Tuesday May 12

Tuesday May 12 Tubman's revenge struck me last night unfortunately so I was up and down a lot, and felt quite tired this morning as a result. We made rounds with the surgical team this morning, and had some interesting discussions about chest trauma and caustic ingestion in a child. We also went to the Maternity Hospital to see a baby with a myelomeningocele. From there we went to the OPD where Santiago saw Ophelia Jallah: he did a transanal resection of a cancer several years ago, and then did her APR a year ago March. She seems to be doing very well with no evidence of recurrence at this point. We then saw a 25 yr old female patient of Konneh who presented with abdominal pain in March, and was found to have a mucin out adenocarcinoma involving both the ovary and her recto sigmoid. It isn't clear whether this is ovarian cancer invading the colon or colon cancer invading her ovary; in any case, this is not good for her. She has a colostomy and wants to be put back together; this is understandable, but I think it is too early and I suggested we wait till September. I think she should have a CT scan at Tapitta, and perhaps a colonoscopy prior to putting her back together. After the OPD, Masmina, Adamah, Dr. Johnson, Munah,Santiago and myself met to discuss the plans for JFK and HEARTT and the postgraduate program among other things. Dr Johnson suggested that they need $50-$60 million to restore JFK to where it needs to be; finding that kind of money seems like an impossible task to me. We also discussed the working of the postgraduate program, and how HEARTT will fit into that. From that meeting Dr Johnson, Munah, Santiago and myself moved to a meeting with Dr Freeman, the Chairman of the postgraduate Surgery program; Dr. Kiiza; Dr. Atem from Sudan who trained in Liberia and Ghana; Dr. Patrick from Uganda; and Konneh. We asked for the meeting to clarify the relationship of HEARTT to the Postgraduate program, in this case specifically surgery. I think it was a productive meeting in which cards were laid on the table. Dr Johnson and Dr Freeman will bring it up at a meeting of the Postgraduate program leadership council. There is clearly a lot of politics involved in all this, which I don't want to get involved in. After the meeting we went up to the 4th floor where Santiago found all of the endoscopy equipment he had sent over last fall. It was being stored behind locked doors at the other end of the building from the Operating Theatres; yet again there is a huge stockpile of supplies in that area which I suspect no one knows it there. There was one room filled with cartons of gloves, for instance; I hope no one asks us to bring gloves on our next trip. In any case Santiago found his equipment, and spent the rest of the afternoon bringing/ having it brought to the old fistula room where he set it al up. There were problems with the endoscopic light so they called the biomed engineers to come up; they were all asking about John Wasik and hoping he will be back soon ! During most of the time they were doing that, I was napping in the lounge, trying to recover from my GI disturbance. I'm better now !