It’s the smell that hits first. Overwhelming. A bitter mixture of sweat, other body fluids and the slightest waft of antiseptic cleaner you wish would overpower everything else. It never does.
Within five seconds you forget the smell as a heartbreaking scream tears through your ears, then through your entire body.
It’s the unmistakable roar of a child in excruciating pain and the sound stops your thoughts, your movements and almost your heart.
I look to the ground to hide the tears I know I can’t stop, and my jaw tenses. I bite my lip hard.
The morning ward tour with Perth surgeons James Savundra and Brigid Corrigan is a shock.
But this has nothing to do with how I feel. How can it when a 10-year-old Tanzanian boy lies on his stomach, tears running down his little cheeks as Dr Savundra gently but painfully checks a tumour removal wound on the boy’s buttocks.
It stretches from his lower back down to the back of his knee. “Sorry, mate.” Dr Savundra gently pats the boy’s head.
This room at the Sekoutoure hospital in Mwanza has no lights on, no air-conditioner or even a fan. But it’s where nine sick or recovering children and their mothers wait for the next piece of advice from doctors.
A little girl, no older than four or five, wrapped in bandages and alfoil to keep her warm after burns surgery, waves her free hand at me and smiles.
It brightens my mood instantly. How can she possibly be happy in here? My grin in return feels big and goofy but it’s a welcome relief from the helplessness building inside me.
Dr Savundra and Dr Corrigan quietly discuss another patient as Subiaco nurse Shannon Muir hands them gloves.
A young man called Emmanuel looks at the Australians as they check his recovery from cleft lip surgery two days earlier.
Emmanuel is doing remarkably well. The Rafiki surgical team fixed his face and he tells me through a translator it’ll mean he can now get a wife and his neighbours will stop teasing him.
A deformed face has been his for 22 years. Not any more. Emmanuel’s story is one of almost 1200 cases the Rafiki Surgical Mission has proudly racked up over the past 11 years.
Babies, children and adults who lived and in some cases would’ve died with their conditions, get another chance, or in Emmanuel’s case, another face.
Twice a year, a team of surgeons, anaesthetists, nurses and physiotherapists leave Perth for a two-week trip to Tanzania.
The fundraised mission is far from a sightseeing holiday for these Perth medicos. They’ll pull 12-hour days, fixing cleft lips, cleft palettes, horrific burn contractures and the occasional tumour removal.
It’s tough, unpaid work in a hospital that has barely changed since it was built in the 1960s.
A reverse-cycle air-conditioner in the operating theatre struggles against the Tanzanian heat. When the power drops out, the scrubs, gloves and hats they wear are like personal sweat suits.
Dr Savundra laughs. He’s spilled surgical ink all over his hand and Dr Corrigan makes a joke at his expense. The operating theatre erupts into laughter.
They love it here but the reason they’re on the trip is serious, Dr Savundra says.
“It’s sad enough for parents when their children come and say some kid didn’t want to play with them in the playground, but imagine if kids like this come home every day and tell their parents that. That would be tough.”
Emmanuel’s 90-minute cleft lip surgery was relatively straight-forward.
A child spent five hours on the West Australians’ operating table the day before.
He had one of the most horrible burns injuries the surgeons admit they’ve seen. His right elbow was fused to his hip, and his right leg permanently bent. It’s the result of falling on to an open fire and not getting treatment before the skin shrank and healed.
In the outdoor recovery room, the young boy with a tumour is in pain, but physio David Crocker says he’s doing well. The tumour they cut out weighed 3kg. Rashidi weighs just 18kg.
Mr Crocker shows me a mid-surgery photo on his phone and my stomach turns. Rashidi has tears in his eyes as the physio moves his legs and checks the 10-year-old’s balance.
“You just don’t see these injuries in Australia,” he said. “They just don’t happen and the healthcare system would never let it happen.”
Mr Crocker’s dad, uncle and aunt have also done the Rafiki mission several times each.
The Rafiki team is quite literally changing lives. An idea in 2004 from Australian doctor Rob Barber, who was living in Tanzania at the time, is now a massive year-round operation.
Fundraisers have put more than a million dollars into sending the medical teams, and tonnes of medical equipment including old hospital beds from Perth, to Mwanza in northern Tanzania.
Perth lawyer Didier Murcia is now the driving force behind an army of medical volunteers such as husband and wife Andrew and Taka Wild who have 25 Rafiki missions between them.
At the end of a long day of running the team’s anaesthetics, I bail up a tired-looking Andrew Wild on the bus back to the hotel.
“It is a long day, particularly when it’s four long days in a row after flying from Australia without any time off, you certainly get pretty tired at the start, but you get into the swing of it and I think we’re all feeling pretty good at the moment,” Dr Wild said
Two mornings later, back at the hospital, I watch a local nurse try to find a baby’s vein with an IV needle. The baby’s stomach rises and falls unnaturally quickly and his eyes are glazed over. I have to look away as the nurse reinserts the needle.
We return to the Rafiki surgical wing, but minutes later a woman’s wailing draws us outside. Her baby son had just died.
I watch as another woman tries to pull her back, but the mother is hysterical. She staggers past us but I don’t know where she’s going. It was the same baby I’d seen alive with the local nurse no less than five minutes earlier.
He’s not a Rafiki patient so the Australians had no idea he was so close to death and I’m told he died from diarrhoea – a common child killer here.
For a healthy Australian that information is hard to get your head around. The difference in healthcare between Australian and Tanzania is remarkable. That’s why the Rafiki surgical missions have such an impact and are clearly so important.
Not only for the cases they’ve operated on and the equipment donated, but also the training they offer local doctors.
I watch as Dr Corrigan and nurse Peta Sherriffs show Julius – a young Tanzanian intern – how to hold the scissors to cut sutures. It’s a small technique but Julius is grateful for the tip.
“It’s an opportunity for them to see how things are done a bit differently in Australia, and we learn things from them as well. They manage to do a lot with very little here, most of their surgeons practice across a wide degree of diseases and so it’s a good opportunity for both of us.”
I leave as the team is finishing two three-hour operations. They’ve got another seven hours of surgery today, and two more days after this one.
They’re doing amazing work and I envy them – not for the long days or difficult conditions but for their willingness to give up their time for people far, far worse off than anyone in Australia is likely to be.
Vivienne Bilsborough holds a small child, whose cleft lip surgery was a success just moments earlier.
“To see some of the adults coming back and hear the stories – they’ve managed to get married, accepted within the community, and catching them at this age, you know you’re making a difference for the future. Rafiki is Swahili for ‘friend’,” she said.
You can bet the Rafiki surgical missions have made plenty of those in their 11 years in remote Africa.
‘You just don’t see these injuries in Australia … the healthcare system would never let it happen.”Physiotherapist David Crocker
FRENCH VERSION
Dans les cinq secondes vous oubliez l’odeur comme une larmes cridéchirant grâce à vos oreilles, puis par le biais de votre corps tout entier.
C’est le grondement incomparable d’un enfant dans une douleuratroce et le son s’arrête vos pensées, vos mouvements et près devotre coeur.
Je regarde au sol pour cacher les larmes, que je sais que je ne peux pas arrêter et les temps de ma mâchoire. Je mords ma lèvredur.
La tournée de quartier matin aux chirurgiens de Perth JamesSavundra et Brigid Corrigan est un choc.
Mais cela n’a rien à voir avec ce que je ressens. Comment peut ilquand un garçon tanzanien âgé de 10 ans se situe sur le ventre,les larmes couler sur ses joues peu comme Dr Savundradoucement mais douloureusement vérifie une suppressiontumorale enroulé sur les fesses du garçon.
Elle s’étend de son bas du dos vers l’arrière du genou. « Désolé,accoupler. » Dr Savundra tapote doucement la tête du garçon.
Cette chambre à l’hôpital de Sekoutoure à Mwanza n’a aucunvoyant sur, aucun climatiseur ou même un ventilateur. Mais il estoù neuf enfants malades ou en voie et leurs mères attendent leprochain morceau de conseils des médecins.
Une petite fille, pas plus ancienne que quatre ou cinq, enveloppésdans des bandages et alfoil pour garder son chaud après lachirurgie des brûlures, agite sa main libre à moi et sourit.
Il éclaire mon humeur instantanément. Comment peut elle êtreheureuse ici ? Mon sourire en retour se sent grand et maladroit,mais c’est un soulagement bienvenu de l’impuissance deconstruction à l’intérieur de moi.
Dr Savundra et Dr Corrigan discutent tranquillement un autrepatient comme infirmière de Subiaco Shannon Muir remet lesgants.
Un jeune homme appelé Emmanuel se penche sur les Australiensqu’ils vérifient sa convalescence d’une chirurgie de bec-de-lièvre,deux jours plus tôt.
Emmanuel se porte remarquablement bien. L’équipe chirurgicalede Rafiki fixe son visage et il me dit à travers un traducteur qu’il vais signifie qu’il peut maintenant obtenir une femme et sesvoisins seront arrêtera à taquiner.
Un visage déformé a été la sienne pendant 22 ans. Pas plus.Histoire de Emmanuel est l’un des près de 1200 cas que laMission chirurgicale Rafiki a fièrement accumulé au cours des 11dernières années.
Les bébés, les enfants et les adultes qui ont vécu et dans certainscas seraient ont décédé avec leurs conditions, obtenir une autrechance, ou en cas de Emmanuel, un autre visage.
Deux fois par an, une équipe de chirurgiens, les anesthésistes, lesinfirmières et les kinésithérapeutes quitter Perth pour un voyagede deux semaines à la Tanzanie.
La mission de fundraised est loin d’être un séjour touristique pources medicos de Perth. Ils vont tirer 12 heures par jour, fixation deslèvres une fente, fente de palettes, contractions horribles brûlureset l’ablation de la tumeur occasionnels.
C’est un travail dur, non rémunéré dans un hôpital qui a très peuchangé depuis sa construction dans les années 1960.
Un climatiseur réversible dans les bloc opératoire de luttes contrela chaleur tanzanienne. Lorsque la puissance est désexcité, lesgommages, les gants et les casquettes qu’ils portent sont commedes survêtements personnelles.
Dr Savundra rit. Il a fait couler d’encre chirurgicale partout dans samain et Dr Corrigan fait une blague à ses frais. Le bloc opératoireéclate de rire.
Ils adorent ça ici, mais la raison pour laquelle ils sont sur le voyageest grave, docteur Savundra dit.
“C’est triste, assez pour les parents quand leurs enfants viennentet disent un gamin ne voulait pas jouer avec eux dans la Cour derécréation, mais imaginez si les enfants aiment cette arrivé maisontous les jours et que dire à leurs parents. C’est difficile. »
Chirurgie de bec-de-lièvre de 90 minutes de Emmanuel étaitrelativement simple.
Un enfant a passé cinq heures sur la table d’opération desAustraliens de l’ouest la veille.
Il avait une des plus horribles brûlures blessures que leschirurgiens admettent qu’ils ont vu. Son coude droit a étéfusionnée à sa hanche et sa jambe droite pliée en permanence.C’est le résultat de tomber un feu ouvert et ne pas obtenir untraitement avant que la peau s’est rétrécie et guéri.
Dans la salle de réveil en plein air, le jeune garçon avec unetumeur est dans la douleur, mais physio David Crocker a dit qu’il se porte bien. La tumeur qu’ils découper pesait 3kg. Roselyne ne pèse que 18kg.
M. Crocker me montre une photo de Mid-chirurgie sur sontéléphone et mon estomac se transforme. Roselyne a larmes dansses yeux que le kiné déplace ses jambes et vérifie l’équilibre des 10 ans.
« Vous ne vois ces blessures en Australie, » dit-il. « Ils n’arriventpas, et le système de santé il laisserait jamais arriver. »
De M. Crocker papa, oncle et tante ont également fait la missionRafiki plusieurs fois chaque.
L’équipe de Rafiki est littéralement changer des vies. Une idée en2004 du médecin australien Rob Barber, qui vivait en Tanzanie àl’époque, est maintenant une opération massive de l’année.
Collectes de fonds ont mis plus de 1 million de dollars enenvoyant des équipes médicales et tonnes de matériel médical, y compris les anciens lits d’hôpital de Perth, à Mwanza en Tanzaniedu Nord.
Avocat de Perth Didier Murcia est maintenant la force motricederrière une armée de bénévoles médicaux comme mari etépouse Andrew et Taka sauvages qui ont 25 missions de Rafikientre eux.
À la fin d’une longue journée de fonctionnement anaest de l’équipe
