Broken Earth : My trips to Haiti with a team from Halifax: Thursday: Running to stand still...

Sometimes on these missions your carefully organised day does not go according to plan. Orthopaedics had 3 cases, Plastics had two cases and as of writing (4pm) we have managed to do one of our plastic cases! Problem was local neurosurgeon had booked a craniotomy for chronic subdural in the room with fluoroscopy which delayed ortho, and in the other room local surgeons had cases booked also. There were also staffing issues locally with only one Haitian Anaesthesia staff on, so we were persuaded to provide coverage!

In an attempt to be productive we agreed to start with one of our cases at 730, a skin graft on a 5 month old with spina bifida and a broken down meningocoele repair. Neither Kwesi nor I are paediatric in our regular practice but agreed to the do the case jointly.

Managed to get started close to 830! All went well though and the little patient was lively and comfortable on reaching PACU.

Then it was time to be helpful and between us we looked after the craniotomy which became more and more involved and didn't finish, after a 9am start, to around 3 pm. While we were in there next door an emergency PEG tube was booked for a 2kg neonate with oesophageal atresia. Kwesi lent a hand for the induction.

Yes the patients are getting smaller.

Which means we finally get to start Ortho at 4pm! We aren't planning on being ambitious and are only doing 2 cases. First a 92 year old with a combined hip screw/IM nail for a femoral fracture sustained chasing cattle, so as you can appreciate he is fairly healthy, give or take some uncontrolled hypertension. Lastly a second incision/drainage of the man with the infected joints we did earlier in the week, which we hope to do next door once the local team finishes doing a multiply cancelled hernia.

We are all getting pretty fatigued. Its like a whole week in the trauma room. Kim was out of action yesterday with the flu/chest infection that has been going through the group, and Dave Amirault is only feeling better today.

All looking forward to a pleasant meal tonight: hopefully at the Visa Lodge. The UN has not impressed with surly service, early closure and worse of all the disappearance of chicken fajitas from the menu!