Sunset Wednesday. Big deal??

So what's the big deal about a sunset picture? It's not like a Corona commercial on a beach or anything exotic... What it does signify is that clinic ended before sunset yesterday! We actually went to dinner last night(!) which was a big deal and a big improvement over the previous two night. Drs. Moore and Chacko, and Heather, one of our nurses were in surgery but still joined us at the restaurant later.

The group attacked the day a little differently on Wednesday. Susan and David Mathews spent more of the day in clinic, essentially getting a head start, while the others operated and completed more cases than the day before. Dave is a general surgeon who speaks Swahili, so in clinic, he and Susan made a great team and made quick progress.

Susan and David also took breaks to visit radiologists and a pathologist to review some findings of some of their Monday and Tuesday clinic patients. Susan also gave a lecture at 3:00pm on Sinus surgery. I think it was a "grand rounds" lecture meaning that it was for everyone and not just a student group. Her talk was well received and she received a "three clap salute" that she can tell you about.

Wednesday clinic

Clinic continues to busy and interesting. One lesson learned is that too many patients have been scheduled for this "camp". (You sure learn a lot the first time you try to do something this ambitious!) The surgery schedule is essentially full through Tuesday, our last work day in Eldoret. Some of the first patients that were scheduled included large goiters that are causing discomfort in the neck. While these patients need surgery, their condition isn't life-threatening. So as more desparate cases show up, we are cancelling the goiters and replacing them with the other cases. Because there will continue to be clinics every day through Monday, many patients won't be offered surgery, but they will still be seen, evaluated, and advised by the ENT's.

keloid, post-op

Here is the keloid patient, post-op the next day. Keloids keep coming back so he'll never be rid of them due to genetic disposition, but he's so happy to have the large one gone! You see parts of surgical gloves sticking out of his suture lines. Well, those are being used as drains to drain any fluids that might otherwise collect. They will be removed with the sutures. He should be released from the hospital today (What is today? I think Thursday... time has less meaning these days...)

Digging a ditch

Drainage improvement project on the road to the hospital. A new drainage ditch is being hand dug by men using pick axes and shovels. First thing in the morning an outline is created with chalk for the day's digging. Then it's all manual labor. No backhoe here! They dig about 100' per day, nearly two feet wide an two to three feet deep. The sheep in one photo are just a bonus for our blog viewers.

Market scenes

A walk through the market on Monday before going to the hospital.

Lecture Monday

Dr. Michael Moore giving a lecture to 5th year medical students on Monday.

Sample of clinic from Tuesday

Here are some photos that Susan took of patients she saw in her clinic Tuesday evening...

keloid picture

Here is a man with the king of all keloids. It was so big, he had to carry it wherever he went. I don't want to be more gross than needed, but this thing carried infections, oozed puss, and let's just say that you're all lucky that you can't transmit smell over the internet.

I'll spare you the surgery photos. This was removed yesterday. After the man awoke from the anaesthetic, he kept saying "thank you, thank you, thank you!".

Tuesday

Another long day. As I write this at 8:30pm, Susan and the other ENT's are still seeing patients in clinic. we started our day hauling out equipment and supplies to the hospital. Actually, the hospital sent a van which had room for our gear, bit not us, so we walked.

Much of the morning was spent with diplomatic duties, tours, and the like. But also we sorted through our supplies which will pay dividends the rest of the trip.

I spent the majority of my day helping the "engineers" put together the "sinus tower". We were successful as the equipment worked and was used for one of the later cases today. This is equipment that Susan asked for from an equipment company who happily donated some used equipment. The hospital had no such equipment before.

I think the surgeons completed about 5 cases, but they had signed up many more! something will have to give. If my math is correct, you can't sign up ten surgeries each day but only complete five the next. We will see how this is resolved. My guess is they will have to turn patients away sooner than anticipated.

The "surgery of the day" had to be the removal of an enormous keloid. If you don't know what a keloid is, look it up. I hope to post pictures tomorrow. Let's just say this patient was very happy and relieved after the surgery was over. The giant keloid weighed in at 18 lbs.

Stay tuned…

Monday: what a long day.

Susan and gang gave lectures to medical students and then saw potential surgery patients… until 9:00pm! Everyone is exhausted. had a late supper of cheese sandwiches and beer back at IU House. There are ten patients signed up for surgery tomorrow, plus clinic to screen more patients, plus some diplomatic meet-and-greet duties before the day really gets going. Oh, and we need to cart our extra bags of medical equipment and supplies to the hospital in the morning. Can't do sinus surgery without the equipment!

Weather is great - hot and sunny.

Good to see friends from here again, either in the hospital or out on the streets.

Hope we get some real sleep tonight.

Welcome to Eldoret

We have arrived in Eldoret!

Nairobi

We made it to Nairobi safe and sound. We are staying at the Serena hotel which is very nice. We leave early in the morning for Eldoret. We did have a little trouble at the airport here. One of our "medical" bags is missing. we suspect that someone picked it up by accident, leaving behind a similar bag. We had a slight delay getting through customs. Susan had official letters for us all from both IU and the local hospital requesting that we be allowed to bring medical supplies. The letter from the hospital in Eldoret seemed to do the trick but the officer wanted to keep one of the letters for the office. we will be glad when we get all this stuff to Eldoret tomorrow (hopefully).

Of course, here's a Tusker beer…

Detroit: boarding for Amsterdam

Boarding in Detroit for Amsterdam waiting for takeoff. Lots of confusion at the desk in the terminal. Apparently the Delta aquisition of Northwest becomes complete this weekend and they are having many issues integrating their computer systems. Who knew that this transition would be more difficult than Y2K???

Indy airport

Every trip starts at McDonald's…

7 of our group of 1¹have checked in. Our 50 pound bags are checked through to Nairobi. That's a relief! Next stop: Detroit.

game day!

go Colts!

Last day

Our last day here. Waiting for Sabila to pick us up to go to hospital. We will finish exams this morning and leave for Nairobi after lunch. Dennis is practicing his swing and the dogs are thinking about marking his golf bag.

Thanksgiving Dinner

After a long day of exams then a difficult case in the OR, it was great to have this wonderful dinner. Everything was delicious. There was so much food!

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you saw it here first...

A familiar face

Nice to see John Kamanda this morning. He says he misses Indiana. we miss him too.

Turkey arrives in USA

Contrast with turkey arriving in Kenya

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Thanksgiving

dinner arrives at IU House Thursday morning.

Checking the tires

the IU dogs always sniff the car tires of arriving cars. then mark them.

Dinner at Dr. Sisenda's

We had a very nice dinner at Dr. Sisenda's house tonight. Got to meet some of Dr. Sisenda's family as well and Makaya and Henri's spouses. The ear surgeons from Holland were there too. It was a great, fun evening.

Downtown dig up

On main road in Eldoret there is suddenly a huge dirt pile. They are digging a drain off ditch down the middle of the intersecting road. what a mess. as if Eldoret traffic is not bad enough.

Morning dog games

Taifa and Chai playing by the gate at IU house this morning. Tusker in the background. then Zawadi and Jack joined and they played on the car.

Busy day

Wow. My days are busy. Exams go from about 8 am til noon. Then discussion til one thirty or so. Yesterday after I joined everyone for lunch then spent the afternoon in town. Today I skipped lunch (so I'm starving now) and went to the OR to watch the Dutch ear surgeons from Operation Ear Drop. It was interesting see attached pucture. Now we are going to dinner at the Chinese restaurant.

Did I say I missed this place?

Eldoret

We arrived in Eldoret this morning. It is soooo good to be back here. It looks, smells, and sounds so familiar. The weather is perfect, about 75-80 and sunny. We walked into town this morning and will spend some time at the Eldoret Club this afternoon. It is so quiet at IU House now since it is Sunday and nearly everyone is gone for the weekend. Exams will start first thing tomorrow.

Nairobi

Made it to Nairobi uneventfully. Having a snack at the Fairview where I'll spend the night. Have to be ready to go at 0630 for the flight to Eldoret tomorrow.
Kyle, this Tusker's for you!!

Amsterdam Schiphol airport

Yea. More than halfway. didn't sleep a wink on the plane but watched three movies and read a magazine. a few more hours here then eight more to Nairobi.

Schiphol sure seems ready for Christmas.

Detroit

Well, here we go for the marathon flights to Nairobi. On the plane in Detroit, ready? for the eight hour flight to Amsterdam.

Go Colts!

Kido is a huge Colts fan!

Halloween

Not everyone loves Halloween.

happy Autumn