Operation Walk Virginia is on the move!

Advance party arrived in Nicaragua

So, no container as yet and it is 11:45. We were at the hospital at 9am and battled. One person saying the container is at Customs, the other saying it is delayed at the border. the last was that it was just outside of Managua and would be 1st in line at customs (for which they paid extra) and would be at the hotel by 1. I’ll give them until 2pm. It’s going to be a crazy afternoon. Please let it get here by then!!! It’s 300 boxes that have to be organized and sorted so that we can do the clinic at 7am tomorrow morning and start operating by 1pm. We hope to do 10 surgeries tomorrow. But we need the cargo!

So, the container finally make it to the hospital by 3pm. OMG what a tense day it was! We got tons done to make operating tomorrow a reality. Kudos to the pre-team – Debbie, Will, Ericka, and Jon! It was a lot of work. They had told us they had this and that and then – no. So they scrambled and borrowed and by 7:30pm we had all the equipment necessary. We had 2 team members delayed until tomorrow but the rest arrived safe and sound. And away we go!

Day One Saturday

Day 1 is a fait accompli. We started the day screening about 70 patients as, surprisingly, we had some no-shows. It was total chaos but we managed to pull it off. We keep asking all team members if they have urinated as it is easily 90 degrees inside and working hard in that heat there is a danger of heat stroke/dehydration. We had hoped to do 9 or 10 cases but were only able to do 6 as it took until after 2pm to start surgeries. They didn’t/couldn’t find the IV fluids and then they were in bottles vs bags which wouldn’t work and also had a very hard time getting pain medications. They don’t usually do surgeries on Sundays.

Can’t do surgeries without pain medications! So we arrived to the hospital at 7am and the last person walked in the hotel door around 8pm. We were a little short on interpreters but managed- some English speaking families were a great help. We needed to make sure the patients understood what their surgery had been etc. Most of the patients are undiagnosed high blood pressures and nobody has allergies – because they never take medications! Those we determine are newly diagnosed, we have some b/p meds for them to take home to get them started. One patient we were unable to help but we did give him a box of Advil to help with his pain. Tomorrow we start it all again at 6:30am. Hope to do 10 cases.

Wow! How cool is this??!! The former head nurse, Eleanor, who retired between the time of our last trip, heard we were here and came back to help us! And is planning to be here every day! That, for me, is truly heart warming. She had to retire due to blood pressure issues (I personally can relate to that) but wanted to come back and help us. On a completely different note, when I was going to the grocery store today to buy snacks (keep the team happy) I saw them first digging up a street and then digging up a sidewalk. They were breaking up the asphalt and cement with a large pole – simply banging it over and over – no machines at all. And then the big chunks? Several guys simply hauling them out. Wow.

Day Two Sunday

So today was a good day but a longer one than planned. The second bus left the hospital at 7:30 and returned at 8:30pm. The 1st bus left at 6:15am and THEY didn’t leave until 7:45pm. the patients are doing really well – one guy walked on the day of surgery and walked 50 feet!

Sunday the AC in OR 3 broke down and the people working the case were literally dripping! Today the AC broke in OR 2. The AC NEVER gets it to temperatures we are used to in ORs – or in cars or hotels for that matter. We went to 3 medical supply stores today looking for urinals, bedpans, cautery knives and lap sponges – we didn’t have enough donated. 2 of the 3 stores were simply in neighborhoods – homes converted into stores. Everything is labor intensive. You ask for the supplies, somebody goes and looks to see if they have them, they hand write all the numbers/information etc on a carboned sheet, you go to the cashier, pay, bring the payment receipt to another window and they give you your stuff.

Day Five Wednesday

So today’s problem was the autoclaves were all broken. for all of you who aren’t medical, they are used to sterilize the instruments needed to do the surgeries. Can’t do surgeries without them. 3 out of the 4 sets had been sterilized over night once we got the door of one of them open. The largest one wasn’t getting enought heat and pressure to properly sterilize. The Nicaraguans were using it but we didn’t feel it was safe. So the small one now worked- it fit 4 trays. it takes 6 trays to do 1 knee. they sterilize for 35 minutes. so we could do 2 sets in 110 minutes. Lots of down time which made it impossible to only do 10 surgeries.

Even with that we didn’t get the last bus out until 6:45pm. Luckily, the hospital allowed us to operate tomorrow – we usually stop today – so we are doing the final 2 of the 12 tomorrow morning. The AC in the ORs is still sketchy – going out in various rooms. You can tell because after the case they come into the storage room totally sopping wet. Once the heat actually went on in one of the rooms!!!!! The last patient today had a few difficulties but made it to her room just fine. When we left the nurse was going to look to see if she could find a lightbulb for the room. Currently it’s only lit by the hallway light.

Homeward bound after a successful mission in Nicaragua