Thursday, January 31, 2013

I Went to Vietnam without Expectations

Drs. Meir Nyska and Sahra Sellers
I went to Vietnam without expectations. Even so, my mind was blown by the experience.

I knew that we would see foot and leg deformities that I'd only seen in textbooks, but I didn't expect that the patients would be so easy to work with. To be honest, we saw deformities that I don't think have ever been described in writing. (And I won't even attempt to try).

It was amazing to see the creativity that patients have used to function despite their deformities: wearing shoes backward, using sticks as crutches, and family members literally carrying each other. I expected that every surgery to correct the severe deformities would be long, complicated, and difficult. I was absolutely amazed at the number of people we were able to help with relatively simple procedures.

When we first arrived at Can Tho General Hospital, it seemed like there were people absolutely everywhere. I was excited and anxious to get started with the evaluations while we waited for the full team to arrive. The patient evaluations on our first two days are best described as organized chaos, especially on the first day as everyone figured out their roles.

Creativity in mobility.
The first patient I evaluated was a little boy with congenital clubfoot. If he had been born in the United States, he would have been put into a cast right after birth. Instead, because of the limited healthcare, he had not yet been treated. Luckily his deformity was still very flexible. We signed him up for a surgical procedure that would take only five minutes to perform, but would completely change the way he walks. I almost started to cry right then and there realizing how easily we could perform the procedure and how much it would change his life.

We started surgeries on our third day at the hospital. I was surprised at how helpful and attentive the Vietnamese nursing staff was, despite the language barrier. They were willing to play charades all day long! Although they don't have the advantage of the most current medical equipment, you can tell that nurses in the Vietnam and the United States all share the same compassion for patients.

This boy came straight from school
to visit the IEP team for screening.
The recovery room and the patient wards were the where it was most apparent to me that we were in third-world country. All the hospital's surgical patients were crammed together in one medium-sized room. I have never seen more groaning patients with bloody dressings in my life.

When we did rounds to check on patients in the orthpaedic ward, we couldn't walk down the hallway without being pulled a room by one of the family members. Most patients had several family members staying at the hospital, typically sleeping on thin mats in the hallways. It was heartwarming to see the patients. You could tell they were in pain but none wanted to admit it.

I've always been a firm believer that a hospital is made up people, not equipment. Even if the hospital in Can Tho can't be described as "state of the art," the doctors and nurses have the same goals and motivations as doctors and nurses in the United States: to take care of patients to the best of their abilities. There were moments where it didn't even feel like we were away from home, because taking care of the patients was everyone's common priority.
For me, our most memorable patient was a 50-year-old woman who had the most severe clubfoot I have ever seen. Her foot was literally turned backward her entire life. We performed a pretty extensive surgery to position her foot facing forward, perpendicular to her leg, and flat to the ground. Immediately following the surgery, we took the drapes down so she could see the new position of her foot. I will never forget the look of surprise and gratitude on her face.

Without a doubt, the people are the most memorable part of this experience: the patients, the hospital staff, the translators -- everyone we met. Beyond the hospital, it was the food. Vietnam ruined me for fruit at home. We ate like royalty! I started to keep a daily journal on the trip, but stopped when I realized I was only writing about food!
People have asked me whether, given the opportunity, I would go back. The answer is easy: I'd go back in a heartbeat!

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