Efficiency, Adaptation, and Forward Thinking: Day 7
- Operation Geaux
- Apr 22
- 3 min read
The day began with a 7:30 AM departure from the mission house, as the team returned to the hospital ready to build on the momentum of the previous days.
A Full Operative Day
Today marked another strong surgical day, with three cases completed successfully—all without complications.
Our first case carried particular significance. The patient, a former leprosy patient, had previously undergone multiple finger and toe amputations. Despite these challenges, she did remarkably well following surgery and was able to ambulate within hours, a powerful testament to both her resilience and the impact of the care provided.
Operational Progress
The team continues to refine workflow and efficiency in real time.
Instrument turnover improved significantly, with valuable help from Kevin Weldon, Binod Deshar, and Daniel Pradhan
Power issues persisted but were less disruptive than the previous day
Mild blood pressure elevations were noted in a few patients and were managed appropriately
With systems stabilizing, the team even found time to improve organization—thanks to Kalli Crutchfield, who took the initiative to reorganize the supply room, improving efficiency for upcoming cases.
Lunch, provided by the hospital staff, was another excellent serving of traditional Nepali cuisine.
Clinical Outcomes
Patient progress continues to be very encouraging:
Patients are mobilizing well with therapy
Pain remains well controlled
Overall recovery trajectory is strong
A New Challenge – Implant Inventory
As workflow improves, a new constraint has emerged: implant availability.
Current inventory:
Femoral components:
2 × Size 1
0 × Size 2
3 × Size 3
Sizes 4 and 5 remain unused
Tibial components:
All 1×10 and 2×10 have been utilized
Looking ahead:
Tomorrow’s patients are approximately 4’6” in height, likely requiring Size 1 components
Plan: adapt with a 1×12 tibial component, requiring thoughtful intraoperative planning
José Patino, with Total Joint Orthopedic Therapy implants is working hard to keep the cases going.
This highlights a recurring theme—solving one limitation often reveals the next, requiring constant anticipation and adaptability.
Building for the Future
In addition to patient care, the team continues to refine systems:
Identifying workflow efficiencies for future missions
Understanding implant utilization patterns
Improving sterilization and turnover processes
Each day contributes not only to current care, but to long-term mission sustainability.
Closing the Day
We concluded the surgical day around 4:20 PM and made our way to dinner at Evoke before returning to the mission house.
The evening devotional was led by Marc Carbo, who shared from Proverbs on the importance of preparation and diligence—how being well-prepared leads to prosperity.
He offered a powerful analogy from fly fishing: working upstream against resistance, navigating obstacles with intention and persistence. In the same way, living a Christ-centered life often requires effort, discipline, and a willingness to press forward against the current.
Marc shared a deeply personal testimony of how he has “worked upstream” in his own life, pointing ultimately to a greater truth:
“All under the sun is vanity… we must look above the sun for fulfillment.” — Ecclesiastes 1:14
It was a meaningful reminder that while the work we do here matters deeply, true purpose is found beyond our circumstances.
Reflections
Today was marked by consistency and growth.
Strong surgical outcomes
Improved efficiency
Fewer disruptions
Clearer understanding of future challenges
And yet, the mission continues to teach us: excellence here requires constant adjustment, humility, and perseverance.
We are grateful for the opportunity to serve—and to continue moving forward, one patient at a time
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