We started the day very smoothly. The first case was the 13-year-old female we saw in the clinic yesterday. She had a major thoracic curve requiring fusion and instrumentation from T4 to L2. The patient was asleep, positioned on the operating table, prepped and draped, an incision was made by about 9:00AM. The surgery went very smoothly. We finished by 12:30. We saw the patients in the ICU. Everyone was doing well. Plans were made for some discharges.
We almost did not get to do the second surgery. There are times when the electricity just goes out. There is a backup generator. So at least we can continue to operate after a few seconds. But the sterilizer re-sets after a power failure, and each time, it is a 45-minute cycle. At one point, one of the sterilizers also broke with our instrument trays in it. Despite all obstacles, as God would have it, we were able to start by about 3:30PM. The second patient was a 20-year-old female with a thoracolumbar curve requiring fusion and instrumentation from T4 to L3. We decided to split into two teams and work at either end of the spine. We performed what was normally taking us about 5-6 hours to do in about 2 hours. This includes the slow process of waiting for the viscoelastic properties of the spine to allow it to bend and come to the rod in order to achieve proper correction of the spine curvature.
Driving in Ethiopia is not for the faint in heart. We saw less than five traffic lights in all our driving. The traffic lights come with a second’s counter that tells you when your light will turn green next. Usually the countdown started at 150! Lanes were optional and speed limit signs nowhere to be seen. Traffic was always very congested. Crossing every intersection is somewhere between interesting and horrifying. It is something that would be hard to explain in just a few words.
One more thing you should know is that people like to chew on qat leaves. Then they spit them out into the streets where the dogs then eat them. These are the mellowest dogs ever. They don’t care if a car is coming or not. They are walking at their own pace and no faster. They are commonly sitting on a sidewalk or a street corner looking really ‘high”.