The apt word makes a big difference. Here are some quotes from the past couple of weeks:
“May God bless you for helping my mama.” – Seven year old Daniel to Bruce when he visited his mother on a post-operative visit in her cabin. She had an emergent hysterectomy a few weeks ago and we were recently stunned to find out that the pathology demonstrated a severe and rare type of uterine malignancy. She is presently seeking a place to obtain further therapy.
“That was so nice.” – PAACS resident giggling with the joy of learning a new procedure that he didn’t know before.
“Watching him operate was like watching a prayer being offered.” – PAACS resident talking to Bruce after watching the amazing ophthalmologist, Glenn Strauss, do cataract extractions and lens replacements in 5 – 7 minutes via an open technique.
Here are some disturbing statistics about Sierra Leone from the 2008 World Health Statistics:
- Total population: 5,743,000
- Gross national income per capita (PPP international $): 610
- Life expectancy at birth m/f (years): 39/42
- Healthy life expectancy at birth m/f (years, 2003): 27/30
- Probability of dying under five (per 1 000 live births): 269
- Probability of dying between 15 and 60 years m/f (per 1,000 population): 556/460
- Total expenditure on health per capita (Intl $, 2006): 41
- Total expenditure on health as % of GDP (2006): 3.5
Life on board the Ship:
The difficult is done routinely on the Africa Mercy and the impossible often is done, even if it takes a bit longer. It is easy to get complacent. Last weekend, we were brought once again to the painful realization that this is not a true hospital. One of the crew members became septic and was in severe shock after a kidney stone obstructed her left ureter and caused a severe kidney infection. She also had pneumonia. We did not have any of the necessary devices on board to help her but fortunately, superb care by the anesthesiologists and the Massachusetts General critical care specialist that just “happened” to be on board with her husband, kept the patient alive until she could be evacuated to S. Africa. They were able to remove the stone and she is recovering slowly by last report. Hopefully she is off the ventilator, soon.
Arega Leta, the resident from Ethiopia who is training at Tenwek Hospital in Kenya, is on general surgery with me and since we have lost our surgical competitors, we are using two rooms every day. We are averaging 8 cases a day. Some of the hernias and hydroceles are massive, reaching nearly to the knee. Some of the men with hernias have trouble breathing well once everything is pushed back inside the abdomen. Another man had almost 4 liters removed from the sacs around his testicles – imagine carrying 8 and a half pounds around tied to your genitals. A third man was sitting on his bed before his surgery, resting his arm on his massively swollen scrotum (hydrocele); two other men had so much fluid that they had bedsores on their scrotums from the weight of them pressing on the chair when they sat.
Friday night, we were corralled into helping host (the expression here is “voluntold”) a group from the NGO Healing Hands (www.thhfoundation.org). They had 44 people; 32 medical and 12 others. One of the non-medical folks was Madieu Williams, the NFL safety from the Minnesota Vikings, who is from here in Sierra Leone (Click here for article). They were supposed to be here at 5:00 PM and didn’t arrive until well after 9:00 and stayed until 11:30. Many of the crew dressed very bizarrely for a party that was held last night and the visitors sure got an eyeful when we ran into them on the tours. They probably thought the ship was a floating insane asylum. Micky and I enjoyed their expressions immensely. Letting off steam is a good thing.
Today, the residents took their four hour, 200 question annual exam. They survived the ordeal and I am confident that the grading of the exam will show that they have passed. Four of the PAACS programs took the exam on Friday and Saturday of this week and the two Kenyan programs will take it next Saturday.
To give you an idea of how the crew and the patients have taken these three residents to their bosom, they awoke to find this artwork on their cabin door. One of the notes read, ““Hi, Doc. I am wishing you success in your exams tomorrow. I also want to thank you for taking care of me during my surgery on the 26th of May, 2011. May God bless you and your family. With love from Samuel S. (with a drawing of an apple entitled “love apple).” Another read (with original errors), “When I was in pain, God send (sic) you to help me and now I am heal and pray that God will also be around you always grant you your heart desire and may our good God always bless and keep you to help others in thousand. Thank you and God bless you very much.”
Sean was really ill for five days with a virus, but he has finally recovered and is back at full speed. He starts his summer camp at the academy tomorrow and he will be attending that for three weeks. The rest of the time, he can always go down the one deck to Micky’s office if the occasion arises. He is ten and knows the ship well. He likes the idea of the independence and we think it is good for him.
Praise and Prayers:
- Pray for the upcoming inspection trip by the COSECSA (College of Surgeons of East, Central and Southern Africa). They will be traveling July 7 – 17 and visiting the Ethiopian, Gabonese and Cameroonian programs.
- Please pray for Bruce’s father – he is facing a decision about treatment of continually positive bladder cancer reports.
- Pray for us as we finish the next six weeks – we are more than halfway!
- Please pray for the G.A., the crew member with the rare uterine malignancy.
Serving Him in Sierra Leone,
Bruce for Micky and Sean