Wednesday, April 9, 2014

And life goes on!


My day started with a teaching ward round where the residents teach the medical students. This is mainly based on revision of the relevant anatomy to the clinical case and their knowledge of anatomy is reasonable compared to our students. We saw 2 post-operative patients from yesterday and they were both progressing well.



                                                                      
 

After seeing a patient in ED with a serious machete injury to his forearm it was time to head to the outpatient clinic. There I saw another young child with severe bilateral knock knee with no underlying bony abnormality and this is the 3rd case in ten days! This seems to be a very common problem here although the residents told me they hadn’t seen many cases in the past. The rest of the patients were routine trauma cases including some follow up of femoral fractures. Since my last visit the hospital has been equipped with the SIGN nailing system which allows locking of the nail without image intensification and has been specifically designed for developing countries. It has hand reamers and the procedure can be done entirely without requiring power. However the nailing has to be done open. This is certainly a step forward and clinical outcomes are good



One size fits all



As the clinic wasn’t very busy there was time for teaching. I gave them a presentation on congenital pseudarthrosis of the tibia, having seen 3 cases since I arrived, and a talk on neurological conditions presenting in an orthopaedic clinic, of which I also have seen a couple. I finished the session with some clinical cases. I must say all the Haitian doctors are very keen to learn and appreciate any teaching I provide them with. As the pathology here is quite different here compared to New Zealand I have to adjust the teaching topics to what is relevant here. There is no point me talking to them about hip and knee replacements as arthritis is rare and that type of surgery is not done here at the hospital.

Tomorrow I am off to Port au Prince for a meeting on Fracture Treatment in Haiti organised by the SIGN group from the United States. On Saturday I will fly to Guadeloupe which is a French Island to visit some very good friends which I haven’t seen for 25 years. Guadeloupe is not too far from here (about the same distance between Dunedin and Auckland) and it takes about 2.5 hours by plane.

I am looking forward to my little adventure!
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