Written By Dr. Kamilla Esfahani
Dumelang! For the last two weeks, I learned more about cloacal defects than ever before. And I loved it. Working alongside amazing urogynecologists, Drs. Ian Fields (OHSU) and Kim Kenne (Iowa), I helped anesthetize over 20 Batswana women in Gaborone, Botswana. These women traveled far and wide to get specialized surgery, including sphincteroplasties, rectovaginal fistula repairs, total vaginal hysterectomies, and colpocleises. Supported by Dr. David Rapp’s NGO, Global Surgical Expeditions, we had the best time teaching our fellow surgeons and anesthesia providers while getting hands-on experience ourselves.
The first Botswana Ob/Gyn residency started in 2020. The anesthesia residency started in 2019 and will have their first graduates in October 2025. Botswana is a large country with a small and tight knit population (of around 2.5 million) – everyone is connected somehow. We arrived during a historical election year in Botswana, where political parties changed for the first time since the country gained independence from Britain in 1966. As Americans, we frequently got the question “So what is it like to have another political party in power?” Fascinating.
Needless to say, performing anesthesia in a different hospital, let alone a different country is always exciting and a learning experience. The residents were excellent and showed me how to do spinals without introducers and with Quincke needles alone, how to clean reusable laryngoscope blades between cases, and most importantly have a collegial blast in the Operating Theatres. Signs of “No noise in the OT” were an oxymoron, as the theatre thrived on conversations and happy moods…and behold, thus reassured the patients.
The staff worked tirelessly to help the Campaign. Urogynecology as a specialty does not yet exist in Botswana and so patients wait months to have their specialized surgeries. For 12-14 hours a day, we worked in the ORs, and the staff stayed behind to ensure proper recovery of all patients and preparation of the ORs for the next day. I witnessed phenomenal team-work and tremendous kindness.
Working this closely with surgeons was also a new and positive experience for me. The figurative blood brain barrier did not exist. We made decisions together, and conversations flowed naturally as we explained our respective challenges, needs, and concerns. The dynamic spoke volumes about the importance of teams, open communication, and equal playing fields in the operating room.
Thank you to my new found friends and colleagues in Botswana, to GSE, and to the Department for this opportunity.
Kae-le-boga,
Dr. Kamilla Esfahani
