Pain. Not something any of us like, and in fact it is something that can be dangerous. It is not just about being comfortable, it is about giving the body the best possible chance to heal. This year’s team is fortunate to include 5 world-class anesthesiologists, 3 who are actively working the operating theatres including Dr. Adrian Bosenberg (right, from Seattle), Dr. Bill East (centre, Kelowna), and Dr. Gillian Moll (left, Victoria BC). The other 2, Dr. Angela Enright & Dr. Miodrag Milenovic are here to train local professionals and were featured in the earlier story “Pain Management Training”.
Anesthesiologists Bill, Bosey & Gillian in the OR.
This is the 3rd trip to Bahir Dar for Dr. East, his 7th to Africa, not to mention many others in China, St. Lucia, and other places. “The difference on a mission is that it is more collaborative” Bill says, “we learn from each other and the locals.” Often in North America the anesthesiologist will meet and treat their patient, and have little opportunity to follow the case post-op, and only rarely will they work with other professional anesthetists on the same case. Both he and Dr. Bosenberg (or ‘Bosey’ as he is known to all) appreciate following their cases from admission to discharge, and conferring on the process and treatment with the full team.
Dr. Bosenberg carrying young child from OR to Recovery Room.
Dr. Moll tells us that she participated on several missions many years ago, but this is the first in a while due to other demands. “I am excited to be doing blocks that I have not done for years!” she says. A “block” is a local anesthetic that is applied in the specific area of a surgery and it has tremendous benefits particularly for these (often) young patients who don’t understand what is happening to them. Bosey is noted world-wide for this procedure, and as a qualified Pediatric Anesthesiologist has been teaching people in at least 25 countries his methods for over 30 years. The block will allow the use of less general anesthetic and the surgical patients that Drs. East, Bosenberg & Moll treat wake up with less anesthetic-induced hang-over and significantly less pain.
Dr. Bill East & Pediatrician Dr. Faruqa Ladha care for young child post-op.
One of the important features of pain-avoidance for African patients is the after-care tradition. In western hospitals, all care until discharge is at the hands of professionals (the nurses). In Africa, most care in the wards is by the family. They feed the patient, keep watch, and if required administer medications.
All of the medical professionals on this “A” team comment on the lack of resources and the anesthetic team are no exception. “You are working with equipment you would only find in a medical museum at home” declares Gillian! Bill as a self-declared “tinkerer” cites this need to adapt as one of the attractions of medical-mission work. Bosey, having participated in more missions than he can easily count, reflects on the difference between applying a block using modern ultra-sound equipment (which will locate the required nerve perfectly), as opposed to the techniques required on mission, basing the application on the physician’s knowledge of the anatomy.
Dr. Gillian Moll with surgeon Dr. Stan Valnicek
You will find the theme throughout many of the stories in this blog: The respect of the patient’s comfort is paramount. Pain and/or fear don’t help anyone in their healing process!
– Peter Schultz & Dina Kotler