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They named her Angel, and she was. She came to have her cleft palate fixed, she’d had her lip repaired already. She was scheduled for Tues. afternoon she waited, but Tuesday morning our cautery wouldn’t work. (You can’t do a palate repair safely in a third world country without it). Angel was rescheduled to Weds. On the first case Weds the replacement cautery caught fire. Locals scrambled to find an adequate cautery and suction machine for her surgery. She was postponed again while we waited for a loaner cautery. Afternoon it arrived. We tested and were able to confirm it was adequate for surgery.

She is the first palate patient I’ve seen offer a full smile on the first post op day. This is what makes these trips worth the struggles.

Although the most visible results of our Uganda 2018 trip are clearly the before and after photos of our successful cleft operations, perhaps the most global impact may come from education. On this trip, we had up to three Ugandan physicians in the OR watching and learning about cleft surgery. We also had an anesthetist, nutritionist and several nurses watching and participating in care. Our own nurses and CRNAs(Janet, Liz, Holly and Nicole) as well as our pediatrician (Mishelle) and our ER physician (Mark) spent time educating the staff in Kyotera Medical Center on a variety of topics including pulse oximetry and airway management, medication management, anesthesia techniques, and ultrasound evaluations. Teaching and instruction was shared between the physicians as well–both among our own team members and between our team and our Ugandan hosts. We feel strongly that education is as important, if not more important, than the surgery that we provided. Thank you for supporting our goals and partnering with us to promote health and healing around the world.

This is Amon. He is a twin, when he was about nine years, he was “burned as a response to not following rituals at birth”. This did not look like a burn to us and he said no one hurt him and he firmly denied an injury, it just happened. Aha, this is the result of Noma “(cancrum oris) is an orofacial gangrene, which during its fulminating course causes progressive and mutilating destruction of the infected tissues. The disease occurs mainly in children with malnutrition, poor oral hygiene, and debilitating concurrent illness”. This is out of our scope requiring staging, two or three surgeries or steps. The team is motivated to help him, but Martin in particular, took on finding treatment for him elsewhere. He has been evaluated and it looks like he will have corrective surgery here in Africa. Our team is committed to this. Interested in helping him you could donate to Global Medical and Surgical Teams with a note to help support this and other efforts they have planned to change lives. #globalmedsurge

We’ve had so many challenges on this trip that is hard to remember them all. On Wednesday we had hoped to do the cleft palate surgery that was originally scheduled for Tuesday. This procedure requires good suction machine as well as a reliable cautery machine in order to control bleeding . Both were in question as of Wednesday morning. We went through several rounds of cautery machines on Tuesday and early Wednesday, including the one that we bought from the US and the one that eventually went up in smoke on Tuesday. We had almost given up hope when Dr. Ambrose somehow procured a functional cautery and borrowed it from the hospital in another town and drove it to us. We were overjoyed because we could finally perform Angel’s surgery. She is a delightful four year old girl who will now have the ability eat and speak more normally.

Also on Wednesday we treated Hope, an eleven month old boy with a bilateral cleft lip and palate. We repaired his lip and will plan to repair the palate next trip. We leave stents in the nostrils for a couple of days until swelling resolves to ensure a good nasal airway. Absorbable sutures and tissue glue are used on all lip repairs so the children can breast or bottle feed immediately and do not have to return for suture removal.

In addition, our team did other operations as well as anesthesia instruction, ultrasound training ( Mark brought an ultrasound machine to donate), pediatric consultations by Mishelle, and we had Ugandan physicians in the OR with us to learn about cleft surgery. Thank you so much for the outpouring of support! Your donations are making a difference in the world right now.

#globalmedsurge

Busy day in Kyotera, Uganda today. Janet, Nicole and Holly set up the OR Mark worked on our medication list for the Ministry of Health and sorted out some unusual tropical medicine cases in clinic. Clay, Liz, Mishelle and Michelle worked the screening clinic. We met some delightful children, accompanied by loving parents and guardians and enjoyed working with the dedicated nurses and physicians at the Kyotera Medical Centre. Thank you for your good thoughts, prayers and support.