doc
Spring 2015 • Kentucky
However, while he practiced his skills in a
hospital rather than a tent, the conditions
were quite primitive, as this war torn area
had lost its previous wellestablished medical system. During surgeries, he could hear
exploding rocket warheads daily that often
fell on the hospital grounds. With inadequate resources, medical supplies had to be
obtained from a neighboring country.
obtain oxygen canisters, and moreover the
hospital had no oxygen lines. He could provide oxygen to patients only by using concentrators. Fortunately, he did have available
end-tidal CO2 monitors and ECG monitors.
While smiling he told me he had his choice
of any gaseous general anesthesia he needed,
“as long as it was halothane.” Due to the
frequently injured civilian population, much
of the surgery provided was trauma-based
but he also assisted in Cesarean sections.
For the more severe injuries, and those
requiring subspecialty surgery, the patient
could often be referred out locally or sent
to a neighboring country. Patients had to be
transported to the border of the neighboring
country and then be moved to hospital. Dr.
Hall did not have the benefit of an ICU nor
ventilators; and much of the time, he had
to provide postoperative care himself to the
patients rather than follow the postoperative routine he was used to at St. Joseph
Hospital. His medical team generally consisted of a surgeon, himself, and a nurse.
He found the political conditions had
changed dramatically when he returned
to Syria later in 2013. Now the area was
infiltrated with members of I.S.I.L while
Syria’s political control had changed for the
worse. He had to land by plane in a country
outside Syria, be transported to the Syrian
border, and then walk across as there was no
passport control. Not only had conditions
changed politically, the means of anesthesia practice was very primitive due to the
destruction of the Syrian healthcare system
by the war. He could only use equipment
that was easy to operate in adverse situations. He and his colleagues were unable to
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These frightening conditions and primitive
equipment have not dissuaded Dr. Hall from
future missions. While he does not plan to
go into a combat area, he will continue to
provide services to needy, medically underserved populations in other countries. He
enjoys the challenge to his anesthesia skills.
Moreover, the medical colleagues he meets
are extremely interesting and they have varied and diverse medical backgrounds. His
experiences have taught him how medical
systems do and do not work. Dr. Hall notes
sadly that we Americans, as not unexpected,
have a significant misunder