Karah Waters
Karah Waters
Tanzania 2017
VIEW FINAL REPORT
Mambo! I am a recent nursing graduate seeking to experience healthcare and African culture in Tanzania. I will be working in a hospital in Dar es Salaam as well as a clinic in the Kidodi village. Join me as I embark on this escapade of being engulfed in healthcare abroad.
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OR Day

August 21st

My experience in the OR was absolutely amazing!!!

 

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It was a nice break to get away from my second week in the ED. We got to go to the theatre at 8am and stayed in the OR until 5:20pm. There was one surgery right after another with no breaks. By the end of the day I was very hungry! I had the chance to see five different operations.

CAUTION: if you don’t like reading about gross things like details of surgeries you may not want to read any further!

Without giving out patient information I’ll summarize everything I saw! The first surgery was a laparotomy. It was crazy watching the surgeon pull out all of the organs. I was able to see how the liver was black due to the illness and see the small intestines and large intestines out of the body. I’ve seen two operations back in the United States but none of them dealt with the abdomen.

The second surgery was a radical mastectomy where they removed an entire breast. This was very interesting to watch and observe! You could see the muscles once they removed all of the adipose tissue. It was very insightful! It’s so important for a woman who’s had a mastectomy to not have her blood pressure taken on that arm because of the removal of the lymph-nodes on that arm. During the surgery I was able to see how much of the breast they actually remove. It almost goes into the woman’s armpit which is where the lymphatic system runs.

After that surgery I was going to see a proctoscopy and biopsy. However, due to the patients condition once he got on the operating table they canceled the surgery.

The fourth surgery was an insertion of a GFT. The patient had dysphasia due to severe tongue cancer. I was able to see the surgeon take out the stomach and place the tubing in. Since the patient can’t swallow properly the insertion of the tube will allow them to feed her through the tube and bypass the throat and go directly into the stomach. They wanted to try this first before they looked into radiation.

Now... the last surgery was UNBELIEVABLE. I had never seen anything like it before. The patient had KS, Kaposi sarcoma. People were also saying elephantiasis. The surgeon said that what this patient had was a rare tropical disease! His leg was 20 times the size of the other one and he also had a fungal infection on top of it. The surgeon said I could take a photo and the patient gave me his permission but unfortunately I’m not sure if I can share it on social media. The patient began having this condition 7 years ago but he couldn’t afford medical help so it progressed to this state. They had to do a AKA: above knee amputation on that leg. I had never seen an amputation take place. I always had wanted to but I never thought I would be able to stomach it. With it being the last surgery of the day as well I was starving and really wanted some food on my stomach because I had a headache and was a little light headed. All of those things aren’t a good combination when you’re about to see a lot of blood and an intense surgery. However, I made it through the surgery without getting queasy or anything! It was absolutely amazing. Just watching the surgery take place was unbelievable. The patient wasn’t put under anesthesia so he was awake for the entire surgery; which blew my mind! He had a sheet dividing the lower half of his body and his face. This is similar to what they do when a woman has a c-section. They gave him a spinal tap so he couldn’t feel anything below his abdomen. However, he could hear everything going on. When it comes to patients I just really put myself in their shoes and imagine how I would be feeling if I were them. For this patient I kept thinking of all the sounds he was hearing and smells he was smelling. Sorry if I’m going into too much detail but during operations they have to burn through the flesh to stop the bleeding. Especially in a leg where there are a lot of veins and arteries they would have to stop the bleeding by burning off the vein in a sense. The smell that comes with that isn’t the best thing in the world. Also, you can hear the sound of flesh being cut. Having to hear the sound of my leg being cut off and smelling my skin burning would not be okay. I just couldn’t imagine what he must have been thinking. As I’m still working on my Swahili I’m able to carry out a conversation in greetings, goodbyes,  and introduction. However, for more in depth in conversations I’m still learning. So I could just small talk with him. The biggest surprise with this surgery was when it came down to the bone, literally. So the appliance they had to saw the bone kept breaking and they weren’t able to cut it. So they improvised. They ended up pulling up the leg and bending it backwards manually breaking the femur. There was a loud pop and the bone was officially broken. When in Africa you see things like this. I couldn’t believe it had happened! Remember that the patient is AWAKE. So he heard his own bone crack! Can you believe that?!?! CRAZY! Furthermore, the doctors and nurses were laughing about it.

Overall, I was very happy about the clinical practice that goes on in the OR/theatre. They have a “Time Out” session right before the surgery just like we do in the US to make sure they’re operating on the right patient in the right place. They did their best to obtain and retain a sterile field. I still saw some not so good things like re-sticking the patient with the same needle or beginning the surgery as the nurse was going over the time out sheet.

Though it was a long day it was a bomba, bomba day! Bomba means fantastic in Swahili. I had only ever seen 2 surgeries in the OR in the US but here I saw 5 in one day!

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