We  arrived at the First Transit Hotel, Hyderabad, India, the last of us by 3AM India time on Sunday, Jan 9, 2011, a 24 hour trip from  the USA. Nine individuals traveled from NYC and four arrived from Savannah. We were joined at breakfast by our friends Sagar, Head of the ARMH School, and T.L.Reddy, founder of the Clap Schools, Mobile Schools, and Women’s Help Centers. The bus was loaded, and we departed for Khammam at 10AM, arriving at 4:30PM after 200+km of bad roads and alarming traffic.

The Surgical Team unpacked and stowed the 18 duffles of surgical supplies donated by supporters from the USA. Meanwhile, Amy and her Pilgrim Witness team sorted and apportioned 6 duffles of Christian Educational supplies, donated clothing, and Bibles printed in Telugu. After dinner we turned in, early, exhausted from the trip and the 10 ½ hour time change.

Monday morning the Surgical Team started screening the 150+ patients enrolled to be seen. The patients came in a steady stream. We scheduled 6  people for that afternoon, under local anesthesia,  small cases of lumps and bumps. Joe, Bob, and the Fordham duo, Sam and Andrew, did them, while Renny & I continued to screen patients for the rest of the day. We finished screening clinic at 8PM, having seen all who were there.

Tuesday AM, after breakfast,  which included the new favorite, “banana-flavored corn flakes”, the real work in the OR started. Dr. Gopi Chand, our great friend and  extremely capable anesthesiologist,  arrived on schedule after we had started with a few cases under local anesthesia. I have been working with Gopi Chand since Betsy & I started the Free Surgical Camp in 1999. He is a terrific asset to our program, and a first rate anesthesiologist.

Nurse Shirley Owen assumed the job of OR circulator, getting needed supplies, etc. Shirley is 80 going on 60. What a bundle of energy!  Sister Deborah continued her usual as Head Nurse and OR scrub nurse just as she has since 1999 with her able assistants Sharamma and Vimalamma. As usual, they run a tight ship, turning cases over in minutes, unlike the USA. They work 12-14 hours with us, with a 10-minute “chai” break AM and PM, and a half hour lunch break, also unlike the USA.

We finished 17 cases Tuesday. Each day we did between 12 and 20 procedures,  averaging 16 cases a day. The case mix was about the same as usual: hernias, both incisional and inguinal, hydrocoeles of all sizes, thyroids, hysterectomies, rectal, breast, and burn scar releases. See the accompanying case list. There were the usual mystery cases which we had never seen before, which defied our diagnosis and treatment. These cases we sent to Mamata, the local private medical school. Mamata is very selective about the cases it takes, but which it does for free.The rare, exotic ones we send over are almost always taken in. One such case was a lady with a marshmallow-sized mass on her nose between her eyes. A previous fine needle biopsy diagnosed it as a lipoma (fatty tumor). When we got into it, it was nothing of the sort. The tumor oozed clear fluid like tears, and we thought it might be a lacrimal tumor. We certainly had not had experience with such a problem, so we closed her and sent her to Mamata where she had to wait a week for their cat-scan to come back online. An opthamologist and a neurosurgeon took her in.

Joe, who does all the thyroid surgery, found several thyroid cancers, biopsying them, and getting them into proper follow-up treatment for life. Joe’s son, Joe Bardenheier, Jr, a business man, was a great help in the OR, scrubbing on cases with his Dad and Bob and me. He also gave John Mark some good advice on handling Vijaya’s insurrection. Joe Jr., unfortunately, had to leave after the first week. Rumor has it that he skied indoors at a stopover in Dubai on the way home.

Bob Dwyer, urologist, finally got to do a cystoscopy this year. Usually he’s stuck doing the lion’s share of the hydrocoeles, which are unlike those seen in the USA. He also does hernias, lumps and bumps, and the stuff that Joe & I do.

My daughter Liz Johnson, scrubbed in on a case with me, found a sebaceous cyst “too yucky”, and had to bow out. She reinvented herself and was a great help keeping the OR Log, and other records.

Renny Schoonmaker and wife Judy ran the screening clinic each day, Judy booking cases for the OR in a most organized fashion. Renny said that he saw cases he hadn’t seen in years, and went to the Internet to look some of them up.

Sam and Andrew, our Fordham U. juniors/pre-meds were indispensible assistants, scrubbing with us through the myriad of cases, changing dressings, presenting patients’ status at rounds, and being all round helpful.

All the Gyn work was done by our old friend, Dr. Sulochana Christopher, not only screening the Gyn problems, but doing the abdominal  and the vaginal hysterectomies. The cultural ethic behind Gyn care is quite different in this part of India compared to the USA, with the husband often making the demands, either actively or passively (don’t come home until you’ve got that thing out!). Dr. Sulochana’s two children, Annie and Ben were a great help to us as well, especially with translating Telugu/English.

John Mark and his lovely wife Vasantha were our wonderful hosts, providing not only our lodging, but our meals three times a day on our very irregular surgical schedule. He was saddled with us and our problems and at the same time carrying out his duties of running CSU, and working on the legal/political Vijaya issues. I don’t know how he survived. In addition, he hosted visits from a Member of Parliament and the Honorable District Collector. Both came to inspect our work, and gave us great thanks and approval.

Also travelling with the Surgical Team, but on their own agenda, were Amy Utley, Mary Negley, and Harriet Doub, who were pilgrim witnesses, visiting orphanages, village churches, old folks homes, polio rehab,  the leprosy village, and others, giving out Bibles in Telugu, and other Christian instructional materials for the Christian groups they visited , both in the Khammam area and in Hyderabad with our friends Sagar at the ARMH School and TL Reddy and his Clap sidewalk and mobile bus schools for kids living in the gutter. Amy will be reporting on their activities separately.

This year’s surgical camp was a big success. As seen on the list of procedures, we did 174 procedures on 163 patients, with several patients having more than one procedure at a time. One man had 7 lipomas removed under 7 locals at one sitting. This, for example, was counted as two procedures on one patient. Several patients had several procedures done under a single anesthesia, such as  bilateral hernias and a hydrocoelectomy under one spinal. We have to be very careful to maintain a wide margin of safety for our patients because our setting is so primitive.

We owe a great debt of gratitude to all the generous people who helped fund our efforts for the Free Surgical Camp, and those funding our Rural Health Clinics and Speciality Clinics, which are run throughout the year at St. Mary’s Hospital. Without these generous donors, none of this work could be possible. Thank you to each one of you. The planning for next year’s Camp will start soon, and support for John Mark and CSU in the battle to continue Azariah’s work, unimpeded by Vijaya’s family’s selfish interests, will also continue unabated.

Thank you for your interest and support, respectfully submitted,
George Longstreth, MD