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6/21/04 (Monday)

6:30 AM.  Today, we start our surgeries.  It will be a busy six days with 27 cases already scheduled and a possibility of 1 or 2 more.  Each day is full with big cases except for Saturday.  We put all the short cases on that day so we can minimize people staying over for the night.  We plan to stay through Sunday and head back to Quito on Monday if we have all the patients discharged and home.  Today we have three hysterectomies and one other procedure.  It should keep us moving along.

There is one home close by with a great sound system.  Yesterday all day and well into the night was loud music with a deep bass thumping away.  It went on and on, well into the night.  I made a comment to Jane about the good sound system and she said people will live in run down shacks but will have the best sound systems.  The sun is coming out and I hear all sorts of birds and the infamous roosters.  The roosters crow all day and most of the night too.  They must also cherish their sound systems!

I pray for our patients today.  They are trusting us to help them.  We must trust in God to help us.  I pray for wisdom and ability for Jane, Sheila, the anesthesiologist and me.  We have no support system for us.  There are no nurses except for Sheila, no ICU, no respiratory therapy, no central supply – no one but us…and God.  We are weak but He is strong.  In our weakness God’s strength and healing power will shine.  He gets all the glory and praise.  We are serving Him by serving these people.  Lord, be with us today.  Empower us to do your work and protect the patients, please.  I pray this in Jesus’ name.  Amen.

11:45 PM.  Our day is done!  Fourteen hours of surgery doing 4 hysterectomies and and umbilical hernia repair.  One hysterectomy was quite complex and was a challenge.  My back is tired and sore from standing all day in one position.  We checked on our patients and they are doing well.  Our first hysterectomy patient had a very interesting finding.  Upon entering the abdomen we found a fair amount of unclotted blood and an ectopic (tubal) pregnancy that was bleeding.  She had had no symptoms of pain or any suggestion of an early pregnancy.  A tubal pregnancy that ruptures can be lethal because of the massive blood loss.  Had she not had this surgery today, she could have bled to death from the ectopic pregnancy.  I believe God led her to this OR and saved her life.

Jane and I operating, Sheila assisting

Jane and I operating, Sheila assisting

Once the patient leaves the OR she is taken by cart from the clinic building to the post-op ward, which is in another building.  The cart has to go down a couple steps, over a bumpy sidewalk and up a step into the ward.  The beds are just mattresses on wooden frames with mosquito netting over them.  A family member must stay with the patient and provide food and comfort.  If medication is needed, the family member goes across the yard and bangs on Jane’s window.  She will get up and tend to the problem.  This care is very primitive but it is all these people have.

Leaving the clinic building going to the post-op building

Leaving the clinic building going to the post-op building

Heading down the "hallway"

Heading down the "hallway"

Getting ready to enter the building

Getting ready to enter the building

Carrying the patient into the building

Carrying the patient into the building

Going into town is quite the trip.  The road is so full of holes and ruts and stones that you can’t drive over 10 to 15 mph.  The homes are just shacks.  The businesses are likewise.  It is quite the culture shock, needless to say.

One of the workers at the clinic has a father who owns a bakery in town.  The father must stay at the bakery 24/7 or else it gets robbed at night.  This is the life here, so hard, so third world.  We have no idea of how richly we are blessed to have a nice home, cars, paved streets, etc.  No idea!  Time for bed…big day again tomorrow.

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