Dhaka, Bangladesh Surgical Volunteer Trip

Yippeee!!

  Two to a bed 
  Originally uploaded by interplast.

Yippeee!!

My supplies are here!

My luggage was lost. We arrived Sunday at 1:00 am and my luggage finally arrived Thursday but the airport security was holding my work supplies stating they needed to be taxed. So I was asked to not pick up my personal luggage until they could arrange picking up both claiming my supplies as personal as well. And it worked! One of the doctors escorted me to the airport today. He told the airport personnel that I was there to help the countries poor people so they should help me. So I have all of my supplies.

So now I can make real splints that will fit the patients and provide good support. A day of celebration. The next celebration will be when the entire team gets the supplies they need. We have all learned a lot about working with what is available, which is valuable to these people because we are working with the conditions that they face each day. Seems much more beneficial when you look at it that way.

In this photo, there are two patients in the bed. With more patients than beds, we make do with what we have.

On to Success!

  On to Success! 
  Originally uploaded by interplast.

Everyone is talking. The patients sit all around us in the recovery room. It is rounding in the true sense of the word. The surgeons review the cases and tell what they want post-op. Then the action begins. Dressings come down. Everyone helps for that. Then we’re on to cleaning the wounds. They wash in the sink with soap and water and then we redress them. Our dressings consist of Adaptic and antibiotic ointment. We have boxes of sterile 4 x 4’s which has been great. These were left from previous trips.

The locals have given us their “Kling” wrap. This is cut from bolts of very loose woven cheesecloth using the same giant scissors that I am using for the splinting. The strips of cheesecloth are then hand-rolled and autoclaved for sterilization. Quite a process.

After the wounds are redressed they get their exercise instruction. I am learning in Bengali how to say straight and hold. And I can count, too! Ak = 1, dhu = 2, tin = 3, chir = 4, and phach = 5. They seem to enjoy that I am trying to learn some of the basics of their language. Many come to me and ask me how I am in Bengali so I will respond, ”I am fine”. They always laugh so I have a feeling my pronunciation needs work.

It is a busy time for the next 2-3 hours and then things begin to settle down. They are all patient and wait their turn watching each other and encouraging each other along. And when one of them gets his finger all of the way down they hold it up so others can see, proud that they can move. On to success!

Teething Time

Little Mim is a 6-month-old girl born with arthrogryposis. Her thumbs are folded into her palm. Her fingers are flexed with the wrist bent down. Her elbows are flexed as well. I was fitting her to splints to hold the wrist/fingers/thumb/elbow into a better position while sleeping. She had the biggest smile and huge round eyes. Every time I tried to put the splint material on her arm, Mim would lean down wanting to have a finger in her mouth to chew on. She is just starting to teeth and she was wanting to chomp down with her little gums. It was making splinting a bit difficult. Every time I reached toward her, her mouth opened. I finally had to ask the mother to hold her finger in Mim's mouth so I could have my two hands to work.

Susie Scissor Hand

  Susie Scissor Hand 
  Originally uploaded by interplast.

Splinting material is a low temperature plastic that must be heated in hot water to make it pliable. It is then molded to a person’s hand to protect it after surgery, immobilize joints or with elastics pulley systems to improve motion. So we pack up our fry pans, Velcro, splinting material and off we go. Except when the supplies don’t arrive…

Shafquat came to the rescue. Previous Interplast trips had left supplies, so he had them brought up to the recovery room where I set up. It is a very big room that the patients are being blocked (anesthesia) as well as recovering post-op. Shafquat sent up a sterilizer with hot water for me to use. There is no temperature setting so the water is just about boiling. It is much hotter than it should be for the splinting material so I do quick dips to try to control it. Then came the scissors……12 inch monsters that chew through the material at best. They are a bit daunting to say the least, and I am now called “Susie Scissor Hand”.

Never Miss an Opportunity to Educate

The first patient was a burn victim. Her hands were severely contracted so, she was fitted to a dynamic MP flexion splint. Her husband is a physical therapist. I asked if he helped her with range of motion exercises. He answered yes and that he used ultra sound which he was very proud of. So I took the opportunity to briefly instruct him on stretching her hands using the splinting concept of slow and gentle prolonged stretch and the importance to prevent further contractures. Never miss an opportunity to educate.