Day 1

The flight from JFK to Brussels was fairly miserable because of the lack of legroom; the flight from Brussels to Monrovia…7 hours…was better because the plane wasn’t crowded so we all had the opportunity to spread out. I got some sleep which was nice. The cast of characters so far includes James Sirleaf, aka Adaman. Adaman is his middle name, and that is how he is known by his friends, so I am learning to call him that. He is quite pleasant, and charming, and genuinely nice to all of us as well as others. When we arrived in Monrovia, many of the workers at the airport recognized him and said hello. We were offered special expedited treatment, but Adaman felt that we should wait in line like everyone else; after a short time, however, given the heat, etc, he relented and we were shown through while someone worked on our passports. We then collected the 11 pieces of luggage for the 5 of us, and drove into Monrovia. Before I describe that, let me tell you about the others… Senora was an ER nurse in Bridgeport, and has come to Liberia a number of times with James. She is staying here in the Presidential Guest House with me. Dr. Dahl is a retired Ob-Gyn from Phoenix who decided to join us about 10 days ago; he met up with us in Brussels. His nephew is a urologist at MGH. Jonas is a ER doc from Wisconsin who has been here before; he brought James, an ER resident from Chicago with him, and they will be here for a month. He has organized a multi-institutional ER resident rotation here, which I think could be the model for other rotations such as surgery. He just took a position as Program Director for the ER residency at the University of Wisconsin; prior to that he was at the Univeristy of ChicagoWe drove into Monrovia from the airport (about a 40 min drive) to drop Colleen and Robert at the hospital dormitory. Here I learned the first surprise of the trip, which is that there are a lot of other American medical people here, all sponsored by HEARTT. A pediatrician from Boston, and about 5 pediatric residents from a variety of different places in the USA and elesewhere; the ER docs as noted; and Justin, an orthopedic surgeon from NY who has been here for 8 months. We have already started collaborating; the pediatrician told me about a baby with a suspected posterior urethral valve who needs his bladder decompressed tomorrow. Wee have some pediatric Foley catheters in the nearly 200 pounds of supplies we brought, so we will probably try that first before going to a suprapubic cystostomy.We all went out for dinner at the Royal Hotel, and it was fun. I can already see that there will be many interesting conversations and collaborations between the ER, peds, and us. They seem genuinely happy to have a surgical team available; we are equally happy to have them here. After a restful night at the Presidential Guest House, feeling secure in a compound is guarded by UN soldiers, I’m ready for whatever challenges the day may bring…and I have no doubt that there will be plenty of challenges!
But before we get to that, let me tell you about the Guest House. George and Laura Bush stayed here apparently; I guess if it is good enough for them then it will be alright for me !It is about a 10 minute drive down the main boulevard from the hospital. It is quite large with a number of bedrooms as well as a spacious living room and dining room area. From my bedroom on the second floor I can see the ocean; there is a damaged building between the Guest House and the ocean, and I just saw a UN vehicle come out from behind that building. Serona told me that the last time she stayed here, several years ago, this was a bombed out building, as I guess it was a target more than once during the civil war. Nice air conditioning, though I don’t think there in any Internet access here. They do have access at the dorm, so I will bring my laptop with me today and I can send my blog from there. As I write this at 7:30 AM, the electricity just went out; I believe this is a fact of life in Monrovia which is just another of the challenges of living here. It will be interesting to see how these unexpected blackouts work at the hospital ! We are supposed to meet Adaman (James) at the hospital at 9 AM, but I have to keep reminding myself that we are on West African time. I guess the time is an approximation of when we might get together, rather than anything set in stone !We will wait for Dewall to come pick us up; he is Adaman’s driver when he is in Liberia, and I think he is a government/protective services employee. In any case, he seems to be the “go-to” guy for any of our needs.