Author Archives: Children's Surgery International

Surgery – Day 2

We got off to another early start, feeling somewhat refreshed after a long day of surgeries yesterday.  Upon arriving to the hospital, we received an update from our night nurses and interpreter, Maria, Aliza, and Molly.

As the day began, one of our first surgeries was a facial cleft.  For four hours, it required the skills of two of our surgeons, Dr. Andrew Scott and Dr. Rajanya Petersson.  It was an amazing transformation that will forever change the life of a five month old child.

Once a child’s surgery is finished, our anesthesiologist, Dr. Zipporah Gathuya, and the anesthetist from the case takes them to the PACU (Post Anesthesia Care Unit) under the watchful eye of our nurses and pediatricians.

Once the patients wake up from surgery in the PACU, they are given a baggie full of goods, including a homemade stuffed animal, blanket, beanie baby, and hygiene products. The kids’ reactions to the gifts never gets old, their stuffed toys never leave their sight.

Once a patient is stable, they are taken to the ward where Nurse Heather, Nurse Norie, and other hospital staff eagerly await to see the final results.

Finally, once the child is able to tolerate soft foods and drinks, they are prepared for discharge.  Our staff sits down with the family and addresses plans for care at home.

On our way home, we had the opportunity to visit a few departments of the local Government hospital.  Walking through the CCU (Cardiac Care Unit), we learned that it cost around 70 taka per night, about $0.90 in the United States, an amount that can be difficult for some locals to afford. Overall, we had a successful day completing 7 surgeries, continuing to screen a few new patients, and continuing CPR training with the medical staff, while continuing to make a difference in the future of the Rangpur Community Medical College hospital.

Surgery – Day 1

We were off to an early start this morning, finished breakfast and arrived at the hospital by 7:30, only to find out there are some cultural differences in the concept of time. In any event, three operating tables were put into action and began the first of eight surgeries today.

Meanwhile, while the postoperative team prepared for the arrival of their first patients, Nurse Dody taught CPR to a group of local nurses and other staff.

We had a successful day of eight surgeries, with a mix of cleft lip and cleft palate repairs performed. We were also able to screen today a few new patients and have added them to the schedule for later in the week. The patients are all recovering nicely, as is the medical team. Our night crew has taken the reigns and we’re all prepared for another busy day tomorrow.

Today we continued our travels after a much needed night of sleep, and boarded a bus to Rangpur.

Traveling through the outskirts of Dhaka and the countryside the struggles of the people and the challenges of the country are apparent; terrible living conditions, pollution, overcrowding. There is hope for the future of Bangladesh.

As the ambassador shared with us, families in Bangladesh are allowed to have the family size they desire. The fertility rate is only 2.1 children per family, which is essentially a stable population replacement rate. Because of current momentum the population is expected to continue to rise from the current 155 million and to peak around 200 million. Note this is all in an area about the size of Iowa.

Bangladesh has recently become independent in rice production, growing enough to export a surplus. And within the next ten years, they are expected to become entirely food independent.

On the side of the road one can also witness many Bangladeshis at work, such as sawmills, construction, welding, brick making, woodworking and craft making. The recent horrific fire in a Dhaka textile plant highlighted the deplorable conditions for workers here. However, the political response both local and internationally may be building momentum for change.

We received a flowery and passionate welcome by the staff at Rangpur Community Medical College hospital.

Our greeters included the Minister of Director for Rangpur District (northwest Bangladesh), professors, presidents, and many other dignitaries dressed in fine suits.

After the ribbon was cut (we’re not quite sure why there was a ribbon), and the flower petals were tossed, we set off to work.

Prospective patients from all over the region arrived, many boarding in the hospital awaiting our arrival. The surgeons kicked off the process by evaluating the patients; once cleared for surgery they had a medical record created by CSI staff.

The CSI nurses involved and trained local nurses while they did their assessments, and the pediatricians worked with local dentistry interns who acted as interpreters.

It was a successful day; every patient who arrived for screening was seen and we have set up our plan for the next five days. Surgery starts tomorrow morning.

On January 15th, 17 members of the CSI Team left from Minneapolis, 3 from Iowa, 1 from Virginia, 1 from  Massachusetts, and 1 from Kenya. Today, on the 17th, we have all safely arrived in Dhaka, Bangladesh. En route we had a layover in Istanbul, Turkey, and a group of us took advantage of the opportunity to see some of the sites around the city. After 30 + hours of travel, we had a short 20 minutes to check in to our hotel in Dhaka, freshen up, and prepare to meet the U.S. Ambassador of Bangladesh, Dan Mozena.

We met with Ambassador Mozena for an hour at the American Recreation Association, Fazly (our logistics coordinator) and Dr. Tim Lander (our lead surgeon) shared CSI’s history and details about our current trip to Rangpur. The Ambassador gave us a vibrant speech sharing Bangladesh’s past, present, and future, highlighting the strengths and beauty of Bangladesh and challenges of its people.  He helped us understand how a CSI mission reaches beyond surgical procedures and education, to serve as an important diplomatic role in how America is perceived in Bangladesh, South Asia, and the greater Muslim world. Bangladesh has the fourth largest Muslim population of any country in the world and is the seventh largest country by population.

And now despite being more physically exhausted than thought possible, we have a renewed sense of strength and spirit as we head to bed, and prepare for our travel to Rangpur tomorrow.

Today the group split up, one group going to see the historical sights in Monrovia and the other going to a local orphanage.

The first option was to go to Monrovia  to experience the culture and vibe of the downtown area.  On our way into town, we stopped at the beach to put our toes in the sand and dip our feet in the Atlantic.  Once we arrived in the city, many locals and their kids were out at the market selling anything from toilet seat covers to expensive fabrics.  We were able to stop at a collection of art vendors and several of us purchased carvings and paintings from local artists.  Peter was even able to find a helicopter made out of old flip flops.

The second bus picked up Debbie from Orphan Rescue and Relief and headed out of town to go to the Francis Gaskin orphanage.  We were able to play with the kids and had such a great time.  The kids even put on a little show for us, entertaining us with songs and dance numbers.  On our way home we were able to stop at a market as well to purchase souvenirs and other local goods.

We arrived back to the Guest House to a delicious Thai buffet, complete with pad thai, curried chicken and vegetable, and fresh pita bread.

We all went off to bed early to prepare for our busy screening day tomorrow.

Even before we arrived in Liberia, our adventure began!  Friday morning we found out that our last flight between Ghana and Liberia was cancelled, potentially causing the mission to come to a halt.

We made it to JFK in New York, still unsure of the plan once we arrived in Ghana.  We didn’t know if we would have to spend the night in Ghana or if another airline would be available to take us all the way to Liberia.  Our plans in Ghana didn’t matter at this point as Delta wasn’t going to let us on the plane, due to the fact that we didn’t have Visas for Ghana.  Sue worked tirelessly to get us Visas for once we arrived in Ghana, but Delta wanted us to have them before they would let us on the plane.  After hours of verbal persuasion and negotiating, 2 plane delays and potential bribery, we were finally able to board the plane.  12 hours later, a representative from Firestone met us at the Ghana Airport, informing us that a Kenya Air flight for Liberia would be leaving shortly; unfortunately our bags would not be able to make the flight.

More Firestone representatives met us in Liberia.  They took all of our passports allowing us to bypass customs.  We were then transported immediately to the Firestone Guest House where we were finally able to eat dinner and relax after a very stressful day of travel.

It is a miracle that we finally made it here!

We woke up early and headed to the hospital after eating a big breakfast.  The screening began right away and so did the chaos!  It was a fast paced day filled with many families anxious to see their outcome.  Screening took longer than usual, but the children and their parents were unbelievably patient and respectful throughout the process.  The Liberian nurses were a great aid in translating Liberian English for us to understand.  We screened 127 patients in total and found that a majority of them were here for hernias.

Tired and hungry, we were fortunate enough to enjoy a Moroccan feast cooked for us by a local restaurant.  The food was delicious, but after such a long day, we were all ready for a good nights sleep.

Today, Monday is our second day of surgery and we have 16 scheduled.  This is the first trip to Hermosillo where bone grafts are being performed by Dr. Dan Sampson of Minneapolis.  These surgeries average about 3 hours in duration.  Dr. Sampson did 4 bone grafts yesterday and 4 today.  Because of their complexity and the need of patients to remain overnight in the hospital, he will not do bone graft surgery on Tuesday, but rather assist Drs. Grischkan and Fritz as needed in OR #1.

We have terrific support in every aspect of this mission due to all the volunteers from St. Andrew’s Clinic and CIMA, which includes nurses too who are here on their days off!  They also provide us with  delicious Mexican food for lunch and breaks.

These two little guys became buddies at the hotel as they were roommates and just happened to be in pre-op together due to moving one of them up on the schedule!  They were also in surgery at the same time and in the same OR too, as well as recovery together!  They were checking each others heart prior to surgery and were having a great time playing the role of doctors while waiting.

Today we had only 10 surgeries and most of the patients were discharged from recovery.  We kept two patients overnight to make sure they were up to discharge in the morning.

As with any mission, there were some inspiring and heartbreaking stories of several of our patients. One of our 15 year old patients was abandoned when he was younger, 5 or 6 he thinks, and has beenliving at a service station since they took hime in several years ago.  They would find him sleeping in the shop for shelter.

Another young woman, now 17, was separated from her parents while trying ot cross the U.S. border on their way to a better life in the States from Guatemala.  She never reuinted with them until this week through a phone call, which made her very happy!  During the years of their separation she had been liing with friends or relatives when she was younger and then made her way to Mexico at the age of 13 or so.  She was then taken in by a family in Hermsillo as a housekeeper.  She has been wanting to improve her life, but she cannot speak!  She came to screening, thanks to Coca and Laura (of St. Andrews) and the CSI team knew after evaluting that they could and would help her.  She came through surgery beautifully and was smiling, talking and giving the thumbs up right after waking up in recovery!  Her first words were “thank you” to the CSI team and all the volunteers who made this happen for her!

Tonight we celebrate: the success of the mission; the collaboration of all the teams; and the making of wonderful new friends at the traditional “banquet”,  fiesta style!

This little guy stole our hearts. CSI could not do his surgery last year and told him to come back this year.  Here is is with Coca (the saint) of St. Andrews and Dr. Paul Melchert, pediatrician, waiting to a hospital gown and gear on for surgery.