Bamako, Mali Surgical Trip

The Team

  Anesthesiologist Bevin Bart and Cleft Patient 
  Originally uploaded by interplast.

The clinical work continues today. We are very pleased with the wonderful clinical and educational opportunities here and the general outcome of everyone's efforts.

Plastic Surgeon Paul Edward has been working closely with Dr. Hamady, a ENT surgeon from Bamako. They have been taking care of patients with noma defects, the result of an infection. A lot of facial reconstruction is often necessary with these cases. The work seems tedious with a lot of forethought required. Good conversations between the surgeons often goes on, with both learning from each other. The results are great.

Drs. LaBelle and Ian Wilson, the other team surgeons, recently have been working with a number Dr. Keita’s surgical residents. There are opportunities for the Malians to learn about lip repairs, burn contracture release and full thickness graft. Both operating room nurses Ingrid and Richard have excelled at teaching a lot of basic techniques to the residents as well as the surgical nurses.

Back in the PACU, (recovery room) Lorry and Betty have a wonderful, dedicated nurse, Moussa, who eagerly listens to their words of advice and teachings. He, like most Malians, is very compassionate and supportive, providing just the care the patients need.

Bevin Bart, Steve Parker, and I have had a parade of anesthesiologists coming through the OR these two weeks. Although all were very capable anesthesiologists already, they are eager to learn about the newer anesthetics, medications and equipment that we brought.

Dr. Badda, an anesthesiologist from the Luxenborough Hospital here, has been instrumental in trouble shooting problems with oxygen and other crucial items.

Mai, Beverly, and pediatrician Joe Herbert have seen many more patients in the numerous busy clinics and the hospital wards. Joe has taught the pediatrician and ward nurses many things about perioperative care and general pediatrics, and lots of hints about logistics of such a mission are offered by Beverly and Mai.

A smooth medical experience like this couldn’t happen with out the effective communication, dedication and enthusiasm of all. The solid basic and continuing education which the Malians have is well recognized. They are bright individuals, always eager to learn more and provide the best care to their patients.

A Well-Oiled Machine

Beverly Kent: Yesterday and today have proven that the team has become a well-oiled machine. We have gotten into a good rhythm and the teaching is proceeding according to plan. Yesterday afternoon, Jean gave his first lecture. It was well attended by the surgeons, residents and interns who come every day to the hospital. It lasted two hours and everyone came out happy.

Last night we tried a new restaurant--Amandine. We ate outside for the first time. The mosquito repellent was passed around and we quickly blew out the candles on the table when we realized they were attracting the insects. The meal was good, cheap and fun.

Tomorrow is our final day of surgery followed by the team party that we give to thank all the people who have been of assistance to us during the trip. We are expecting around 55 people. Dr. Kaeta had me personally phone the television reporter and the newspaper journalist who reported on our visit last week to invite them to our party. We have worked out something with the hotel which will make it easier on all of us.

Smiles of Gratitude

Dorothy Gaal - How quickly our first week has gone. We have evolved from a cluster of individuals, (some of whom who knew each other from previous trips) to a well-tuned team. Still, we approach each patient with compassion and vigilance. Anxiety about the success of a new Interplast site began to dissipate each day as patients and families offer smiles of gratitude, and relations with the local medical staff and host and hostesses strengthened. Assistance to the team has also come from Mai’s extensive family and physicians from other NGOs. We’ve been able to exchange ideas with our Malian colleagues and accomplish both the clinical care and teaching goals of this trip.

The sensory stimulation is great in this country. The sounds of the Muslim call to prayer each morning and the sight of Malians dressed regularly in colorful, flowing garments engage the senses. Temptation to document these lovely folks is huge. We do it with respect and with the goal of sharing our experiences both medically and culturally. The scents are interesting as well: the earthy aroma of this arid land, the wonderful culinary delights and the inevitable odors of living in sickness or in health.

Our days have been appropriately focused on our clinical work. The journey to and from the hospital is short, but we’re exposed to the old and new in rapidly-developing Bamako. We had a wonderful time seeing the countryside and Niger river life during our weekend of rest. Today it was back to work, but no one minds at all.  We’re truly fortunate to have this medical and cultural opportunity in this land so different from our own.

An Exciting Weekend

Beverly Kent - The weekend was a welcome change after the hard work of the first week. We had two days off and were determined to enjoy our free time in exploration of as much of the Malian culture as possible. Saturday morning we split into two groups. Three people decided to stay in Bamako while the rest of the group accepted Mai’s invitation to visit both her mothers who live south of Bamako.

The group of 10, “The Village People”, started out on our three-hour bus trip towards the town of Bougouni on Saturday morning. We didn’t leave as early as we had planned, but we were well on our way by 9:30 AM. The road out of town had been recently paved and we started out at a fast pace. Unfortunately, the new pavement ended after about 10 miles and we were forced to endure the holes and bumps of the unrepaired road that stretched all the way to the town. It got worse and worse as we got further from Bamako. Apart from the bumpiness and slow going, the scenery we were witnessing outside the bus was amazing. My memory of Mali from 8 years ago was of the desert — miles and miles of unending sand. This was probably because the team flew directly north east to Timbuktu from Bamako. The southern region is obviously agricultural and deliciously luscious, at least in comparison to the sand dunes of Timbuktu.

Our first stop was at the house of Mai’s biological mother in the town of Zantiebougou. She warned us that the definition of family is all-encompassing and there were many people who resided with her mother. She had prepared us for the number of people who would be awaiting our arrival. We were a bit surprised by the number of people who arrived once they had heard of our visit. There were dozens sitting in the garden and they had prepared a large meal for us. Mai’s mother is in her nineties and she appeared to be as sharp as a woman years younger. It was important that we greet each and every person there before we were set out for a leisurely visit of the town. One of the neighbors owned a small restaurant and several of us plopped down out of the hot sun and had a drink while others wandered around exploring the town. Finally after Mai felt she could leave without causing too much of a fuss, we set out for the village where her father’s second wife, her “little mother”, resides. Zantiebougou also is the site of a woman’s cooperative that manufactures shea butter, used by all the big cosmetic companies in their beauty products. Apparently shea butter costs about $50 for a small jar in the U.S. The shea nut is first cracked open and the fruit is pulverized by pounding on them with a wooden instrument. The end product is a smooth, thick cream and Bevin and Lorry swear by it for making the skin super soft. Apparently they both use it every day. We all bought several jars. I felt that at least we were supporting the local cooperative and giving the women a well-deserved boost. After the visit to the factory, we headed to Mai’s second mother’s house. Once again we were surrounded by extended family and greeted each one individually. Soon afterwards we left the house and started on the return trip to Bamako. We were all hot and exhausted but so pleased with our experience. We never imagined that we would see close up the rural life of Malians and it is something we will never forget.

We arrived at our hotel close to 10pm and most of the team turned in right away. The three team members who stayed in Bamako had a great day visiting the market and the various museums. Dorothy and I were heading for the elevator when Mai stepped out and burst into tears. I immediately thought that it was the exhausting day with the team that had been too much for her, but she informed us that she had just gotten off the phone with her older sister and one of her brother in laws had died of heart failure just that day. He was a famous sports journalist and died in the Dominican Republic attending an international boxing competition. Dorothy and I did our best to comfort her, but she was feeling extremely guilty as she hadn’t been able to phone that sister, his wife, since her arrival in Bamako. I told Mai to take whatever time she needed, even if it meant her unavailability to the team. We would manage without her. The next morning we saw her at  breakfast and she explained that one of her sister’s was coming to pick her up and she would spend the rest of the day with her newly widowed sister receiving the visitors who always drop by expressing their condolences. She also explained that the culturally sensitive thing for us to do as a team would be to drop by the house as well. I told her that we would of course be there and she gave instructions to our bus driver on how to get to the house. We planned to go in the late afternoon.

The team was split into two groups on Sunday. Our new friend who we discovered in Bamako, Dr. Tim Herick, an American physician who is attached to a religious group that cares for street kids, was able to arrange with the head of USAID in Mali for us to borrow his boat and take a ride on the Niger. The boat only holds eight people so we knew from the outset that we would have to form two groups for the boat ride. The first group was scheduled to go down the river at 10 AM while the second group attended mass at the cathedral in town (the oldest building in Bamako). That group included even non-Catholics who were interested in experiencing the ceremony. We had our bus driver coming and going all day as the different groups coalesced and split apart in all sorts of permutations as we went to the National Museum, the market (of course the biggest group), the hotel, the second boat trip at 2pm, and an air conditioned restaurant at lunch.

Personally, I’m terrified of crowds and after stepping out of the bus at the market, I quickly jumped back in not able to face the constant pushing and haggling involved in buying crafts. I went and had a leisurely lunch with those determined to eat. Our bus driver, Ibrahim, told me that he would accompany me to the market and do all the bargaining for me. I jokingly asked him if he would hold my hand as we entered the market place to protect me. Paul heard that I was going with Ibrahim and stated that he wanted to go holding the other hand. So the three of us went back to the market place while the second group was on their boat tour. It was quite a different experience. We explained what we wanted and he led us to the little stalls that had the merchandise. He did all the haggling for me…it took quite some time but I was happy to wait as he got me reasonable prices.

We picked up the museum group and the boat group and headed back to the hotel in the late afternoon. All of us were very pleased with our day. I arranged with the help of our bus driver to have a money changer come to the hotel as everyone wanted to change more dollars. We put him in a corner of the bar and I sent the volunteers in to exchange their money individually. I felt like some sort of gangster but the business is all above board. The guy even has a business card with his face on a 100 dollar bill. I knew the rate that Mai was able to obtain for us the first time we exchanged money, so I insisted he give us the same rate. We haggled—for the team I was willing. He finally gave in with a smile when I told him we could find someone else.

On the way to dinner shortly past 5, we went to Mai’s sister’s house to pay our respects. Mai had left shortly before our arrival but I was able to take my cues from a young woman who greeted us in front of the house. Everyone was aware we would be coming and we joined a long line of people going into the house. We were let in front of everyone. After expressing our condolences to the widow and the other family members in the room, I wasn’t sure what to do next. The young woman accompanying us told me that we should sit for a moment before leaving. It was truly an incredible and unique experience for us. There was tremendous sadness in the room but we felt the overwhelming sense of support of extended family and friends that the immediate family was experiencing. It was a wonderful glimpse once again into the Malian culture that we were privileged to be a part of.

Dinner was fun and we ate in a new restaurant (to us) that the three team members who stayed in Bamako the day before had tried. Some of us ordered a bottle of wine for the first time—a French Muscadet. Then back to the hotel rather early for a good night of sleep and the beginning of our second week. We all thoroughly enjoyed our weekend.

Rest and Relaxation

Tomorrow we start our weekend of R&R. Some of the team members have opted to stay in Bamako for the day tomorrow, while most of us are going with Mai to visit her mother in a rural town two hours to the south. Mai’s father had two wives and so she has two mothers. Her biological mother is the first we will visit. After that, we are going to a nearby village to visit her second, younger mother. In this village there is also a place in which they manufacture shea butter—a product used in many beauty products for the skin. It is quite expensive to buy in North America (Bevin swears by it, says it leaves the skin extremely soft), so we are all going to stock up on it. Sunday, we have plans to shop and take a boat trip on the Niger River. Some of the team is going to mass Sunday morning at the cathedral in Bamako, apparently the oldest building in the city.

We have another full day’s schedule on Monday so I am hoping that the weekend gives us some fun and relaxation. This team really deserves the time off.

Electricity Issues

Today we are working later than we had programmed for another reason. Early this afternoon, the electricity went out completely. Even the back-up generator could not bring us back online. All our patient monitors switched automatically to battery back-up, and the surgeons were able to complete their surgeries using flashlights and head lamps. The anesthesiologists told me that unless the power came back on, we would not be able to perform any more surgeries today. When I told Dr. Keita what I had been told, he said not to worry because the problem would be fixed in time. Well, he was almost exactly right. We had a bit of a pause, but true to his word, the electricians built a second fuse box and all the electricity was restored. We had overstressed the system with all our equipment. All the volunteers were laughing because they said at their hospitals in the U.S., the problem would never have been resolved that fast (work orders, need for parts, etc.). So we are now feeling quite sheepish about all our “we are on African time” jokes. Apparently it can be an advantage to work in Bamako!

So Much Need

We are nearing four o’clock in the afternoon today (Friday), and we know that we have quite a few hours of surgery left to complete. Yesterday, we were fully prepared to spend a long day with the schedule we had created for today. There is so much need and the team is eager to accomplish as much as possible. Most importantly, the team members are willing to put in the extra time because our Malian medical partners are so eager to learn. The educational process adds to the time of surgery, but it is important in establishing a true relationship with the site. Dr. Keita is so pleased with the participation of his residents. He told me that they still have to perform their regular duties back at the university hospital and have sometimes even gotten into disputes if they feel another resident has had more surgery time with the team.

Every time the air conditioning fails, or we have some sort of technical problem, someone arrives to take care of the problem in short order. As these things are happening every day, it is really quite remarkable the speed with which everything is fixed.            

Soccer Trumps Health Care

I decided to bring the laptop to the hospital today and this is the first official entry from the recovery room. Dr. Keita told me this morning that the news piece on the team ran on last night’s news at 8 PM. I asked him if he had seen it and he said no, the soccer game was on and he was watching that. He said his mother called him after seeing it and said it was very good. He added the comment that she was his mother and so was only going to be complimentary in her assessment. The team decided that since every single time we see a television there is a soccer match in progress, there is very little chance that anyone actually saw the news feature. Dr. Keita said that the piece would be run over and over again, so I guess if there is ever an off night for soccer, we might have an audience for the piece.

Bevin is keeping us in stitches, and paired with Betty we have intermittent laugh fests. This is probably one of the funniest teams I have ever been with. However, all the humor is balanced with incredible empathy and care for the patients. It is really touching to watch.

Interplast in the Malian Media

A reporter from a local magazine was here this morning with his photographer. They interviewed Dr. Keita, Mai and me. I told them that it would be much more interesting to interview a volunteer. They insisted on knowing why I work for Interplast so I told them. Then Ian walked into the room and I hope they had time to interview him as well. 

The journalist wanted a picture of the doctors working and Dr. Keita requested that I allow them to do so. I told them they had to stand at the entrance to the OR and couldn’t show the patient. I asked the surgeons for clearance. They warned that the surgery (an arm burn contracture release) was quite bloody. It was soon obvious that the photographer couldn’t wait to leave the OR. Even from the entrance it was easy to see all the exposed muscles, tissue and fascia of the patient’s arm. He began swaying a bit and after a couple of shots, he rushed out of the room.

They also got permission from the mother of one of our young cleft patients to take pictures pre and post op. The name of the journal is L’Essor, one of the main journals in Mali.  So for you Malian readers out there, send us a copy when it comes out!

Mai's Birthday

Today is Mai’s birthday. We are celebrating her birthday by having another dinner at her house. We have insisted on paying for the food. This morning we told her that we would even kick in for a birthday cake. Such a generous group!

Last Clinic Day in Mali

Yesterday we held our last clinic. Joe and I decided to hold clinic by ourselves as the surgeons were so busy. We thought that if we were able to find potential patients, we would have them examined by a surgeon when one became available. Once again, we were overwhelmed by patients who had arrived for clinic. We were without a Bambara translator for awhile, so Joe and I fended for ourselves.

We made everyone line up and Joe went through the line and pulled out patients that he thought looked like they had an issue that could be solved by reconstructive surgery and asked them to wait on the side. It was a very fast procedure. I was left to explain to all the rest why we couldn’t help them. Luckily, I was able to find individuals in the crowd who could speak French and Bambara. After two hours, we had identified and cleared two patients. I told Dr. Keita that we could no longer hold clinic because our schedule was full. He warned me that after the airing of the news last night, we could expect a lot of new patients at the hospital. I told him that I didn’t want to cause him any problems, but we couldn’t hold another clinic. Dorothy came to me quietly in the late afternoon to ask if there wasn’t some way to hold clinic and give potential reconstructive patients a paper giving priority to those patients next year when we return.

The problem here in Mali is that there is no way to cut off clinic in the middle without starting a riot, and I am not willing to ask any of the team members to spend hours away from our surgical patients to help out with the clinic. So I spoke to Dr. Keita and asked if it would be possible for him and his colleagues to identify potential patients and contact them before the team arrives next year. He was very willing to comply. And Dorothy was satisfied with this solution. She is an extremely caring person and I felt bad that I was coming off so hard-nosed.

Lunch has arrived and so I will try and see what I can do about making sure everyone gets time to eat. Everyone is good about relieving each other and I wish there was more I could do to help in this way—but alas, I’m no medical person, no matter how authoritative I think I sound.

Cleft Palate Baby Girl

Cleft Palate Baby Girl
Originally uploaded by interplast.

Cisse, a 15-month-old baby girl from Koutala in the southern Mali was born with a cleft palate. She had a cleft of her soft palate (Veau 1) which would have resulted in poor speech if uncorrected. Her mother cared for her other three children and Cisse eventually overcame her difficulty with feeding, which is a common problem associated with cleft palates. She is now at the ideal age to undergo palate repair, as she has not yet developed speech habits. People with cleft palates often have great difficulty speaking clearly, so I was glad to be able to step in at such a critical point in her life.

I repaired her cleft palate (Furlow double apposing Z-plasty) and was assisted by Dr Coulibaly. The local surgeons watched the procedure closely in order to learn, and hopefully get further training to offer cleft palate repairs in Mali.

A Long, Hot, Busy, Televised, Day

Today was once again a very long, busy day. The hospital bus was once again waiting for us in front of the hotel and we left at 7:30amon the dot! “Africa time” does not exist on this trip here in

Mali! It is obvious that our host colleagues are concerned about our well-being and are warning us daily to take our anti-malarial medications and to have a good time.

We operated on seven patients today. Once again the operating rooms were filled with Malian surgeons and residents listening attentively and looking in the text books our surgeons brought with them as they observed or scrubbed in on all the cases. We didn’t have any anesthesia help today, but that was probably because the chief anesthesiologist at the hospital was involved in the visit we had today from the national television station.

The piece supposedly ran this evening on the news and we have been promised a copy of the film. The reporter and film crew arrived around 10. They clearly wanted to film one of our patients pre-, intra-, and post-op. I told the reporter that we were most concerned about patient confidentiality and that before they could do any filming, the patient and/or the family had to agree to participate. I asked the team if they were bothered by cameras in the OR and they were ok with the idea as long as the patient agreed to being filmed. We had a beautiful little child with a bi-lateral cleft lip and her mother agreed to have her daughter’s operation be filmed. Mai and I wanted to make sure that the mother wasn’t coerced into agreeing, so Mai was the one to explain what the film crew wanted and told her she did not have to agree if she didn’t want to.

The reporter, the director and Dr. Keita all supported the mother’s choice to say no if she didn’t want to do it. The whole experience was very positive. First Jean Labelle was interviewed in French and he explained what the operation would mean for the patient and how we would treat the cleft. Then Dr. Keita explained the same thing in Bambara. Mai was also interviewed and she spoke about how she became involved with Interplast and how we came to be working in Bamako. She was a wonderful PR person for the organization. I was interviewed off-camera by the journalist and was able to fill in some of the holes. We’re all anxious to see the video. Ian was the operating surgeon and he was filmed working with the Malian maxillofacial surgeon.

Things became a bit tense at the end of the working day as almost all of the air conditioners had stopped functioning and we were all hot, tired and irritable. We left the hospital after a short meeting including our host colleagues at around 8. It was Ingrid’s birthday today and she wanted to eat pizza. An American doctor who is working here gave us a list of restaurant recommendations and we found one not far from the hotel. The bus took us there and waited for us to finish dinner before bringing us back to the hotel. It was a perfect way to end a very long, stressful day. We were all able to relax together and laugh. All tension had disappeared. A happy team returned to the hotel for what I hope is a good rest.

Working With Our Malian Medical Partners

Today was our first day of surgery. We have filled the schedule until next Wednesday and held another clinic all afternoon today at which we picked up another 8 patients. We will have our final mini-clinic tomorrow and I think after that our schedule will be full through Thursday. We will not operate on Friday as we leave late in the evening.

Our Malian medical partners are incredible. Every day there have been many of them with us in the clinic and today in the OR. Lots of residents, but even some attending surgeons, like Dr. Kaita, a pediatric surgeon has been with us the entire time and Dr. Toure, a maxillofacial surgeon who just back from training in France. He was not yet back when Bill, our chief medical officer who evaluates sites, was here in January. He is capable of doing many of the surgeries and he has scrubbed in on every case so far.

The teaching is amazing on this trip, in all arenas. There are many surgeons in the room of course, but there are also anesthesiologists and nurses who have come to work with the team. Everyone is very excited about all the learning and sharing that is going on. Dr. Jean labelle, a plastic surgeon from Florida who loves teaching on Interplast trips, is in seventh heaven. I think that Ian Wilson, our 2006-2007 Webster Fellow, is learning quite a lot also from Jean. Ian was especially pleased with a hand case he did today with Jean.

We are all tired as we work long days and it is very hot. We went to a French restaurant on Sunday night and have discovered the local fish which is delicious. Last night was Chinese, and tonight Mai invited us to her home in Bamako. Her relatives prepared a scrumptious meal with vegetables (we were so happy to eat vegetables that were safe!) and fish. We are dying to see Bamako by daylight but have not yet had the chance since we have been in the hospital all day and sleeping at the hotel at night. Perhaps this weekend. We are making all sorts of plans for our weekend off. We'll see what we finally decide to do. Not much time to think of all that quite yet.

I have had zero time to take pictures, much to my regret. I am spending all my time translating and am so happy to have the PACU nurses take over the administrative tasks. I am keeping the PCIP (patient care improvement project, our patient database) up to date I'm happy to say, but it is not easy. Mai is wonderful, as we knew she would be. She is busy translating and working out the nuts and bolts of our trip.

Tomorrow a film crew is coming in the morning to film the team at work. I have told the director that we will not allow the crew to come into the OR but they are welcome to film the team working with all the Malian partners from the door.   They understood completely and understand our concerns about patient confidentiality. I think it will be great PR for all of us for the people to see the Malian doctors working together with us.

I have more to write but must sleep. I'm about to collapse. There are some really incredible pictures that the other volunteers have taken and I have asked them to send to Seth Mazow (the Interplast staffer who manages the blog) so he can post them.  Hopefully he will receive them soon so you all can see what it's like to work here with such incredible host colleagues.

 

Interplast Team Working Through Challenges

I'm dead tired but I didn't want to go another day without telling everyone what is going on here in Mali.  We had clinic on Sunday for four hours and there were crowds in front of the hospital.  It was a good afternoon. The boxes arrived at the same time we did at the hospital and part of the team was able to set up while we ran clinic.

It was much like the clinic in Timbuktu 8 years ago, the last time we went to Mali. We saw all sorts of patients, even those who had eye problems, orthodontic problems and dermatological ailments, all important issues but not within our scope of reconstructive surgery. The doctors had told everyone exactly what we could do, but they insisted on seeing the Americans and this country is very tolerant of people's wishes. They understand that if we tell them the same thing it will be accepted. So the cases paraded all afternoon in front of us and we were able to get 10 fairly good cases out of the afternoon. Around 5:30, someone made the mistake of announcing to the crowd that we would be finishing up at 6 and that we would start again the next morning at 8. Suddenly what had been a fairly orderly process turned into chaos. The crowd swarmed forward and disputes began to break out. I was safely ensconced in the surgery room (which was air-conditioned!) with the surgeons and was not aware until I looked outside to see what was going on. Our poor nurses, anesthesiologists and pediatrician were overwhelmed by the crowd. And the heat was intolerable. They all looked like wilted flowers and I was afraid they would not last long.

Fortunately we had a good meeting with our host colleagues that evening and ironed out the problems. We were able to set up a much more efficient system on Monday and the day went by without any problems. The surgeons were in one air-conditioned room and the rest of the team were in another cool room on the other end of the corridor. We placed tables to block the crowd and it worked wonderfully. Anesthesia did the scheduling, the PACU (post-anesthesia care unit aka recovery room) nurses ran the administrative table, and the pediatrician was helped out by one of the OR nurses. I had one OR nurse with me and the surgeons who was able to escort every patient we accepted for surgery to the admin room with any sort of special message that was needed.

The problem of lunches was quickly solved when we decided to make sandwiches at breakfast time in the hotel and take them with us to eat at noon. We have done that for two days now, but Mai had time today to finally arrange for lunches to be brought in to the hospital. The team prefers bread, cheese and fruit to more elaborate meals. The Malian surgeons were quite surprised when we said we were going to take a break around 12:30 yesterday and we pulled out our sandwiches. They took for granted that we would want to break for an hour, and we said, no, just 10 minutes.

The team is getting on splendidly as I knew we would. It is a very experienced team with several strong personalities. Communication is not a problem as everyone is ready to give his/her opinion, but no one is hard-nosed and we have found a solution to everything. I'm very proud of all of them.

Greetings From Bamako, Mali

Hi!  I'm Beverly Kent, director of volunteer services at Interplast.  For the next two weeks I will be here in Bamako, Mali as a part of our first surgical trip here.

We have arrived safely in Bamako. Our boxes are stuck in customs, but we hope to have them out by tomorrow. We will start clinic (the period where we evaluate which patients we can operate on and when we will do so) this afternoon.  It's very hot here, but beautiful nonetheless. I'm off to get the gang together for a visit to the hospital.

Keep checking for updates!