new beginnings

Yesterday we started the 2nd leg of our grand hospital tour. This stop -Al Yamamah children’s and maternity. We knew it was going a difficult transition starting from scratch but we were up for the challenge. Unfortunately we didn’t think they would be so off the mark for a NICU. Not only do they not have essential equipment like monitor leads, temp probes or ambu bags. They also don’t have the staff. Nurses are taking up to 4 patients at a time, one (or 2) of these patients being intubated. There are 2 RT’s for the entire hospital. They work 12-16 hours a day 5 days a week – all straight time. The equipment is so dated and tattered that it takes over an hour to set up a vent without a leaky circuit. Andrea was quite entertained watching the  assembly ‘procedure’ today. By the time they do a round of vent checks and set up stand by equipment the day is pretty much shot. They do not have nursing aides or equipment techs so it is the responsibility of the nurse to clean the isolettes and other medical equipment while caring for their  patients. We really hope we can implement some positive changes with out remaining time here but Im sure what can be done until the staffing matrix is modified.

Anyways on a lighter note Tonight was Jane (housekeeper/little sister to us all) birthday. We wanted to take her out to celebrate but couldn’t convince her to give up her duties for one night, so we brought the party to her. We ordered chinese food and picked up a cake. Back home this process would normally take an hour (maybe less). In Saudi it takes 3 hours – plus. Even planning our outing around prayer we still always seem to get stuck waiting to enter or leave a store. It was well worth the wait though, we even got Jane to relax a bit while we ate dinner and dessert!

Dr. Swenson to arrives tonight, lets hope he can handle us. It will be nice to have fresh meat in the house!! We’ll have him post tomorrow so we can fill ya in on his first day on the job.

Posted in Posted by Amber | Leave a comment

you can’t make this stuff up

We made it back safely last night around midnight. Who would’ve known that a 24 hour trip would turn into such a mess. On Sunday we ended up taking a taxi an hour and a half away to Abu Dhabi to the Saudi embassy. In the typical Saudi fashion, they opened when they wanted. Then we sat waited (on the ladies side of course) for about 45 minutes as the employees walked back and forth with these briefcases; setting them by the door and walking away. When we finally got up to the window we were told it would take 2 days. We had had it and started getting upset and told the official that we had flights out in a few hours and needed to get this done right away. So we were told we had to go to a different location to have someone fill something out online and then we had to come back again and it would only take 30 minutes. We were very wary by this point and starting making plan B plans (like walking across the street to the US embassy and just having them send us home).

We hopped in our taxi and had a little difficulty finding this travel place, but we did find it. Then we were informed we had to have passport photos. So we were directed to another shop where we had our mug shots taken (literally..we will show you when we get home). Luckily the guy at the travel place spoke decent English so we were able to clearly communicate with him. After that we headed back to the Embassy. Only to have them tell us we would have to wait another two hours. That was not going to fly with us and luckily the guy got it done sooner than that. Six hours later we were back in the taxi and on our way back to the hotel.

We said goodbye to Papa Dave as he boarded the plane to go back home. We were all very jealous and wanted him to take us with him. The Dubai airport was beautiful so we killed some time there doing some duty free shopping and sitting at a wine bar. By then every one of us was running on 4 hours of sleep and was extremely crabby. We didn’t even know if the visa would work this time around. Fortunately the plane was very empty and we were all able to lay out on the plane. Customs went fairly smoothly besides Jen getting harassed by her officer. We got picked up and got in bed around 1am. Left at 7am to work at the new hospital. Needless to say we all are still exhausted mentally, emotionally, and physically.

Posted in Posted by the Team | 3 Comments

to hell and back…and back again.

Sorry for the delay in posts. Here’s a really long one to make up for it. As some of you may know things have been a little difficult. Here is a synopsis of the events in the last 24 hours. This is a true story!

Friday April 13th

Yesterday at 11am before our flight, we went to Al ain to visit a former patient and their family. We were concerned about the time constraints as we didn’t want to miss our flight back as Dave’s flight was scheduled to leave a at midnight (which left us just enough time to finish season 2 of Downton Abbey).  The family made us a huge authentic Saudi lunch that had to be cut short because of time.

2:30pm An hour before scheduled check-in, the team leaves and books it to the airport. Amber points out to us that it is Friday the 13th and who knows what will happen which Andrea replied, “Oh nothing is going to happen. I’m not superstitious.” We were all disappointed that we had such a short time in Dubai and hoped that some day we would return. Sandy says, “I will probably never come back here again.” “Never says never” said Andrea. We make it to check in 3 minutes before the cut-off. Our group leader dropped us off as she was taking a different flight. “See you in Riyadh and please wait for me at customs,” she said.

Jen & Andrea were disappointed that we didn’t have time to officially peruse the duty free and see the Burj Kalifa so they stocked up at the gift shop and caught the last tram to the plane as the rest of the team had already boarded and were worried that they were not going to make it.

4pm: Plane is boarded and there is a delay because of loading the carry-ons. Little did we know that this precious time would make a huge difference in our day.

6pm: A sandstorm is happening and our plane circles the airport. Two attempts were made at landing. The first time the flight crew prepared for descent and the second time the landing gear came out. We descended to about 1000 feet and suddenly the plane veered back up. There was no visibility in the orange dust.  Amber has asthma attack from perfume sprayed form the ladies ahead of her. Mohammed (Amber’s neighbor) runs to the bathroom and ends up laying down in the galley sick. A flight attendant runs up and asks for seat cushion. We think we’re going down and need life jackets (she really only needed it for Mohammed). Nobody wants to admit it, but we are all thinking we are going to die. We are then notified that plane is rerouting to Doha because we wouldn’t have enough fuel to attempt another landing.

7pm As we were descending, there was very bad turbulence and lightning.( We were thankful for clean drawers…little did we know we would be wearing them the next day! )Landed In Doha with applause and waited for instructions.

8pm Paramedics arrive for Mohammed. Announcement “We have two situations. One man is sick and the paramedics are working on him. The second situation is that we have two ladies trying to get off the plane.”  Jen requested water for us, but the attendants could not reach them because a man was praying in the galley.

8:30pm They offer people to get off the plane and rebook on a different flight at their own expense after the pilot pleaded overhead that people should stay onboard and that safety was number one and we should look at the Lufthansa airplane to our left going back to Riyadh.

9pm Airport police board the plane and yelling ensues with passengers. It is translated to us that someone had smoked in the bathroom and he was going to be fined. The passengers disagreed and there was mutiny.

9:30pm Announcement that an additional hour will be needed to sort through the baggage of the departed passengers. More people decide to get off the plane to fly to Dubai.

10pm A security check of all carry-on baggage starts. All overhead bins were opened and the flight attendants had to verify owners of every single bag. The passengers in front of us all had multiple bags per person which was the main reason for our initial delay.

10:45pm We finally take off and just have to worry about landing in Riyadh. We are told that if we still cannot land in Riyadh, we will fly back to Dubai. We discuss how we are going to get Dave’s luggage to the airport so he can run to his next flight home. Another fight breaks out this time with two ladies fighting about food with the flight attendant.

11:20pm We land in Riyadh and breathe a sigh of relief because we made it safely back.

11:40pm We are still waiting in the plane and Dave’s hope of going home are fading fast. Then an announcement comes overhead saying that we cannot use this gate because it is on the wrong side of the plane and we need to wait for a tow to bring us out. It seemed like this nightmare isn’t going to end.

April 14

12:30am We wave goodbye to Dave’s plane that takes off without him. Dave is ok with this because he wants to just get a good night’s sleep and shower back.

1am We get off the plane and head to customs. We were not accustomed to this as we were greeted by Embassy officials to the VIP Prince lounge with coffee. Andrea and Jen get sent to the customs office first  and the others follow. We all sit down in the customs office with a German man  who is also being detained and the official keeps saying, “No problem No problem.” We were so thirsty from not having food for the last hours that we contemplated drinking the already opened bottle of water that had been sitting on his table. Turns out that our visas are a single-visit and that they cannot allow us back in the country. We made calls to our group coordinator but she tells us she will deal with it in the morning. Dave suggests that we all just fly home and we all wanted to at this point, but we were told that Children’s could be sued if we did. We told her that we only have 5 minutes to decide whether or not to go back on a plane to Dubai and she said she couldn’t do anything about it so we would just have to go back. We had a name of our sponsor, but nobody to call to vouch for us. “We are saving your babies! We have to work at 7am tomorrow” says Sandy.

They escorted us to the gate and a guy in a suit (we think a PR guy) asked us where our group leader was and why they aren’t coming with money  “to make this go away.” We were told we would get our passports back on the flight. Jen said, “I am not going anywhere without my passport,” and then stated that she needed a hug, to which Dave and Amber quickly obliged.  The PR guy then suggested we go to Dubai and get a good nights sleep. We were then granted permission to go to the bathroom, but shortly after were told they were holding the plane for us and we needed to board NOW.

The pilot (same pilot that flew our first plane) comes out to the gate looking exhausted said he needed to take off immediately or else he would time out. We run onboard as the flight crew ask us what happened. “Didn’t you get enough of the last flight?” joked one attendant. We are all on the verge of tears as we explain why we weren’t let into Saudi. There are only 23 people on the plane because this flight should’ve left at 6pm. Dave pleaded with the flight attendant to buy the duty-free items for his grandkids that didn’t get purchased on the last flight, but she laughed and said, “No, I don’t think so.” And walked away. The rest of the flight went smoothly at 41,000feet at 600mph across the Arabian Sea. We raided their food cart as we were starving. As we started descending, Sandy and Andrea were startled by more yelling that started in back of them which we’ve come to realize is just their form of communication.

4am: We de-board and get through customs without issues (although we were worried and kept thinking of what ifs) Amber is missing and we find her buying a large bottle of wine. Dr. Brasel tried to get money from an ATM that happened to be from the Bank of Iran. We joked that guns would come out and he would be executed. Then his card actually got rejected.

5am: We found the nearest hotel and as we are checking in, we are told we must wait until 6am to avoid paying an additional day charge. So we wait deliriously in the hotel lobby until that time.

6am: We finally get to our rooms. Dave goes to bed, but woke abruptly at 8am to see if he could get on the internet (which is not working) to get a ticket home. Then he realized he needed to get an adaptor to charge his laptop. 25 durhams later, he came back and charged his laptop.

8:30am Desperately trying to book a flight back to the U.S. the internet does not work and Dave goes down to the business center to attempt. It still doesn’t work in the business center and he calls the IT department.

9:30am Dave goes to bed. The desk calls to tell him the internet works now.

9:45am Phone rings and wakes Dave up as he thinks he has missed Andrew’s call, not realizing it is 12:45am in the U.S.

10am: Someone knocks on the door was to see if there is any laundry to bring down

10:30am: Another guy knocks on Dave’s door to see if he can clean his room.

12:30pm: The girls are knocking on the door ready to go eat breakfast.

1pm: A Caribou coffee is found and we go insane connecting to the internet and making sure that all our family knew about our situation as word spread via Facebook that we were back in Dubai.

The rest of today was spent at the Dubai mall. We had a great lunch next to the Burj Kalifah and discussed in disbelief the situation we are in and laughed at how we can say we have been deported and how crazy unbelievable the last day has been. We now have new outfits, socks, underwear, migraine medication, contact solution, razors, carry-on luggage, and gifts for grandchildren. And the money we took out from the ATM this morning is depleted.

We thought it would be a great idea to end the night with drinks at the hotel bar. While walking into the bar it was completely obvious that we were the only females in the bar not “working.” Dave pointed out that two of them were “females” and to end the night we had a lovely naked man drying himself off with a towel and staring at us from his room overlooking the patio we were seated at. You just can’t make this stuff up.

Tomorrow we are supposed to head to the Saudi Embassy to get our visas stamped and fly back on Monday. We will see what the next day brings as our group tends to have many unexpected adventures…

Posted in Posted by the Team | 6 Comments

Dr. David send-off

Time started to fly by this past week and after this weekend we are saying good bye to Dr. David. We tried to convince him to stay but he has guests coming into town. We are headed to DUBAI to celebrate!

Dr. Aaron will be joining us in a few days and then we will be halfway done with our stint here. We completed our rotation at KSMC and will be starting at a new hospital next week.

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Another day yesterday with interesting encounters and laughs. Yesterday evening someone (who will remain unnamed) wanted the toilet fixed since it was backed up. Well a maintenance guy came and started working on it. First it was a snake, then they poured two gallons of acid down, then the toilet was “Halas!” (for those of you who read Jen’s previous post). That means finished. The new toilet will be coming today.

The toilet is "halas"

The past few days we have really focused on doing one-to-one teaching with the nurses and respiratory therapists. Amber and I did a night shift last night to catch the previous evening shift (they do two shifts of days, two shifts of evenings, two shifts of nights, one day off, then start the cycle over again). Even our patient was getting some early morning education on in-line suctioning!

Aboudi learning in-line suctioning


This morning Dr. Brasel gave a short lecture on nutrition and starting feeds early with breast milk and preventing Necrotizing Enterocolitis in neonates.Interestingly we learned that in this culture they don’t use banked milk because they think that if a baby takes another mom’s breast milk, they will become their “son” and the baby will be siblings of the children of the mom who provided the milk.

getting immersed in Saudi culture

Change of shift

Amber and I got off of work at 11am and thought we’d make a quick stop at the grocery store as we are hosting a “dinner party” for the rest of the residents at the compound. We went to our usual Hyperpanda and told the driver we would be out really quickly. (Our poor driver drove us around all day yesterday and then came here at 2:30am to bring us to the hospital) As luck would have it the store closed its doors for prayers just as we were ready to check out. During prayer time, all stores shut down and you can’t go in or out. As a matter of fact, security guards come through to make sure cashiers aren’t working. So our “quick” grocery run turned into an hour and a half. We were so tired and delirious by that time that our conversation became very jumbled.

Tomorrow is the start of our NRP (Neonatal Resuscitation Program). All of us will be teaching part of it. The last team had a lot of difficulty with the online log-ins and test taking as English is nobody’s native language. We will see how it goes!

Posted in Posted by Andrea | 5 Comments

Everything is bigger in ….. Saudi

Another bright and early day in Saudi-land and for once we left on time (Randi’s driver may have been a different story). We were all excited to her Dr. B’s lecture in grand rounds but sadly we had to miss it, altho he informed us he would give a private talk between episodes of Downton Abbey.

Instead of spending the morning at KSMC we headed to the Ministry to meet with the “big man” who wanted to discuss our progress. All and all he was satisfied but was just as frustrated with the supply issue as we were.  We are hoping he can get the ball rolling!

As the others headed back to the hospital, Andrea and I went home to “rest” for our upcoming night shift. We decided that a little shopping excursion was worth the exhaustion we may be feeling tonight. Back to the compound to pick up Pushpa and off to the Lulu hypermarket we went. This market was a best buy, herbergers, and staples all in one.  Those who say everything is larger in texas has obviously never been to Saudi. We could of spent all day there but my checking account (and husband) would not be happy. I found a few essentials and gifts for those back home. We did Dr. B’s shopping  in exchange for pictures of his grandchildren in their saudi garb!

As nice as it was to have a few free hours we kind of missed the nicu crew and are looking forward too tonight. Lets see if they are as crazy as we are back home after the sun goes down!!!

Posted in Posted by Amber | Leave a comment

Another day completed. It did take some time for the driver this morning but we were able to get to King Saud for rounds. We were not disappointed with avoiding a “code” today. It is diddicult to not actively participate but we try to step back and let the locals deal with the issues. I actually saw a nurse give PPV with respiratory today and she did a nice job-only thing was that the event was precipitated by some quite vigorous pulmonary toilet. generally don’t get to lunch and work right through. Jennifer spent the day on infections while Andrea, Amber, and Sandy worked with the nursing staff on PPV and in-line suctioning.  We obviously don’t need to schedule code practice! The ladies bought dinner at the wooden bakery while I worked on my Grand Rounds for tomorrow. Randi has arranged to meet the health minister tomorrow but since I am giving a talk, I will miss the event (I may be in trouble).  Hopefully, we will feel like we have accomplished something at the end of this two weeks inshallah!

Posted in Posted by Dr. Dave | Leave a comment