Here at Macha, your role is endless. One day, we had an emergency laparotomy surgery, and I somehow ended up acting as an anesthesiologist. Where there are not many professionals available, you do not say “cannot do it.” You say “maybe I can try.” My knowledge on anesthesia is limited, and on top of that, resources are limited too! The most surgeries are done without intubation (anesthesia machine is currently broken), so we give epidural block. Then, use some diazepam or ketamine to sleep. So, monitoring vitals is your main role. When monitor beeps, you worry, but you just hope that the surgery finishes on time. Otherwise, the surgeon tells you what medication to give to the patient. Definitely, OJT (On the Job Training)!
On the other day, I had an opportunity to assist for tubal ligation with a Zambian doctor. The technique was very similar to ones in the US. Family planning is well known here, but not much vasectomy – it’s a cultural thing… Unfortunately, female tends to suffer more than male. I am at least happy that local people are talking about family planning – a very important public health issue!