Last year I joined Vancouver-based GO-MED for a two week surgical mission to the Philippine mountain city Baguio; this year's trip was planned for the provincial hospital in Dagupan, a 4-5 hr drive up the coast from Manila.
About a week before leaving I received a call from the mission coodinator asking if I could obtain some more sterile gowns. My hospital uses standard sterile packs (containing instruments, a gown, and drapes) for vaginal deliveries that are opened as delivery nears. If a cesarean happens instead, the disposable drapes and gowns can't be reused, the hospital figuring that it is cheaper to buy new than re-sterilize. But my own clinic will take discarded but otherwise clean and unused supplies and re-sterilize them for me. I come up with ten more gowns.
When I finish packing, I have two 50 pound bags with these supplies, plus surgical instruments, medications, scrubs, and non-sterile supplies.
A light day, as the team learns to work with each other, and with local staff and equipment. I do just one vaginal hysterectomy for a fibroid associated with heavy bleeding. She was pre-screened as an abdominal hystectomy, but I changed that to a vaginal hyst, which went well. She went home in two days (would have been one day in the states, but here both patients and the local staff prefer longer stays.
In Baguio, the residents were eager to assist with vaginal hysterectomies, since they are not allowed to to vaginal hysterectomies for fibroids (only for uterine prolapse). But here interest is minimal; I don't know why the difference.perhaps because they are busier. Later in the week I asked one resident what her call was like the night before (she was assisting me on surgery the day after a 24-hr call): two ectopics, two CS, and 9 vaginal births, including two breech extractions. Whew). As with Baguio, all ob-gyn residents are women.
