Uganda, Day Seven, 8/17/07

Today would be our last day in the theatres. Each surgeon was to do just one case each. I was planning on scrubbing Dr. Parker's shunt, but I felt my time would be better spent teaching the Ugandan surgeons how to use the implants and instruments I had brought over to stay at the hospital. Since we had only performed one instrumented spine case that week (Dr. Haglund's posterior cervical on Wednesday), we hadn't really had a chance to teach much instrumentation intraoperatively. Plus, I felt that if I had brought all this equipment but didn't show anyone how it worked, I would have done them no favors. It's actually pretty astounding to see so much equipment they already have yet don't use because they either don't know they have it, don't know what it is, or don't know how it works; these things have just been parked here by well-meaning individuals with little to no instructions on their use. So, I inserviced Dr. Michael, who was very pleasant and eager to learn the proper use of the equipment. I really have enjoyed his and all of the Mulago surgeons' company over the course of the week.

Leaving Mulago was bittersweet...mostly bitter. The surgeons, sisters, and attendants were very sad to see us go. Rashid, an attendant who had befriended me earlier in the week, brought me a gift wrapped in a cardboard box that had once held surgical masks. Inside was a picture of him, some Cadbury chocolates, and a small drinking glass from his home--probably one of the only glasses he owned. I felt completely heart-broken and honored at the same time. I had no idea what to do to thank him. We were changing clothes in the locker room at the time, so I just took off my Duke-blue scrubs and gave them to him. He was overjoyed and gave me a big bear-hug. We proceeded to go through all the new "handshakes" we had learned and practiced that week, and we promised to keep in touch. We finally left to cheers from the theatre workers, and we traveled back to the hotel to finish picking up the bags we had packed the night before.

We were now on our way to meet His Excellency General Yoweri Museveni, the President of Uganda, at the Ugandan House of Parliament. (Pastor Senyonga had orchestrated the meeting). We actually had to make more than one trip to the capitol because our meeting was delayed by the President's other meetings that afternoon. While we waited at the sentry, we used this bus-time to snag a few catnaps and catch up on much-needed sleep. No offense to His Excellency; we were really excited to meet him, but our sleep cycles were pretty scrambled by that point. After all the security screenings, we were shuffled into a meeting room where His Excellency came in to meet us. All of the press were there as we met him and had pictures made. I thought it was a very nice gesture.

From there, we piled into minivans and set off for Queen Elizabeth National Park in southwest Uganda. (We would stay the night in Mbarara en route to the park). We stopped to take pictures at the equator, and one of our vans got stranded with engine trouble. The problem was quickly fixed, but little did we know what this little snag was foreshadowing.

Later that night as we trundled along the pockmarked roads of the bush--last in line of our 4-van convoy--we got a flat tire.

"We've had a puncture!" our driver, Michael, exclaimed. The other vans sped off into the night, oblivious to what was going on. We pulled over to the side of the road, and got out to change it. I noticed the condition of all the tires--bald as a baby's behind with steel belts exposed. This van would have failed inspection years ago in the states! But, such is life in Uganda. There really is no such thing as preventative maintenance here. When something breaks, you use whatever rudimentary tools you can find to fix it, then fix it again, then fix it again until you finally cannot fix it anymore. At that point, you leave said object where it lies and look for another one. So Michael and I assessed the situation and began to change the tire. However, this task proved much more difficult than first imagined. It was pitch-dark, we had no hazard lights, all kinds of traffic were whizzing by us doing 60+, and we were starting to hear the denizens of the bush rustling beyond the roadside ditch. On top of all that, our tire jack would raise the van high enough to remove the flat tire, but not high enough to put on the fully inflated spare. We pulled the van up to some higher ground, thinking we would have a more optimal place to set up the jack, but this didn't work either. Then, we came to an impasse--should we keep calling the other vans to come back and bring another jack that might raise the van enough, or do we improvise and pull a risky maneuver to get the van higher into the air??? We decided that it might be hours before the vans ever realize we were stranded, so we proceeded with our plan (which I do NOT advise anyone doing unless you are absolutely desperate and have no other way out). Michael and I gathered whatever smallish stones we could find in the ditch and made a little mound. We placed the jack on the precarious pile of rocks to get the van a little higher.

"Ok Michael," I said, "as soon as I take this flat off the hub, we've got to get the spare on as fast as we possibly can...I don't want this van floating up here with no tire on the wheel, just to have it crash down on the two of us when those rocks collapse!"

"Ok," he replied.

Well, it worked. Michael and I looked like a pit crew that would make the good ole boys at Talladega proud. We were slamming on lugnuts left and right, and before we knew it, we were back on the road to Mbarara.

We finally made it to the Lake View Hotel in Mbarara. How would I describe this place? Well, let's just say it would have been a "roach motel," but the roaches had packed up their things and left this place long ago. I kept expecting to see little girls riding tricycles through the halls or blood gushing from elevator doors a la "The Shining." It was truly eerie. Senthil got a chuckle out of my trying to get situated in my bed under the mosquito netting--which happened to be full of mosquitoes. I was sitting there trying to kill the little pests inside the net like Mr. Miyagi in "The Karate Kid!" What good was this thing?!?

Wow, what a day! I don't want to toot my own horn here, but how many people can say they've been in surgery, met the President of a country, walked across the equator, and changed a flat tire all in one day?