Bamako, Mali - Bonnie MacEvoy, anesthesiologist: Some of us went to tackle the task of building an OR suite from the ground up (except for the walls, which were already there) - recovery area, clinical office, supply room, sterile processing, cleaning and sink area, OR with tables, vaporizor manifolds, airway/IV/surgical supplies, suction, waste gas scavenge and record keeping. Interplast does a great job of imploding all these items into the boxes we bring and we must rehydrate them all to life.
Patients come from all over to be seen and hopefully selected for surgery. Some do not have a problem that is surgical (one girl had not spoken in her life), others cannot be safely done with the equipment we have and the time to do it in (extensive burn grafting) and yet others are not things we can deal with at all (club feet).
Patients are first seen by the surgeons: the senior staff, second attending and the Interplast Webster Fellow. Consideration is given first as to whether the case ought to be done at all (technically) and if so, a plan is devised. We also have along a nursing professor who is teaching local nurses and is in charge of dressing changes and wound care and a hand therapist extraordinaire who treats some post-operative patients and takes others for hand therapy only. One of our translators is a very organized engineer and keeps all our needs and details running smoothly. Everyone has his/her own niche and essential roles.
Those who are chosen to be scheduled are then funneled to the next room where they are seen by two nurses for hemoglobin, weight, height, vital signs, and photographs for identification on the day of surgery and then to the pediatrician and anesthesiologist for the final screen and clearance.