…at Santa Ines…the day goes well and to finish off, the team bands forces to complete an involved, extended surgery in the orthopedic OR.  The smallest acetabulum the team has brought to Cuenca (size 38) and a size 9 for femur are required to correct this patient’s hip.  Ironically, this tiny hip ends up very difficult to ‘reduce’ (ie. moving the hip into the socket) and all the surgeons and Smith and Nephew rep’s need to ‘pitch in’ .  The patient is a petite 140cm tall, 100 lb, 36 year old woman who has had hip pain since she was 5 years old.  Both of her hips are high riding and, on this mission, she will have one hip completed.  Hopefully she will be able to have the second done at a later date.  Her procedure is a shortening osteotomy with emperion implant and cables around her femur.  One of the happy results of this surgery, beyond offering her a much more functional hip, is significant pain reduction.

Overall, 5 ortho patients are helped today.

Dr. Temple reports that at the Military hospital, the surgeries ran like clockwork.  As a whole, efficiencies are realized.  The previous day’s experience allowed the team to assess resources, shuffle a few supplies/instruments between the two hospitals, and streamline the critical paths in the process: patient assessment, proper patient admittance/registration, documentation, instrument processing, patient preparation, surgery, recovery and discharge.

It is quite impressive how this group of volunteers can flex and adjust and learn in an unfamiliar hospital environment and in response to unforseen circumstances.  Pam Railton notes how pleasing it is that, with one OR nurse down with illness today, the remainder of the OR teams fill in to do what is necessary to keep operations running throughout the day.  It is evident that this group thinks nothing of a little extra effort in order to help out – it is all in the course of a day’s work.  Throughout, the patient remains the priority and the team helps as many patients as possible: 3 hernia operations are completed and Dr. Huang is pleased that his opthamology team had the opportunity to help 10 patients today.  All staff at the Military hospital are very helpful.

To finish off the day, Dr. Temple once again enjoyed the opportunity to speak at the local University of Medicine.  There were 100 in attendance this time.  The University makes a request for more of our team to attend and speak at the school and so it is decided that  Dr. David Fermor and Dr. Peter Huang will attend the University tomorrow to talk on; establishing an airway (Anesthesia) and; Basic Medical Care for the eye (Opthamology).   Dr. Temple jokes that his lecture was really from Dr. Diana Asper Ayer as she is his interpreter and he really doesn’t know what adjustments she may be making to his talk!

We are fortunate to be treated again by the local Rotary club to snacks and coffee for the volunteers during breaks.

An undesirable development in the day accentuates the committment of this team of doctors and nurses.  There is concern over fevers developing in a few patients and the medical personnel watching over these patients do not take a break.  We do not see these volunteers at dinner and they arrive back at the hotel very late as they remained with their patients to make sure all was done to make them comfortable and healthy.  There is discussion of adding a few more ward nurses to future missions so that a break can be offered to these dedicated volunteers who refuse to leave sick patients.

Aside from the direct work of the mission, there are a few other challenges that Cuenca presents  for our vounteers…

• The streets of Cuenca are not necessarily safe for women to walk alone (between hospitals/hotel) even during the day – all precautions are taken – and so, our available male volunteers are asked to be on call to accompany our women volunteers who need to travel in between during the day – thank you fella’s!
• Thanks to Jordan Wood and Bill Wilkin’s for coming to the rescue of a couple of volunteer nurses who found unwanted intruders in their garden side room…the brave knights showed up with an umbrella to knock the huge slugs off the wall and a great volume of salt was used to ‘neutralize’ the enemy. A salt moat was constructed to border the ‘Welcome’ mat in front of the door (the under door space being the enemy’s point of entry). That’ll fix’em! …there is a photo documentary of this enemy forces strategy somewhere…hopefully it will be added to the blog later!
• The language barrier does present some challenges…one of our doctors had to be put on notice by his daughter that he had a little mix-up in his Spanish  enunciation.  She tried to catch him before it was too late…but…let’s just say she didn’t catch Dad in time …he received a very strange look from his young male patient when he tried to tell the patient that he “has a very nice mother”, and well,  it came out a little wrong when the word he used for ‘mother’ really means  ‘breasts’.