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Fatma Mohammed Al Saleh: Now you see it, Now you don’t
October 10, 2014
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Now you see it. Now you don’t. This is how fast the “express toe amputation” happened. At least that’s what I call it. It was a regular day at the Kandy Teaching General Hospital. Casualty theatre. Which meant a crowded room, chaos, and crazy cases. It was one theatre. Not because they lacked in rooms but because the patient load was so big they had no space. An average of four surgeries would be on at once. Each patient beside the other one. No curtains, no barriers. Just gurneys. Only one of the beds was equipped with facilities for general anaesthesia. The rest just got through what they had with some local anaesthetic and loads of teeth grinding, fist clenching, pounding, and loud moan inducing pain. It’s just fascinating what they can do with so little.

Patients came in and out. They had to be treated fast. So each patient came in, got exposed at the site, painted with betadine, injected with some anaesthetic, and either cut open, sutured, got a piece of their body chopped off, or had their wound cleaned. Wrap them up and send them out. Walking most of the time.

That day there was one patient that came in with a gangrenous looking toe. It looked just like a piece of charcoal. I figured he was diabetic. He was laid on one of the beds at the periphery of the room. His fingers intertwined behind his head. He looked so chill. As if sitting at the beach. Without any notice a doctor came and placed a piece of cloth under his foot. Soaked his toe with betadine. Grabbed a scalpel and started incising around the base of that toe. Just like when you use a steak knife. Cut. Cut. Cut. When he was done with the whole circumference and depth, reaching the bone of course, he put his scalpel in the metal dish, held the bone cutter and simply chopped that toe off in one go. TRRK BLOP.
 
The toe dropped to the side. On with the scalpel again. Hacking off what was left off that charred toe. I have no words to describe what was swarming in my mind. The patient was not on any anaesthetic. He just stayed there in his beach-tanning like position. Wrapped up. Sent home walking. Here comes the next patient. The next story. I asked to take some photographs and was allowed to. But I figure they are too gory to post here.
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Follow on Twitter  Instagram: @_theuntitled
Fatma Mohammed Al Saleh, a 22-year-old Emirati medical student,
is training in general surgery as part of her programme in Sri Lanka.
She is a passionate photographer and writer. Fatma shares her deeply
felt experiences about the healthcare system in Lanka.

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