Never Have I Ever . . .

This is reblogged from Georgia Ainsworth's blog, "Ainsworths in Africa."  Georgia serves with the communications team aboard the Africa Mercy.

 

 

I’ve seen it on the gory documentaries, I’ve heard the exaggerated stories of those who have had work done themselves, but never have I ever witnessed a live surgery in an operating theatre. 

That was until this week.

Rose looking like a 19th century midwife, and me – gender questionable

If one thing is certain, it’s that the cases that this hospital ship sees are far beyond those that are dealt with in western society. That’s not because we’re anything special here, nor does it make our surgeons back home any less skilled. What it means is that, for the people we are serving here in Cameroon, what should be a simple procedure when the issue is first identified, becomes an unnecessarily complex and mind blowing case study.

 

According to the World Health Organisation, in Cameroon there are 77 physicians for every 1,000,000 people.  In the UK we have more than 36 times this amount and we constantly hear how much they are being stretched and are under pressure. More people die each year due to lack of access to safe surgery than TB, Malaria and HIV combined. Ability to access healthcare here becomes borderline impossible, resulting in a life expectancy of 53 years. That one took me a while to swallow.

Myself and the other writer within the comms team got to experience the surgery behind neglected orthopedics- essentially bones. Bones growing in all the wrong directions, and all the wrong places. Bowed legs, windswept legs, backward bending legs. You name it, these surgeons have probably seen it.

I ‘reported for duty’ at 08:30 ready to don my mask, goggles and scrubs (which, by the way, are my new favourite work attire- SO comfortable). I asked if I needed gloves only to be told that would only be necessary if I was planning on operating on the patient myself- I’m good thanks.

A quick selfie at the sterile threshold and off we went.

The first thing that hit me was the brutality of it all. They don’t tip toe around the job that’s for sure. If you’re slightly squeamish, I’d skip down to the bold line if I were you…

As they shoved (yes, I have chosen the word ‘shoved’) the surgical instrument of choice into this kids leg, they began yanking it back and forth to make a decent sized incision. For anyone reading this blog who is medically inclined, please forgive my ignorance and complete lack of knowledge here… I’m just going with what my trusty old senses gave me:

Sight: Bones being clipped, snipped and purposefully broken. Clippers delving into the tissue of the child on the operating table, viciously manoeuvring their way around the same way I upheave my cabin searching for my keys when I’m running late. A piece of blue sheet covered the patient’s face and body, removing all personification so the rough work could begin- the one limb left outside no longer had such a connection to the little seven year old boy under the sheet to whom it belonged.

Sound: The thick sound of scissors closing as they cleaved through flesh. The grating of bone against metal and the ‘pick’, ‘pick’, ‘pick’ of tweezers removing pieces of fibula that were growing where they shouldn’t. When I wasn’t listening to the sound of the human body being tampered with, background music filled my ears instead. Yes, that’s right, music was playing- and not just chill concentration music. Dancey stuff. I strained to listen to the lyrics hoping for a giggle; Bleeding Love or Dr. Beat or maybe even Pink Floyd’s ‘Comfortably numb’. The entire experience was kept in time by the constant ‘beep’ of this little boy’s steady heartbeat in the background.

Touch: My sweaty palms. I wasn’t allowed to touch anything else (thank goodness).

Smell: The sterile surgical mask that became a hot box covering my mouth.

Taste: I’ve had an eye infection recently and have been on antibiotics and drops for the past week. A medicinal taste was left in my mouth from the dose I’d taken earlier that morning and I was reminded how fortunate I am to be able to take medication and not have to suffer with something far more drastic later down the line. A literal taste of humility.

OK YOU CAN OPEN YOUR EYES AGAIN NOW

Half way through the operation the surgeon, Dr Frank (who forms half of the Mercy Ships’ dream team with his O.R. nurse/wife, Kathleen), looks up at me and says ‘so, what do you wanna ask?’

I wasn’t fully prepared to ask questions and was pretty embarrassed that, as a writer, I was lost for words. There I was surrounded by a group of experienced medical professionals from across the world: Surgeons, anaesthetists and O.R. nurses- I was in awe at the amount of knowledge in one room. When I eventually got round my own tongue and spoke, I asked him if he has ‘seen it all’ or if there are still cases after all these years that take his breath away.

He mentioned Ulrich, one of my orthopaedic comms patients that I have been blessed to meet and get to know. I have the privilege of telling his story. It’s nothing like I’ve ever seen before (obviously), but to hear this experienced surgeon (who also moonlights as a blacksmith FYI)  comment on the severity of his case too- made me realise how mind blowing it really was.

 

 

 

"He moves like an insect. Like a cricket. I’ve never seen anything quite like it” says Dr. Frank. “Just when I think I’ve seen the worst case I’ve seen in my career, I meet the next Ulrich and it keeps me going”.

Ulrich’s legs are the result of quadriceps contraction- a condition whereby your muscles don’t grow at the same rate as your bones. This results in bent limbs to compensate for the shortened muscle. Because of this, Ulrich has had to adapt to life this way as he has no access to someone who could ‘fix it’.

I sometimes have to pinch myself that this is my real job. When your role involves building relationships with amazing people who have such rich stories, you forget that you’re at ‘work’. Never have I ever had that ‘Monday morning feeling’.

Until next time,