Guatemala--Day 6

Guatemala Day 6

Luis (med student) and me. I'm teaching him how to intubate the kiddos

 Well my wish for a shorter day didn't happen, left the hospital around 7 tonight.  It was an interesting day, I started with a palate surgery and then was asked to help in the hospital's other OR.  Currently Hospitalito Atitlan has two ORs but the facility is really only set up to mostly function as a clinic. They have no surgeons or anesthesiologists and the ORs are only used for emergencies...if time is available they transport all patients to a regional facility.  The ORs are minimally equipped and they use anesthesia equipment from another era (things I have only read about in books) and medications that have long since expired.  Aside from the local Guatemalan physicians, there are currently 3 family practice docs and OB doc in the facility from the US.  The OB doc is here for short term like us, but the family docs have 3 year commitments with the hospital and take care of almost everything at the facility (two of them are from Oregon).  If a trauma arrives or a pregnant lady needs an urgent c-section they are responsible, meaning they are often doing things well out of their comfort range.  Today they had a patient needing an OB procedure done under spinal anesthesia, and while they had a visiting OB doc to do the procedure they had no anesthesia providers to provide the spinal......so the family docs do occasional spinals when needed.  I was in the interesting position of being a resident but teaching a doctor who was about 15 years out of training how to do a spinal.  It was a great experience and the doc really appreciated my help, and hopefully now she will feel more comfortable in those emergency situations when she needs to fill the position of an anesthesia provider.  

Otherwise we had a tough day with some unexpected challenges, but everything ended up great.  We helped seven kiddos.  We even had one mom and son show up to the hospital after hearing we were there to try to get help for her son.  He had a cleft lip & palate but the repair needed was too extensive to be able to be done with the equipment we brought...so unfortunately we had to turn them away.  

After work the group headed in to town or a great dinner, and now we will all sleep well knowing that we are over halfway towards our goal of 35 surgeries.  

One last thing....the story of today was me standing in the back of a pickup truck to get to dinner....a rather common form of transportation here although this was the first one that I had seen as picking up tourists.  You would think that a group of medical personnel would be a little smarter then getting in the back of a pickup and standing up riding with a total stranger, but we were all really hungry, and it only cost 75 cents.