Tuesday, August 7, 2018

IEP in Namibia, Day 1: Patient Screening

Our first day was very busy. We started the morning taking most of our equipment to Central Hospital, where we’ll be doing all the surgeries. There we met the matrons (head nurses) of the operating theater and the equipment sterilization departments. We bring most of our own instruments, so we worked with the department to organize everything for sterilization in preparation for Tuesday’s surgeries.

By 11a we were on to Katatura Hospital, where we worked in 2016, to do the patient screening. There were quite a few patients ready to be seen, so we quickly got moving. The team usually focuses on foot and ankle deformities but based on the specialties of people on this mission team we were also seeing patients with knee, shoulder, and arm injuries.

I’m their first stop. I check in the patients and create an information sheet (chart). I gather their basic personal information – name, birth date, contact information. Then I gather details about why they’ve come to see the team for evaluation. There are many languages spoken in Namibia, so I often run into communication challenges. But it’s rarely a major issue because the other patients are quick to help translate.

From me, they move on to be photographed. We take photos to help identify patients and to collect information about their deformities. For example, if it’s an ankle deformity, we take pictures of the person’s ankle from different angles. This helps when the doctors need to revisit a case in the future, compare before/after, or to include in their research articles. 

Next, the doctors examine patients and assess whether we can help them with surgery. In some cases, surgery can actually cause more problems than leaving the deformity as it is. If a person’s body has significantly adapted to a deformity, any changes can create new problems that make things worse.

It was a bit of a chaotic scene. In Vietnam, the local nurses very carefully control the whole process, even keeping patients in a “staging” area before we see them. Here, everything happens in one big room. People have to sit in a crowded room for several hours and there’s occasionally some jockeying for position or disagreement about who should go first.

By 5p, we’d evaluated 73 patients ranging in age from 2 months to 63 years old. Of those, we currently have 31 identified for surgery at Central Hospital. We’ll run two operating rooms and the team will move between rooms depending on patient needs. Some procedures go very quickly, while the complex ones can exceed two hours. We always have more patients to evaluate during the week as more people learn that we're here. Once again, flexibility is key!

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