We arrived in Liberia on Sunday night March 15 after a long pair of flights from NYC. We were greeted by thunderstorms and torrential rains on the drive from the airport to the Murex hotel. After s short but solid sleep we brought our 12 bags of supplies to the JFK Operating Suite and greeted many old friends. We then went to Grand Rounds and listened to a talk on HIV Care in Liberia presented by the Infectious Disease physicians. They noted that the HIV medications which they receive for patients comes from WHO so they still have access to them, but a USAID grant provided the funding for computers and staff tor their surveillance and contact tracing. Without that USAID funding, they are not able to continue that work. After that talk, Dr. Tamba, the CMO, invited me to introduce the team which I did, and then I informed them that this would be my last trip. I was moved by their expressions of sadness and thanks.
On Monday and Tuesday we did about 15 cases, and almost every one involved a member of our team and a Liberian resident. Our previous experience has been that the Liberian residents were reluctant to operate with us, perhaps somewhat out of fear but the Liberian surgeons told me often that their residents seemed to think they could learn all that the needed to know from books rather than operative experience. I think finally the message has gotten thru that there is no substitute for operating if you want to learn surgery!
Yesterday the best news was speaking to Dr. Williefrank Benson, a Liberian surgeon who trained here and then went to Nairobi to learn pediatric surgery. I have talked in previous blogs about the problem of caustic ingestion in children. Women buy crystalline sodium hydroxide and mix it with water to make lye which they use for making soap. They store the lye in any convenient container, such as a coke bottle; the children see a bottle of clear tasteless liquid and think it’s water. The lye can cause serious injury to the esophagus leading to stricture and inability to swallow food. Sometimes we have been able to dilate the stricture, but they often recur.the only longterm solution is to replace the esophagus but moving a length of colon into the chest to bypass the strictured esophagus. This is a big operation on a child requiring combined abdominal and chest surgery; it’s not something a general surgeon would want to do, and until Dr. Benson came back from his fellowship, there was no pediatric surgeon in Liberia. But now he is here and he has done several successfully! This is yet another milestone for Liberian surgery!
Looking back over 15 years I am impressed by the progress Liberia has made in healthcare. The are still a lot of problems, but overall I’m thrilled to have been here to witness the improvements.
I’m going to stop now. I wrote the above during the day today, but there was bad internet. Now its 10pm and we have just finished dinner. And we have a long day ahead tomorrow.
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