Dear TNMS supporters,

Traditionally this is a day of mixed emotion for the team. The patients clapped on our arrival at clinic. That never happens at home. There were a lot- probably 90 patients. We saw a few follow up patients, gratifying for the patient and the team generally.

The selection of patients for hip surgery is slightly more complicated than at home because we have to ration care. We have a limited number of spots in the OR. Each time we see patients we have to reflect on whether we can safely do the patient and whether if things go wrong, the patient will have care. We do have a good strong Ecuadorian colleague taking care of our post op patients but occasionally we need an Orthopedic surgeon. So we are cautious but still have more patients than slots. The local orthopedic surgeons, when called, have helped, fortunately an infrequent event.

The clinic itself is loud and feels chaotic but is well organized. One group of patients travelled by bus from the jungle. This is a long trip, perhaps 10 hours. Several of the 8 qualified. We have a mother/daughter combination this year.

As usual there are many patients who cannot work, cannot support their families and therefore are desperate. There is a big benefit to a whole family to having the painful hip fixed. It is difficult to tell people they don’t qualify, usually because of medical conditions that co-exist. Heartbreaking this time is a 13 year old with such difficult heart trouble, we could not offer care.

The team communication and spirit are very high and when the day finished we could rest. As a group we were ready for the days to come.

With gratitude,
Jim