Day 4:
Our first day of surgeries in Uganda was a lesson in adaptability. Despite an 8 am start, our team faced numerous uncertainties. We had to determine our operating room locations, staffing, and whether basic amenities like running water were available. After extensive discussions with the Ugandan team, we developed a workable plan.
We began our day with a 7:30 am presentation to the Ugandan medical students and residents. Though there were delays, Bethany, from the Texas Back Institute Spine Biomechanics Lab, delivered an excellent talk on pre- and post-operative gait analysis, followed by Dr. Steve Gorlick’s demonstration. Dr. Isador Lieberman concluded with remarks on the importance of gait analysis in providing quantitative evidence of surgical outcomes.
Our team split into two groups. Dr. Lieberman and Dr. Kenneth operated in Ward 7, while Dr. Hisey and Dr. Fisher worked in the spine ward OR. Rob, Bethany, and I (Jacob) ensured smooth operations between the two ORs.
Bethany and I ran a pre-op gait test on Dr. Hisey’s patient. We faced challenges, including a lack of internet for troubleshooting, but with Dr. Kisinde’s help, we completed the test.
Dr. Lieberman took on a complex case involving an intradural-extramedullary mass. With limited supplies and tools stuck in customs, the procedure required extreme precision. The relaxed atmosphere in the OR helped ease my initial nerves, and I quickly adapted, learning to assist with sterile procedures. Meanwhile, Dr. Hisey completed his cases in the spine ward.
Our key takeaway was collaboration with the Ugandan medical team. Respecting their environment and effective communication are crucial for our mission’s success.
Day 5:
Our day began with a 5 am workout, followed by Dr. Kalin Fisher’s lecture on spine surgery implants.
During morning rounds, we visited trauma patients, witnessing severe injuries from Boda Boda accidents, falls, and shootings. The conditions were shocking, with family members providing most of the care and safeguarding medical scans.
In a makeshift workshop, hospital staff crafted personalized medical aids from recycled materials. This resourcefulness was inspiring and highlighted the importance of creativity in overcoming resource limitations.
Dr. Kenneth and Dr. Fisher’s patient had a challenging case of Pott’s disease with a spinal abscess, which was a successful surgery. Meanwhile, Dr. Hisey performed a successful manual traction on a patient with a C6/7 dislocation. Dr. Hisey’s patient suffered a C6/7 dislocation a month before our arrival and had been awaiting surgery ever since. The challenge in this case was presented as Dr. Hisey and his team worked to find a way to put their patient into traction (apply a pulling force to a part of the body to align or stabilize bones or relieve pressure). In the States, the facility would have a dedicated machine that puts pressure on the patient to achieve this. However, the doctors didn’t currently have access to the equipment they needed and had to creatively find a way to manually induce traction. The team was able to adapt and overcome the obstacles to help the patient.
Our big lesson was the value of improvisation and perseverance. Rob’s determination to find missing supplies underscored the importance of effort and creativity in overcoming obstacles.
Surgery was finished for the day and the team collected in the bus and enjoyed a fantastic meal at The Lawns where we enjoyed some local delicacies, including Bushwack, Eland, Buffalo, and Waterbuck. Post dinner, we could officially say that the day was over. We headed back to the hotel and crashed for the night.
