Name: Leenta Nel
Credentials: RN, CNOR, RNFA
City and State: Victoria, BC
Current position: OR staff nurse, Victoria General Hospital
Student status: Graduated from NIFA’s RNFA program June 2009
Originally from South Africa and now based in Victoria, BC, Leenta Nel accompanied Dr. Glenn Geelhoed on a NIFA-sponsored medical mission to Central African Republic in 2012.
How did you get involved in this mission trip? NIFA had offered to pay the transatlantic airfare for a few students to work with Dr. Geelhoed if there were people willing to go. I said I was willing to go, and then there was a telephone interview. I mentioned that previously I had worked on a mission trip in Malawi (when I was still living in South Africa) and had a basic knowledge of that part of the world and some knowledge of tropical diseases. I was a successful candidate.
What was your role in the mission?
In poor lighting, I held a flashlight so that the other RNFA could close the wound
I worked as an RN and also as an RNFA, facilitating surgeries. I was one of three RNFAs that would set up the room, get the patient in, put in an IV, prep the patient, get the surgeon, and then afterwards we’d close up and prep the room for the next surgery.
The doctor would consult with many hundreds of people who came to see him. That way he could triage which patients needed surgery and which could do without.
How long were you on the mission?
Primitive roads
Two weeks. We performed surgeries for one week in one village, then we traveled to another village and performed surgeries there for another week.
Traveling between the two villages took us 8 hours. It would have been 17 minutes by air, but we were traveling through the African bush on non-paved roads and it was very treacherous driving. And we had to be escorted with armored security guards due to the political situation in the area. Dr. Geelhood made it clear that he provides for our security
Armed guards traveling with us
but not our comfort; he negotiates with the local governments to make sure the mission people will be okay.
What is one vivid memory you have from the mission?
The day we converted a wire coat hanger into a catheter introducer. This incident explains how you have to think laterally: you go with what you have, your knowledge and your instincts.
Pressure cooker used to sterilize a coat hanger to become a catheter introducer
The patient had an enlarged prostrate, which meant he couldn’t pass his urine. When the body gets infected with one’s own urine, a person can die a horrible death. This was a person who had walked for three days to get to the clinic. We had a Foley catheter but not an introducer.
Halfway through the procedure, there’s a part where you need to insert the catheter. We couldn’t get it past the pathology.
After trying lots of things, I whispered into Dr. Geelhoed’s ear, “I have a suggestion.”
“At this moment I’m open to anything,” he replied.
Example of one kind of advanced pathology we encountered
“We have a wire coat hanger in the mission house,” I said. “With a little knowledge we can bend that.” I was scrubbed, so the other RNFA, a guy, went over to the mission house, took the coat hanger, bent it into the shape of a catheter introducer, cooked it in hot water for 20 minutes, and saved the patient’s life. This incident is mentioned in Dr. Geelhoed’s book, Mission to Heal.
What have you learned from working in medical missions?
We should bridge the knowledge we have in a First World
Everything we left behind was used in some way; here a surgical glove used to make a broom to sweep the grounds
country with the difficulties they have in a Third World country. In fact, I think every doctor who qualifies in a First World country should have the experience of working in a Third World country. The Third World needs surgery, and newly qualified doctors need experience. Instead of focusing on avoiding getting sued, you are working with patients who are thankful for any help you can give them at all.
Second, there are things we waste in the First World just because we don’t want to be sued. In the Third World, they can use those things. But there’s also a knowledge that you gain about what is needed and what we waste in America. You can’t send expensive things that require electricity to many places in a Third-World country, for example. You need to know what’s usable and what isn’t. If people go out on a mission in their student years they will later understand what they can send there. We need well-qualified people working in suffering Third World places.