Men anpil chay pa lou

Which is Creole for 'With many hands the load is not heavy'. This could almost be the motto for our mission, since every day I am privileged to witness great teamwork and professionalism in dealing with the not inconsiderable challenges we are facing. Everyone pitches in to help regardless of discipline. No hierarchy here as we work together to get things done.

Today started for me with a stage 2 nasal flap reconstruction for a human bite on a 26 year old woman. Which went very smoothly in spite of the lack of full monitoring: no capnograph or volumes available! Rest of the day was frustrating as we were competing for OR time with the local surgeons. I had a few problems to sort in ICU: an emergent reintubation in one patient and the withdrawal of care in another. The latter was a tragic case of a teenage boy with a severe scoliosis and respiratory difficulties who became increasingly septic and unresponsive. Family took a long time to come to terms with the fact he was not going to get better. Finally today they agreed to let us stop life support, so we kept him comfortable, switched off the ventilator and pulled the tube and he slipped away peacefully and mercifully. Again a situation that we would be unlikely to see up North: the scoliosis would have been corrected no doubt before coming to this point.

Later on came the demonstration of teamwork that prompted me to title this post as I did. A little 3 year old HIV positive kid with an empyema had a thoracocentesis  and at the end desaturated dramatically and had to be reintubated. Heather and myself had to help the Haitian anesthesiologist to resuscitate the unfortunate child and the help given to us by the Keith, David and the ortho nurses Kim and Denise made all the difference. Epinephrine and some aggressive ventilation stabilized her enough to transfer to PICU for further treatment.

We finally got into the OR to do our cases late, while the others went to the UN for food. First case a 14 year old with a tibial sarcoma for an above knee amputation. Got to do some creative regional anaesthesia for pain control. Fortunately there is an excellent amputee program here, so he should rehabilitate very well.

Our colleagues did not forget us and brought back some very welcome food!

Have to wind up this post as it is time for our last case: a 1 year old with an infected ankle. Think we will all sleep well tonight. Really looking forward to our day trip to the beach tomorrow!!