I have enjoyed my first week back at the BMC.  There is a large volunteer group here, so I have been able to concentrate on working with and learning from Dr. Andy Norman.  His focus is on female vesicovaginal fistula and rectovaginal fistulas.  These kinds of fistulas are very common in third world countries as complications of pregnancy and prolonged labor.  Over the last few months, I have been collecting cases for Dr. Norman to help me with this week.  We did a number of fistula cases, as well as some other GYN cases.  I learned from him how to do a Le Fort operation for uterine prolapsed, which is an ideal surgery in elderly women instead of putting them through a hysterectomy.  I also started to learn how to do vaginal hysterectomies.  I think I am going to be sticking to abdominal hysterectomies for now, until I can do a few more vaginal cases with someone else because the anatomy to me was all backwards, but it was great to start at learning a procedure.