Thursday September 8

     Another very good day in Liberia !  We did 7 cases in the OR, which was quite a feat under the circumstances; it happened because of the concerted efforts by a lot of people to make it happen. The cases included a ventral hernia, 3 ostomy decommissionings, 2 inguinal hernias, and a submandibular gland excision. On one of the hernias, a recurrent right inguinal hernia, we used sterilized mosquito netting as a mesh; we believe this is a first in Liberia. The use of mosquito netting for mesh has been described in a trial in Uganda reported in the New England Journal of Medicine last January ; we were excited to bring the practice to Liberia.I had a large mosquito net which I bought for Liberia but never needed to use; at home I cut out some pieces of it, washed and dried them, and put them in sterilizer bags. I brought them here, and Precillar sterilized them for us. I didn't think they would be ready, but just as we were wishing we had a mesh to implant, Precillar walked into our OR and said they were sterilized and ready for use !! Amazingly coincidentally perfect timing !!
       We kept people working till 6 pm, and there was never a complaint, a whine, or any suggestion that anyone was unhappy doing all this work. The residents stayed with us all day also. Deirdre and I work together with Dr. Teseer Utam all day; he is a PGY-3 and has great potential.  It was an excellent teaching day, and I think we were all quite happy at the end of it.
      After refreshing ourselves at the apartments, we went out for dinner at the Royal Hotel with Masmina, Teresa and Alex Cummings, and some friends of theirs. The sushi was outstanding, and the company was excellent. Teresa is Chair of the Board of HEARTT; Alex is Liberian and recently retired as Chief Administrative Officer of Coca-Cola in Atlanta, and he is now running for President of Liberia. It was a wonderful evening, and most appreciated by all of us. Who would have ever thought you could get good sushi in Monrovia, Liberia ? Lol
       There are so many aspects of this work that I love: teaching the Liberian residents, helping the Liberian people, learning about life in Liberia, and tonight I was focused on the amazing experience this offers to the residents we bring along. It's hard to explain it, but they are often wide- eyed with wonder at the pathology they see, and the solutions to problems that they are able to come up with. And on top of all that, they be to do operations which they rarely ever see or do in the USA. I am truly grateful for the opportunity to help them experience all of this.