Day 4

Day 4:  Another beautiful morning in Samfya with the lake completely still …. like glass. It’s definitely going to be another very hot day.  We had breakfast on the veranda which was quite pleasant with tea, eggs, bacon, baked beans and toasted buns. Mark and Caitlin worked in the SCCP clinic all morning.  Brian went out with Becky on home visits and did all the medical documentation during the visits.  Holly and I headed over to the hospital with our 7 duffle bags full of OR supplies in tow. We inventoried all the supplies and helped organize them in storage.  Dismas Mwanza is the surgical tech who helped us all day, and was very pleasant to get to know.  He and Violet, the general nurse (no specific OR training) who is assigned to the OR, have been at Samfya District Hospital between 8-10 months and help Dr. Lushiku with cases and are responsible for the instrument packing and sterilization.  That brings me to my first disappointment of the trip and is a correction from yesterdays post.  I guess the autoclave, which is technically operational, has not been actually used to sterilize any instruments yet.  I guess the person who installed it only inserviced 1 person, but that person was transferred soon afterward to Kasava in the north.  Carmen has asked Lushiku on numerous occasions about the autoclave, but I guess has asked the wrong questions regarding it’s usage.  That means that all the instruments that have been used over the past year have been sterilized in those small, crappy Chinese autoclaves.  Violet admitted that most of the packs are wet when they come out and are left out to dry (again, this does not meet most infection control standards…at least in Western society).

Despite this, Holly and I did do a case today…hooray!!!  We had to wait for the final day of last year’s trip to accomplish this.  The patient was a 52 y/o male with an enlarging cystic mass  (2cmx2cm) on the left side of his mandible.  Holly and I excised it under local anesthesia alone and it overall went well.  A couple of reminders that we’re operating in Samfya: 1) the first instrument tray that we opened has rusted instruments (again a sign of wet packs), and 2) the electricity went out halfway through (had my headlight but couldn’t continue using the Bovie.  The patient was so thankful and we prayed with him before he left. 

 

We had lunch at Mark and Carmen’s….was nice to have a trustworthy salad, and then back to the OR to finalize the organization of the supplies and try to take a look at the big autoclave and perhaps find the user manual on the internet.  We didn’t have any luck on getting the actual manual, but did find out that the company that produced it is based in India, so I have a few e-mails out to their tech support team.  This kind of feels like groundhog day, remembering e-mailing the Chinese company last year for the small autoclaves.  On my way home, saw a young boy playing in a puddle near a faucet outside the clinic with her Mom right next to him washing the family’s dishes showing the realities of how most live in Samfya.

 

Dinner at Mark and Carmen’s was fantastic.  They served us Indian food (chicken tiki, homemade Nan bread fired on an open grill, vegetable curry and cucumber salad) and I gave Nala and Lily (their 2 girls) some Rainbow Loom craft kits from Andrew and Katie.  The girls seemed to really enjoy them and spent most of the night figuring out how to do it.  Andrew and Katie made a few instructional videos for some of the designs which I passed onto Carmen for the girls to watch. 

Tomorrow, there is one case scheduled and then we are going to try to get the big autoclave fully, totally, completely operational.  Holly and I are also scheduled to give a mid-wives training for delivery techniques and neonatal resuscitation based on videos that an OB from Willowcreek put together. 

Prayer request: 1) For patience and understanding regarding the autoclave