"African Medicine"

When we first got here and had the power outage with a pending a c-section, Domoina told us that "this is African medicine". We didn't really notice the effects of this until we started in the OR this week....

Right now we are in the rainy season so it's like Florida and we have daily afternoon rain storms. When the storm is predicted to be more severe (like the hail storm... yes hail... that occurred yesterday) the surgeons are really rushing to get the surgeries done as quick as possible in the AM. This is bc the city power almost always goes out when it rains and the hospital generator is broken. So once it starts raining there's a high chance the power will cut out at anytime. Yesterday I was closing the femur fracture and all of the sudden the power clicked off. It was too dark to continue so the staff starting looking for flashlights or candles to help. Fortunately we were almost done with our surgery, but Megan was midway through a hysterectomy where suction and cauterization is key! They simply had to wait for power to return and fix any bleeders by hand like they did before the fancy tools. 

Another interesting part of "African medicine" (which is more like 3rd world medicine bc it's similar to what I saw in Peru's hospitals) is the sterilization process. There's a main sterilization area where everyone hangs out between cases and two ovens to sterilize the tools. The scrubbing technique includes a bar of hand soap and a sink but you still wash all the way up to the elbows. And there are open windows in both ORs. The amazing part about all of this is that the infection rate at the hospital is extremely low! So either the Malagasy people have tough immune systems or they embrace the fact that a little dirt don't hurt! The more I'm here, the more I'm convinced that Americans (including me) are wimps... 

Other funny things we've seen that would never fly in the US is people coming in/out of the OR drinking coffee, performing surgery while barefoot, and eating food in the sterilization area. 

While I say all these things, it should not take away from the fact that the surgeons here are wicked smart. They learn ALL aspects surgical medicine and are a jack of all trades. We have seen Dr Harison and the other surgeons perform surgeries from head to toe without a blink of the eye. They also are able to repurpose their limited supplies and provide optimal care for patients. It's absolutely amazing to watch an older, less expensive, less complicated version of medicine that provides outstanding results! We are learning so much and will be better healthcare provides bc of this experience!