Thursday, November 10, 2011Today I was finally able to demonstrate the drill to Gerald and the residents. Since there had been no appropriate cases during the week, we bought some fresh goat heads from the market and performed burr holes and craniotomies on them. Fortunately, the electricity cooperated. The residents had a great time learning to put the drill together, practicing with the different...
Scaling up head trauma and critical care capacity in a resource-poor setting: Mbarara Hospital, Uganda (4 of 4)
Scaling up head trauma and critical care capacity in a resource-poor setting: Mbarara Hospital, Uganda (3 of 4)
Wednesday, November 8, 2011 We arrived on Tuesday morning only to find that the electricity had been out for several hours. The hospital has two ORs dedicated to obstetrics, and this area has its own generator. However, the two general surgery ORs do not have a generator, so all surgeries were being postponed. In the afternoon, I met Gerald Tumusiime, a general surgeon. We found him...
Scaling up head trauma and critical care capacity in a resource-poor setting: Mbarara Hospital, Uganda (1 of 4)
Saturday, November 5, 2011 My main goal for the 10 days I will spend in Uganda is to help scale up head trauma capacity at Mbarara Regional Referral Hospital in Western Uganda. I have brought along a cranial drill and plan on training the general surgeons and residents in its use. In addition, I plan to look at how the hospital is managing head trauma, and help set up baseline data collection...
Scaling up head trauma and critical care capacity in a resource-poor setting: Mbarara Hospital, Uganda (2 of 4)
Monday, November 7, 2011 In the morning, I toured the hospital with some of the visiting doctors. The hospital is addressing the medical needs of a large urban area (Mbarara has about 150,000 people) and of the surrounding rural areas, despite limited resources. It is basically a collection of low-rise buildings connected by pathways. The wards were built around 1950 and look as if they were...
Otolaryngology in Mbarara, Uganda
Otolaryngology in Mbarara, Uganda(2 of 3)It has been a busy week in Mbarara. Much of the first day in town was spent with introductions, meeting clinical faculty at Mbarara Hospital and academic administrators at Mbarara University (MUST) who help coordinate post-graduate training and the relationship between MGH and MUST. The short meetings made me not only feel welcome but also gave...
Otolaryngology in Mbarara, Uganda
Otolaryngology in Mbarara (1 of 3)As travel goes, the trip to Mbarara, Uganda, had a bit of everything. There was delay in Kigali due to an airplane crash on the Entebbe runway, failure of my hotel shuttle to pick me up (with several taxi drivers unexpectedly unwilling to take me), and the theft of some of my medical equipment out of my checked luggage somewhere in-transit. But there was also the...
Ethiopia, the land of thirteen months of sunshine
Project: Surgical Capacity Assessment in EthiopiaPartners: Harvard Humanitarian Initiative, MGH Department of Surgery, Harvard Program in Global Surgery and Social Change, Global Surgical ConsortiumEthiopia, the land of thirteen months of sunshine, is big. Huge, in fact. I spent this past...
A central TB diagnostic lab
I spent the past two days on a computer at the National Health Laboratory Service�s TB lab in Cape Town, finding codes and dates needed to link sputum samples to clinical data for a cohort I�m studying of MDR TB patients from a nearby farming region. The South African government somehow has decided to keep this NHLS facility occupying prime downtown real estate � next door is historic Somerset...
MDR-TB in rural Western Cape, South Africa
I�m spending this month at Brewelskloof tuberculosis hospital in Worcester, a small town in South Africa�s Western Cape province. It�s just a bit over an hour�s drive from Cape Town, but it�s a completely different world from that fairly cosmopolitan city. It�s a farming town � lots of vineyards, some other fruit, a few livestock � and there�s not much else going on, although the setting...
Hurry Up and... Teach?
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�Combating Chronic Diseases in India using Community Health Workers�, Blog 1
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Mobile West Bank Neurologist
I had the wonderful opportunity to spend a few weeks working with Physicians for Human Rights (PHR) in Israel, and to participate in a "mobile clinic" that brought a group of physicians, nurses, medical students, and other volunteers to both cities and small towns in the West Bank. I want to use this...
Beyond Biblical Days
Kuda Maloney, M.D/MPhilDermatology ResidentTrinidad and Tobago: A feasibility study on the utility of a standard set of Images as a screening tool for Hansen�s disease.Two heavy barrels block the entrance to the street, communicating the wordless instruction to STAY OUT. But the man leaning against the fence recognizes the social worker, waves two youths over to move the barrels and we drive through....
Thank you means no? Gia Dinh Hospital, Ho Chi Minh City, Vietnam
It's hard to live between culture, and I've found myself floundering a few times. Americans are so earnest, so honest, so straightforward at times, and I've grown to love this way of being. But I forget.When my grandmother suffered a series of devastating strokes in Romania, we very sadly had to admit her to a nursing home, I'm sure with plenty of guilt of soul searching on the part of my parents....
Please bring food, water, and a caregiver Gia Dinh Hospital, Ho Chi Minh City, Vietnamskss
Since the decades of war ended in Vietnam seems to have always fostered large families (four or five siblings is common), until the recent introduction of a two child limit. The culture and even the language is built around a complex web of pronouns and deferential or authoritative addresses based on relative status drawn from age and kinship, then continuing out into relative social status outside...
Privacy and Personal Space, Gia Dinh Hospital, Ho Chi Minh City, Vietnam
Even in Boston I'm taken aback considering the experience of the sick, sharing rooms and experiences that are only making illness harder. The actively dying share rooms with the nearly well, and young, and I wonder if the thin curtain in the middle helps or hurts, if it would be better to just draw it back and share the spectacle of the illness.In Vietnam this question has been in part answered for...
