Yo, Ho, Ho and a Good Night's Sleep!

Our adventure has taken a bit of a turn now that I've found a new job on the "Eye Team".  As you recall late last week in a fit of honesty the team that does screening admitted that since they aren't travelling into the bush to find patients there wasn't a lot for me to do in regard to evaluating patients for future surgeries since most of that work had been done at the huge screening done on the first of February.  Not sure what the rest of the team is doing but I was asked to help out the Eye Team. 



In addition to the hospital - which is primarily a place for patients pre- and post operations - there are other teams doing dental work, some palliative (comfort) care for patients we find that we can do nothing for but give comfort and the eye team.  Much of this work is done off the ship so until last week I had little knowledge about what they did so this past week was another in the "fire hose" learning variety for me. 


Part of the reason they felt they had a new found dire need was one of the extremely competent optometry techs from Dartmouth was leaving on Monday night to go home.  She had been here for several weeks and has a ton of experience at home in patient evaluation both pre and post op.  Apparently the rest of the team was very new in their jobs, didn't do this sort of work at home and didn't have a huge amount of patient care experience either.  So - although I know very little about eye surgery it was felt my patient care experience would be a big help. 


Eye surgery is a huge, huge need here in Africa.  I never knew that there are 45 Million blind people in the world and 90% of these people are in developing nations like here in Togo!  The World Health Organization has a program called Vision 20/20 wherein their goal is to prevent or eradicate all preventable causes of blindness by the year 2020.  This is an enormous goal since at the current projected rates, if nothing is done the number of blind people in the world will actually double to nearly 90 million by then.  I've spent most of my free time this week reading up on these diseases and how to diagnose them.  If you're interested in learning more about the Vision 20/20 initiative here is their link:  http://vision2020.org/main.cfm


So - on to the eye team week.  Everyday the eye surgeons - ophthalmologists - do surgery on the ship.  For the most part they do cataract surgeries and pterygium removal.  This is a sort of fleshy growth from the white part of the eye that can grow over the iris and eventually cause blindness.  They also sometimes do strabismus surgery on little kids that have early evidence of lazy eye.  In order to keep the surgeons operating our team evaluates as many patients as possible for operable eye cases and sees the patients both before and after surgery and refers the patients that need extra evaluation to the surgeons that operated on them.  This is very high volume work in that they do 40 or more surgeries a day and they are all done as out-patients.  The day workers lead these poor, blind folks on and off the ship conga line style up and down the gangway.  It is quite a sight to see.  I'll have to see if I can get a picture of it one of these days. 


Since the surgeons operate everyday we see all the patients the following day to take off their eye patches, evaluate their vision and determine whether they have any post surgical problems.  You can imagine the sight of 40 or more patients sitting outside under an awning with their eye patches on everyday.  So, I started telling Peter I was off to Pirate clinic, argggg!


In addition to seeing the post op patients we also go off to two large churches in Lome, Togo every week to evaluate people who would like us to help them with whatever eye problems they have.  This is somewhat similar to the big screening we had for all the surgical specialties but on a slightly smaller scale.  One of the churches had over 1000 people show up!  Fortunately for me this past week neither of our screening days was that well attended.  We have at least 10 of the local people that are fluent in multiple languages there to help us and actually perform a lot of the testing the patients go thru prior to seeing the optometrist and me.  The optometrist we currently have working with us is very knowledgeable and has taught me alot.  Unfortunately she is going home to Scotland next Friday and then we'll have a local man helping us for several weeks until the next volunteer comes.  Hopefully by then I'll be able to function a bit more independently. 


The patients go thru the stations getting their visual acuity and eye pressures done then we look at them to confirm that there's a cataract and good pupillary response and if yes, refer them for secondary screening. 


After hours of doing this we grab a sandwich in the field, screen some more until there's no more patients and then go back to the ship and see yesterdays post ops. 


On days where we're just at the ship we see the post ops and we do the secondary evaluation of the folks we saw at the churches.  During this evaluation we confirm what we saw at screening, do a mini physical exam and if all is well they are scheduled for surgery. 


The days on this team are very long and very busy! 


Fortunately, we've been sleeping better than ever!  I confirmed that my new malaria medicine is keeping me awake at night so I've divided up my pill and am portioning it out over the week so I've been able to get to sleep a little better.  More importantly - the Well's Fargo Wagon aka shipping container from Texas made a surprise appearance in Togo this week!! 


Soon after we accepted the offer to come here last fall we decided to do a small test of the shipping to the ship system by purchasing two, very nice, egg crate foam mattress pads.  We knew that depending upon how the International center got them to us we might have to pay a hefty, by weight freight charge so a high volume, low weight item wouldn't cost too much and if they never arrived it wouldn't be the end of the world. 

Peter couldn't wait for it to be on the Bed!



See how happy Peter is?

So, for the past six weeks Peter has been increasingly worried that our mattress pads were appropriated by someone, lost in the mail or floating aimlessly at sea somewhere.  But NO!  We now are sleeping on cloud like comfort since they were on this latest container!!  Whooo-wheee! Before plopping down on the new pads Peter was dancing around the cabin 


This has been great for both of us since he's been working very hard since we got patients on board and has been taking call every couple of nights.  He's also the senior medical doc here so he's often asked for his opinion regarding patients that the other doc works up.  



We got two new surgeons here this week so Peter and Dr. Fiona had alot of admissions and post op patients to take care of this week.  The maxillo-facial surgeons here are quite amazing.  The senior max fac guy has been on the ship for about 20+ years and many surgeons come here to work just to learn from him.  Peter said he did an amazing surgery this week where he completely rebuilt a man's nose from his forehead as his own had been destroyed somehow.
Here are a few pictures taken when Peter and I were doing the initial goiter patient work ups. 



Ann telling Dr. Fiona a story

So that's about it for this past week.  My eye is better so I started wearing contacts again today.  We got off the ship for a lovely dinner out with our friend Dr. Fiona and ended up getting the name and phone number of a cab driver that is willing to come pick us up when we need him so our mobility may improve from here on out. 

Thanks again for all your kind comments and most especially for the phone calls from  both of our sons.  Please say some prayers for our younger son, Tommy as he has a horrible case of the flu and has missed some classes this week.  We spoke with him last night and he's going to visit his grandmother this coming weekend (I think) but I'm sure they would both be happier if he was completely on the mend by then.  Have a blessed end of February and we'll send out more news in March!