One of the R1’s who is working in the burn unit, Dr. Christian Ortega, had been asked by me through interpreters last night to come up with some numbers related to the burn unit functions, and he did a fantastic job, providing a several page document that he had partially translated into a form of English for my benefit (I am not one to talk about bad English: my Spanish is totally unintelligible!) The document was well received by everyone else at the meeting as well.
The plastic surgeon who is director of the burn is Dr. Rodrigo Ludena, and he apparently has been in Loja for years, but has never met with Interplast before. He spoke about his training in Columbia before he came to Loja, how he had noticed that burn care was suboptimal many years ago and had been trying to improve such care for a long time. He did state that he was glad for any help that could be provided by Interplast to the unit.
Another person who came to the meeting was the representative of the INNFA, a nonprofit organization that apparently is headed up by the first lady of Ecuador and which provides support to children in need. They have also agreed to help adults with burns in Loja.
After the meeting I did rounds in the burn unit, unfortunately without a translator, and got a better look at the severely burned child - a very sad case. According to Dr. Ludena, he has a 90 percent burn - and I think he would have great difficulty surviving in a premier North American unit. I was concerned about the management of his pain during dressings - they didn’t seem to be giving him anything, but because of the lack of effective communication I could not be sure. I was also asked to see a few pressure sore patients: two paraplegics and a diabetic. I advised the rounding group that I was not prepared to do major flap surgery on these patients - I don’t have the right equipment or the time - and also I am not hopeful that the underlying cause for these severe ulcers will be corrected. One of the paras had a big skin graft on his back from a previous Interplast team that had healed well.