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Uganda Spine Surgery Mission 2016 Team One: Day 4

 

Quote of the Day: “Two broken arms, a broken ankle and a scoli … what a family”. Sherri’s assessment of a family we met at an impromptu roadside clinic today that was “walking wounded”. Sometimes witnessing the struggles of others put your own in perspective. We are humbled every day by the patients we see in Uganda; their strength, persistence, and ability to pull together and hold one another up have become an inspiration, and a reminder of why we do what we do.

Another satisfied candy customer

It’s Day 4 and Team One is in 5th gear. We started the day with another lumbar fusion in a lady with a fracture in her lower lumbar spine. Although there were a few issues localizing the operative level, we made it work and were pleased with the result in the end.

 

Between this case and the next, we all set out into the hallway to see several patients in the daily unscheduled – but not unexpected – clinic. I began to notice today how different each of the team members skill sets are (not only from a vocational standpoint, but personally as well), and how well these skill sets compliment one another and make our team stronger. Stanley’s translating abilities, for instance, are essential to the team’s function in Uganda, but his drive and attitude are also a great example and source of inspiration. Michelle is an excellent physiotherapist, but she also provides a level of caring and heart that is evident in her every patient encounter. Brian is a jack-of-all trades who fills in many workflow gaps for the team – sterilizing tools, taking C-arm pictures, and serving as circulating OR nurse – but his comedic injections provide us with much-needed laughs (he also has the appetite of some kind of large animal – and is always kind enough to finish whatever we can’t at dinner). Kari and Sherri are also both excellent at what they do; Kari a fast and vigilant neuromonitoring technician, and Sherri a surgical technician with a level of experience that is unmatched – but their sense of humor and positive attitudes also inject a new level of energy and enjoyment into everything we do here.

 

 

A typical clinic scene, with Stanley (2nd from right), our ever-present translator,and all-around hard worker, and Michelle (left), our physiotherapist and thoughtful scribe.

Kari: “There is always clinic.”

Indeed, clinic seems to pop up anywhere and everywhere, so we always keep a handful of dumdums and a notebook handy. There is no lack of spinal pathology in Mbarara, and the pathology here is often far from the adult degenerative disease seem commonly in the U.S. Tuberculous osteomyelitis, bodaboda trauma, and a wide variety of untreated spinal deformity are unfortunately plentiful.

 

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Michelle tending to a wound.

 

 

With a team as small as ours, everyone assumes multiple roles. Some of these roles are less glamorous than others.

One of our patients presented with leg pain due to a herniated disc in her lower back. She wasn’t quite ready to have surgery, so we treated her pain by injecting steroids and anesthetic near the compressed nerve to relieve the inflammation and treat her pain.

 

 

Dr. Hisey getting ready for an epidural steroid injection. Not a typical neurosurgical procedure, but we do what we can to help our patients.

 

Kari, our neuromonitoring tech, graciously agreed to scrub in and replace Sherri (our surgical tech), while Sherri went on a mission to find some much needed supplies.

 

Team One hard at work.

 

At the end of another day, we had some extra time and decided to walk around the hospital grounds to browse the avocados and other fruits and vegetables for sale at a nearby roadside market.

Dinner was at a wonderful little restaurant just a few miles away – Agip – where most of the team ordered a variation on their favorite food. This would be tilapia kabobs.

Dr. Leiberman also arrived late tonight, arriving on the bus from Entebbe at 1:30am with a huge number of totes carrying the supplies needed to keep the spine machine going for a while longer. We all got some rest, excited to start the next day with Dr. Leiberman on board.

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