Wednesday, June 3, 2015
It’s the evening of April 22nd, and I've finished my third day in the operating room (OR) at Soddo Christian Hospital. This has really been an eye-opening experience. I don't think that I'll be complaining about OR lights any time soon, especially after last evening when I performed a girdlestone procedure with only a camping headlamp. The hospital lost power for about 15 minutes during the surgery and the backup generator failed to work ― turns out its pretty dark.
Soddo Christian Hospital is a very busy place. Patients and their families camp out on its lawns, waiting to be seen. The hospital is extremely grateful for the donation of beds from OIC/UCLA, and I have yet to see a single empty bed since I’ve been here.
Our team includes Dr. Duane Anderson, Dr. Bob Greene, Ethiopian medical resident, nurses, and therapists. Every morning, we prep about 50 patients as a team. We then identify the emergent cases that have recently been admitted, and we schedule them for their OR procedure. Typically the ORs start running at 8 a.m. and we see about 15 cases in 2 rooms (one with 2 beds in it). The types of trauma cases vary, but we often see severe lower extremity traumas related to the dangerous road traffic here.
Many patients travel for hundreds of kilometers to get here, and have often seen either local providers or native healers first. Frequently, patients arrive a few days after their injury, because this is the only hospital in Southern Ethiopia with any type of orthopaedic equipment and expertise. Unfortunately, this means that many patients present with infections, and most operative work involves washouts and flap coverage of soft tissue loss. Once the emergent cases are dealt with, we operate on patients with chronic problems. The etiology of these problems is unbelievably different than what is seen in the United States. I've already seen several cases of tuberculosis of the bone and polio complications. I’ve also seen cases of malunions or nonunions, caused by unsuccessful surgery elsewhere or complete lack of prior medical treatment. The work being done here is incredible. Given the lack of equipment and resources, the caliber of care being delivered is really impressive.