bathe myself. “How often does this happen,” asked the very tired and a bit cranky hotel guest from her “really nice room?” “Well,” says the desk clerk, usually between 6:00 and 9:00 in the morning and 6:00 and 9:00 in the evenings are the worst times because EVERYONE WANTS TO SHOWER THEN!!!!!” Finally, he needed to “show me about the toilet.” Apparently the same low water pressure “sometimes” keeps the toilet tank from refilling. If that happens, I just take off the lid and push down on the big blue pump a few times and, voilà.
On the bright side, though there are no hangers, no hooks, no drawers, I do have three outlets if I unplug the television and crawl under the bed.
So back to the photo of the bare-breasted woman. Its of a painting, about 16x24 inches on the wall at the foot of the bed. Lying in bed, unless your eyes are closed, Miss Sensuosity dominates the view.
Before I go to the other photos and forget about roosters and dogs, I’ll include them now. Our day started at 6:00 am with breakfast in the hotel restaurant, followed by team meeting at 6:30 and departure for the hospital at 7:00. I set my alarm for 5:00 because I had to have my bags packed for the big room switch. At 4:30 I was awakened by the vigorous call and response of several roosters. It took me right back to last year’s trip to Guatemala when I persuaded my friend and former medical school classmate, Mary Rappazzo to go with me. The daily 4:30 wake up calls of the Guatemalan roosters probably contributed to her lack of interest in returning. The other person who jumped right into this trip was Bette Palovchik, the founder of Shuarhands, the foundation that funds the Guatemala program. Bette was never happy unless there was at least one dog wandering around in our exam rooms, and I’m happy to report that there were three small terrier mutts who strolled in and out all day.
So, back to the photos, and I’ll keep it brief. We screened 200 patients today and the first new photo shows them lined up ready to start the process. There are then a couple of slides of Christian, the scruffy looking guy with the beard and glasses, who is actually the team leader for anesthesia. He’s South African and was going through the chart for all the first time anesthesiologists and interpreters. The blond woman in the front is a Peace corps volunteer who is interpreting for us. Then there’s a photo of most of the anesthesia team celebrating something, followed by some hospital scenes.
Today was the first of two screening days. We saw 200 patients and there are 200 more here to be screened tomorrow. There is a Swedish film crew here filming a documentary for Operation Smile. A television journalist, Malou von Sivers is the “star” of the show and a big Op Smile supporter. Her teenage daughter is here as well. She was born with a cleft palate so Malou knows what these kids and parents are going through. They chose two kids ahead of time to follow, went to their homes to get in depth coverage, etc. One is a four year old boy who unfortunately arrived sick and has pneumonia. Malou and the film crew were involved all the way along as Jonas, an anesthesiologist from Sweden and I screened and then evaluated this little guy, trying to find a way for him to have surgery. We finally got a chest Xray and that was the end of any thoughts about surgery. On the bright side, it’s good he came as the family lives in a very remote village and he might have become very ill before anyone realized he needed medical care. Also, those of you who watch Swedish documentaries might see me on Swedish TV.
Among the patients we saw today were several teens with untreated cleft lips. With so many babies at screening, the surgeons plan to set up a sixth table and try to do the teens under local anesthesia just so they have a chance to have the surgery. Even though I know the logical reasons to do the babies first, I’m really pulling for the teens. It will change their lives.
I also saw a three year old with a mildly low oxygen saturation. It’s a little tricky hear because we are at 4900 feet elevation and many of the patients come from sea level. Saturations of 94-95% are common. This child, however had an 02 saturation of 78-80. Although she had no murmur and no symptoms, we got a chest Xray and she had a classic boot-shaped heart, seen most commonly in tetralogy of Fallot. She needs an echocardiogram to see what’s really going on, her chest Xray looked like it came out of a textbook.
I also saw a very sad case. A thirteen year old girl was there with her two month old baby boy. The pregnancy was the result of a rape, and the girl was sent off to live in a convent with an order of nuns that helps to “save the souls of girls who have been defiled.” The grandmother has taken over care of the baby who has a bilateral cleft lip. I always do a fairly complete exam on the under one year olds as they may not be having any regular care. This baby had a large inguinal hernia that will need to be repaired in a few months.
Finally, I saw a three year old girl whose mother brought here because she isn’t speaking. She also had a few other things, a mild left sided weakness and mild left club foot, but when I asked Mom if the girl could hear, she said yes, the child heard well and understood everything. Of course the child didn’t respond at all when I had Mom call to her from behind, without the benefit of gestures or lip-reading. I think this child is also delayed, but her deafness likely will turn out to be her biggest handicap here.
So just a few short things before I wrap up for tonight. We have great interpreters. Two are young Peace Corp volunteers who’ve each been here for about 18 months and will be leaving in another six. They both are fluent in Malagasy and seem very culturally aware. We also have a young Baptist pastor who started out in the church of a Baptist missionary from the US. When the missionary went home six years ago, this young man took over the congregation. He’s here just to help. Finally, we have three young Mormon elders. They are very nice and do a great job. They dress, as is their usual style, in dark pants, white shirts and ties. The rest of us are in much more casual clothing, but they seem comfortable with who they are.
The last thing is that when we were driving from the capital to Antsirabe, in a huge line of busses and trucks, the busses would stop periodically and open their back doors. Though the busses already looked packed, people rushed to climb on. As traffic started up, the busses started as well, and the stragglers ran after them being dragged in by friends until the back door guy finally closed up. I wonder how many people get injured or die each year trying to hop on moving busses?
OK, that’s it. I’ll keep my fingers crossed for Shutterfly.
Anyway, last night, the first night in Antsirabe, I was in a double room but was assured by the desk clerk that when I returned from the hospital today, I would have a single room, “really nice,” (French style air-kiss from his fingertips emphasizing what a great room this would be.) He told me to leave my bags in the old room on the first floor – what we would call the second floor – and they would be magically transported by the hotel staff to my new room. When we arrived back from a long first day of screening around 6:30, I went to the office and was given a key for my new room, this one on the 2nd (3rd) floor. I trudged up the stairs with my backpack and giant bag of baby/kid toys and exam equipment only to have the hallway go pitch black half way to my room. I stumbled along, and after missing it twice, managed to find the right door by feeling the raised numbers. It turns out there are timed switches at the start of each hallway that must be flipped on before you enter if you would like to have your way lighted. Who knew? (not me.) My luggage, of course was not there, but just outside the door was a large red plastic bucket with a medium sized red plastic scoop inside. I assumed it had been left by the cleaning person – HA! – and went down to the office to find my bags. They were, of course, still in my previous room, so I hauled them up one at a time. A few minutes later, the desk clerk knocked on the door to “tell me a few things about the room.” It seems the water pressure is low on the second floor, so if the shower doesn’t work, I can fill the bucket with water from the sink and use the scoop to bathe myself. “How often does this happen,” asked the very tired and a bit cranky hotel guest from her “really nice room?” “Well,” says the desk clerk, usually between 6:00 and 9:00 in the morning and 6:00 and 9:00 in the evenings are the worst times because EVERYONE WANTS TO SHOWER THEN!!!!!” Finally, he needed to “show me about the toilet.” Apparently the same low water pressure “sometimes” keeps the toilet tank from refilling. If that happens, I just take off the lid and push down on the big blue pump a few times and, voilà.
On the bright side, though there are no hangers, no hooks, no drawers, I do have three outlets if I unplug the television and crawl under the bed.
So back to the photo of the bare-breasted woman. Its of a painting, about 16x24 inches on the wall at the foot of the bed. Lying in bed, unless your eyes are closed, Miss Sensuosity dominates the view.
Before I go to the other photos and forget about roosters and dogs, I’ll include them now. Our day started at 6:00 am with breakfast in the hotel restaurant, followed by team meeting at 6:30 and departure for the hospital at 7:00. I set my alarm for 5:00 because I had to have my bags packed for the big room switch. At 4:30 I was awakened by the vigorous call and response of several roosters. It took me right back to last year’s trip to Guatemala when I persuaded my friend and former medical school classmate, Mary Rappazzo to go with me. The daily 4:30 wake up calls of the Guatemalan roosters probably contributed to her lack of interest in returning. The other person who jumped right into this trip was Bette Palovchik, the founder of Shuarhands, the foundation that funds the Guatemala program. Bette was never happy unless there was at least one dog wandering around in our exam rooms, and I’m happy to report that there were three small terrier mutts who strolled in and out all day.
So, back to the photos, and I’ll keep it brief. We screened 200 patients today and the first new photo shows them lined up ready to start the process. There are then a couple of slides of Christian, the scruffy looking guy with the beard and glasses, who is actually the team leader for anesthesia. He’s South African and was going through the chart for all the first time anesthesiologists and interpreters. The blond woman in the front is a Peace corps volunteer who is interpreting for us. Then there’s a photo of most of the anesthesia team celebrating something, followed by some hospital scenes.
Today was the first of two screening days. We saw 200 patients and there are 200 more here to be screened tomorrow. There is a Swedish film crew here filming a documentary for Operation Smile. A television journalist, Malou von Sivers is the “star” of the show and a big Op Smile supporter. Her teenage daughter is here as well. She was born with a cleft palate so Malou knows what these kids and parents are going through. They chose two kids ahead of time to follow, went to their homes to get in depth coverage, etc. One is a four year old boy who unfortunately arrived sick and has pneumonia. Malou and the film crew were involved all the way along as Jonas, an anesthesiologist from Sweden and I screened and then evaluated this little guy, trying to find a way for him to have surgery. We finally got a chest Xray and that was the end of any thoughts about surgery. On the bright side, it’s good he came as the family lives in a very remote village and he might have become very ill before anyone realized he needed medical care. Also, those of you who watch Swedish documentaries might see me on Swedish TV.
Among the patients we saw today were several teens with untreated cleft lips. With so many babies at screening, the surgeons plan to set up a sixth table and try to do the teens under local anesthesia just so they have a chance to have the surgery. Even though I know the logical reasons to do the babies first, I’m really pulling for the teens. It will change their lives.
I also saw a three year old with a mildly low oxygen saturation. It’s a little tricky hear because we are at 4900 feet elevation and many of the patients come from sea level. Saturations of 94-95% are common. This child, however had an 02 saturation of 78-80. Although she had no murmur and no symptoms, we got a chest Xray and she had a classic boot-shaped heart, seen most commonly in tetralogy of Fallot. She needs an echocardiogram to see what’s really going on, her chest Xray looked like it came out of a textbook.
I also saw a very sad case. A thirteen year old girl was there with her two month old baby boy. The pregnancy was the result of a rape, and the girl was sent off to live in a convent with an order of nuns that helps to “save the souls of girls who have been defiled.” The grandmother has taken over care of the baby who has a bilateral cleft lip. I always do a fairly complete exam on the under one year olds as they may not be having any regular care. This baby had a large inguinal hernia that will need to be repaired in a few months.
Finally, I saw a three year old girl whose mother brought here because she isn’t speaking. She also had a few other things, a mild left sided weakness and mild left club foot, but when I asked Mom if the girl could hear, she said yes, the child heard well and understood everything. Of course the child didn’t respond at all when I had Mom call to her from behind, without the benefit of gestures or lip-reading. I think this child is also delayed, but her deafness likely will turn out to be her biggest handicap here.
So just a few short things before I wrap up for tonight. We have great interpreters. Two are young Peace Corp volunteers who’ve each been here for about 18 months and will be leaving in another six. They both are fluent in Malagasy and seem very culturally aware. We also have a young Baptist pastor who started out in the church of a Baptist missionary from the US. When the missionary went home six years ago, this young man took over the congregation. He’s here just to help. Finally, we have three young Mormon elders. They are very nice and do a great job. They dress, as is their usual style, in dark pants, white shirts and ties. The rest of us are in much more casual clothing, but they seem comfortable with who they are.
The last thing is that when we were driving from the capital to Antsirabe, in a huge line of busses and trucks, the busses would stop periodically and open their back doors. Though the busses already looked packed, people rushed to climb on. As traffic started up, the busses started as well, and the stragglers ran after them being dragged in by friends until the back door guy finally closed up. I wonder how many people get injured or die each year trying to hop on moving busses?
OK, that’s it. I’ll keep my fingers crossed for Shutterfly.
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