Almost 5 months in Nepal has quickly come and went. We just finished eating at the Lazy Gringo in
Kathmandu. We have come full circle, as
this is the first place we ate upon arriving in Nepal. Lots of dal bhat (rice and lentils) bookended
with chimichangas. The bags are ready
and we soon board a plane for Africa. The
Lord has blessed our family with health, safety, good friends, and plenty of
work to do during our time at Tansen.
Andrea found herself busy at the hospital 3 half days per
week working with the children. This
included playing with children, working with pastoral care, and providing
distraction during painful procedures.
While at Tansen, Andrea taught 3 classes on child friendly approaches to
the pediatric patient, including lecturing to an auditorium of over 80 nursing
students. Teaming up with Pernilla
Ardeby, a pediatric nurse from Sweden, Andrea wrote a chapter on emotional
support and distraction for the pediatric patient. This is soon to be published and adopted
nation wide for the pediatric nursing curriculum.
It has been a productive time in terms of orthopaedics. In 4 months at Tansen Mission Hospital I have operated on over 250 patients. We worked 6 days a week at the hospital, Sunday-Friday. I had clinic 1-2 days per week where with a single resident we would see 60-100 patients per day. The efficiency and hard work of the clinic and operating theatre staff make this possible. About half of the operated patients were pediatric. 73 of the patients operated were pediatric patients with elbow fractures of every kind. 12 patients got 13 intramedullary SIGN nails for femur and tibia fractures. After assisting a number of cesarean sections, 8 patients had orthopaedic C-sections for fetal distress and breech presentation, as this is part of surgical call. Dr. Dipak and Dr. Tul were able to take some well-deserved breaks.
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| SIGN Nail |
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| Open fractures treated with provisional external-fixation, now for SIGN nail |
Being here for some months has allowed me to see many of our follow-ups. In an earlier blog post I mentioned a horrible accident involving a bus going over a cliff in which many people were killed and 17 badly injured patients were brought to our hospital over 30 minutes. With the treacherous roads This is not an uncommon event here and the Tansen triage ran smoothly as usual. One of the patients had a bad pelvic fracture. After consulting and crafting an operative plan with Dr. Peter Cole we operated on this mans pelvis including placing percutaneous sacroiliac screws which had not been done at Tansen before. At 10 weeks from surgery he is in no pain, happy, and ready to get back to work so he can support his family.
I owe a huge thanks to Dr. Dipak Maharjan, Dr. Tul Bdr Pun,
and the lovely patients of Nepal for giving me a fellowship of orthopaedics in
the tropical developing setting. They
gave me experienced instruction on how to address tuberculosis of the spine, hip,
knee, and ankle. They also helped me
diagnose and treat pyomyositis, acute and chronic pediatric osteomyelitis the
likes of which I have never seen. Dr.
Anod’s surgical approach to pediatric supracondylar elbow fractures I will
always take with me.
The moments that will be forever with us stem
from sharing Christ’s love with our Nepali friends and patients. Through our daily work, devotions, and worship we have had much treasured fellowship.
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| Cooking with small spoon at ortho Christmas party |
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| Poinsettia |
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| Mom and Uncle Gary playing with Tansen patients |
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| Beginning of 10 hour bus ride to Kathmandu. No whahka whahka yet (vomit). |
We have been blessed by the safe arrival of the SIGN nail sets sponsored by Dr. Ebeling and Dr. Esterberg which will be the first program in Zimbabwe. Please see our earlier post on SIGN nail if interested (www.signfracturecare.org). This equipment was shipped by Orphan Grain Train on a large shipping container which made the 4 month journey from Nebraska to Karanda.
Merry Christmas and Happy Holidays!
Andrea, Ryan, & Winslow Horazdovsky
