Ta Ta Tansen

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.

SIGN Nail

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.

  

Cooking with small spoon at ortho Christmas party

 Despite it being December in the mountains and not having heat our family is feeling warm.  We had a wonderful visit from Andrea’s mom, Diane, and Uncle Gary.  They brought us a new drill!  Instead of snow there are poinsettia trees.  The past weeks have been filled with Advent and Christmas celebrations with the Nepali and mission community.  Our Tansen Men’s Barbershop Choir performed White Christmas and Silent Night at a couple of them.  We are blessed to have been a part of and supported by the Tansen community.  It has been home to us and we are sad to go.

Poinsettia

Mom and Uncle Gary playing with Tansen patients

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.  Currently having some difficulty with the Zimbabwe medical license, but trust that all will work out as it is meant to.  

Merry Christmas and Happy Holidays!

Andrea, Ryan, & Winslow Horazdovsky