Surgical call

Another picture of Chemchemi - I'm heading there in a little bit to go swimming - its hot today, feels like around 90 degrees. There is usually a slight breeze during the day and it cools off during the night.

Ndanda is about two hour west of the coast and at a higher altitude than Mtwara, (the larger city on the coast) - so the climate here is a little more temperate with a little less humidity.

I took Surgical call last night. I'd say it was a successful call night. For one I managed to stay out of the operating room and two I did get a little bit of sleep:)

The first patient I admitted to the male surgical ward; he fell off a motorcycle and landed on his head/back....he actually had been admitted to a close regional hospital and referred to Ndanda because his condition was "deteriorating". According to his transfer papers, he had a fractured tibia. He also had a lot of bruising around the eyes, and had old stitches. He was actually conscious and clinically stable, with normal vital signs and benign exam. I'm not sure why he was "deteriorating", but I admitted him for pain meds and to get xrays today. He will probably go to the theatre tomorrow with the orthopod.

Things had quieted down until about nine and then four patients arrived almost the same time.

Two patients were referred together from a different nearby hospital. One, an old woman who had sprained her knee and a yound girl who came with pain and swelling of the vulva. I believe she had a Bartholin gland abscess. I tried to I&D the lesion but didn't get much fluid back. Plan to do an exam under anesthesia, and either word catheter placement or marsupialization tomorrow. A couple women came in labor and delivered normal vaginal deliveries. A young girl came after she delivered a nonviable fetus at home, with the placenta in-situ. I gave oxytocin, but did not have much hope that the placenta would deliver spontaneously. So around 1am I got a call that she had started bleeding. I went back to do an evacuation - was more difficult because the placenta had to be extracted in pieces... she was feeling fine this morning and bleeding had stopped so I hope all of the membranes are gone.

My relief was supposed to come at 8 but I didn't see him, so I hung around until half past then was told he might be in church. A woman arrived with three prior c-sections, full term, rule out labor. Fortunately she was not in labor and could wait until the next shift.

About to go to the pond for a swim because its beautiful today.....I certainly can't complain about the weather!

BTW many of the volunteers here have been having visitors come, so I expect you to start getting your vaccines now and make sure your passport is current. I have a spare bedroom waiting for you. I can provide you with the food and accomodations - but not making enough money to pay for the airfare, sorry:)