Once again, Board Member Dr. John Grechus, M.D. shared memories from one of his early trips to Liberia. I hope you enjoy reading it as much as I did. --Kathy Beth
In general when American doctors do surgery in the United States, the operating room's lights are so bright, they can be dimmed to save their retinas from being burned out like looking at a solar eclipse. Moreover, the OR's room temperature is cool enough to drop a patient's core temperature requiring warming blankets for prolonged cases. The reason is for infectious disease prevention; the same reason a refrigerator preserves food better than your back porch (unless you live in Missouri January 2018). Being a rural OB-GYN in Farmington, Missouri, I certainly got used to bright OR lights and cool OR temperatures. So I was appreciative of even limited air conditioning at Bomi Hospital OR on our first Dignity:Liberia 2-week mission trip in 2011. Dr. John Mulbah, M.D. and the Liberian Fistula Project invited Dignity:Liberia, partnering with the Liberian Fistula Project medical team, to participate in 10 fistula repair surgeries that year. What a blessing! Our medical staff partnered with Liberian doctors and nurses for an amazingly good 80% success rate for “dry beds” post-op day #1. Many of these women went to the Fistula Rehab Center, which moved from Bomi to Phebe Hospital, upcountry the next year.
In Bomi, the resources were limited, yet improving since civil war strife ended. There was no electronic positioning of operating tables, but cranks and hydraulics still worked. The surgical lights were adequate but personal surgeon headlights greatly aided care. There was no suction, but cotton sponges still worked. There was no cautery, but meticulous surgical hemostasis was still obtained with sutures. There was no anesthesia machine, but hands-on mechanical monitoring of vital signs provided by great nurse anesthetists kept our patients alive and comfortable. There were no paper disposable surgical gowns and drapes, but surgical sterile cotton gowns over rubber aprons provided patient/physician protection—but added a layer of uncomfortable heat.
Okay, I was sooo ready when the generator ran out of gas, lights flickered and went off, and the over taxed air-conditioning unit quit. Dr. Mulbah announced, “This is our last case!” Everyone knew exactly why, with muffled laughs of knowing all the soft, coddled, spoiled American doctors and nurses would pass out of heat exhaustion and dehydration if we did not stop. Eight out of ten Liberian women's lives changed forever.
My life changed forever.
John Grechus, M.D.
In Bomi, the resources were limited, yet improving since civil war strife ended. There was no electronic positioning of operating tables, but cranks and hydraulics still worked. The surgical lights were adequate but personal surgeon headlights greatly aided care. There was no suction, but cotton sponges still worked. There was no cautery, but meticulous surgical hemostasis was still obtained with sutures. There was no anesthesia machine, but hands-on mechanical monitoring of vital signs provided by great nurse anesthetists kept our patients alive and comfortable. There were no paper disposable surgical gowns and drapes, but surgical sterile cotton gowns over rubber aprons provided patient/physician protection—but added a layer of uncomfortable heat.
Okay, I was sooo ready when the generator ran out of gas, lights flickered and went off, and the over taxed air-conditioning unit quit. Dr. Mulbah announced, “This is our last case!” Everyone knew exactly why, with muffled laughs of knowing all the soft, coddled, spoiled American doctors and nurses would pass out of heat exhaustion and dehydration if we did not stop. Eight out of ten Liberian women's lives changed forever.
My life changed forever.
John Grechus, M.D.
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