Day 7 - Frustration and Hopelesnes

Today was a tough day, for many reasons. With the full moon last night the animals were wild last night, dogs barking and roosters crowing all night long. Think I got about 3 hours of sleep.
We didn't stick around for Sunday mass because we were supposed to start in the or at 8 am. We piled into the truck and headed to town, it was amazing to see everyone dressed in their Sunday best heading to church. We passed many different churches on the way to the hospital. We had hoped to do a number of cases today, but when we hot to the hospital no patients were there! We waited and we waited, but no patients! So frustrating. The team that showed up yesterday, dr newfield and 2 nurses, headed to the er to see if there was any work to be done. We headed to the clinic to check on our postop patients from yesterday. Many were laying on a blanket on the floor in the hallway because there were no beds. What is upsetting is that the meds that we ordered for our patients, were not given to them. The nurses told the families that they needed to go buy their medications and pay for the postop xrags! There is a ton of donated medications and crutches that are to be given to the patients but are not getting there. Turns out that the nurses are getting the meds from the depot but don't give them to the patients, they are most likely selling them! Hard to believe that they are doing this!
When the patients finally started to show up, we got the ball rolling in the or. Some of us spent the morning rounding with Dr Alexi. To say it was overwhelming is an understatement. We saw so many unbelievable sites, from anthrax infections of the eye to infected amputations. We saw post op xrays from some of the other teams, some were great others were apalling. So hard to get things right without fluroscopy in the or. I don't blame the other teams, but at some point we surgeons need to check the work and fix what isn't acceptable. Too easy to just do the case and walk away and not spend the time following the patients. That is my greatest concern about this whole catastropy, we come in trying to help, but the system is overwhelmed and we as surgeons need to make the time to follow the patients. It is far to easy to just do the case and walk away or do another case. We need to spend just as much time following the post op patients ad doing the surgeries. The local docs don't have the time to care for all the patints in the hospital. I think the biggest problem is lack of leadership. If I can do nothing else
while I am here, I hope that I can at least organize the people that are here at our hospital to get everything done as efficently as possible. Ideally I could help to organize the other volunteers here at the other hospitals too, but it is hard because you don't want to take over from the hatians and make us look like arrogant Americans. Such a fine line to walk between caring for the patients and not overstepping your welcome.
There is still so much to be done. I'll try to post some photos, if you have a weak stomach you may not want to look.

this is a girl with anthrax of her eye!

This young man had compartment syndrome of his arm and a late fasciotomy, now with necrotic muscle of the majority of his forarm and no sensation in his hand.

this gentleman had his arm trapped when a building collapsed in PoP. Someone came by and cut his arm off with a knife. now he has an infected amputaion of what is left of his arm! Yummy

this poor woman we found on the ward today. as you can see she seems fairly happy. Despite the fact that she has an above knee amputation on the right. what you cant see is that she has a badly fractured Left femur fracture that no one is treating. We are going to fix that tomorrow so she at least has a leg to stand on. ( bad joke)

This is one of the wards, you can see all the family members there taking care and feeding the injured patients. These are the lucky ones that get beds, others are laying on the floor in the hallways.

Hello, my name is Mona and I'm working on steve's team as a recovery room nurse which I thought would be usefull but found out differently. I've ended up being an anesthesiologist assistant to our anesthesiologist because there is such a lack of equipment and no monitors to speak of therefore he needs more assistance than he would in the states. When I finally did bring a patient back to what should be a recovery room, the conditions were deplorable. We bring people to large wards of 20 or 30 beds and find that they are actually lucky to have a bed. I often bring them to a rolled out rug on the floor or a sheet layed out on the floor. Family members and not nurses are caring for Them if they are lucky enough to have anyone. I brought a female back to a ward today who had no family, her bed sheets were soaked with blood, there was no staff or supplies available to clean her up. It is very hard to leave these patients who's IVs have run dry, are having substantial pain and are not given pain meds, our docs are opening dressings and finding infected amputated stumps and wounds and finding that antibiotics hadn't been given. We can only do the best we can and hope that some good comes from it.