Wednesday May 13

Wednesday May 13 We arrived at the hospital in time to catch the tail end of the surgical conference being held in a library room near the dental clinic. Moses was fortuitously discussing upper gastrointestinal bleeding; he was asked a number of questions by the faculty, and then we were asked if we had any questions for him. It seemed like the right moment to tell them that through Santiago, JFK was the recipient of a full endoscopy set-up including 2 upper scopes, 3 colonoscopies, 3 flexible sigmoidoscopes, and a tower with 2 Fuji processors. He had sent all of the 15 boxes of equipment from Evansville to a shipper in Maryland who then freighted them to Liberia last fall. The faculty, especially Dr. Sherman, was beside himself with excitement, so we immediately went to the old fistula room in the OT where the equipment had been set up. You might have thought it was Christmas with the number of smiles in the room ! The endoscopy unit is a big deal for a lot of reasons: it is an important resource as JFK rebuilds itself as a major referral center; it provides the surgeons, and surgical trainees, the chance to use current technology; and it will help build pride in the services provided by JFK. We left there to make rounds as a group. There was a pediatric burn patient, and the trainees were grilled in detail on burn care. Santiago and I agreed that it was a wonderful thing to see because through such grilling they will learn and not forget. As we left the Pedi unit, Santiago and I were discussing the need for a pathologist with Dr. Freeman. A ways into the conversation, he began telling us about when the Japanese government donated 2 microtomes (machines used to cut extremely thin slices of tissue for viewing under a microscope) in the late 1990s in the midst of the Civil War here. He then proceeded to tell the riveting story of his life in Liberia during that time, with war going on all around. He eventually walked with others from Monrovia to Robertsfield, the site of the airport; it takes an hour to drive that distance today. It took them a day in which they had to hide from combatants, stop to sleep in an abandoned house, and basically feared for their lives. It was yet another Liberian story that should be recorded for posterity. After lunch we were asked to stop in to the ED CCU to see a hospital employee who was quite ill. She had started feeling sick a month ago, and soon went to Ghana where she was diagnosed with acute myeloid leukemia. Her daughter told us that in Ghana they recommended that she go to India for treatment, but it would cost $20,000. They didn't have that kind of money so they brought her back to Liberia. In the past day she was have increasing difficulty breathing, and her eyes were bloody and swollen, so they brought her to JFK. I told the daughter that unfortunately there was nothing to be done, and that she was in no condition to fly to India at this point even if they had the money. It was a sad, but not atypical situation. For the rest of the afternoon, Santiago continued to fix up the endoscopy suite and teach Precillar some of the tricks involved in the care and feeding of scopes. I went to the Admin building to meet Robert Dolu, and to give him some funds from Karen. We had an excellent conversation about Ebola etc; we will spend some time with him on Friday morning visiting the Eye Clinic and the school that Karen worked on funding. For dinner we met Michelle and Payla at Fuzion(used to be Jamal's on the Boulevard). They are working to build community awareness of infection control at government hospitals through a grant from the Paul Allen Foundation. Michelle has been in Liberia for 6 months, got malaria despite taking malarone, and got amebiasis; other than that she is doing well and seems to be enjoying herself.