Today was our first day of surgery. Besides all the normal challenges a team would face in any US hospital, our team has to stay focus in order to overcome the additional challenges, of getting used to a physical hospital layout that is different from what they are used to, machinery and equipment that maybe different from what they are used to, and supply areas that have been recently put together. Oh, yes, and sometimes there is a language barrier. However, despite all these challenges we had a fantastic first day. The team really came together. By the end of the day we had seen 16 patients and replaced 17 joints. Of those, 4 were hips and 13 were knees. All of the patients did very well. We left the hospital after approximately 11 hours. Ready to take on more work tomorrow.