Day 12

 I promised myself that I would stay out of the operating room while I was Kenya, but that promise went flying out the window today. Rumor had it that a neurosurgeon from Nairobi was coming in today so a few of us went up to the main theatre to check it out. While waiting on him to arrive we stumbled upon one of the coolest procedures being done by an orthopedic surgeon. This woman had been in a severe car accident and the lower half of both legs had been severely mangled. The procedure being done today was a skin graft over the exposed portion of the leg. It was amazing to watch how a skin graft is done in a third world country when there are no donors available or allowed. The skin was harvested from the thigh and I found myself in that tricky place where I start to think that surgery gives as much pain as it eases. The surgeon explained that she was an amputee candidate but they were going to try this measure first. I was also sad to find out that this woman was pregnant during the accident and had lost the baby.  My prayers are for her today, for full recovery and for babies to come.

When the neurosurgeon arrived we went to the theatre to watch him treat a 2 week old baby with Spina Bifida. I had the privilege of holding this precious Hadija as they prepped her operating room. Spina Bifida has a characteristic swelling at the base of the spine and hers was removed today. We then saw a VP shunt put in for a patient with hydrocephalus and that was WAY COOL but also nerve wrecking because the patient was only a few weeks old as well.

I also saw an appendectomy done on a 10 year old girl. It was interesting to see how the doctors approached this situation as no ultrasound was available and the girl could only say she was having severe abdominal pain and had obvious swelling in the abdomen. I’m pretty sure that the incision for an appendectomy in the states is only an inch or two long. This girls incision spanned from the base of her sternum, around her belly button, and then bellow her belly button about 2 inches because they were not sure what was the cause. The surgery was deemed “exploratory”. Thoughts from the doctors and students in the room included Peritonitis, Intestinal Obstruction, etc. but I don’t remember anyone mentioning the appendix (My Swahili is not so good so it could have been mentioned). The bowels were taken out of the abdomen and all of the excess peritoneal fluid (?) was suctioned out. The doctor then found the appendix and yikes-a-bee it was so infected. They charted this as the cause and promptly removed it. After a warm water/ metronidazole bath her intestines were gently placed back inside her body. This situation was the most glaring difference between first world and third world technology but it is so interesting to me to see the doctors use basic technique to treat a patient just as successfully. She will have a bigger scar than if the procedure was done in America but saving someone’s life isn’t always aesthetic.

                                        The first case, her bone was completely exposed.

                                                                 Operating room.

                                                           attaching the first graft.

                                                        Harvesting the second graft.

                                                         Attaching the second graft.

               Oh I forgot to mention that we stumbled on this hysterectomy as they were finishing.

                                                                   Baby Hadija

                                                              The Appendectomy.                                

                                                                        Bowels!

The Culprit.

               Needless to say It was quite a full day and my heart and head are full of surgery