Day 4 Clinic and Surgery

     After breakfast, we again marched up to the clinic where long lines were waiting.  The pastor led singing and prayer and then it started.  My day alternated between gyn consults in the clinic and surgery.
     Surgery is interesting because it is all yours.  First figure out the instruments you need and find them in the pile of instruments available.  Then figure out how the sterilizer works and get them sterilized.  Then figure out what else you need- prep, drapes, local anesthesia, gown, gloves, sponges, etc.  Gather it, set it up, try not to contaminate it.  Do the surgery, which to me was the easy part after all the rigamerole.  No matter what the surgery, the patient goes home that day.  Usually with ibuprofen for pain, not narcotics. 
     Interesting cases:  the day started with a little boy who fell out of a tree and had a compound fracture of the ulna and radius.  The wrist hanging loose and both bones protruding.  Jim did a wonderful job of fixing this.  We also had a man who had been attacked with a machete.  Most of his 11 lacerations were on his scalp and face with some defensive wounds on his right hand.  This occured 3 days ago so his wounds were debrided, 2 fingers amputated and antibiotics.  He actually walked out at the end of the day.  There were many other wound debridement surgeries.  I wasn't involved in any of these.  The Jamaican team was a great help. 
     Our work day is over.  I am actually looking forward to a cold shower and then dinner prepared by the Jamaican army again. 
     Rooster/donkey symphony tonight ready for another day tomorrow.