Admedabad to Khambhat

My flight last night was delayed by 1.5 hours because they couldn't identify the correct number of people, not sure what that really means? The boarding system in Dubai turned out to be crazy. There was no order. Everyone just lined up, the tickets got scanned, and we were basically placed in a holding pin. after being there for an hour they opened the plane. It was a mad dash. no lines, no organization, Just a crowd of pushing people headed in a general direction. due to this chaos, boarding lasted close to another hour. Finally we were ready to fly. After a grueling 3 hour flight, full of screaming babies, we made it to Admedabad. Customs was not difficult to go though, collecting the luggage was a different story. It took another hour just to collect the bag. I went out and met the team. There was a truck for all of our luggage and a bus for us. Finally, at 6 am we started the 2 hour bus ride to Khambhat. It was amazing the gross property that was everywhere. Every 50 feet were a group of people huddled around a fire just to stay warm. There was trash everywhere. Cows, camels, goats and story dogs roamed the streets looking like skim and bones. The driving here is absurd. There is no real speed limit and you are supposed to drive on the left hand side of the road, however that seems like a suggestion more so than actual law. After passing through many villages, farms, and towns we made if to Cambay general hospital. The hospital is spread out over a decent size campus. We took a tour, and amazingly they have some decent technologies. They have a ct scanner, mammography machine, cardiac center, new dialysis unit and 10 bed ICU. The operating room was surprisingly nice in the fact that had lights. The surgeons operated in their regular clothes with a pair of flipflops, and the scrub nurses were outfits of some sort and flipflops. Their masks and hats were two towels stapled together to form some sort of contraption. Although it was not up to American standards, it gets the job done. fter the tour we went and ate breakfast. I am not sure what it was but it was tasted, minus the yogurt which tasted sour and was more liquid than solid. The tea here is wicked strong and the coffee super bitter. After breakfast we dropped off our medical supplies and went to the guest house where we will be staying. We have the entire third and forth floor. The room has two beds, a fan, and a bathroom. The bathroom consists of a toilet you flush by dumping down a bucket of water (thank you Tanzania for teaching me that skill) no toilet paper, and another set of buckets where you use one to mix the cold and hot water and the other one to dump the water mixture on you in essence creating a shower." I thought I would give the shower a shot so I went to get my toiletry bag out from the top of my checked luggage bag and what do you know...it's not there. Someone at some point over the last 3 days of travel stole my soap, shampoo, conditioner, sunglasses, razor, flashlight, mosquito lotion and vitamins. Who take that kind of stuff? So now I have to figure out where to get it, not something I was planning on having to do. So after a water shower it was nap time for everyone for three hours. After naps we went back to the hospital for lunch, which again was something that I don't know, but rather tasty. After lunch we went to setup all the operating rooms, while the surgeons screened for patients. We unloaded 15 bags of medically supplies onto 2 sets of shelves and two stretcher. With all of the supplies laid out we went to the operating rooms to look at the anesthesia machines. I was a disaster. There is only 1 machine that works and it has a halothane vaporizer but no halothane. The other machine has no vaporizer and has some old school way of delivering anesthesia that I have never learned about nor have any of the other anesthesiologist who have been practicing for 40 years. The other anesthesia machine does not work at all. This was a huge let down because we were told there would be working anesthesia machines or else the group would have brought their own portable ones. So tomorrow should make for am interesting day. I am not sure how many cases are scheduled but it appears that everything will be down under local or spinal. Here's to hoping it goes smoothly.

Tonight, over dinner, we meet with members from the local India society of medicine. They thanked us for being here and presented us all with roses. For dinner we had a thick and thin pancake made from rice floor, which gives the pancake a saltier flavor. For 1/2 of the thin and thick, plus a cup of soup was around 8 rupees. 48 rupees is $1, so it's basically pretty cheap to eat over here per person. However, since they are covering all of our food and lodging, I imagine everything adds up.

Oh, I also took a rickshaw ride, well two actually. it was an experience to say the least. i took a video and will try to upload. It's now 9:45 pm, time for bed. The 6am wake up call will come early tomorrow. Especially since there is loud prayer going on over megaphones right outside the window. I will try to add some pictures when I can, the Internet is extremely slow. I may have to do a separate photo page when I get back since some pictures are on the iPad, some on the iPhone, and some on a real camera