Gone Fishing

Monday Morning….The Course is about to start. There is anxiety and uncertainty wafting in the air. We, the foreigners who came to share our knowledge and learn from our colleagues are ready to teach Essential Surgical Skills. “Where is Bill?” Bill comes running into the room sputtering words that sound similar to a word salad…. “There is a man with a fishing spear in his back and I think he has a pneumo and I am going to operate……Glynn you are coming to intubate, Lianne you are scrubbing.”

That was it. It was decided. The man would have surgery to remove the spear and insert a chest tube to relieve the pressure caused by the pneumothorax (air trapped in his chest that compresses his lung).

We left the course, not quite sure what to expect. Bill, chest tube in hand was determined to do this…This would be Mongu’s first official chest tube insertion.

Bill, Glynn, and myself got ready. We discussed with the team what we would do and what everyone’s roll was. We prepared a water seal container with a suction canister, ringer’s lactate, and tape…pretty much a pleurovac right? (sorry for those non-medical people, just imagine a really home made system).

Bill and I scrubbed in for surgery. Bill ready to insert the tube took a long time to explain every action to the doctors and nurses. He is a fantastic teacher! The tube goes in and a large amount of air is released….The patient goes under and we remove the spear….

Let’s talk about this spear for a minute. This man comes from a town an hour away from Mongu. He had a few drinks with his friends and decided to play fight…The fight got out of control and he over powered his mate. The “friend” was so mad he went home and got a fishing spear. Needless to say we have a patient with a 5 prong, barbed fishing spear in his back.



Having a good look at the spear

The patient turned out to be an incredible opportunity to teach both doctors and nurses. Normally the patient would not have had a tube inserted and may have died from respiratory distress. With the new skills the doctors and nurses have learned we are certain we will be seeing more chest tubes in Mongu!