139. Takeo Eight: Wrap Up

So, about a hundred cases.  Four general surgeons did mostly hernia repairs, with some partial thyroidectomies, and one mastectomy (which may or may not be curative for a large tumor present for a year and with no options of chemotherapy).  

The two gynecologists saw mostly prolapsed uteri, a combination of poor nutrition (weak ligaments), heavy work in the fields (heavy lifting), and for some many births (though the average operative patient had just two or three births, again poor nutrition's effects on fertility or perhaps many war widows).  Also, a couple of uterine fibroids, ovarian cysts and an exploratory surgery for an ectopic pregnancy based on external ultrasound, which "strongly," but in the end mistakenly suggested ectopic pregnancy. 

I did 10 cases over 5 days, which is about what I had planned for (I brought ten pre-sterilized surgical packs with drapes, gowns and "lap tapes"--think small wash cloths).  We had more than enough supplies and medications and in fact left much behind for hospital use.

The only organizational disappointment was lack of pre-screening, which put us behind a day, but not more than that.  On other trips lack of pre-screening has had a much more negative impact. Within the surgical team, many working together for the first time, communication among the staff couldn't have been better; I'd work again with any of them, docs or nurses, anytime, anywhere.

Finally, we used almost no narcotics for postop pain.  Other missions have had limited amounts of narcotics.  We just provided ibuprofen and.... ice.  Families would go out and buy block of ice which would be wrapped and placed on the patient's abdomen. Just based on my visual observations, I don't think these patients experienced any more pain that what I see with patients who have immediate access to various narcotics.