On the first day of the 2012 Free Surgical Camp, there was an opening ceremony where our India hosts expressed their gratitude to the organizers, donors, and participants, and then it was like the gun went off for an ultra-marathon. Day one action included the screening of many of the poor who have come in hope of surgical salvation from their torment. I looked at many of these poor people with such sympathy for their plights- just having to live with their condition with no hope of treatment, knowing help is out there but unavailable, must be terrible.

The chaotic nature of the screenings was remarkable. So many people pressing on each other, anxious to be seen, the noise, the language barrier. But the doctors were so focused and calm, as they had to be, that the whole process somehow works. I was amazed at how quickly the “consultations” occurred, the doctors confidently assessing each patient, decades of experience clearly on display. Included among the core American doctors are the local doctors participating in the camp, as well as future doctors getting some valuable experience.

The second day was the first full day of surgeries, and a long day it was, ending just before 10pm, 19 surgeries in all. The screenings continued as well with Dr. Longstreth charging through more than 75, a huge number. There are two tables in the OR, a few feet apart, and there is constant shifting required to allow passage. The power has been going out on average 3 times a day, each time requiring a generator to be started which takes about 5-10 minutes. During these the surgeries continues apace, hardly eliciting a comment. It’s very impressive to watch.

I had the experience of going into downtown Khammam shopping for some shelving to improve the operating theatre organization. Dealing with the language barrier was challenging but the experience of joining in with the local culture was very interesting. Crossing the road on foot, for example, is a very challenging undertaking, not done in one move, but in multiple steps, with pauses midstream as traffic streams by on both sides, inches away, horns blaring, a game of chicken with pedestrians given no leeway.

There are endless small shops, most no more than a single car garage in size, crammed with merchandise, space at a premium. A hardware store I went into had plumbing pipes lining the floor of the 3′ wide aisle which you walked across, a shifting unsteady platform. Up two flights of 1 1/2′ wide concrete stairs, narrowed further by debris (merchandise?) to dusty, jammed cases of more items to sift through (miraculously, I found what I was looking for, or at least something that would work).

Most shops had many people in them and everyone was in physical contact, or nearly so. They slide by each other smoothly and seemingly never causing anger. Indians are masters at the art of weaving- that is weaving in and out to get around each other, whether on foot, bicycle, scooter, motorized rickshaw, car, or truck. In fact all these levels of travel mode are often occurring on the same road surface, making for what appears to be total chaos to this western observer, but which is totally normal for the locals. I think it is completely necessary, given the sheer numbers. Using western norms would quickly lead to gridlock, given the volume of travelers.

One more observation on travel in India: the passing on the roads is unbelievable! The smallest opening is opportunity to pass another vehicle. Head-ons seem certain, and yet the drivers go and make their moves with literally inches to spare. If the oncoming traffic is a motorcycle, the road is considered open, and the cyclist must get to the edge of the road, which generally is not too wide to begin with. It is terrifying to behold, but is nothing extraordinary for the locals- simply amazing driving!

I have little time to write, but I’ll do my best.

Regards to everyone,
Dave