the long bone in his thigh, the femur. Here at our hospital and in most hospitals in Rwanda these fractures are treated by traction and bed rest for many weeks rather than surgery. This is because 1) there is no one to do the operation and 2) the risks of infection and lack of equipment make the risk of surgery generally too high.
In this case however, as you can see from the X-ray, the bones were so separated that the chance of healing was virtually nil. We heard of a visiting orthopedist a few hours away and we attempted to transfer him, but they sent him back to our hospital after a few days- likely they were overwhelmed with similar cases, I never could arrange a phone call to find out why.
Regardless, I was left with a pretty typical dilemma: a definite need and no one to help except yours truly. Personally, it is hard to refuse an attempt at doing something, yet my lack of experience and the knowledge that I could do great harm weighs heavily in these decisions. After all, I'm not an orthopedist but a general surgeon.
So, I read, I prayed, and I asked for help from my orthopedic friends (thank you Carl). We decided to go ahead and try. This man had been patiently waiting in his bed for three weeks, crippled. Our plan was to place a rod into bone canal to reduce the fracture. Sounds simple, right? I learned otherwise.
The short story is that by God's grace we were able to get the job done- was it hard? Yes Was it done perfectly? No, but his femur now is in good position to heal!
I could give other stories that are similar, some of which I can't help at all, situations that are beyond anything I can do medically. It could be discouraging but the grateful attitudes and the few folks with whom you can really make a difference, really buoys you up to continue.
Wow, great job Tim!
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