Wednesday, November 16, 2011
This post is an excerpt from my Father in Laws emails... it gives you a bit of a glimpse of what they are doing in China.
At the Rehab Hospital in another part of the city, doctors, PT, OT, nursing and others have gathered to assess the approximately 100 potential surgical candidates. Decisions are based on a number of factors. Is it possible to do? Is it the right timing (for some surgeries on children age and development are taken into account)? Will surgery make a functional difference for the person? and so forth. Many of them are unbelievably disfigured. Huge tumors, a pinky finger that is turned 180 degrees and attached to the wrist, gnarled hands due to burns, cleft lips and palates, a black mole covering the whole face. This is a mere sample of what is needed.
Shortly after lunch a phone call informs us that surgeries will begin about 2pm. That means we need to prepare medications to be given just prior to surgery. The people start to arrive. They sit on beds in the hall, waiting. As it turns out it was not until 3pm that the first cases went for surgery. Just before they are moved upstairs they are given a dose of an antibiotic and Tylenol. One after another the call comes from the OR to pre-medicate patients and have them brought up for surgery. One by one they return. The ward doctor then decides on what medications they require to prevent infection and control pain. If strong pain killers are used they also need something to lessen nausea and constipation. Once we receive those orders we move into action providing individualized doses for 4 daily dose times. On this day the surgeons decide to add a couple of patients to the list and they carry on until 7-7:30. Normally they are supposed to be out of the OR by 6pm. Oops! With jet lag and all we are all tired but complete the day. Those of us who stayed to the end had missed the team meal. As we are walking back to the hotel we found that most places to eat were already closed. While the group is deciding what to do Tim and I return to the hotel and locate a KFC (24 hours) we had heard was near by. After we dragged ourselves back to the hotel we fell into bed ready to begin all over again at 6am the next morning.
I find it quite interesting that my response to being here this year is quite different than last year. Last year everything was new. The sights, the sounds, the smells, the people, the transportation, the stores and so forth. So far I have not taken a single picture.
But the purpose remains the same. There are people here that are experiencing life changing surgeries. The child that had a second left thumb removed. People who are able to use their hands again. Some who are able to walk with ease now. A child who was severely burned who had a “contracture release” of the eyelids and can now close his eyes. The same thing with his mouth so he can again eat properly. One can not begin to fathom the change these surgeries will have in the years to come. A not so little boy who has been coming for a number of years to repair the damage caused by burns.
The days have been grueling. Each day begins at 5:30-6am and often ends at 9-10pm. Fortunately there are some important members of the team who take care of us. They run errands to take things to other sites where we are working. Some times we need them to go shopping to purchase supplies or medicine. Most importantly when we can not take time to go out to eat they purchase food at nearby restaurants and bring the food to us. There never seems to be a lack of snacks either.
We now have patients at 3 different hospitals. One of our pharmacists returned home today so our human resources have been severely stretched. I was fortunate to set up pharmacy for just one day where the operations occurred today. The challenge in being spread out over different facilities is finding out that a medication we need, or a bottle or something related to packaging has not made the journey with us. This happened a couple of times today. Fortunately we were a short walk away from the other hospital and could easily retrieve what we needed with relative ease.
Today as I walked between locations I was amazed at how efficiently a seemingly dysfunctional traffic system operates. The road is shared by cars, truck, buses, bicycles, scooters, motorcycles, and even the occasional cart pulled by a person. There is a lot of horn honking. Yet in the midst of what seems like chaos, the traffic moves. Lane markings on the pavement serve as suggestions. If there are 2 lanes that are often three rows of traffic. Often vehicles straddle the line as if to indicate that they wish the opportunity to move either right or left depending on which lane they think might be faster. At other times, especially at intersections of major roads, traffic passes one another in what I might liken to the RCMP musical ride. They cross paths and one would think that a collision is imminent. But as they weave their way across the intersection everyone comes out on the other side without incident.
Crossing the street as a pedestrian is also an adventure, but one I feel quite comfortable about. The trick is not to freeze in the headlights, so to speak. When it is busy you can only make it one “lane” at a time. First you have to watch for bicycle and electric scooters along the curb. They sneak up quietly. Sometimes from the opposite direction than they should be going. Then there are 2-3 lanes coming at your from the left. Once you make it to the centre line you may now have to wait for a stream of traffic approaching from the right. And don’t forget about the scooter/bicycle traffic. At night the challenge is doubled because headlights appear to be optional, especially on bicycles and scooters.
On our way back from lunch at a nearby eatery one of the team purchased a pomelo. At the moment there are street vendors with cart loads of them every where. Apparently they are in season. There are also bananas by the bunches on carts waiting to be sold. Since we were in the hurry up and wait mode, the pomelo peel ended up on my head to the delight of some of the staff and squeals from the children. That lead to a number of pictures with groups of kids. It is so fun to interact with them. After this event the doctor who works at the hospital asked how many grandchildren I have. I guess he thought that my goofiness indicated that there might be grandchildren.
Orders began to arrive fairly soon once the doctors came, but with 25-30 patients still at Rehab hospital it took a long time for all of them to be seen. For many today was the first day that bandages were removed after surgery. This is a long process so order changes trickled in over the next hour or so. The pharmacy team worked hard to complete the orders because tonight was a team dinner. We managed to complete things by about 5pm and head out for the bus ride back to the hotel.
Tim and his dad are on their way home -- 24 hours of travelling and he will be home!