0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Commentary |

Perspective of West Africa:  Why Bother to “Mission”?

Fizan Abdullah, MD, PhD
Arch Surg. 2008;143(8):728-729. doi:10.1001/archsurg.143.8.728.
Text Size: A A A
Published online

Extract

Deep in the Ashanti region of Ghana, “well” is a relative term. Everything was going well for us until that 14th operation in 24 hours. Before that 14th case, our team from The Johns Hopkins Hospital, which had been working for the last day at the remote Asakore Mission Hospital, had already had a headlight failure that required us to use a camping light during surgery, inguinal hernias so large that we had no other option than to place mesh in unsterile conditions, and a cautery malfunction that delivered an unforgettable mild shock after passage of an observable spark to my body. (The adjective “mild” was used by the rest of the team and remains in dispute!) Despite these various setbacks, things really were going well until one of our team members, whom we had posted in the recovery area, pulled me out of the operating room urgently. She took me to see a 57-year-old woman whom we had just operated on to remove a large, mobile, submandibular mass. In light of the facilities available to us, our only option had been to perform the operation using local anesthesia and intravenous sedation. I found the patient gasping for air and could see that a mass the size of a small melon had developed on the right side of her neck in the hour since we had finished the surgery. Because the nearest mechanical ventilator was 150 miles away, and there was limited lighting for reexploratory surgery, my panic was a reasonable expectation. Surely, my friend and anesthesiologist, Devin, who was a veteran of 12 such missions (this was my third visit to Ghana), would have some miraculous solution. However, all I saw were his eyes over his mask screaming the question, What are we doing here?

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 2

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Epidemiology of HBV subgenotypes D. Clin Res Hepatol Gastroenterol Published online Jul 15, 2014.;
Jobs
brightcove.createExperiences();