Good times

August 13th.

Dear Folks: Well the blogs are getting more infrequent as the internet access becomes increasingly sporadic, and our fatigue at the end of the day prevents us from wandering to an internet café. After a very trying early part of the week, we had a very productive teaching day on Wednesday, with the Dr. Claude talking about anesthesia considerations of the prone position, and then practicing rolling Kwesi to the prone position, as well as a Dr. Theo doing an excellent overview of the coagulation process, and issues in anticoagulation, deep vein thrombosis prophylaxis etc.

We were then picked up at the end of the day and driven by the hospital driver to a hotel in Butare, which is a winding 2 hour drive south of Kigali. We had a dinner by the pool, and then today had as far as I am concerned one of the best in OR teaching days yet!!

With the residents we did a femoral block, subclavicular, and interscalene block and then I showed Dr. Theo how to do a TAP block on an elderly patient who had abdominal surgery for cancer. On top of that Kwesi went through all the considerations and issues of using and LMA, including having a back up plan, dealing with laryngospasm etc. I did a whole lecture on local anesthetics today also-so really amazing. Kwesi went over the nerve stimulator, and muscle relaxants.

Then off to dinner tonight with Dr. Patrick and Dr. Theo, and we had a great chat about the residency, giving some feedback about the residents and also teaching issues in both Kigali and Butare-it was a very frank discussion and I think we were able to communicate our concerns. Every time we talk to these guys we come home inspired and ready to put in our all the next day.

We are heading back to Kigali tomorrow and then going to Akagera game reserve on the weekend where we hope to see elephants, giraffes, hippos etc. And get this we are going to camp-so I am going to be huddling in a tent hoping that I don’t get eaten by a lion-HELP! Never mind the lion-I guess there are these nasty bugs called TSE TSE flies which transmit sleeping sickness-so if you see me falling asleep in the OR when I get back this is what I am going to claim.

During this time I am reading Shake Hands with the Devil-. It is hard to believe that the terrible events of the past took place here as the kindness of people has been wonderful, and we watch people great each other, holding hands and kissing. The place is vibrant-with people everywhere. Little babies strapped on backs, ladies with 30 pounds of avocadoes balanced on their heads-etc.

Well got to go.

All the best
Love Jennifer