Monday March 12, 2018

      After a long but uneventful two flights from JFK(NY) to Brussels and then Brussels to Liberia, we arrived at Robertsfield Airport  last night around 8:30 pm. As I came through Immigration into the baggage area, there was a Liberian man waiting for me with a paper sign saying "Dr. Knight and team HEARTT." After we collected our 12 bags ( 9 of them duffel bags filled with medical supplies), we made our way outside to the 2 vehicles waiting for us. We loaded the supplies into one car, which headed to JFK Hospital, and we went in the other car with our personal bags headed to our hotel. The airport is about an hour drive from Monrovia; as we drove in, I realized that the man who had greeted me, and who was driving the car loaded with our medical supplies, was Dr. Jerry Brown, the newly appointed Acting General Administrator of JFK. He was a surgeon at ELWA Hospital prior to assuming the position at JFK, and I had met him once or twice at past surgical rounds at JFK; I felt totally embarrassed that I didn't recognize him at the airport. So I asked our driver to stop at JFK on the way to our hotel, where we helped them unload the medical supplies and I was able to apologize to Dr. Brown for being an idiot and not recognizing him at the airport. He was very gracious, and we had a good chat before heading to our hotel. We are staying at the Murex Plaza Hotel where we have stayed on our previous 2 trips, and as usual they took good care of us last night.
      Today we went to JFK around 8:30am, and joined surgical rounds in progress, followed by attending the hospital-wide Grand Rounds. At each occasion we were warmly welcomed, and the good vibes helped me know this is going to be a productive trip. I had several conversations during the day with Professor Ikpi, the new Head of Surgery for the Postgraduate Training Program and Chief of Surgery at JFK; it became very clear to me this afternoon that he and I are on the same page about the goals of this visit. When we started coming to Liberia in 2010, the main goal was to perform high volumes of surgery because it was unlikely to get done if we didn't do it; now, with a core group of strong residents and faculty, our mission has changed to a collaborative teaching role. I want this to be a mutually beneficial educational experience for everyone involved: faculty as well as both the Liberian and the US residents. Today we made a good start !
       For several hours from morning into the early afternoon, we were in the Out-Patient Clinic with Dr. Gbozee seeing patients and scheduling many of them for surgery. And as usual, we saw some very large hernias, some small little problems, and some conditions that left me speechless. In general, the conditions we see that boggle my mind are not tropical or exclusive to Liberia; rather, they are often conditions which could be seen anywhere in the world, but here they have progressed much further because of lack of access to healthcare. For several patients that we saw today, I think their disease has progressed well past our ability to do any good for them surgically.
        We spent some time at the Liberia Medical and Dental Board office this afternoon taking care of licensing business. While Sandeep and David had a short interview with the physician Head of the Board, I had a nice chat with Masmina and Mary. Then we went back to JFK and joined the last part of the Surgery Morbidity and Mortality Conference. Most Surgical Departments do a weekly or biweekly "M&M" Conference in which complications and deaths are discussed candidly in an attempt to educate all participants so that we are less likely to make the same mistakes again. I think M&M conference is a critically important piece in surgical education, and it was a pleasure to see that Professor Ikpi has added this to the schedule at JFK.
       After going through our supplies, we made a quick trip to the Operating Theater to see our friends, deliver some supplies including the dermatome that Support JFK bought for them, and to plan out the operating schedule for tomorrow and the rest of the week. We have made ambitious plans, but I think we will accomplish most of our goals because we are all going to work together to make it happen.