.....Dr Sarom, the ROSE surgeon, taught and performed surgical procedures in the basic, but adequate, operating theatre. We would often have to be the scrub nurse and assist at the same time; as time went on we were able to help more and more. After we had seen and assisted at several of the cleft lip operations, Dr Sarom declared, "Next time you be surgeon!" Dr Sarom supervised me closely as I operated, his stepwise teaching paid off and the results were impressive. The buzz from completing my first operation was heightened when the little girl thanked me a week later. "Now I am pretty," she said.
I became familiar with the tropical diseases that I had previously heard about only in lecture theatres. Though the medical ward was an incredible learning environment, with late stage everything and full of florid clinical signs, it was hard not to get frustrated by the lack of resources. The country ran out of insulin during our stay, the strongest analgesic available was pentazocine, and the availability of x ray equipment was a luxury. The variation in the training of the medical staff was more difficult to cope with. The concept of ensuring the airway and protecting the cervical spine after trauma was alien to most doctors, and it was unsettling to see patients' lives put at risk from such simple oversights.
We went on several outreach visits to regional hospitals. In an Italian run emergency hospital near the Thai border, I gained first hand experience of the horror of landmine injuries. A demining truck had driven over an antitank mine after being told that the route was clear of mines. We treated the two passengers, one whose spleen had shattered, the other with several broken bones. The driver had been killed instantly. The wards of these rural hospitals were full of the limbless......
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