Sunday, November 3, 2013

An overview update (not really that much new...just an overview!)

An update I emailed out, minus pictures unfortunately...
I just wanted to send ya’ll a little update on my time here in Congo so far – I’m sorry it took so long to send something out like this…I try to update my blog a little more frequently, so feel free to check out as well as befriend me on Facebook.
It’s hard to believe I have been in Congo for over 10 weeks now.  Several days after I arrived we had the big Selection Day in Pointe Noire.  Over 7000 people were in line, with about 4000 prospective patients.  About 1700 were given cards to come back for further screening or admission dates.
It was a very hard day – Nick (my boss) and I felt like we had to turn away more people than accept.  Thankfully most of the diagnoses were evident if it was a condition we could or could not help with surgically for orthopedics.   Our other rehab team members helped out with the plastics screening portion.
The week after the Selection Day, plastic surgeries started.  This is a specialty in which rehab invests heavily – there are many burn contracture patients, birth deformities, neurofibromas and the like which we help the patients regain their movement and strength.  Many of the patients receive skin grafts, so there is a delicate balance of allowing wounds to heal and quickly regaining movement so it will come more easily.  Even though plastic surgery finished several weeks ago, we still have a handful of plastics patients in the hospital who needed a 2nd graft or whose wounds are taking a very long time to heal.  Erin, our hand therapist, makes plastic splints for the patients who need them to optimize functional positions and regaining range of motion.  I was able to do a few small finger splints myself this year, so I was excited to put a new skill into practice – even if they were only for the pinky finger!  J
Orthopedic surgeries started 2 weeks ago and will continue for another month.  In orthopedics, we only operate on children – this usually assists in healing time, (As well as they are easier to carry up and down the many flights of stairs if needed!  I just realized how thankful I am for that fact this week after carrying up a little girl whom we are precasting before her surgery next week!  There are 42 steps from the dock to the ship, and 64 steps from the gangway down to the hospital just in case you were wondering!)  Probably the most common procedures we do in orthopedics are femoral or tibial osteotomies.  This is performed on a child with knock knees or bow legs to make the legs straight and involves cutting the bone, adjusting the position, putting a pin or screw to hold it in place, and then casting the broken legs.  The cast is then cut in half to accommodate swelling for several days, at which point one of the rehab team overwraps the cast again with fiberglass to allow the patient to stand on their newly straightened legs for the first time (usually about day 3-5 post operatively).  Usually the older kids do well and the smaller kids scream.  We have one particular fellow named Gaga, however, who at the age of 4 is quite the little soldier and always with a very serious look on his face accomplishes whatever he sets out to do, which lets 6 year old Grace beside him see things are not so scary.  It’s funny how the dynamics of ward medicine influence a patient’s reaction to treatment!  So the past week I have been learning much more about casting – overwrapping, wedging casts to overcorrect alignment to accommodate for future growth, windowing casts for pin care.  Since I was not here during the inpatient phase of orthopedics in Guinea, these are new things to me!
I am also starting to take over the duties of the rehab team leader as Nick leaves in just 2 weeks.  I think I’m a *little* past my horribly overwhelmed stage, but I don’t know if that will return once he actually leaves or not!  Managing a multinational team of changing people in a changing patient population is definitely going to be a challenge!  Thankfully most of the crew has been here before, so I will only have 1 person totally new to the ship to train.  We have been able to get a little bit of extra help of about 17 hours a week from other crew members with physical therapy backgrounds, so that has been very helpful to our team of 4 fulltime crew and 3 dayworkers.  There are many days when the crew work late, shorten lunches and don’t get as much done as they wanted to, so we are still trying to prove by our statistics that we could definitely use more help.
Biking & camping trip to the beach about 40 km away
On a different note, exploring some of Congo has been fun.  I am now a ship’s driver, which means I can check out a Landrover for $0.35/kilometer for up to 4 hours.  Driving in Pointe Noire is its own adventure – constantly looking out for pedestrians or vehicles not doing what you expect them to, with few traffic lights to navigate busy intersections.  In comparison to what the driving looked like in Guinea, however, there is much more orderly driving here, for which I’m thankful.  It’s easy to get to some decent beaches (though I haven’t yet gotten in the water due to strong rip tides), and I’ve also gotten to go upcountry to Dolisie twice – once for pleasure and once for hospital business.  In Dolisie the mountains are all around and you breathe a sigh of thankfulness at the beautiful scenery and slower pace with friendly people.
Life on the ship is busy, though it perplexes me how it can be so busy seeing as I have no commute time, and don’t have to grocery shop or cook my own food.  That should make up for at least an extra hour per day!  There is something usually each night that I participate in, whether it’s Bible study, Tuesday night pizza, inservices, meetings or ultimate Frisbee.  This past week our rehab team went to the house of Bob, one of our dayworkers.  His sister prepared a wonderful meal of 2 kinds of fish, chicken, fried plantains, rice, and a bean/cassava leaf mixture.  We met more of his family and had a good time of laughter, stories and fun.  He recently moved to this house which is very far away on the outskirts of Pointe Noire, but has 3 bedrooms, a common room and a kitchen.  It houses him and his 2 boys, his brother and sister in law with their 2 children, and his sister who will be returning to her home in Brazzaville soon.  Elly, his sister, worked all day to prepare the meal for us, so we felt very honored. 
So just wanted to give you a little picture of what life has been like so far – God is definitely teaching me a few things through this change in position that I am not able to do everything on my own, sometimes my typical approach to a problem may not always be the best, and overextending oneself does have some consequences.  I invite you to pray with me on these things:
·         Healing for our patients (especially our plastics patients that are still hospitalized – particularly Geril, one of my favorites and a sweet teenage boy with deep wounds between his fingers)
·         Being a support to my friends and accepting their help when I’m overwhelmed
·         Adequate staffing for rehab – particularly late Nov/early Dec when staff changes and someone is on vacation and in Jan – March when the 2nd block of plastics runs yet outpatient ortho is in full tilt
·         Health and safety – I’ve had a little bit of a runny nose the last few days
·         Actively pursuing God and not being passive in my relationship with Him
·         Figuring out how to be the best team leader I can for rehab – protecting and caring for my team, managing cross cultural differences, providing an atmosphere of spiritual growth

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