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Uganda Spine Surgery Mission – Day 2

The team formally began the journey together to Uganda after we all met at London Heathrow airport. This year, 4 separate teams are travelling to Mbarara to provide care. Our team includes: Dr. Izzy Lieberman (veteran spine leader) and his son Josh (rookie volunteer), Dr. Michael Hisey (rookie spine leader) and his son Matt (rookie volunteer), Dr. Zvi Gorlick (veteran GP), Dr. Michael Silverstein (veteran orthopaedic surgery resident), Sherri LaCivita (veteran scrub tech), Brain Failla (veteran equipment rep), Kari Zagar (rookie Neuromontoring tech), Zoe Blumenthal (rookie volunteer) and Michelle White (rookie physical therapist). After a long hiatus, I (Mike Silverstein) was both excited and anxious to get to Uganda and get to work! My last time here was 6 years ago when I was a medical student with limited knowledge of what was ahead of me. I knew this time around my ability to contribute would be different, but exciting at the same time.

After a late arrival into Entebbe, we loaded our supplies and luggage into the van. Then we were tasked with a very long drive to Mbarara. Drs. Lieberman and Hisey were in charge of making sure the bus stayed on course. It was not a smooth ride to say the least! We finally arrived at the Lake View Hotel at 5:30am on Sunday. All of us took a much needed shower and nap. The team met for lunch a few hours later to stop by the hospital and go to Nakomat (a local store).

We stopped by the hospital to unload the 19 crates of medical supplies and equipment we brought with us. The hospital hasn’t changed much from our previous mission, with the exception of a newly installed finger-print door lock at the entrance of the surgery wing. A quick tour of the campus followed, at which point we went back into the bus for a quick trip to Nakomat to stock up on supplies. Nakomat is the equivalent of Wal-mart, so we were able to buy water bottles in bulk, some nuts and other snacks.

Afterwards the team returned to the hotel for a relaxing afternoon. Jet lag caught up with us, so we did our best to entertain ourselves and avoid falling asleep too early. This was helped by a surprise visit from Sister Rose, the head nurse in the operating room. She was able to meet the first-timers for the mission, and gave us an update on the happenings at the hospital over the last year. A few members, Brian, Mike and Zvi took a quick cab ride back to the hospital to assist Sister Rose in sorting the supplies.

The team gathered again for diner at the hotel, the menu being the exact same we had at lunch, however by now the chicken options were available to order as they had finally thawed out! Most of the team had chicken dishes, with the exception of Brian who ordered the “whole fish” and trust us, it was a WHOLE FISH. With full stomachs we hit the hay, preparing for a long day ahead of setting up in anticipation of starting surgeries!

Day 2 began early for Drs. Lieberman and Hisey, Zoe and Sheri, who started their morning in full stride with a jog. As the sun rose above Mbarara, the rest of the group joined them for breakfast in full scrubs, convening and conversing before our departure for the University Hospital to set up shop.

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After reuniting with our equipment, we immediately began unloading boxes and stocking the storage room shelves with all the essential supplies and more! We organized our gear despite knowing very well that all of these supplies would be exhausted at an alarming rate once surgeries began, forcing us to wait for the next group to refresh our supply and then get organized all over again. In addition, learning of the local CT machine’s state of disrepair was yet another cause for concern, since this would require us to send patients off-site to get the images vital to their diagnosis.

These quickly became minor worries when we realized that the crowd surrounding the hospital was here for us, waiting for aid and treatment that they desperately needed, even though we hadn’t planned to see patients until Tuesday, Day 3. Despite this unscheduled clinic, we organized our storage and equipment and, more importantly, made sure patients would be seen. While team members were on their way to the clinic, the rest of the team worked on unloading the OR table and putting it together.

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Drs. Lieberman, Hisey and myself (Mike Silverstein) were able to get 2 rooms to start seeing patients. There were over 50 patients waiting to be seen! We organized the list of patients and decided to see the children first and then the adults. The first patient of the day was a five-year-old little girl, Ester.

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Frightened by the prospect of examination, Ester began to cry and hide behind her mother. Only after we gave her a lollipop did she agree to let us begin the physical exam. Each child came with their own emotional background, each one more touching than the next. Many of the children needed further scans and tests before final decisions could be made, but a few were scheduled for surgery later in the week. The original 40 adult patients were then divided between Dr. Lieberman and Dr. Hisey, and we still had to ask around 20 patients to return the following day. Hours followed of slow conversations in broken English and rough translations. While draining, the clinic experience in Mbarara exposed our rookie volunteers the hardships of running a hospital in this part of the world. In one unexpected day of clinic, we almost completely booked an entire week of surgeries.

Lession of the Day: When you have good people, good things happen!

To support the Uganda Spine Surgery Mission visit: http://www.ugandaspinesurgerymission.com

Texas Back Institute