Monday, July 17, 2023

July 17th Screening Day

 * I am posting my travel day & Screening day on the same day as I was not up to blogging yesterday but didn't want to get behind :)

Cairo Mission Day #1…Screening Day & Feeling Better 😊

I slept really well & woke up feeling A LOT better compared to my travel day which with the time change was 2 days ago because today in Cairo it is July 17th and I left on the 15th & arrived here close to midnight on the 16th…so however many hours that is I do feel better! I think I am at 75%. I met Chris at breakfast she was trying to be up when I get here last night but with her travel & time change from Sweden, she was tired.  It was quite an interesting breakfast set up…. lots of meats & cheeses, lost of olives, grains & spreads, some whole fruit, bread, a place where they would cook eggs & a full dessert bar???. I opted for a scrambled egg & a piece of toast & paid dearly for a diet coke to see if that tasted ok.

On the drive to the hospital, we passed the Nile Ritz Carlton, so my bold assumption is we are close to the Nile River. There was more homelessness on the streets than I expected. It was not a long drive to the hospital & per my research it definitely is 40 years old, lots of dirt, broken windows & leaking pipes but it is the largest pediatric hospital in Egypt & they say there is a “new area” I just think we aren’t in it?

At our team mtg we were told to expect this to be a difficult and heavy mission with lots of palates & other cranio facial anomalies. This is on the 2nd mission in Cairo but throughout Egypt they do “local missions” without international volunteers every 2 mos mostly correcting simple cleft lips & international missions quarterly – a recent one was in Alexandria. If only I had that geography gene because I have no idea re. Egypt as a country. They also are planning on about 60 patients in 3 ½ days of surgery with 5 operating tables so 15-20 pts/day. The patients were all waiting on the 7th floor of the hospital so as to not wait in the outside heat & screening was on the 2nd floor but first they had to be registered HOLY MANUAL PROCESS….paper & pen with white out for 6 pages of questions, I am sure it is the same registration at all mission but this seemed rough. Chris is a Nurse Coordinator” in Sweden & we both were unsure how long the day would be with 3 registrars & each one taking 30-45 min at best so she started “coordinating” & I was her biggest support. We recruited 2 other “volunteer guests” businessmen from the UAE who spoke Arabic & were happy to help – that almost doubled our workforce to 5 registrars. The we brought 5 patients/parents down – had them start the process & brought down 5 more to be in the queue when a spot opened. It still was a lengthy process, but Chris was “on it” other wise we might still be there! By 11 am only 1 pt had fully gone thru all the screening stations but by 3 pm things were humming & we had 51 registered & 28 thru screening. Literally almost EVERY PATIENT was a palate. There was one cute baby girl w/ an easy lip repairs I got to hold the entire time her dad was getting registered & of course the Mimi in me LOVED that!  It was apparent that several of the children had syndromes or other anomalies. All of the “moms” women had head coverings & the majority were in Burkas but you can see their “Smieyes” – “Smiles w/ their eyes” a term we used in Covid where everyone was masked 😊 There was one very tearful dad with his 4 year old son, he just was teary, I gave him tissue & water & thru the translator he said he simply wanted “help for his son” – he broke my heart every time I saw him during the process (he was pt #19 so I am anxious to see if his son has surgery)

The morning snack at the hospital was lot of random pastries that I wasn’t quite up for but I did have a banana & my epic fil was that I didn’t bring my Tums & my saltines. I am always careful about what I eat on missions but right now I am VERY Cautious! And the “hamburgers” they brought in for lunch would have been a no-go even if I was healthy. I did pack a trail mix that worked for me but need to pack more going forward. Also, I gave one of the students money & he went to a street vendor across from the hospital & bought me 6 Diet Pepsis to take back to my room so that was nice!

There was a baby that had a primary cleft lip I had hoped would be repaired & I helped the mom thru the process. The baby had a feeding tube to help her gain weight & I thought she looked an appropriate size for surgery. About 4:30 pm as she finished, I saw her crying deeply…it turns out her baby has a small ASD (Atrial septal defect or hole in her heart) & that eliminates her ability to have a surgery without a cardiology clearance & there is not a pediatric cardiologist in Cairo. This young mom was devastated & certain her baby would die without the surgery…I had no words. I asked Malika what could we do? On past missions we referred them out to the WHO or another NGO for the Cardiac care & then they came back on another mission.  That did not seem to be an option – what about an obturator (like a retainer that closed off her opening in her palate & helped her to eat, also not an option. I felt totally helpless. They did say if she had a higher calorie formula that would help & she could be scheduled to come back for a recheck in 2 months (I wasn’t sure how that mattered since she needed the cardiologist piece) but I asked if I could provide funds for the formula. They said we could not give them money but could get the formula & give her a 2-month supply… I was “all in” financially but had no capacity to do this & fortunately one of the local volunteers was as moved as I was & went to a 3 pharmacies to get the formula. Truly what I hoped for was a surgical repair & I was reminded of my PICU Mantra as a bedside nurse – “when you can’t cure you can always provide some care”

Later in the afternoon when everyone was thru registration & waiting to be screened Chris & I were in the hallway with them & were a “big hit” with the 6-10 year old crown who wanted us to take selfies with them on our phone cameras – I am unsure if they wanted to see themselves, if it was our blonde hair or they just thought we were nice…anyway that was our 1 min of Egyptian “fame” LOL. Screening ended about 6 pm (which seemed like an eternity for 60 patients) & we had our pre-surgery meeting so that we didn’t need to have it tomorrow night. They confirmed that 85% of the cases are palates & yep that does cause me some anxiety. We have a strong PACU team 3 of us were together in Morocco & one it's her 1st mission plus we may have a local RN but it may get a lil crazy….but that is what I signed up for & why I am here. These kiddos would never ever get this surgery unless tis team was here for them. them. It was after 7 when I got back to the hotel, then showered & fully enjoyed my peanut butter sandwich! Now I am 100% which is good because I have pyramids to see tomorrow! The team day option was to go to 2 old churches which I am sure would be nice – they are concerned it is too hot to be outside at the pyramids but this is my “Palates & Pyramids Mission” so the pyramids are a must…lots of sunscreen, our private local guide & the high is only supposed to be 101 at 3 pm & we are leaving at 8 am so I think we are good – just a lot like Palm Desert right??? Good Night From Cairo!!!

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