Huge apologies to those of you who read my blog regularly and have been disappointed by the lack of the weekly update. I returned home for 10 days as my mother in law had died and it has taken a while to find the time. And that really is an indication of howbusy life is on the ship. There are always activities out of work hours in which one can become involved as well as the work itself involving working extra hours.
Just before I left for a brief sojourn to the UK I had been working in the plastics room. Tertius Venter as a South African surgeon and workedsolidly for 5 weeks re creating faces, giving function to contracted limbs and restrong the shape of faces. Many of these patients have been the victims of fires of one sort or another. Lamps are often fueled by oil and the subsequent burns from accidents with these can be horrific. Equally, young people can be given the chance to use their hands properly as syndactyls are released (fingers joined together from birth). The work requires patience by the bucket load and certainly is displayed by the surgeon.

However coming back to the ship felt like coming home as I am currently in the lead anaesthetic role and probably know more about the anaesthetic department on the ship than the hospitals where I work in the UK simply because I'm here more often!

Having been working in the rooms where many of the large facial tumours are removed has involved difficult intubation tehniques. We have a variety of 'toys' on the ship which help us with this task. Probably the greatest difference here is that no-one minds how long it takes to pass a tube and have the patient anaesthetized. No-one has pressing appointments. this doesn't mean that we take our work any less seriously, just that there is less pressure of time. This is the place where I have most practice ofdifficult airways, a reflection of the workload. I am also trying to gradually sort through the equipment we have and make better use of the hold for storing some of the items and ths create more working space in the pharmacy in the department.

I was able to leave the ship on Saturday and spend the day with a friend visiting a chimpanzee sanctuary not too far from Freetown. The hunting and killing of chimpanzees is forbidden in Sierra Leone because of the risk of extinction. At one time they were a common bush food. The chimps are rescued from homes where the owners mistakenly buy the babies and then realise that they cannot care for them. The average chimp is 5 times stronger than a human and would wreck a home in no time. Close by the sanctuary are some water falls and my friend and I walked to these falls. As rainy season has almost come to an end the rivers are full and so the falls were spectacular. We climbed over some boulders so we could enjoy sitting out a little way from the waters edge and enjoy the peace of flowing water.



As we walked back to the ship after catching a taxi to the edge of the city, I was able to enjoy drinking straight from a coconut, just as it should be drunk and greatfor quenching thirst after quite some walking. In all I think we walked about8 miles that day and my day had started with a run outside with the ward physician who is a like minded runner....