Quick Update from Kalabo, Zambia

Hi all,

This has to be quick, and I´ll try to do a more complete update later this week...

Arrived yesterday at Yuka Mission Hospital near Kalabo, in the western provice. From Lusaka, it was a 8 hour bus trip, followed by 2 hours in boat on a tributary of the Zambezi river. For most of the past week I was at the Lusaka Adventist Eye Hospital, where they actually do more than just eyeballs, turns out. They´re pretty well off there so I didn´t do much work there, just a financial analysis to see if we ought to upgrade their equipment, and how long it would take for it to be worth their while financially for having done so.

Here in Yuka, it´s an entirely different story. They have an anesthesia machine, a Boyle´s model, with serial number 1605. The thing was in a closet, and no one knew how to use it. There is no circuit, and no anesthesia gases. I might not have even recognize the vaporizers, except they were labeled with big letters... ETHER and HALOTHANE. They were like nothing I´ve ever seen. They belong in a museum! In fact, I may try to bring them home just to have as my own personal peices, come to think of it.

Well, at the moment, I´m using a wireless connection at the Liuwa Plain National Park Headquarters (legally, I might add). I and a doctor from Yuka, along with a 4th year med. student from Rio Plata, Argentina, are waiting to hear from the medical director of Yuka who had told us to meet him here in town at the district hospital for an emergent operation for a patient who came in a few hours ago to Yuka. The patient, as best I can tell, is septic (38.7 ºC), and has a belly tighter than a drum head due to abdominal perferation (they didn´t take X-rays, and they had to retrive the one, manual, mercury, BP kit from the nurses station so I could measure vitals myself). I checked and was glad to see that at least he had an IV in place. Too bad it was only a 20 g, and was dripping quite slowly. I opened it up wide and asked if it was his first bag of saline, then realized as I spoke the words he should be happy he´s getting any fluids at all. Back at Mwami, they don´t give IV fluids to any but the hypotensive or C-section patients. It´s just not available, and very expensive.

The OR there at Yuka is under repairs, since it started raining in after the roof collapsed a few days ago. The bats love to fly in under the roof of the hospital buildings, pee and poop all night long for years and years until the ceiling rots and caves in. Such is life, eh?

Outside, no snake citings yet :) I did, however (mom, you´ll love this story), meet the red fire ants they have here last night. Fortunately for me, and my scarred for life psyche, there were only 2. But, they both bit me at once, just like the old days, on my legs after I inadvertantly walked too slowly past them. I´ll try to get a pict of these beggers... they travel in hords here, HUGE groups of them. I saw them this morning, traveling about 10 to 12 ants wide, both going and coming in a trail that flatened out the sand. You CANNOT stop and look at them long. They DO notice you, and the DO come after you. I´m having flash-backs just writing about it.

*Dream-like sequence here*
I was about 4 years old, playing in the front yard in Savannah, GA. I didn´t know it, but I was standing on a fire-ant hill, and suddenly, after climbing both of my legs up to my crotch, one of them gave the signal to bite, and so they did... all at once. After that, all I can remember is excruciating pain and being stripped naked faster than a trauma in the ER so I could be washed off.
*End PTSD recollection here*

Back in the present, we´ve been notified that the doctor who asked us to come for surgery here in Kalabo is in a meeting. I asked if the Kalabo hospital could deal with the surgery without us... I mean, they have a hospital with a functional OR, doctors, maybe even a nurse of two on duty, what the big deal? They said the Kalabo doctors are in the same meeting! Trouble is, the power in this region goes out every day at 7 PM until 9 AM the next morning. So, if you want to operate WITH electricity, they´ve only got 1 more hour to go. I also learned that while Kalabo District Hospital does have a new anesthesia machine, there is no one there who actually knows how to use it. :) How convenient.

My guess is this guy isn´t going to get a surgery until tomorrow. And that´s if he lives.