Email from Kirsten Reems Monday 5th June 2006:

Wow, Here we are in beautiful HOT Indonesia, amazing amazing time so far!! This will have to be quick, internets really hard to find!!. We're in Solo at Soeharso Orthopedic Hospital, normally it has 200 patients, right now it has 500plus. The earthquake hasnt done any damage at all to Solo, but it is taking all the complicated ortho patients....which is TONNES from the quake, so many stopries of walls, beams, beds, falling on people...its quite a poor city. We're staying in the hospital in a little room, no shower, lovely squatty potty, tiny cots....life is grand! Nancy's great to be with, she's really enjoying it too. and I cant get over how much we are learning and how much we are teaching!!
The things we are seeing are horrific, we spent all day today doing wound care and dressing changes in the infection room, honestly the worst infections I have ever seen, never even thought possible. The technique they use to change dressings is awful, no sterility, same instruments and gloves between patients, and antibiotics are unaffordable for most of these poor people, so infection just spreads. We did a lot of teaching today, and got them doing sterile technique, and we're doing a presentation to all the staff ( they're coming in on their day off to hear it !) on wound care and infection treatment because they are so lacking in it! The worst so far was an 11 year old boy, I took off his dressing, expecting to see a "normal" surgical incision and I found an entire exposed tibia! The whole bone, right there, green flesh around it, unbearable small...he still had sensation, but the kid needed an amputation so bad....and a man with 4toes all open bone....like, right there! Amputation needed to happen now! I got some amazing ( well horrendous) pictures and , these people have np pain meds....NONE! They get bupivicaine in the OR and that is all, Its just amazing if you compare it to so many in our narcotic dependant needy sociaty. There are about 5 other doctors here from other parts of Indonesia and the Phillippines but thats it, no other military help or NGO's so we've got lots to do !
So work work work for 4 more days, its exhausting and amazing, this just fires me up! even though its so hot, you're barely sleeping, and you're working your butt off....you feel so alive, so purposeful, and we're so useful!