My hands are shaking as I try desperately to close the gap that has unexpectedly opened up. The operation has not gone well and the patient is in bad shape. Sweat drips down my forehead as I shoot a concerned glance at my assistant. She is shaking her head in dismay. “Have you got any ideas?” I ask. She suggests using a knife. I’ve already tried that option and it hasn’t worked well. She passes me the pliers as I watch yet another unidentified piece fall out. “Watch where that goes, we might need it later!”
I’ve brought my little laptop ultrasound home from work in an attempt to fix a busted hinge. On the way I visited the workshop crew, who helped with some wire and super glue. Unfortunately my enthusiasm to fix it has resulted in it ending up in multiple pieces on the dining table.
Despite the cheap design, this little ultrasound has been a great asset on the ward here at Galmi. It is a window into the uterus, and the pictures speak a thousand words. Is her baby alive? Where is the placenta? How many babies are inside? Is it a molar pregnancy that risks spreading to other parts of the body? Is the pregnancy growing inside the tube and ready to rupture and bleed?
So often I have found the answer is unexpected and sad. Today I met a woman who has had 8 pregnancies. She only has one living child – all the others were born too early to survive. This time she was in her eighth month. The baby hadn’t been moving much though and as I ran the scanner over her belly I felt a lump in my throat. There was no heartbeat.
Most days I have someone who needs to go to the operating theatre for some reason. When compared to my attempts with the ultrasound machine, the surgical team here at Galmi are a pit crew at a race track. If I didn’t have other work to do I would love to spend more time as a fly on the wall in the OR. The surgeons are skillful and tackle all sorts of real emergency surgery every day. Operations often happen in four theatres at the same time. There is a surgical training program with five residents from across Africa. The anaesthetists and surgical assistants are experienced and slick. Whenever I have had to take someone to theatre for a Caesarean section it’s been great to be part of the team.
The operation on the ultrasound ends up going well. It comes back together nicely and the new hinge seems strong enough. I hold my breath as I press the power button – and the familiar screen flickers back to life.
Later that evening Cathy sweeps up some miscellaneous screws. I hope they weren’t important…