Our first day at Geetmanjali Hospital, which opened only four years ago, but seems old. Intensive care units are well staffed and with up-to-date monitoring, a CT and MRI, and a laboratory. In contrast, the wards where our patients are admitted are open rooms with 60 beds. The windows are open without screens, and the operating rooms we will be using are dirty and lack US sterile conditions. Families congregate and set up blankets, prepare food, and leave their belongings in the hallways and on the floor of the wards.
After we arrived, we toured the hospital and set up our screening clinic. The doctors and nurses and support staff in the hospital are friendly and helpful. Families heard about the Rotaplast mission though newspaper and radio advertising by the Udaipur Rotary Club, and 60 or so came for evaluation. After registering with one of our non-medical volunteers, each child was first seen by a plastic surgeon. If the surgeon felt the child was a candidate for surgery, then the child was seen by a pediatrician, anesthesiologist, dentist and speech therapist. We met the children and their families, with local volunteers translating Hindi into English.
I was struck by the number of children with severe malnutrition, anemia (likely due to malnutrition) and growth retardation. One of the children was a 2.5 year old who weighed 16 pounds, did not speak, barely walked, and looked like a six-month old. The child was also severely anemic. The anesthesiologist and I had to turn down the case as we were concerned the child was too malnourished to safely tolerate the surgery. We asked what the child ate. The answer was milk and grain cereal, no fruits or vegetables or other sources of protein and vitamins. Poverty here is extreme and so is the resulting malnutrition.
The clinic was busy and full of energy. We selected cases for the first five days of surgery, 10-12 cases/day. Over the next few days more families and children will present for evaluation and we will run a clinic each afternoon to identify additional cases for the last 3-4 days we are here. After clinic we set up the operating, recovery and sterilization rooms. Towards the end of the day the team met in one of the ORs to run through emergency scenarios and conduct a mock code. I am really impressed with the skilled team of anesthesiologists, surgeons and nurses. Everyone is a team player. We are all here to do as much good as we can, safely.
We left the hospital around 5:30 PM, and at 7 PM we left for the official Udaipur Rotaplast ceremony at the Udaipur Rotary Club building. There were many speeches (some in the local language Hindi) which did not end until 10 PM. We left without having dinner and went back to the hotel to end of our first full day.
Our first day of surgery. We left for the hospital at 6:30 AM and Al and I rounded up the 10 patients scheduled for surgery. When we walked in the ward room all of the families stood and greeted us. We examined the patients making sure nothing developed overnight (like a fever) which would lead us to cancel the surgery. All of the children were good for surgery, and Al and I spent time speaking with the families and taking pictures. The families were honored if we took their pictures, and they liked to see the picture in the digital view of my camera.
The team operated on ten children today and all went well. I have the benefit of watching the anesthesiologists put the patients to sleep and perform their safety monitoring. The most amazing thing is what our plastic surgeons do; they are truly magicians. They work wonders and transform these children, they make new smiles. It is amazing. I work with the recovery room nurses to get the children recovered from their anesthetic and ready to go back to the ward. On the ward, I work with the local nurses and doctors to give the patients pain medications, fluids and medications.
I enjoy my regular ward trips to check on the post-op patients and see how happy the families are when they see the new smiles on their children. A wonderful sight is the patients' mothers, sisters, and grandmothers dressed in their colorful salwar kameez (Indian dresses). The wards are a sea of colors. At clinic today we saw 20 new patients, and 16 are candidates for surgery. The days are long, and everyone is working hard. It is a pleasure doing this as the outcomes are transforming for these children and their families.