Yesterday was a mild 80 degrees. Today the heat was oppressive. Sunny and 90. Luckily the power is back on and the air conditioning in the operating theatres is working.
I forget to tell about my trip to church yesterday. I wasn't sure where the church was or what time services were or even the name of the church. Opinion varied. But I walked into town and started walking in the general area. There was some pretty good music coming at the Universalist Church and told myself I'd convert if I couldn't find the Catholic church. But I kept walking and just before 10 saw people heading down a side street. What luck! The cathedral. When I entered everyone stood up and started singing. What I didn't see was that the bishop and about 10 deacons and altar servers had entered from a side room and were following me. For a couple seconds I thought the welcome was for me. But the place was rocking. The entire service lasted 2 hours, including over an hour of singing. The songs were in Xhosa, as was about half of the service. But there was plenty in English, and even the Xhosa wasn't much different than the Latin Masses when I was a child.
Today I went to Bedford Orthopedic Hospital. It's a 180 bed hospital about 5 km outside of town in the middle of nowhere. But they had 3 operating rooms going all day and did 16 cases.
Mostly fractures and infections. I helped with a few of the pediatric cases and then showed the consultant and resident how I do an interscalene block with a nerve stimulator. The patient weighed about 140 lbs. and we could practically see the groove. The block worked and I finished up the day going back to Nelson Mandela Hospital to give a lecture on muscle relaxants.
Monday, March 30, 2009
Sunday, March 29, 2009
Earth Hour
Last night we were supposed to turn our lights and electrical appliances off at 8:30 for an hour like everyone else in the world. The power went out at 8 and was off all night. We are all set for Earth Hour for the next 13 years.
Yesterday I went to the Nelson Mandela Museum in downtown Umtata. The presentation was well done. Two wings of the museum have gifts and awards he received when got out of prison and was then president. One of the gifts was a South African flag with an impressionistic picture of Nelson Mandela painted on it by Leonard Nimoy (a.k.a. Mr. Spock). It may have been a gift from the Vulcan Government.
Yesterday was also a shopping day. The volunteer physical therapist picked up a battery powered Ryobi drill to use in the orthopedic outpatient clinic. They have a way to keep it sterile and use it there to put in pins so patients don't have to be admitted for some of the smaller fractures. On Tuesday I will be visiting Bedford and see if they are really using it. It cost $39.99. I wonder how much a Zimmer drill costs?
Not much to do when the power goes out at night. It's too dark to go out for a walk. My computer battery lasts about 2 hours so I can work on lectures and watch DVD's for a while. Best thing is to sleep.
Yesterday I went to the Nelson Mandela Museum in downtown Umtata. The presentation was well done. Two wings of the museum have gifts and awards he received when got out of prison and was then president. One of the gifts was a South African flag with an impressionistic picture of Nelson Mandela painted on it by Leonard Nimoy (a.k.a. Mr. Spock). It may have been a gift from the Vulcan Government.
Yesterday was also a shopping day. The volunteer physical therapist picked up a battery powered Ryobi drill to use in the orthopedic outpatient clinic. They have a way to keep it sterile and use it there to put in pins so patients don't have to be admitted for some of the smaller fractures. On Tuesday I will be visiting Bedford and see if they are really using it. It cost $39.99. I wonder how much a Zimmer drill costs?
Not much to do when the power goes out at night. It's too dark to go out for a walk. My computer battery lasts about 2 hours so I can work on lectures and watch DVD's for a while. Best thing is to sleep.
Friday, March 27, 2009
Friday
The power came back on. And water started flowing again. But today I am roughing it. My house has a small washing machine, but no dryer. I had to drag the clothes rack outside. 90 degrees and sunny with a little breeze, so shouldn't take too long. Last night I boiled eggs and made a sandwich for dinner. The eggs were cooked to perfection.
I was going to go to the orthopedic hospital today, but for some reason the cases in all 3 rooms were cancelled. The assistant chief of anesthesia here says they may be taking inventory. With all the shortages of supplies and equipment I wouldn't think it would take the entire staff all day.
This afternoon I was going to go to Itipini, the shanty town built on an abandoned dump. They told me the clinic didn't have any patients, so I stayed here at the Nelson Mandela hospital. Cases were pretty much done by noon. Everyone was glad to leave early.
Tomorrow I am going to the Nelson Mandela Museum and look for a one hour photo developer.
I was going to go to the orthopedic hospital today, but for some reason the cases in all 3 rooms were cancelled. The assistant chief of anesthesia here says they may be taking inventory. With all the shortages of supplies and equipment I wouldn't think it would take the entire staff all day.
This afternoon I was going to go to Itipini, the shanty town built on an abandoned dump. They told me the clinic didn't have any patients, so I stayed here at the Nelson Mandela hospital. Cases were pretty much done by noon. Everyone was glad to leave early.
Tomorrow I am going to the Nelson Mandela Museum and look for a one hour photo developer.
Wednesday, March 25, 2009
No Power. No Water.
The power did go out for good last night. Walking home in the dark without streetlights or road signs was a challenge. But watching the electrical storm from the front porch was a real treat.
This morning there was still no power or water. Not just for me, but also for the residents and the staff that live on the grounds of the hospital complex. And the hospital was on auxillary power, so the air conditioning wasn't working. All day long we watched the temperature rise to 29 degrees C (85 degrees F). Which only got us ready for going outside where it was sunny and over 90 degrees F. I thought it would be colder here in the Fall.
The hospital does not have a cafeteria. The only food or snacks are in a Coke machine on the fourth floor. But that isn't hooked into the auxillary power and wasn't working today. And there was no power for the projcetor for my lecture. And because it was so hot I cut the lecture short.
It's taken a while, but I think I've figured out the difference between the consultants, house officers, community service physicians, and interns. Consultants are residency trained and board certified specialists. House officers can spend their entire career as house officers. The community service physicians are not serving time for a criminal offense. Interns are still just interns.
Today I was in the pediatric room. Saw the excision of two hydatid cysts in a liver, the excision of a cervical cyst and an umbilical herniorrhaphy. Surgery is supposed to start at 8, but the patients usually don't arrive in the OR till 8:15. And with delays and equipment issues, anesthesia doesn't start till 8:30. And with luck, surgery starts at 9. Today there were problems with an oximeter and a capnograph. There were no spares, so we waited till the technician got them working again before proceeding. People are so accustomed to delays that no one seemed upset. As a corollary, coronary artery disease is not very common here.
Time to find a church and pray that the water comes back on soon.
This morning there was still no power or water. Not just for me, but also for the residents and the staff that live on the grounds of the hospital complex. And the hospital was on auxillary power, so the air conditioning wasn't working. All day long we watched the temperature rise to 29 degrees C (85 degrees F). Which only got us ready for going outside where it was sunny and over 90 degrees F. I thought it would be colder here in the Fall.
The hospital does not have a cafeteria. The only food or snacks are in a Coke machine on the fourth floor. But that isn't hooked into the auxillary power and wasn't working today. And there was no power for the projcetor for my lecture. And because it was so hot I cut the lecture short.
It's taken a while, but I think I've figured out the difference between the consultants, house officers, community service physicians, and interns. Consultants are residency trained and board certified specialists. House officers can spend their entire career as house officers. The community service physicians are not serving time for a criminal offense. Interns are still just interns.
Today I was in the pediatric room. Saw the excision of two hydatid cysts in a liver, the excision of a cervical cyst and an umbilical herniorrhaphy. Surgery is supposed to start at 8, but the patients usually don't arrive in the OR till 8:15. And with delays and equipment issues, anesthesia doesn't start till 8:30. And with luck, surgery starts at 9. Today there were problems with an oximeter and a capnograph. There were no spares, so we waited till the technician got them working again before proceeding. People are so accustomed to delays that no one seemed upset. As a corollary, coronary artery disease is not very common here.
Time to find a church and pray that the water comes back on soon.
Tuesday, March 24, 2009
Weather Report
Sunny. 85. At least till the thunderstorm came over the mountain and down the valley a little while ago. The power and internet access have been off and on a few times. This will be a short story today.
Monday, March 23, 2009
Restaurant Review
Wimpy's, at the domestic flight terminal of the Johannesburg Airport, has one of the best breakfasts in the world. It was the only place open this morning at 5 while I was waiting for the last leg of my trip to Umtata. Two eggs, two pieces of bacon, two sausages, a tomato, one slice of toast (in deference to Dr. Atkins) and a cup of coffee for $4.62.
The flight from Dullles was OK, but too long. No stop in Senegal, so 15 hours in the air. Luckily the seat next to me was empty so I could spread out a little and get a few power naps in.
The person who met me at the airport is a volunteer here in Umtata. He has his own blog, though I forget the name. You can google Jesse Zink or Mthatha to get to it. It has pictures and is infinitely more interesting than my blog.
Tomorrow I start at Nelson Mandela Hospital. It is just down the hill from my house and looks like an easy walk. As best as I can tell, I will be working with rotating interns, house officers and medical students, though they have different titles here.
The flight from Dullles was OK, but too long. No stop in Senegal, so 15 hours in the air. Luckily the seat next to me was empty so I could spread out a little and get a few power naps in.
The person who met me at the airport is a volunteer here in Umtata. He has his own blog, though I forget the name. You can google Jesse Zink or Mthatha to get to it. It has pictures and is infinitely more interesting than my blog.
Tomorrow I start at Nelson Mandela Hospital. It is just down the hill from my house and looks like an easy walk. As best as I can tell, I will be working with rotating interns, house officers and medical students, though they have different titles here.
Saturday, March 21, 2009
Dulles
A six hour layover at Dullest. Not a whole lot longer than some laparoscopic surgeries. And I get to walk around and eat and watch people and doze off once in a while. So maybe it's not too bad of a wait.
It's a little too early to say how full the plane will be. It's 45 minutes before boarding starts and it looks like there are only about 50 people here at the gate. That includes the two kids crying over in the corner. Make a note to self: Find my earplugs.
It's a little too early to say how full the plane will be. It's 45 minutes before boarding starts and it looks like there are only about 50 people here at the gate. That includes the two kids crying over in the corner. Make a note to self: Find my earplugs.
Friday, March 20, 2009
Tomorrow
Tomorrow is the start of the two day journey to Umtata. First, a short flight from Syracuse to Washington. Then a few hours at Dulles Airport, followed by fourteen hours in the air to Johannesburg with a one hour gas stop in Senegal. Finally an overnight stay in Pretoria before an early morning flight to Umtata. I hope I have enough crosswords, books and journals. My computer batteries are only good for about 4 hours. Maybe I should see what will be playing at South African Airways Sky Cinema. I can always finish packing in the morning.
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