An update from the "pearl of Africa"

The broken anesthesia machine is now FIXED (at midnight). THANKS, Elizabeth!

Wonderfully six children have been healed. They are recovering and their families are glad. This has not been without challenge. Twenty-four hours a day the team is caring for the children. Twelve hours a day someone is fixing the equipment- and that would be me. The equipment at the Ugandan Heart Institute is quality equipment but has not been without problems. Some functions have needed to be enabled on the devices. Those are the easy problems. Some problems have been typical electronic problems like reseating cables and connectors. Others have been more serious and parts have been replaced by scavenging from defective machines. Yesterday a part was needed to repair a machine. I asked Melad the technician here to call the equipment's service representative here to request the part to be delivered overnight... as if. Unfortunately access to parts are not readily available and other options had to be explored and delivered. The equipment here is supporting great work and great people. My hope and prayer is that it continues.

The internet is back up (at least for now) so expect some posts

But we think we figured out what was wrong: somebody has been monkeying around with the cables!.

Gifts for the children

The team brought gifts for the children to have after their surgeries. Brightly colored bags are filled with pencils, notebooks, crayons, bubbles, kazoos, etc. The bubbles and kazoo are wonderful for improving their lung function. The favorite seems to be the Beanie Baby stuffed animals. The children are asking for them immediately after they wake up during the day and evening post op. They are most comforting.

My own children, Kyra and Connor, helped select books for the children as well. The older children received the High School Musical activity book. I was pleasantly surprised that they knew of the movie and one had even seen it. The smaller children have Sesame Street books, with the middle aged children choosing either Pirates of the Caribbean or The Chronicles of Narnia. The country has primary education for all.

(As an aside, we have learned on this trip that even Uganda has "universal" health coverage. . .)

Thursday update

Hello all, we are still with very limited (and slow) email access. Hopefully this will improve today. The team finished in the OR at 8:30 pm last night and we had a pizza party to relax. The infirm members of the team are getting better each day, hopefully to return back to work in the next 24-48 hrs. Sleep is improving, though still erratic. Luckily the Ugandan coffee is STRONG.

The four patients done so far are doing extremely well. Two will transfer to step down status today. Two more patients to OR today with the first case having just gone back. The teams are working well together. The knowledge transfer continues. We are expecting a VIP tomorrow

More later.

Wednesday Update

So far the cardiac surgeries have gone fairly smoothly. The first two patients had correction of their surgical defects without any difficulty and both are eating and recovering in the ICU. In fact, we left the OR at 9 p.m. last night, which is awfully good for the first day. The first patient for day two is in the ICU recovering, while the surgical team is in the OR with the second patient. It will be another 9 p.m. evening for the team.

The team has been fatigued by jet lag and varying illnesses (flu, GI upset, dehydration, etc.), but we have rallied around each other to support our sick colleagues and pick up the necessary work loads. We will continue to monitor our team's ability to complete the 10 scheduled surgeries. Thankfully, we came well prepared with a wide spectrum of medications to treat every possible ailment. IV fluids have been given without problems. We hope all of us will soon return to our healthy state and that no one else becomes ill.

Sorry for the lack of communication

We have had no internet access for the last 2 days. We have brief power outages, particularly during rain storms and late at night. Fortunately Greg Griffin, our perfusionist, had prepared the bypass machine for battery operation, so the surgery could continue without complication. Access to our hospital email web accounts has also been sporadic. SORRY!

Dr. Dorostkar from Univ. of Minnesota joins Team UNC

Dr. Parvin Dorostkar, a pediatric cardiac intensivist from the University of Minnesota, joined our team for this mission. She will be assisting Dr. Kocis with final cardiac evaluations and care of the post operative patients.

Travel Directions: RDU to Entebbe

TEAM UNC Arrives in Kampala Uganda

17 team members boarded an airplane @ RDU Saturday at noon carrying 900 lbs of additional medical equipment and supplies. Sunday evening at 8pm (local) (1 pm EST) we arrived anxious to begin our mission. We stayed at a hotel outside Entebbe airport due to safety concerns of traveling at night and more importantly the recent riots in Kampala sparked by a disagreement between the the president of the country and a tribal king. We drove into the city early this morning, spending 1.5 hrs on the main road from Entebbe, then veering off to back roads for the final miles into the Capital due to gridlock. We have checked into our modest housing on the perimeter of the Mulago hospital complex. It will be our home for the next 10 days.

Our heavy/large equipment, which was shipped in August, has finally entered the country last night in the belly of our plane, but is still in the process of clearing customs. We need that equipment to proceed with our planned surgeries. We are hopeful the shipment will arrive by 5pm today. It will be a late night unpacking that shipment. We are all scurrying about reorganizing the pediatric cardiac ICU (4 beds) and stepdown unit (4 beds). Much of our organization system from previous missions remains intact. The OR team is unable to enter the OR now due to an adult esophageal surgery that is underway. We expect that operation to end soon and the OR to be transformed into a Pediatric Cardiac OR. Drs. Lwabi, Dorostkar, and I will begin the final screening of patients now. We have narrowed the potential pool to 12 to fill the 10 planned surgeries. Patients vary in age from 11 months to 14 years. Our new team members are quickly orienting to their new environment though jet lag is present in all.

We are still planning on having our joint cardiac surgery case conference this afternoon to review the patients. There's a lot to fit in today.

Repairing the Ugandan Children's Hearts

Our colleague, Dr. Craig Sable from Children's National Medical Center, has screened hundreds of children in the previous years. We have identified 17 patients for consideration for surgical repair, although we only have space for 10 operations on this mission. The cardiac lesions we will be repairing this year are ASD (atrial septal defect), a hole in the upper chambers of the heart, and VSD (ventricular septal defect), a hole in the lower chambers of the heart).

1 Mary N
2 Peter K
3 Oliver N
4 Asasire M
5 Joachum D
6 Atwib S
7 Anna Grace
8 Jovita K
9 Regan T
10 Hellen B

With Alternates:
A1 Joan O
A2 Faith K
A3 Fahad M
A4 Matovu Hussein
A5 Ethan K
A6 Jesse W
A7 Pheona A

Final determination will be made at the time of our last preoperative evaluation on Monday and Tuesday September 28-29.

A prayer card has been created by Samaritan's Purse (attached) for those interested in praying for the successful repair of these children's heart defects and our team's safety.