CAPTIONS FOR ABOVE PICS:
1. The DJs/medical staff
2. Surgeons with serious focus
3. View of the operation
4. Finishing up with the power out

My first exposure to the “OT” was as I hung around in the hallway waiting to chat with some of the doctors. I saw them finishing up through the glass doors and to my shock watched the green-scrub mob pile out – after completing a round of group photos!

Later in the week, I donned a scrub uniform and a pair of communal plastic sandals, took my camera and notebook in hand, and walked into the OT. I was jovially welcomed in and instantly disoriented by the social atmosphere of the OT. I was met at the door by a doctor who, to my surprise, handed me one of the plastic cups of Coke that were being passed around and invited me to take a seat. People were lounging around chatting in one corner and two men on the other side of the room hovered over a laptop DJ-ing the green-themed party with an assortment of Hindi film songs. Though I tried to quickly quiet them, all sorts of judgments about ethics and safety and poor education and abuse of power flew into my mind (I have since learned that contrary to my expectations, such environments are not-uncommon in Western hospitals as well!).

Moving through my initial shock and impressions the more serious aspects of the scene came into focus. A subtle combined smell of blood, metal, and antiseptic filled my nose… A head moved and I noticed the woman on the table, sedated, but not unconscious, and barely recognizable in a contorted position and tiny under a pile of sheets… I noticed the intensity and focus of the 3 female doctors centered in the room under a pool of fluorescent light. Earlier in my life I couldn’t have been paid to watch a live operation. Yet now, motivated by some strange and growing desire to understand all aspects of this thing called “UP” I edged my way around the room, trying to get a good view and figure out exactly what was going on amidst the instruments and blood and tubes.

After far exceeding the bounds of what my squeamish self could handle and wondering what exactly I was doing there, I widened my focus again and started identifying some idiosyncrasies of the OT. Despite attempts to create a sterile environment through scrubs and flip-flops, the windows were open, letting sun, hot humid air, and anything else that wanted to, come right on in. I was shown the expensive new air conditioners primly sitting unopened in the corner unable to acclimatize the room because there wasn’t sufficient power in the hospital to run them. And I learned my biggest lesson of the day…. One reason there were so many people in the OT is because they were a living blood bank. Since there was no available blood supply, these medical students were not only observing the operation, but provided a secure source of blood in case a live transfusion was needed. In fact, only women whose blood types matched the regularly screened medical staff were permitted to have an operation, despite meeting other conditions for being good surgical candidates.

A bit later, just as things were starting to wind down, the power failed. The music went off along with the lights and monitors. But without a skipping a beat the green cast of characters switched modes, whipping out temporary lighting and taking charge of manually monitoring everything the machines previously covered. The operation was finished successfully by flashlight and the patient was unceremoniously whisked away to the recovery area. As the green team started to wind down, clean up, and de-robe, I couldn’t help but view their group picture taking with a new light… Perhaps with all the pressure and challenges lurking beneath the surface of their work, they deserved a moment to celebrate and document a job well done.

****

Witnessing the camp was, at times, an overwhelming and unbelievable lesson, revealing another layer of what it means to be a woman with UP in Nepal. The shocking lack of sanitation (lack of!!?!?) and the smell of sweat, bodily fluids, and sterilization solution are not things I will readily forget. The experience, though now months back is still as vivid for me as it was when I was there, and led to a new level of appreciation for the medical system we have in the US, despite the bureaucracy & challenges we often face. It also made abundantly clear the importance of preventative efforts and cemented my commitment to working for this condition, and maternal injury more generally, to receive international attention.