9 October 2007
Another interesting day in Mthatha. We could do without rain for a while though. It has been so cold that I have had the Reynaud’s start up. I am looking forward to some more summer like weather but I suppose then I will complain about the heat without air conditioning. The high today was about 20Celsius which is mid 60’sF but with the cold rain it felt much colder and we have only a space heater in this house.

Today was to be my first full surgery day. I was glad I had been told to bring my own masks, etc. They often run out of those. They wear scrubs with the next layer a plastic apron then a sterile cloth gown and double gloves. There are very few disposables. Drapes are cloth; suction is a metal suction tip. The residents do most of the simple hysterectomies…on their own. The attending scrubs in as needed and does the complicated cases. Today we did the patient with the painful abdominal mass. It was bilateral solid ovarian tumors. My guess is dysgerminoma. Frozen sections are not available here. We don’t know what the painful muscle masses are. We will go back to try to drain them under US guidance but it seems unlikely they are related to the ovarian masses. We found another on her left upper arm. If that wasn’t interesting enough the power went out during the case. I didn’t know it was possible to do surgery by the light of 3 cell phones! Within a few minutes, the generator did kick in. The main power to the hospital came on later in the day. All the other elective cases were canceled and I came home early for the first time. It was interesting how each part of the crew had a different problem to deal with and knew what to do. For example, anesthesia also had to go ‘manual’ and bag the patient and go without any monitors.

I am struck by the contrast of the limited resources within the hospital and the large new hospital itself. It looks to me like a hospital that would have no need of volunteer physicians or donated materials, but both are truly appreciated. I certainly would be of more help if I could speak the language. Later this week I will start to work with the colposcope in the clinic.

The afternoon was still cold and rainy and tonight, just as I was fixing supper, the power went out here. It is still off. I am thankful for the lovely battery I have on this computer. Megan and I are going to watch a movie while sitting under blankets with our hot water bottles from the last of the hot water. We would make popcorn if we had power or popcorn!!

Tomorrow I start learning vesicovaginal fistula repair, assuming we keep the power on.