Large team has big impact in Bangladesh

REPORT of BANGLADESH CAMPAIGN,   December  2018

On December 1st at 5:00am we, the 7 members of the team, met in the Madrid airport: Arturo Cruz, Pablo Lozano, José Miguel Morán, Pilar Murga, M José Fornier, Almudena García and Teresa Butrón. We plastified the bags and posed for the photo before the check in. In Barcelona the two other members, Ingrid Tapiolas and Nuria Ridaura, did the same. We all met in Doha, and flew together till Dakar, capital of Bangladesh, we collected our luggage and went to the national terminal where we had again a checking and we had to explain that we carried our surgical instruments plus a diathermic machine. The certificate about our participation in a humanitarian campaign was very useful. Finally on December 2 we landed in Chittagong, went through customs without problem and met Nasreen Baqui, Director and owner of the hospital, and a cousin of her.

We went to the hospital situated in the outskirts of the city, a 4 floor building which is chiefly used for the rehabilitation of handicapped persons: it is low and has some beds, the first section is for consults, in the second there are 2 operation theaters and 2 presurgery rooms, and the third has about 12 beds for hospitalization. The main surgery room has a ceiling lamp with one arm, and other standing up, plus 2 pre-surgical tables, and a third one with a room with about 12 beds. The main surgical room had a ceiling lamp with one arm and another standing up. Besides are added 2 surgical tables, a respirator with ECG which we found on the last day and O2 canister plus 3 scalpel generators. The gas they use is halothane.

 In the next room we placed 2 stretchers and precarious lamps which had to be made up for with forehead lights. The other two rooms are used as pre and postsurgical. We divided ourselves this way: Lady nurses placed all the material with the help of Pilar, our anesthetist nurse, who was very much in demand. The rest of us went to see patients in three rooms with the help of volunteers: medicine students of 3, 4, and 5 year, hospital doctors supervised by Dr. Sayad Boksha (Physician at Chattagram Mas-O-Shishu Hospital Medical College, Bangladesh), in charge of the campaign and responsible for it, who was of great help during the whole campaign helped by…

We finished the day with a common meeting to organize team work for the next days, and we drew the surgical plan for the next days and the shift to the Well Park Residence hotel at 29 minutes from the hospital. The first day we met with the volunteers to examine the instrumental and to organize the sterilization in hernia kits. The whole instrumental was in a container. The have a vertical autoclave.

We started operating 14 patients on 2-3 tables (16 procedures) which we combined with the usual consults with the help of voluntaries who translated from Bengali to English, and we finished the day organizing the groups for greater efficiency and preparing the instruments kit for best waiting times between interventions. The next days everything was more fluid, we distributed work and so some examined patients while others began operating, and one examined patients till we could begin with another in another operation theater.  Thus in some moments we operated upon 4 patients at a time. We stopped on Friday as Fridays are feast (like our Sundays) and we had some excursions with the volunteers in the river.

The next 4 days we continued operating with a good rhythm attending to 138 patients, 42 of them children, with a total of 155 procedures. We did have morbidity on the last day: a hematoma that did not require revision and a urinary retention that required catheter, reintervention of a child of 18 months for hematoma that acquired a bradycardia and he was translated to a hospital. He recovered satisfactorily.

OTHER ACTIVITIES: The excursion in the river, with lunch, supper with volunteers in several restaurants to enjoy Bangladeshi food. The last day there was a farewell party in Nasreen’s house, the volunteers brought some dished we all enjoyed, diplomas were given, also thanksgiving speeches and many photographs. The campaign ended with good feelings for all.

POINTS TO KEEP IN MIND:

-         The organization was complex. Nashreen answers more whatsapp, and only occasionally emails. Although at the end everything went well.

-         Preparation of instruments: They had sets of hernias but all together in a bottle without any separation. It would be convenient to put them together: 4 camp clothespin, 2 separators, 4 Crile forceps, 2 dissection forceps, one scalpel, and 1 needle-holding. Thus they could be sterilized and they would allow for an efficient change of patient.

-         The respirator has an ECG monitor which appeared on the last day. Halothane gas which we do not use.

-         It is a rehabilitation hospital with operation theaters little used, and it has few dressing gowns.

It has a vertical autoclave with a 1-2 hour cycle.