kids selling coconuts in Roertsport

child with heart disease

Last Entry - Accra

Hi Everyone,

Tammie and I are now in Accra, awaiting our flight home in a very nice hotel.  We were so excited to have hot showers, water pressure, fast internet and a good cup of coffee!  Drinks at poolside should definitely help our transition back to western culture!

It is hard to put all of this trip into perspective.  The needs of the medical system in Liberia are so overwhelming that what we have done feels only like a drop in a bucket.  I will remember, however a few kids that we did end up helping.  On one of our last days, a baby was rushed to the emergency room from the operating room because one of the surgeons injected some lidocaine, and inadvertently injected it into the baby's bloodstream.  He started seizing, stopped breathing and tried to die.  We worked alongside the ER physicians and basically saved the baby's life.  It was a really great moment for all of us, who had been witnessing kids die left and right.  The ER residents in particular have had an amazingly hard time with this.  I feel like I have been the Mom/therapist for this group, trying to get them to focus on what they have accomplished, rather than what they haven't been able to do.  So resuscitating this baby was a really great morale booster for all of us.

I managed to connect a family of  a child with congenital heart disease to an organization who flies these kids out of country to get surgery.  His family came to see me in clinic in their finest clothes, because I was an American doctor.  It was really touching.  Hopefully he will do okay, because he is getting pretty symptomatic with his heart disease.

We did alot of teaching with the residents and interns (there are 4 of them) and tried to help them manage patients. The sad thing is that there will not be another bona fide pediatrician here until August.  They will have to manage the service on their own, a sad thought.

Finally, I will remember our trips to Robertsport (an unexpected pleasure), and the fantastic group of people I have met here. Many of the people working at JFK hospital this month are people who have spent much time working in Liberia and other developing countries. They are an impressive and inspiring group of people.

Thanks to all of you who have been following along with this blog. I am looking forward to seeing all of you soon!

Love,

Trish

view from my porch in Robertsport

International volleyball

Last Day in Monrovia

Hello everyone!

Today is our last day in Monrovia, as we will be flying out to Accra this evening.  Kenya airlines is the only reliable airline that flies out of here, and they only have 3 flights per week. Tammie and I will then stay in Accra for 2 nights while we await our flight home on wednesday am.  We have decided to treat ourselves and stay in a 4 star hotel in Accra, complete with swimming pool, ocean view, restaurant, etc.  It will be incredibly luxurious after the time we have spent in Monrovia!

We spent our last weekend back at the beach in Robertsport.  I will try to upload some pictures. It is truly an amazing place.  It is located north of Monrovia, and I recently learned that it is only about 30 minutes away from the border with Sierra Leone.  Very few people know about this place, so the beach is very empty.  It is a very well frequented surfing spot, however, and there are frequently surfers there, since the waves are huge.  The water must have been about 75 degrees temperature wise.  The only problem with the beaches in liberia is the undertow and many rip currents.  They are so strong that most Liberians are very afraid of the water, and won't go into it, since it is known to sweep people out to sea.   On Sunday, it was relatively calm, however, so we all went in, and it was fabulous!  We also had a great volleyball game on the beach with a bunch of Liberians who were hanging out there. 

Tammie and I are going to be giving grand rounds here this morning, before leaving! Should be a great way to wrap up our time here.  Overall it has been an amazing experience. We have seen so much. It is sad to see so many sick children and so much suffering here.  We can now go back to the US with some plans to try to help out from stateside.  We are trying to organize a schedule to have US doctors and residents covering here for the entire year, starting in August. Pediatricians and residents from my department will be coming over, as well as docs from Mt Sinai med center and Univ. of Chicago. Hopefully, we can start to make some changes here that will help in the long run.  That way it feels like we will get something accomplished, rather than just coming to see what happens here over a few weeks.

If there is internet access in Accra, I will write more.  Thanks everyone, for following. It's good to know that you are out there, and I look forward to seeing many of you soon!

Love,

Trish 

rounds in the hospital

Child with Malaria

Hi Everyone!

I am having an amazing adventure here! Things are going very well.

Today, Tammie and I went to go visit the "Doctors without Borders"  hospital which is just about 45 minutes from here   They are an amazing organization. The hospital was great. They have over 100 beds for kids, an HIV ward, a TB ward,  a malnutrtion ward.   There are 3 pediatricians for 150 kids.  Sometimes, the census swells up to 250 patients.  The doctors there are so impressive. Many of them have spent time in some of the most war torn and devastated places in the world (darfur, sierra leone, congo)...They deal with the sickest patients in the world.  Their mission is to go into war zones and care for patients.  They are respected throughout the world.  They drive around in ambulances that have a "no guns" sign, and rescue people.  Since Liberia is no longer a war zone, they are due to pull out of here soon.  Everyone is wondering where the 150 kids they treat per day will go.  They are apparently due to pull out in December.

After that, we went shopping in Liberia with one of our Liberian friends.  Amazing experience. The city streets are just jammed with people.  Apparently during the war, all the people who lived in the country flocked to the city, and the population swelled by a factor of 5.  No one has left since the war ended, so the city is amazingly over populated.  We went into a lot of shops to look for souvenirs.  It was really fun.  It is so amazing to be a minority.  Everyone looks at you, tries to shake your hand (tries to rip you off!)

This weekend we are heading back to the amazing beach again.  

The adventure continues!

Miss everyone.  Hope everyone is good. Mary or Jack, since you are following me, just wonderin if Mom is doing okay.  Drop me an email. I can check it here.

Thanks

Love, Trish

Pictures of Hospital

Greetings from Monrovia

Hi Everyone,

Greetings from an internet cafe in Monrovia.  

This city is really quite interesting. There are droves of people who walk up and down the sidewalk all day, since they are unemployed, and have nothing more to do. There are many run down or destroyed buildings, and then you find a brand new building or upscale cafe (frequently owned and occupied by Lebanese people, and frequented by  foreigners).  It is an interesting experience to be a minority for a change.   Overall, people are very nice to us Americans. We are frequently dressed in our doctor gear, so folks know that we are helping out at JFK hospital.  People will come up in the street and say hello, try to shake your hand and thank you. Overall, the people here are very nice.  

Today, we rounded on the inpatient unit.  We have seen 2 kids come in with a toxic ingestion of some herbal preparation they use to treat what they call "thrush", which is not really thrush at all. The herb causes kids to vomit, and these two kids got really sick from the toxic exposure.  A 9 month old passed away yesterday because of this treatment.  Since there are so few doctors here, people try to use all of these herbal and home remedies to treat illness.

I saw a 3 year old in clinic with severe congential heart disease who desparately needs surgery, but there is definitely no one in this country qualified to do it.  We are trying to look into the possibility of having the child transferred to another country for the surgery. I saw a 4 year old with Down's syndrome who had never been diagnosed with Down's syndrome, so Mom could not figure out why the child wasn't growing and developing, so I had to try to explain it to her.

And that is a typical day here....

Miss everyone.  I will try to upload some more pics.

Love

Trish

attempt at Pics

Attempt at Pics

May 18th

Hi Everyone!

Greetings from Liberia .  So sorry to take so long to add to this blog.  The internet here is extremely spotty, and slow.  Tammy and I are now in an internet cafe (if you can believe they have them here) with luxuriously fast internet speed. I may even be able to upload some pictures....

This has been an amazing experience. It has taken me a few days just to get my feet on the ground here.  Liberia is a very poor country. It is amazing to see the poverty people live in.  Working in the hospital has been very hard. I cannot believe how sick the kids are that we manage, and how limited the resources are. I am seeing diseases that we never see in the US.  Malaria is rampant with half of our ward filled with malaria cases (don't worry, I am on prophylaxis).. We see babies with tetanus, which is an awful disease with a very high mortality rate. We never see it in the US because we all get vaccinated. We also saw a child die the other day from something called epiglottitis, again, a disease we never see any more because it is vaccine preventable.  I spend time on the pediatric ward, in the "NICU", where premature and sick babies go, and also in the clinics here. The clinics are just packed with kids needing to be seen, and unlike here, where a good 50% of the kids I see have colds or other minor illness, these kids are sick with malaria, malnutrition, sepsis.  It is a bit overwhelming, and I feel sorry for the few interns and residents that have to manage all of these kids when we are not here

That being said, it is an amazing experience to see all of these illnesses that we hear about but never see in the US

Despite the poverty, Liberia is also an unexpectedly beautiful country.  The beaches are among the most beautiful I have seen.  As the country stabilizes, NGOs and other expatriots are starting to show up to provide help.  A "niche market" is starting to sprout up to cater to these people, many of whom are foreigners and have money to spend.  We have gone to some restaurants that are right on the beach.  Interesting in that they tend to be frequented by the UN soldiers, many of whom carry guns.....You can drive down a street and see incredible poverty, then run into a market that is brand new and carries many American items..

This past weekend a group of us took a trip out to a small beach resort called Robertsport. They have these luxury tents that you can rent that are right on the beach....I will try to upload a couple of pictures.  The beach was just amazing.  The undertow is really strong, so hard to swim alot in the water, but many people surf there.  There are about 5 other docs here from the Univeristy of Chicago who are staffing the emergency room. We all went up as a large group.  It was truly amazing driving up to the beach.

That's all for now. I am doing really well, but miss everyone very much.  I should have some great stories for you when I return,

Love,

Trish

I have arrived!!

May 13th, 2009

I have arrived in Monrovia! Hard to believe I am on the other side of the world from all of you. My journey went off without a hitch. Things have gone amazingly well.  It is ALOT of travelling (over 30 hours door to door) . I flew from JFK in NYC to Accra Ghana for the first leg of the journey.  Sat next to a Christian Evangelist on the way over. That was interesting.  Arrived  in Ghana yesterday  and had to wait there for about 5 hours before taking my flight to Monrovia.  Although, safe, Accra does seem to be the home to many scam artists,  as people tried to make me purchase a visa that I didn't need, or pay $50.00 for a second checked bag!! Fortunately I was forewarned about all of this!

I met up with a few people from Liberia in the Ghana airport. When they found out I was a doctor travelling to LIberia to help out, they were really nice to me, and looked out for me....made sure I made it up to the gate, etc. , kept calling me "dear". People here are very nice, and truly appreciate the people who come over to help.  People will grab your hand on the street and shake it !

The flight on Kenya Air from Accra was beautiful.  It was like flying SAS, with wonderful food, and wine. Who would have thought. ..When I arrived in Monrovia, Tammie was waiting for me with a driver.

I will make rounds in the hospital this morning. Apparently things are pretty grim there, as there have been several child deaths this week.  I think it has taken a toll on everyone who is working here.

Internet access is spotty here. I will write more when i can.  Miiss everyone!

Trish