Global Health Progress

Dr. Glenn Geelhoed, professor of surgery, international medical education, and microbiology and tropical medicine at the George Washington University, writes about his first medical mission of 2009. The team rises to new challenges in the form of a blackout during their time in Far North Luzon General Hospital, where they performed 204 operations in four full days.

January 21, 2009 — Once again it is near midnight as I crawl to the mat on the floor to try to summarize what has gone on non-stop since awakening this morning.

I did several hernia repairs, a thyroidectomy, then a smooth and swift bilateral total thyroidectomy, and then we went about our business of taking out lumps and bumps, as we were awaiting the turnover on the major OR tables.

With three patients on OR tables (though only one asleep), the lights blinked brighter and then quit altogether.  We turned on our headlamps and debated what should be done. I got the patient off the table who had not yet been anesthetized (since the spinal for one and intubation for the other had not yet occurred). Supporting the patient on each side, we walked to the recovery room and put the patient in a chair, since all beds were occupied. Meanwhile the anesthetized 18-year-old was supposed to receive a bilateral cleft lip repair. There was no way that Dr. Alfredo Casino (known as “Poppy”) could do this procedure, although the battery-powered monitor was still beeping away, since there he would require cautery and suction, both of which require electricity.

As we stood in the dark with only the dim shafts of light from the headlamp, I started singing “This Little Light of Mine, I’m Going to Let it Shine.” Soon everyone joined in a rather impressive harmony that resonated through the entire darkened hospital and all the long queue of waiting patients with arms held in slings with IV’s dripping into them.

People were calling out to ask if there was a generator, or to call the mayor, or for any number of absurd requests, as though they alone were inconvenienced by the blackout. Besides, I had reminded them after our harmonious song fest, this is how I had operated for the last three weeks — without power or plumbing — and perhaps we are now getting too used to electricity and feel like we are out of business when we do not have it.

We did learn later that the power outage came from two men who were electrocuted in the process of doing something to a transmission line. All of us did better than the two men who interrupted the electricity in the first place, even including the subject of an emergency operation which we accomplished without incident in the dark and finished as the electricity came back on.

Now, after many more operations (29 more to be specific), we have stopped the intake of new patients for screening and we are trying to settle in at an early closing time. We have pushed the limits of the envelope here in Luna, where we had been told at our welcoming reception that there had been concern since we only had about 20 people pre-registered for our surgical mission — and that is less than half of what we did just yesterday and less than what we did today alone.

“Build it and they will come” could in this case mean, as the man whose foreign body of a metallic chip in his hand had expressed to me — “I can’t believe you are actually here offering this service as a voluntary gift, so I had to wait to see you were actually delivering on that promise.” Now, every neighbor of his is also lined up outside waiting for our shop to re-open tomorrow morning for our fourth flat-out OR day even as we are consuming supplies at a great rate.