Church at 640, surgical meeting with residents and staff next, then rounds and surgery. Lots of severe orthopedic trauma in the ward : beds all right next to each other with people with open fractures, multiple fractures, infections, etc. One man had external fixators put on both femurs and left tibia 3 months ago and is not close to being healed, multiple others waiting for surgery, little kids right next to adults with amputations, fractures, osteomyelitis, a lady with a back injury and high fevers getting worked up for malaria, all kinds of bad problems. One patient came to the clinic a week out from an MVA with quadriplegia - not much we can do, no way to image the spine other than X-rays, which were suboptimal. Another with an open arm fracture 7 days out, etc, etc. 

Performed 3 surgeries: IM nail for femur fracture, ex fix for open tibia fracture, bridging elbow ex fix for open humerus fracture after motorcycle accident at least 7 days ago already infected. No X-ray or fluoroscopy possible for any of them - good thing I have X-ray vision.

Gave a talk on open fracture management to the PAACS residents despite the fact that they treat a lot more of this stuff than I have ever thought about.  Most of the treatment protocols we use in the US are ridiculously impractical here, but they were very interested in our approach to this problem. 

The surgical residents and staff all had a Bible study before my talk, with everyone present. The topic was Jesus' approach to judgement and humility, and the importance of the evidence of that teaching in our daily walk. The specific verses came from the incident where Christ forgave the woman caught in adultery and told those who wanted to condemn her that he who was without sin should cast the first stone. The interaction was insightful, and the idea of a surgery conference focusing on humility and servant-hood was certainly something new for me. 

What a blessing. The staff have a Bible study tonight that the Streatfeild's (Australian medical missionaries) lead and I'll be going there shortly

Bob