A 28-member team of health care professionals from Duke University Medical Center is carrying nine tons of surplus medical equipment and donated supplies to the 1500-bed New Mulago Hospital in Kampala, Uganda. Mulago Hospital staff will be trained to use and maintain the new equipment then surgeons from both countries will join in conducting a number of brain and spinal surgeries.

The project is administered by Duke’s Global Health Institute.

Friday, August 17, 2007

"We Take the Spice Out Of Life"


Michelle Gailiun writes:
I have such mixed emotions about what I've experienced this past week, and it is this man, Dr. Joel Kiryawele, who has helped me gain some understanding about it. One of the things I've witnessed but not talked about much is the cultural differences between the Americans and the Ugandans and how they play out in the realm of patient care. Some of our clinicians have expressed astonishment and even outrage about the seeming lack of urgency and attention they feel the patients here are receiving from their caretakers. It has been very difficult at times and I have wondered about that, too. I asked Dr. Kiryawele to talk about the differences he perceives between us and how they color the way we provide care, and this is a condensed version of what he said:

"The way we handle things is different. Ugandans are soft-spoken and laid back. Time is never so important to them as long as you get something done in the long run. So the way we handle emergencies is different; the way we handle disappointment is different. Here if the patient wakes up and finds that there is still something wrong, it is easier to forgive. Americans are faster, they are more into output - what have I achieved today? Neither extreme is good. The challenge is to find a balance."

"Ugandans have also suffered a lot. I remember when I was a boy going out into the streets and seeing people lying shot, bloody and dead. It leaves a scar. You never knew if the next bullet would be in your own house. So we may look callous, but it is really a survival mechanism. We have learned to take the spice out of life every moment."

So I sit here writing and looking out the window, soaking up the lush and vibrant landscape, knowing that we will have to leave in just a few hours. I know that behind the deep green curtain lies bone-crushing poverty, terrible disease and death. But I also see extraordinary spirit and grace. It is hard to hold all of these things in one embrace, but I will try, and I will will keep Joel's words in mind as we head back home.

We came with much, but we leave with much more.

Robbie "Puka Boy" Diggs

Michelle Gailiun writes:

The applause-o-meter hit 100 last night when Robbie stood up to introduce himself to our hosts at dinner. I think all of us see him as the unsung hero of the mission, because without his expertise, we would have been worthless in the OR.

It was Robbie who stayed up 'til 3:00 a.m. on the Internet the night we got in, trying to see if the converters and transformers we bought would sync up with the equipment that we brought in and that which was already here. It was Robbie who took to the street and spent $250 of his own money buying parts we didn't have. It was Robbie who saved the day when one of the surgical microscopes crashed half way through a procedure. And that's just for starters.

Robbie is truly the "glue" that held everything together when it was literally falling apart. Here he is, fixing an electrical surgical unit - still don't get what this really does, big guy - giving credence to Robbie's contention that, "I can get by with y'all because you don't know a thing about electricity." (Note to Robbie's boss: Think raise/combat pay.)

In a sense, everyone here was heroic at one time or another, and I realize not everyone showed up in the blog postings. I'm pretty sure I didn't get shots of everyone in action, and some people popped up more than once. I hope we can all take some time to post a few favorites in the coming days. And stay tuned....Mike Garrison's video is going to be a knockout. He, like everyone else, has been working like a dog and has gotten great material on EVERYONE!

Another Kind of Miracle


Michelle Gailiun Writes: Get this -- I walk in the recovery room and find Margaret here drawing pictures on a big sheet of paper on her lap. I look closely and there are lots of nurses names and measurements - and a big stack of fabulous fabric nearby. (click on image to zoom)

A dressmaker! Of course! Doesn't every hospital have one? No? This one does. And about everybody in the room has already placed an order. Incredibly, She calls them in and announces they will be ready TOMORROW.

Another miracle. But then again, we've already seen plenty of miracles this week!

Scrub nurse T. Carver and nurse Michael the Angel (he swears it's his given Christian name) selected a lovely floral print (below).

I especially like watching T in the OR because she's not afraid to boss people around and she guards All Things Sterile like a pit bull. Don't know Michael that well, but he had us all roaring and taking his picture tonight at a dinner hosted by some of the hospital and state health leadership.


More Pictures



Michelle Gailiun writes:

Right up to the last day, our docs and nurses were still pumpin' in the OR.

Top - Here's Teresa Cordero doing a little one-on-one with a member of the Ugandan team.

Bottom - Yvonne Carver filled me in on what a circulating nurse does. (She is one.) Basically, she is the link between the sterile surgical arena and the rest of the world. So a circulating nurse can go into a back room like this one and pull out supplies, go check on the patient's family, move scopes and lamps around the rooms...all sorts of useful things, and always busy.

Thursday, August 16, 2007

A Lost Dream


Michelle Gailiun writes:
I also had the chance to visit the Uganda Cancer Institute today, where I met this little girl, Salifa Nakiyuka, who had come with her mother from a village far away in Eastern Uganda a few days ago.
The director of the Institute, Dr. Jackson Orem, suspects she has either retinoblastoma or Burkitt's lymphoma. Interestingly, the hospital ( before it became an institute) was originally dedicated to Denis Burkitt, an Irish surgeon who worked here in the 1950s and who was the first to describe the tumor that can lead to huge growths like this one that targets jaws and abdomens.
The Institute is a bleak and dismal place, even though Orem says Case Western Reserve, Johns Hopkins and the Fred Hutchinson Cancer Center all have active research programs here. The NCI (National Cancer Institute) originally funded the place, drawn by the Burkitt's research, but pulled out support during Idi Amin's brutal regime and never looked back.
So here's how cancer treatment works today: A patient comes in, say, with a breast tumor. They can image and stage it. Then, the doctors give the woman a prescription for chemotherapy and tell her she has to go find the drugs somewhere and pay for them, and if she brings them back, they can administer them.
It's a blunderbuss approach, even when it works. They don't have any way of testing tumors here for any markers that can guide treatment. Everyone is automatically put on Tamoxifen, since they can't tell who has a hormone-sensitive tumor and who does not.
Another note...Orem says 60 per cent of the patients here have Kaposi's sarcoma, a complication of HIV infection. I am saying a prayer for Salifa tonight. And tomorrow.

Now For the Not-So-Good News

Michelle Gailiun updates the case of Subra:
I thought I'd first show you little Subra as Dr. Ali Zomorodi adjusted the Mayfield frame around her head, steadying the field where the incisions in her skull and neck would be made.
Subra is 7 years old and has already lost one eye to retinoblastoma - or so everyone believes. She's been to several hospitals before landing here, and unfortunately, no one really knows her diagnosis for sure.
Doctors believed she had a life-threatening aneurysm, and she has been near the top of their to-do list since day one. She and her dad have come from a village far away and have waited six weeks for this day. Surgery began around 3:00 Wednesday afternoon.
Surgeons were surprised and saddened to learn that Subra did not have an aneurysm after all - which might have been "cured" with a well-placed clip. Instead, she has a brain tumor. What kind - they're not sure, but a brain tumor of any type is never good. Doctors took a piece of it to biopsy.
But a nurse told me that a biopsy at the local facility could take a month or more, and the family has no money to go to a private lab that might be able to determine the type of tumor in a matter of days. Radiation is a possible treatment, but they can't begin it without a definitive biopsy report; I am reminded that her pathology report on her earlier eye problem was lost.
Her dad, Wathum tends her with the most tender touch, but she still cries a lot, perhaps missing her mother, perhaps not feeling well, and maybe a little scared, too. Many of us feel quite distraught. I miss her dear, bright smile.

Young and Handsome


Michelle Gailiun offers another update:
Remember the guy who had that baseball-sized growth atop his head just yesterday? (Post: Life Altering Surgery) Well, here he is, smiling today.
When I stopped by his bedside, he said to me, "Yesterday I was old and ugly, and today I am young and handsome!"
I couldn't agree more.

Good News and Good News Coverage


Michelle Gailiun writes:

I mean, it's really good news - on lots of levels. (I first wrote about Nelson in the post "Fought for You")

Check it out: This is little Nelson on his father's lap, sister, and mom in red on the left - all reading news in the Daily Monitor about his remarkable recovery! The Duke surgical story was highlighted on the front page again and then inside, almost a full page including the shot of Dr. Zomorodi you saw yesterday, a very well-written story and even an editorial. The Mulago staff was especially pleased ( and somewhat surprised) with the coverage because the Monitor is seen as an independent voice and is sometimes critical of Mulago's performance.

Nelson was running a bit of a fever today but Ali said it's normal...besides, he has malaria, too.

Wednesday, August 15, 2007

A Case of Mistaken Identity


Michelle Gailiun writes:
Take a close look at this adorable little 7-year old boy....er....girl. Yes, Subra Rashidi here exemplifies all that can go right...and wrong...in medicine today.

When the Duke docs made rounds on the first day, they saw that Subra was partially blind, probably due to neuroblastoma, a cancer of the eye that can only be cured by taking the eye out. But scans showed another problem - a pretty good-sized aneurysm behind the socket that doctors likened to a ticking time bomb. If it would burst, it would be deadly. Surgery was the only option. Subra's hospital record noted that the boy had been to several other hospitals before landing at New Mulago.

Communication with the family had been difficult because they spoke an unusual dialect and didn't understand the native Luganda. We noted and corrected a misspelled name on our own notes....but it wasn't until moments before surgery that Subra's dad, overhearing a nurse talking to his son, turned to me and said "girl, Subra is girl." While it made no difference in her treatment, it did serve as a huge red flag for us all to take nothing for granted, and to double- and triple-check for accuracy. Subra is still in surgery as I write. Her father is so thankful.


I am so in love with Subra's family. This is her dad, Wathum, waiting for her to get out of surgery. He has such an interesting story himself. He says his mother died when he was eight; his father, when he was 13. He scrapes out a living by raising food for the family and selling what's left over. His wife is staying home with the other two children while he is here with his daughter, and they fear a surgery will mean they will have to pay for drugs they can't afford.

He said his hope for Subra is that she will be able to attend school, because "school will make a difference." He says he also hopes he will be able to leave something to his children when he dies. Wathum usually wears a faded yellow trench coat with the word "Sears" on the side, but today was warm, so you see him here without it.

He says he has never been to school, but I have witnessed his extraordinary tenderness and consistent care of his daughter over several days now, and when I noted that he must have learned to be an excellent father somewhere....and he just beamed. Made my day.

Life-Altering Surgery


Michelle Gailiun writes:

Take a look at the lighted, right center of this photo (click on image to zoom) and you will see a large, baseball-sized growth atop this patient's head. It's a benign, tumor-like growth this elderly gentleman has had since he can remember, and one that Dr. Stephen Parker is about to remove.

It took Parker and PA Senthil Radhakrishnan several hours to do it, but it should give the patient many more years of life where he will look in the mirror or see his image in a passing windowpane and know that he is, indeed, much like everyone else.

Low-Tech, High-Touch



Michelle Gailiun writes:
This footnote from the OR today. I can't say I really know how blood is warmed up before transfusion at Duke, but this is the way they did it today in the
OR here at New Mulago Hospital in Uganda. Benefits: Cheap, reasonably effective and right at your fingertips.

More Giant Birds


Michelle Gailiun writes:

OK, so I've developed a wacky fascination with these weird and menacing birds....the marabou storks that have pretty much overtaken downtown Kampala. As I was walking over to the National Theatre this morning to pick up some music for the mini-documentary we hope to make out of this trip, I chanced to look up and see two nests the size of semi wheels in the tree above me....and a big patch of white splotchy stuff on the sidewalk in front of me. I stepped quickly to a clearer pathway and hoped I wouldn't ever be caught under one of these guys at a time when they just couldn't wait. They're not nice, trust me. And they're everywhere.

Tuesday, August 14, 2007

The List


Michelle Gailiun writes:

It was interesting today....almost everyone on this unit, including Sharot Namubiru here, had seen or heard of the surgical list that's circulating among the staff. Some of the children made it, some did not.

Sharot's daughter, 1 month old Patience, was not on it. She has spina bifida and needs surgery to correct it. But as Jen Bland is explaining to her, we did not come equipped to handle surgery on such tiny infants. Jen first became aware of her plight when Sharot had come running up to her as Jen was bringing up another patient to the unit. Sharot was desperate and asking for help, but Jen didn't know what to say. Later, Sharot stopped me and handed me a note she had written, asking me to take it to Jen.

The note reads:
"I am a Uganda aged 22. I come from a poor family of 18 children. I am HIV positive. I'm married and my husband is now jobless for two years. My child is suffering from hydrocephalus and spina bifida. I don't have money so that I can look after her because I'm not a working class. Please do me a favor so that I can get some help. And the fear of the lord is the source of wisdom."

Dr. Mike Haglund said he will work with a local nuerosurgeon to make sure Sharot and Patience get care. Triage brings tears.

"We are no longer Third World, We are First World"

Comment from a general surgeon who is also the Deputy Director of the Hospital after touring the OR and recovery room.

Michael Haglund writes:

Day Two of the neurosurgery mission finished today at the somewhat humane hour of 7:30pm. However, that did not relate the fact that Day One finished after midnite for a large portion of this outstanding team. As a surgeon, you finish your last case around 7pm, round on your patients you operated on during the day, check out the last one in the recovery room and head for home by 8pm; however, you sometimes forget the recovery room nurses that are watching your patient for several hours after the surgery (and by that time you are enjoying dinner at home) and finally the nurses in the ICU who are accepting those patients from the recovery room. So, although Drs Zomorodi, Parker, and myself all finished our last cases around 7pm, the rest of our team stayed until midnite to make sure everyone was tucked in and safe for the nite. MVP awards to our team who was "Left Behind" last evening including Dr.s MacLeaod, Zomorodi, and Schroeder, as well as the nurses: Meg Zomorodi, Sara Goins, Jen Bland, Liz Beautz, Karen March, Jody Wellwood, Maggie Cote,and Senthil R. who have transformed the recovery room and ICU into a first rate area and were willing to be left behind to make sure everyone of the patients we operated on was safely tucked in.

Save of the day was Dr. Zomorodi's patient whom we rounded on last evening and debated whether he was well enough to even go through the surgery. We have had several patients where there disease and their deteriorating condition, prohibited their having surgery. After long discussions, we decided if we ever were to go for it, and risk one of our patients dying in this first of its kind neurosurgical mission to Mulago, this was the one. Emotions were high as the surgery was quite difficult, but in the end emotions were high from a much more positive standpoint, when the little boy who was near death the evening before with a paralyzed left side, awoke from surgery turned toward his ecstatic mother and picked up his left arm in the recovery room. God is sure good and the present to this wonderful family will never be forgotten. In Royal Family Kids Camp where I have been a camp doctor for the last 7 years ministering to foster kids, they talk about the story of "the one", the one that touched your heart, the one you will not forget, well, today at Mulago many doctors and nurses have their "ONE" for this trip. As Ali Zomorodi said afterwards, if this is all I accomplished on this trip it would be enough!

Simon Says


Actually, Simon Kyansi, 27, the man you see lying here, wasn't saying much this morning, but if he were feeling better, I bet he'd be saying "thanks."
Simon came in with a deeply fractured skull - the result of an accident on one of the thousands of motorcycles on the streets here. He was leaking spinal fluid from his nose, so our docs went to work and quickly repaired the damaged bone and stopped the leak. The equipment you see at his bedside came from Duke, and he wouldn't have had access to it had we not come.
Interestingly, he also has a lumbar (lower spine) drain in place. Nurse Jen Bland says it's an extremely difficult procedure to manage and one where a single misstep can be lethal. The technology was brand new to the ICU nurses here, so much of Monday was spent training the staff on how to handle it.

Fought for You


Michelle Gailiun writes: Success! I think this shot pretty much sums up why we're all here.
That's Dr. Ali Zomorodi on the left, checking in on 6-year old Nelson Akandwaholo, who just came out of surgery, and his mom, Diana Noggita. Just yesterday, a large and menacing abscess in Nelson's brain had left him totally floppy on one side - he wasn't even able to move his arm - and he was losing ground daily. Zomorodi's surgical team spent hours cleaning out the area and removing the pressure, and shortly after he went to recovery, he started sitting up and lifting his left arm - which you can see in the picture. The team was ecstatic. Some were in tears.
And so was mom, who happened to mention that her son's name means "fought for you."

Monday, August 13, 2007

Footnote


We all fell in love with this adorable little boy who tried his hardest to get Mike Haglund's attention as he spoke to the staff and children at Pastor Jackson Sengoya's orphanage on the outskirts of Kampala.

Flesh-eating Birds Terrorize Tourists


Michelle Gailiun writes:
OK, so this isn't the greatest picture. It was taken from a bus, and I feel the better for it. I'd read the description of these monster birds in a popular tourist guide, which I am paraphrasing here: The Marabou stork is a carrion-eating bird, almost five feet tall, with a large, expandable airsack below its head. Its black and white feathers resemble an undertaker's suit. They are found in rural and urban environments, especially in DOWNTOWN KAMPALA. No kidding, these guys are everywhere. Like I said, I really don't want to get any closer (although probably will, just to get a better shot). BTW - other interesting wildlife advice from the same guide: Never stand between a hippo and its water source and don't bathe in crocodile-infested waters.

The Americans Have Landed


Our Duke Medicine in Uganda correspondent Michelle Gailiun is having some connectivity issues. She emailed photos and text over the weekend and we're posting them from Durham. Enjoy!

Nothing like setting high expectations....During a formal program welcoming the Duke delegation, Dr. Stephen Mallinga, the Ugandan Minister of Health, (shaking hands with Dr. Steve Paker) likened our arrival to D-Day. He told the crowd, "The Americans have landed. Things are never going to be the same at Mulago Hospital." He also said that many people have come through his office wanting to help the people of Uganda, but none has ever come back. Mallinga and others seem to sense that Duke's program is just a first step in a long and enduring partnership. Everyone seems to be excited about it - the nurses, especially. I overheard one of them during the ceremony say, "Come on, let's unpack!"

Kampala The Beautiful


Uganda is lush and soft, almost like a bright, damp watercolor. While Mulago Hospital is quite plain and needing many of the most basic medical supplies we take for granted, patients enjoy this when they look out the window. Staff at the hospital say torrential rains hit around mid-afternoon and wash everything clean, if for only a few minutes.

Doctors Screen Patients All Day


Duke Docs spent all day Saturday screening dozens of patients who had come from miles around hoping they would be treated. Here, Dr. Mike Haglund looks at some images of the patient in the foreground as Senthil Radhakrishnan looks on. To Haglund's left is Ssenyonjo Hussein, MD, a neurosurgeon at Mulago who was trained in Germany. Most of the physicians here speak many languages. The surgeon on the far right speaks English, German, Chinese and Russian - as well as the native Ugandan languages.

Duke Delegation Makes the News


Lots of reporters were on hand to cover the mission - many, I suspect, due to the presence of the Minister of Health, Dr. Stephan Mallinga, who called for a continuous exchange of personnel and resources. Reporters from UBC-TV, TOPTV-Radio, Kampala, The Guardian Newspaper, the Daily Monitor, New Vision, Radio Simba and Radio West were among those who questioned Dr.Mike Haglund and leaders at the Mulago Hospital. Some of the stories were slated for today, but the front page of the Monitor today had no mention of Duke. Instead, the headline read: " Congo Troops Occupy Ugandan Territory."

Families Camp Out Nearby


When patients come to Mulago Hospital, their families come too. It's the family's responsibility to bring sheets and blankets, personal items and some of the food they will need. Most of the time, families camp out on the lawn, but the afternoon rain often sends them running inside. Mulago is full of leaks, however, so sometimes, inside isn't necessarily a whole lot better!

Patients and Families Hope for Treatment, Cure


Everyone was surprised at how many young children were waiting to be evaluated. Many of them, like this little girl, have hydrocephalus and will need shunts to drain off the fluid around their brains. A nurse says many of the mothers who come here been abandoned by the father of their child because they delivered a baby with an abnormality. Physicians spent much of the day evaluating case by case. For some, the outcome of their deliberations will mean the difference between life and death.

Photos from Michelle






Michelle Gailiun writes (and snaps):
This is the main campground for the patients' families. The paths link the water source, the cooking area and the hospital. Although some family cooking is done outside, there is limited hospital food available, too. The next picture shows the line for the mid-day meal, which today was rice and beans.

Sunday, August 12, 2007

Day 1 and 2

Michael Haglund writes:


Things are going great so far. I have a tired but outstanding team from Duke who have worked very hard to make this all happen. I am truly blessed by each ones great effort in their sacrifice and giving. Saturday less than 10 hours after arriving we had a reception and ceremony in our honor where the official donation was handed over to the Minister of Health and the representative from the Presdient. Dr. Mallinga said he was suprised to see me back, since so many American doctors want to meet with him but never return. He said he was very suprised I continued to write him, but when he saw the email when we were (only) at $500,000 dollars worth of equipment he thought it might happen. He said he was overwhelmed and overjoyed by what we had accomplished and congratulated Duke University on their efforts.

Dr. Mallinga had a great quote, he said this was Mulago Hospital's D-Day. He said when the Americans landed on D-Day and a Frenchman ran to them knowing nothing would ever be the same, he feels the Americans that had landed in Uganda the night before would change things so nothing would be the same at their National Hospital. He also pledged support for whatever we need during the after-ceremony press conference. We unpacked all 9 tons of the equipment in one afternoon, with not ONE piece of equipment damaged, except for the crate nail into the side of a piece of plastic on one of the monitors which was otherwise very functional. When was the last time you sent 27 people from RDU to Detroit to Amsterdam to Entebbe, Uganda without one piece of lost luggage and without any damage to 9 tons of equipment. MVP for the day, Mr. Robbie Diggs who we worked to the bone for the whole unpacking procedure, super strong work by our clinical engineer.

We screened over 100 patients and narrowed that to 69 possible operations. Late Saturday and into the wee hours of Sunday morning myself, and Drs Zomorodi/Parker, and Senthil R. our PA made a tentative list with the help of our anesthesia colleagues, Drs. MacLeod and Schroeder. Senthil then proceeded to win the MVP award of day two by staying up to 4am typing the tentative list. We now have 45 cases scheduled for the week. Some are too sick to operate on and we have already seen one child who has waited weeks for us to arrive, deteriorate so it is no longer safe to do their operation. IF we had only been here a week earlier. It is hard making life and death decisions, but with the Lord's help and guidance and a chance to pray over those we could not help, we are making it through that difficult part of the process, still it hurts pretty bad to basically condemn someone to die without a chance.

Today, we visited Pastor Jackson Senyonga's church and their orphanage, many in the group were deeply touched by the orphans and the system of building homes for them and assigning a widow to be their house mother. They sang us a wonderful song also. Wow, were they precious. Also, it was very powerful to see our whole team on the platform at church with 5,000 Africans praying over them for over ten minutes for our success, health, and spiritual empowerment during the week. You can't help but feel uplifted by that dramatic moment.

Anyway, we actually move to the next phase: performing operations, and we have ten cases on the list including four craniotomies, a cervical fusion, several shunts, and a Chiari malformation. Mike and Michelle have been wonderful and very hard working capturing all the wonderful moments thus far and I can't wait to see the movie :o)

Saturday, August 11, 2007

Kampala the Beautiful

Kampala is a worn and lovely city - very soft around the edges. This is the view from one of the intensive care units at Mulago Hospital. (Please note, if image does NOT appear, it's not from lack of trying...it takes about an hour to keep working the network here before one goes through. And then I have a feeling it's just 'cause I'm lucky.)

We're Here!


We finally arrived in Kampala after 16 hours in the air. We were thrilled to find a shuttle waiting to take us to the hotel...but the ride was a little scary. Even at 11:00 p.m., the streets are crowded with people out having a good time - shopping, bar-hopping and flying around on the ever-present motorscooters that double as taxis!

Wednesday, August 8, 2007

Farewell, Godspeed, Good luck!


Michelle Gailiun writes:

We caught Chancellor Victor Dzau thanking physician assistant Senthil Radhakrishnan for volunteering to join more than 20 others from Duke on a medical mission to Uganda. The group leaves tomorrow, taking nine tons of new and surplus medical equipment from Duke University Hospital to New Mulago Hospital in Kampala. Dzau called the mission "inspirational" and a tribute to Duke's commitment to global health and the Duke Global Health Institute. There's a lot of work ahead: A Ugandan surgeon told us that 270 people from 70 families were already lined up outside the hospital hoping to register for surgery.

Thursday, August 2, 2007

First Shipment will be in Uganda by Monday




Michael Haglund writes:

I just got off the phone with Mike Ball from Cavalier Logistics who has done a remarkable job of making this all happen. I had no, I repeat no idea how to make this work logistically, but Mike not only has taken many hours on his own to accomplish the shipment of 9 TONS of medical equipment and supplies to Uganda, but is personally flying with our first shipment and staying in Uganda until everything arrives. Kudos to Mike and Cavalier for all their help. Flughts from British Airways will also arrive Wednesday and Friday with our final shipments and go to a guarded wharehouse until we arrive on Saturday to unpack everything.

On a completely different note, I am amazed to see this all coming together. The number of people both out in front and behind the scenes who have worked tirelessly to help is astounding.

One great story was we were going to have to all wear a cervical collar on the plane since the huge box of collars came after we had sent everything to Cavalier in DC for shipping and after T. and Ciaran had driven our jam packed rental van to DC with our supposed last load, and after Duke and Jane Pleasant's office had shipped overnight 18 boxes of supplies for anesthesia to DC. So, Jean Bartis saved the day by getting the collars overnighted to DC and Mike Ball agreed to put them somewhere.

Now, we just have to fit all the extra stuff in our suitcases to make it all work.

Wednesday, August 1, 2007

Smallest Supplies Can Mean a Big Difference


Michelle Gailiun writes:


It's hard to believe that we're only a week away from departure. There seems to be so much yet to do. I caught up with Dr. Haglund outside the OR this morning and he showed me this small filter. It may not seem like much - it doesn't cost more than a few dollars - but it's a critical component to a ventilator. Without a filter, a ventilator is useless. Most of the ventilators at the New Mulago hosptial in Kampala have been sidelined because they lack filters. You can bet there will be plenty of these among the six tons of supplies that will be leaving shortly!