See One, Do One, Teach One

The whole reason Megan and I are here is to set up an international rotation for the Mercer PA program. We are essentially the guinea pigs to trouble shoot for the school as well as make connections/impress the doctors. The hope for this new international rotation is that PA students can come to Madagascar and do 1 week of mobile clinics with Scarlet and the Mercer pharm students and then 3-4 weeks in the OR with Dr Harison.

Megan and I are working on meeting all of the hospital staff and introducing them to what all a PA student can do. They do not have PAs in Madagascar (we actually can only see patients if a licensed Malagasy nurse is our translator) and so it's been an uphill struggle to communicate our role and capabilities in addition to the language barrier. However the surgeons, anesthesiologists, nurses and other staff have been more than helpful and very receptive! We are also fortunate that Joanna, a nurse practitioner from the USA, came here last year and worked as a NP for 9mo. We are able to explain that we are training to be like Joanna, which has really helped with the language barrier! 

The Lutheran hospital that we are at is a teaching hospital for Malagasy medical students as well as Norwegian nursing students. (Fun fact, Norway started the Lutheran mission here in Madagascar so their presence goes wayyy back). This is great for us as PA students bc the hospital is used to teaching and having students around! The Norwegian nursing students have the option to rotate in Madagascar during their 4th year for 2mo. The first month is spent at the Lutheran Hospital while they take Malagasy language lessons. This is bc most of the surgeons and nurses here speak at least some English and French. The second month is spent at the public hospital down the road where they are thrown into several different settings.

Megan and I started our surgical time on Tuesday and have been in the OR the past 3 days. We have seen and helped with so much already! One OR will have a goiter removal followed by a hernia repair and the other is doing a c-section followed by a fracture reduction. Each day is different and you have no idea what is coming through the doors!! We have to be ready for anything and willing to jump in at a moments notice!

Tuesday was actually a national holiday (All Saints Day) so the hospital was "closed" and was only taking emergency cases. We needed the extra R&R in the morning to make up for the chaotic travel day on Monday but that afternoon we had several cases show up. We were able to go on a surgical consult for a small bowel obstruction and potential c-section to determine if surgery is necessary. We then scrubbed in on an emergency hernia repair and c-section. Lastly we helped suture a hand lac and were present for a vaginal delivery all in the course of a couple hours while the hospital was "closed"...

Wednesday morning was full of patients at the mobile clinic and then we came back for afternoon surgeries. We scrubbed in on a huge umbilical hernia repair, an ovarian cyst removal the size of a cantaloupe, and a bilateral inguinal hernia repair. The last case of the day was an 18yo girl who is currently paralyzed from the waist down due to a TB infection in her hip bones. The infection has turned into either osteomyelitis or AVN (lost in translation) and required surgical removal of the femur neck to allow the girl to be able to sit upright in a chair again. Right now her lower extremities are so disfigured that she is only able to lay flat. It was a very sad case and her prognosis is pretty poor but I'm glad we were able to provide her some palliative care to allow her to sit up again. 

Daily devotion: John 5:3, 5-9

“In these lay a multitude of them that were sick, blind, halt, withered. And a certain man was there, who had been thirty and eight years in his infirmity. When Jesus saw him lying, and knew that he had been now a long time in that case, he saith unto him, Wouldest thou be made whole? The sick man answered him, Sir, I have no man, when the water is troubled, to put me into the pool: but while I am coming, another steppeth down before me. Jesus saith unto him, Arise, take up thy bed, and walk. And straightway the man was made whole, and took up his bed and walked. Now it was the sabbath on that day.” -John 5:3, 5-9

As we were talking with the paralyzed girl, all I could think of is this passage and how I wish we could help her walk again. She is a beautiful girl and it's such a shame that a disease could cripple her for life, but you must always remember there is a greater plan. We do not know what her personal and family life is like nor can we guess what God has in store for them. All we can do now is extend compassion and love to this girl and all other patients who need healing. Please pray for her today so that she may have a brighter tomorrow with less pain. And please pray that she may find God in her current situation and trust in His will.