Friday, January 18, 2013

Dehradun January 18, 2013 - end of week 1

It has been a crazy week.  Starting with 48+ hours for most of us in travel, 2 days of lost time while negotiating for our equipment, and 3 days of hard work on a shoestring.  I am most impressed at the creativity and flexibility of this team in the face of power outages, lack of familiar work setting, and challenging patients.  Bravo, everyone!

 Kush using steps for surgical lifts while working.  I bet he would stand on a bucket if he had to!

 My circuit.  Giving general anesthesia with only a tank of oxygen, tank of nitrous oxide, make-shift circuit and waste gas scavenge, IV medications, and a wary eye.  This guy moved around a lot, getting huge doses of propofol and narcotics.  I think the surgeon has a special revenge planned for me...

 Kush at work; cute hat.  His children came in today and watched surgery.  They are very young; 12 and 13 I believe.  They were very helpful to the other volunteers and coordinators, and a delight to have around.  Kush said his father Yogi did the same thing, bringing Kush to even help with procedures at a very young age.  Kush is hoping his children will that a liking to surgery, and so far it looks like it is working.

 Another example of innovation.  Yogi needed a pointed retractor for his procedure, and bent an 18G needle into the shape he wanted.  The sparcity of equipment is most visible as the surgeons work, but they have been creative and gotten amazing results.  This "retractor" worked so well and shows that necessity is the mother of invention.

 This gentleman has had skin grafts around his eyes before, after serious facial burns.  The shrinkage of the lower lids from scarring rolled them down, exposing his inner lid and leaving his unable to fully close his eyes (ectropion).  Both his upper and lower ducts were rolled away from the globe, which left him tearing but not effectively watering his eyes.  The plan was for a medial canthoplasty (see the purple Z lines at the corner of his eyes), and more skin grafted under his eyes to give them more slack and returned function.


Afterwards - a bit gruesome for the non-medical to look at, but it is a thing of beauty.  His eyes close, the skin lays flat, and after some healing and time, he will be very delighted with the result.  Art in the OR!

 Cute spelling.  Works for me!

 There are feral dogs everywhere.  They all look very similar, like the breeds have averaged over years of random breeding.  They look very much like dingos.  Today we had very long and hard rains, and several dogs took refuge under the canopy over the steps of the hospital.  I tried to talk to them, but they are very spooked by humans.

 Beth, our burn therapist, arm wrestling with Faruk,  My money is on Beth!

 Much deserved dinner together.  A true feast!

 Deb, my roomie, and John - relaxed and satisfied.  Jobs well done!

 Gary, Terri, David, and Kush.  Smiling well-deserved.

 Gotta love Indian food - so many dals, sauces, and veggies.

Lilly and Les - adorable!

Thank you thank you thank you to everyone for a great week.  A milestone and maybe a game-changer for Resurge.  Amazing, creative, experienced, and capable people.  I would put my life in their hands without a thought.