March 10th, 2019
Our second day in Rwanda began more ominously than the first, with thunderclouds rolling into Gitwe’s valley as we walked to the hospital in the early hours of the morning. Similar to yesterday, a queue of prospective patients awaited us outside the hospital, with thyroid goiters ranging in size from a ping pong ball to larger than a human heart. The goiters, which are most often caused by dietary iodine deficiency, can cause issues with swallowing and breathing due to their proximity to the trachea and esophagus, not to mention problems with various thyroid hormones. Our day began with a relatively simply thyroidectomy (the procedure involving taking out the goiter), with Drs. Dhingra and DeBiase completing the surgery. Drs. Sebelik and Chandra completed the second surgery, with the teams then staggering to complete a total of six patients over the course of the day.
One of the most memorable patients of the day was a woman named Donatha, a mother of ten whose goiter crossed over the entire front of her neck. The removal of the mass took a few hours in and of itself, with Drs. Dhingra and Sebelik scrubbing in to carefully transect the muscles of the neck whilst avoiding important vasculature and nerves in the region. The procedure became an anatomy lesson in and of itself, with both doctors getting increasingly excited upon finding neck structures not usually visible with goiter removals. Donatha recovered well from anesthesia, and moved to post-op a few hours later. She smiled softly at us when we visited her later, excited in her own soft way about the removal of the mass that had been a constant obstruction to her daily life. The day ended with the sun setting after beating out the rainclouds that had lingered throughout the afternoon as we finished rounding up the patients and finally left the hospital to walk back to our lodgings, preparing to get some rest before beginning again tomorrow.