Thursday, September 5, 2013

Post Screening Day thoughts

So Screening Day was definitely a success...there were about 7300 people in line (including caregivers), and over 4200 patients were seen/screened by different surgical teams.  I don't know how many patients we screened in ortho - rough guess would be anywhere between 300-400 possible patients.  (We had about 125 +/- "yes" patients and it felt like we had atleast twice as many "no" patients.)  It was the biggest screening day in Mercy Ships history.
 THE LINE

It was a tough day for Nick and I...Nick is my boss, an Australian physio.  Thankfully he's done some screening before as without our orthopedic surgeon actually being there it did fall to us to make the decisions of who was/wasn't a good candidate for orthopedic surgeries.  We did have several cut and dried criteria - only operating on children (who will heal up faster plus be easier if we need to carry them up/down the stairs while they might be in casts or nonweightbearing.  Also we were just doing lower limb surgeries, so no upper limb stuff (although some of those we were able to refer to the plastic surgeon instead)  For those needing a tendon release, criteriea were limited as well.

The reason it was a tough day was because we felt like we said no to so many people - many many possible patients that came through the line had cerebral palsy, and be it someone with low tone and decreased ability to sit/walk by themselves, or having more tone where they had very tight muscles that may benefit from a tendon release - most of those we had to say no to unless it was 1 sided and they had good strength and it would really improve their function.

So it felt like some stretches we had to say no to everyone...sometimes you would just be able to look at a person and know they were not a candidate, but you still wanted to treat them with the love and compassion that they need.  Yet at the same time you knew there was a massive line continually waiting for you to see them so you didn't have much time to spend.  But even if they couldn't have surgery I still wanted to give some idea of possible treatments that might help them, give a stretching tip, etc.  It was hard to find the balance of quickly yet compassionately caring for people and trying to answer questions they had - often it was like they were at a doctor's visit and would ask what else could they do and expectations they could have, but I felt very limited by time and even knowledge - not knowing what is available here in Congo as well as not being familiar with all the range of diagnoses that came through.  But I love it when people are proactive about their health, so I wanted to try to answer as much as possible...so tough.  Thankfully it was fairly cut and dried which patients we thought were good candidates for surgery, so atleast we didn't have to waver back and forth on decisions.

At the end of the day we had to put all of the heavy wooden desks back in the different classrooms we used, lifting them over banisters and cramming what seemed like way too many desks into a room, so that was a hard end to a long day.

So overall I really don't know how I feel about Screening/Selection Day.  I was very excited for it - I even had the butterflies in the stomach like before a big sporting event.  But the day itself is very difficult emotionally, because you know so much more could be done, so much more is the inequality between the western world and much of Africa and other developing areas.

I've been reading the Beatitudes recently, and it makes me think of these patients we had to say no to.
Blessed are the poor in spirit (discouraged), for theirs is the kingdom of  heaven.
Blessed are those who mourn, for they will be comforted.

Also, right above the Beatitudes it talks about Jesus healing the sick (Matthew 4:23-25), of Jesus healing EVERY TYPE of disease and sickness among the people.    And he healed them all.   So maybe Screening Day is also a good reminder that while we might have a lot of skillful medical practictioners, a lot of fancy equipment, and have the desire to help all the patients possible in West Africa, we are NOT Jesus.  We still need him despite our thoughts that we can handle some things on our own...
  My Mercy Ships family and home sweet ship...

No comments:

Post a Comment