Monday 6th October:
I wake up to beautiful sunshine, the roads are dry and dusty. It is the end of the wet season and the start of the dry.
We get to the ward for 7:30. There are 4 patients who arrived the previous night ready for surgery this morning. They are looking nervous, so we go and see them and take them a little teddy bear which my mum had made, and a football shirt donated by my husband and friends. This puts a little smile on their faces. There is a lady with a young baby. She can’t take the football shirt out of my hands fast enough – apparently having a football shirt is a statement, and they will be excited to take these back to their villages.
The nurses then advise us that the baby has diarrhoea, and so they decide to send them back to Facing Africa House and operate once they know they are both clear. They can’t risk D&V on the ward.
A new lady arrives. She and her baby have been flown from a very remote area of South Sudan and she has a very advanced Noma. She is missing her entire cheek. This lady came last year for surgery, but as they were about to operate, they discovered that she was pregnant. She was willing to terminate the pregnancy in order to be able to have an operation as she thought she was about 3 months pregnant, but a scan revealed she was 5 months. It was agreed that she would return to her village and come back for surgery this year. When Chris arranged to fly them to Addis, the child (now 6 months) had no name, so he named her Addis. She was a beautiful baby, who the mother obviously doted over. She has arrived for a scan to see the extent of her Noma. She and the baby stop overnight and will return for surgery next week.
I play with the baby, who is amazed by some bubbles that I blow to her, and we play with a little soft ball and a teddy bear that I have got for her. She looks so healthy and alert, whilst her mum is so thin.
Today, there are 4 operations, each taking 2-3 hours each. Theatres surprise me. No outdoor shoes past the red line, and scrubs and hats must be worn. The 2 theatres that we are using join together, like an anaesthetic room and an operating room. Each room has a surgeon and a scrub nurse, and the circulating float between the two rooms. The oxygen machine (which belongs to the hospital and not Facing Africa) is not working and the anaesthetist is manually pumping the oxygen bag. The suction machine is a portable one, which keeps stopping and starting as the electricity keeps cutting out. Our BARRIER® drapes and gowns are used along with our Biogel® surgical gloves which the clinicians seem more than happy with. The technique is the same as we would do in England, but I find out later that after we leave theatres, the hospital theatre staff look through the bins and keep any drapes and gowns that don’t have much blood on and that they can re-use.
In the next theatre (this is NOT an OR being used by the Facing Africa team) there is an operation on a baby. The surgeon comes over to speak to me. He is a neurologist and has removed a lump from a 4 day old baby. He should make a full recovery, although this will be a huge expense for the family. Next on the list is a C section. I’m invited in to watch as they cover her with linen (non sticky). Finally the baby is born, but after 20 minutes of resuscitation, the baby still hasn’t breathed and has died. So sad, but the staff take it in their stride, although such deaths are rare at the Korean Hospital where very good doctors work.
The theatres are set out as you would expect any theatres to look like. However, the theatre doors have holes in them, and the trays are wrapped in stained linen (this condition does not apply to the ORs that are being used by Facing Africa). Instruments are cleaned in house and there is a little room in theatres where three women are cleaning drapes and instruments. There is a communal scrub area (situated opposite the reception area in theatres). The water and soap pumps are operated by buttons which you press with your knee. Once scrubbed, you walk into your theatre to gown and glove.
The staff on the ward earn 2000 Birr a month (£60). Often rent is 700 Birr, and the nurses will have two jobs to be able to afford this. Rent is for a mattress on the floor of a bed sit. They won’t have a kitchen, just a camping stove to cook on.
Check back tomorrow to read about Heather’s last day on the mission...