Mid-week post: great invention!

Great inventions have always been made in emergency situations, so I have been told. Though it will never turn out into a great invention, kudos to the presence of mind of the caregiver who came up with this quick and indeed very clever way of modifying a broken wheelchair to make it functional!



And there was latte!

I had an amazing cup of latte in a small coffee shop that came highly recommended. Addicted to the Starbucks latte, I was so grateful for the wonderful coffee at ‘Oasis’. It is a shame the place closes at 6.30 pm but I should be thankful for small mercies! The walk to Oasis was via Promenade gardens that had unusual trees and flowers and also a statue of our very own Mahatma Gandhi, with real eyeglasses!

Timeless Sunday!

Today was a timeless Sunday. We visited a place where time has stood still and seems to have no meaning. There are no clocks, no supplied electricity and no locks at the wonderful 20-acre oasis of the winemaker Warren and his artist wife Tracy.

The place is called PANDAMA, named after the Pandama palms that grow wild here. Actually, everything grows wild at the retreat and nothing is planted. Water is from a nearby creek, the lights are solar and the only fan is the breeze from the forest. The two Macaws have to be kept in the cage because of  the ‘Wild-woman’ (the residential cat who has a month old un-named kitten). The other residents include Onynx, Moonlight and Spice (all dogs). Warren (an ex-US Navy veteran) makes fruit wines and I tasted beautiful whites and reds made from starfruit, soursop, rose, lime, cherry and jamoon. Jamoon is an Indian berry that brought back childhood memories of stained black lips and tongue giving our (my sister and me) secret away that we had eaten it despite being told not to. This fruit also grows in Guyana and its botanical name is Syzygium cumini (thanks to my botanist mom who taught me to look for the botanical name of each plant/tree as it did not change whichever country one lived in). The pièce de résistance was the pineapple wine with a dash of the hot pepper wine!  I ended up buying both.

We had heard a lot about the black creek that is on the property. I had gone there with the firm idea that come what may, I was not getting in the black water. Period. Beth, on the other hand, is an adventurous sort and supported by Kristen, went right in! Finally, I could not see them enjoying so much so had to get in. It was totally not what I had expected. The water was cool, clean and coffee coloured due to the tannins from the leaves and finally, Tajh (the other OB/gyn resident) also had to give in!  We spent a long time in the creek and once we got out, the dogs too came in to cool off.

We returned to Project Dawn, pleasantly tired, relaxed and happy. Was this the effect of the creek water? Tracy had mentioned that it makes one young and allows the soul to breathe. Will time be the augur??? 😇




Work week 3

Another week has gone by. Things have not been smooth, to say the least. There are so many things that are not right, in so many ways.

Patient communication is such an issue here. It is not considered important to inform the patient about his/her progress, the reason for surgery or its cancellation or results of surgery, let alone anyone from his/her family.  The mother of a child who underwent surgery a few hours ago asked me what surgery was done and who did it. I cannot imagine this in the world where I work. It takes such little time and does not cost anything so I cannot understand why it is not done.

While the inside of my head was buzzing with thoughts and opinions that wanted to get out regarding this, the local newspaper published a letter to the editor about poor communication from Guyanese physicians. The writer writes about the play of the power struggle between patients and doctors with patients who have moved to the 21st century of health care delivery and doctors who are stuck in the 20th century with the view that they are the bosses and should not be questioned. He mentions poor communication as an endemic disease that is prevalent here. You may need to cut and paste the link. https://www.kaieteurnewsonline.com/2018/08/13/poor-communication-by-doctors-in-guyana/

All is not bad in the health care here. Whatever drugs are available, they are free for the patient. Perhaps, the west needs to look at this!IMG_1900

Work week 2

This has been a busy week, a week of interesting cases and unusual conversations. Many things considered mandatory in London, Ontario seem almost frivolous here. Things like a sheet to cover the patient’s exposed body, blankets, bedsheets on the patient’s bed, pillows, alcohol wipes, paper towels, labour epidurals, screens to keep patients’ privacy, informed consents, safe sharps management, anaesthesia machine checks, the help of an RT, availability of blood for transfusion. Oh, I could go on forever!

Beth and I have decided that we are going to kiss our anaesthesia machine and glidescope when we return! She has also said that she is looking forward to her OB call. This one I am not too sure about and I will have to see if she changes her mind!!!

Here is a patient who very kindly allowed us to photograph her for teaching purposes. She came in for a mandibular tumour excision. We did promise her that her face would have a black stripe over her eyes. A very pleasant woman who lives in a remote area of Guyana and came in for surgery as she could not eat anymore. IMG_2017



Kaieteur falls weekend trip

We had an amazing weekend. We were invited to a Guyanese wedding on Saturday. An anaesthesia resident was getting married (to an OB resident!) and we were last minute invitees. What an opportunity to see a local wedding! Despite both the groom and the bride being of different faiths, the ceremonies did not take too long and then it was food and dancing. We all had fun!

We had been negotiating with various travel agents for a weekend trip to Kaieteur and Orninduik falls. Finally, after finding the right price, on Sunday morning we were at the Ogle airport to take the small 12-seater Cessna 208B to the Kaieteur Falls. It was raining heavily and the trip cancellation was looming on the horizon. However, 2 hrs of waiting was rewarded by a sudden clearing of skies and takeoff

There are no roads to this protected national park and the only other way is to hike for 7 days through dangerous rainforests (that many still do, believe it or not). Neither were we brave nor did we have the time so we flew over miles and miles of dense Amazon rainforest for about 50 minutes and then the falls suddenly appeared.

The Kaieteur Falls are about 4 times higher than our own at Niagara so one can imagine the absolute perpendicular drop of the coffee coloured water. I believe that they are the world’s largest single drop waterfall by volume. There is sheer isolation without any touristy stuff here. The 12 people on our flight, one pilot and one guide were the only souls (apart from the 2 park rangers and one local guide stationed there). Not even mosquitoes! There are carnivorous plants in the jungle that eat all the small insects. I was fortunate enough to see the little golden frog that was discovered in the jungles of Amazon in 2008 and had made the news. It did hide but not before I had taken its picture!

Orninduik falls were another 25 min flight away and as the falls are not deep, we enjoyed bathing in them. It then started to rain just as our time to return was drawing near. Our pilot was very experienced and he brought all of us safely back to Georgetown in the evening. A lovely end to an eventful week about which I will tell in my next post.





Cricket stories

Today I will share with you a West Indies cricket experience. For those of you who are uninformed, cricket is a sport, not an insect! It is widely played throughout the world except for North America! Countries have their own teams (e.g. England, Australia, NewZealand, India, Sri Lanka, South Africa, Pakistan to name a few). As the Caribbean countries are small, they play as one team: West Indies and it is one of the powerful teams in the world.

Created in 2013, the Caribbean Premier League is an annual Twenty20 cricket tournament held in the Caribbean and most Caribbean teams participate individually, with each other. The matches are much sought after and we were lucky to have one in Georgetown where Guyana Amazon warriors were playing St. Kitts & Nevis patriots.

With our new found OB/Gyn friends Jennifer and Kristen, we went to the Providence stadium to see the colourful and noisy carnival last night. Remind you, Jenn and Kristen along with Beth are (or at least were) cricket naive. All three of them had a crash course in cricket, thanks to aunty ‘Google’ and uncle ‘Wikipedia’. And then it was a blast. Yours truly tried a hand at taking selfies and after many miserable failed attempts, nailed it and the proof is here for all to see!!!!IMG_2010

Guyana end of week 1!

Today is the end of week 1. We have been in Guyana for 7 days now. This was a very eventful week and I will report the interesting events.

Clinical work is interesting in the Georgetown public hospital corporation. We had a teaching session with the residents (at various levels of training) on Thursday and got to know them as well. Now I can tell a few names and I am sure I will get better, as the days go by. Maxine is the senior most and will be visiting Hamilton, Ontario in a few months time. She is waiting for her CPSO license. The PGY4s (this is a 4-year program) visit Hamilton for 3 months, regularly. This is such a wonderful opportunity for the Guyanese residents as they get to see things that they have only read about.

We visited the OB suite. It is a relatively new building that was finished in 2017. There were 4 C-sections planned for the day. The place is run by nurse-anesthetists who do all spinals/GAs. Attendings are available in the building across the street in case of problems. It was Deja Vu for me and it seemed that I had stepped back in time, at least 35 years! There is minimal OB analgesia service and lack of equipment/personnel may be partially to blame. Also, the residents/attending stay in the main ORs.

Just as we were getting the hang of the Project Dawn, we had to move out on Friday as the place was needed for a larger orthopedic group. Now, we are in a hotel in the town. This is a reasonably comfortable place and we both have our own rooms but we have to eat out every night. I am worried about restaurant food for 12 nights. I have not hand-washed clothes for more than 2 decades and this is not something I am looking forward to!

On Saturday, we walked to the botanical gardens and the attached zoo. This was a nice trip and we saw some strange animals. We met one of the anesthesia consultants who was also there with his daughter. On our way back, Beth bought coconut water and we did some grocery shopping. Beth cannot stop trying to pet stray animals and I cannot stop telling her not to. Let us see who wins.

We went out with the two OB/gyn residents from USA and had a nice evening. Today, we walked to the local Bourda market and bought some fruits and vegetables. We are both craving fresh greens and fruits! No to mention “LATTE”!!!

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