Liberia 2017

Kwendin #21 | March 7, 2017

It's almost 4 pm and we got home from the clinic a while ago. There has been time to eat a late lunch and talk a bit, and now Bob and Kristie have walked over to the school to have a look at the sewing class. I'll be interested to hear how it is going. I know it has slowed down enough that Bob has decided to let one of the sewing teachers go after the next couple of months.  

I was up in the night a couple of times. The first time was after a phone call to Kate came through from the clinic. A maternity patient was in labour. So she and Kristie gathered their stuff and woke Mohammed to drive them to the clinic. I stayed home.  

The next time I was up was when it rained. The rain started with gusty wind, which roars through our house since all the louvre windows are opened to the max. So it slams doors in the house. Almost half of our doors don't actually latch when you close them, soo the next gust slams them again. No, you don't sleep through that. It rained harder than I have seen it rain here before. In Kenya they called that kind of rain "ta mbembe" which means, like kernels of corn coming down. It filled our rain tank to overflowing.  

I just can't stand to see water running on the ground, so I started filling containers from our taps to relieve the overflow iin the tank. I filled a couple of buckets in the bathrooms, and was on my third 5 gal jerry can of water when I saw the car headlights coming along the road.  

"Good," I says to myself. "The girls have delivered that baby and are home."  

But it was Kate by herself. The lady was still in labour, but making no progress despite it being her fifth baby. Not a good sign.  

So I gathered my stuff and we went back to the clinic.  

I had a good look at the lady. no progress over 4 hours despite good contractions, and the head still high, and the baby's hearbeat starting to drop with contractions. This is going to need a Caesarian Section. The midwife phoned Tappita Hospital to see if they could send an ambulance for her. Nope, the ambulance has just gone out for someone else, and by the way they hit a truck with the ambulance. OK, that's clear. She is going to go to tappita in our vehicle. We "gathered our stuff" for such a trip. Kristie volunteered to go along and carried a delivery kit with her in case the lady delivered en route.  

That left Kate and I to walk home in the dark and the drizzle. Which was quite a nice walk actually. We did have to tiptoe around some sizeable mud puddles but that was fine. The horizon was lightening up as we arrived home and it was time to put the kettle on for us all to have some tea/coffee/cocoa/ovaltine or whatever for breakfast.  

Kristie arrived back before we were ready to leave for the clinic, and we agreed that she and Kate could stay home for a while (having been up since 0100 am) while Spencer and I went to the clinic early.

I took out one lipoma with Spencer's able assistance, and saw a number of hernia patients for suture removal or dressing changes. I am starting to assemble a list of lumps and bumps for Friday, our last day.  

By 10 Kate and Kristie had arrived, so I left Kate and Spencer seeing the rest of the patients and I went off to Tappita with Kristie. We carried with us the 15 year old diabetic, who was hoping to meet up with the specialist and be given a free glucometer.  

We had quite a list of assignments once we got to Tappita.

Let me try to list them:

  1. Discharge our 5 surgery patients from yesterday.
  2. Talk to the surgeon about the fellow with Fournier's gangrene, so as to be able to take over the case from now on. And see the patient on the ward and change his stinking dressing. Hm, that didn't sound right. It was literally stinking, needing to have a clean dressing.
  3. Facilitate the diabetic getting her glucometer.
  4. Get Xrays on two out patients that I want the surgeon to see, and make sure he knows about them and will see them.
  5. Get three other patients seen by Dr Sherman who I have been waiting for all week.
  6. Check on the maternity patient from last night.
  7. Surprise, patient #6 from Sunday afternoon showed up today for surgery tomorrow! I had to tell him we could not do the surgery this year--now has to wait for next year. Very difficult message to receive.  

Many steps in each of those tasks. For instance, Dr Sherman is actually not back yet. But at least he is in the country (he has been in Burkina Faso) so I was able to phone him, and describe the patients and discuss them with him. He would like to see them but not till next week. So I registered them and wrote all that in their charts, and for the two that need surgery I paid a deposit for them.  

Hey, the lady from last night ended up delivering normally instead of having a Caesarian! Good news. Kristie sent a text back to Kate who went and told the midwives, and there was a great celebration. We saw her and her little baby boy. I consider that the best possible outcome for our referral.  

I am thinking we are done with Tappita hospiital for this year. Unless of course there is another emergency. I'm not counting on that.  

Another surprise today was to learn that tomorrow is a stat holiday in Liberia! Decoration Day. You're supposed to go to the graves of your relatives or past heros and decorate their graves. But we have patients booked in the clinic tomorrow, so we will go. Might be working wth a skeleton crew for staffing. We shall see.  

Bob had an old friend from 1980 come visit. Robert Saye used to be caretaker for his 500 chickens, and now he is the pastor at a small church in Boyee, 30 min away (where the new clinic is). The decision has been made to go to that church this Sunday. I've been assembling a small box of supplies for the clinic, so we can deliver that on Sundaywhen we go.  

Our host from Monrovia John Karmo will be coming up to Kwendin on Friday, and stay till Saturday to meet with people and try to smooth out some of the ruffles in this community. That will occupy us all on Saturday but Friday will be busy at the clinic I am sure. There is talk of a goat which will get slaughtered for a feast Friday night--enough meat for lots of people to have a meat meal that day.  

Our solar panels are keeping the batteries nicely charged since we topped them up with the generator. Some things do work once you fix them!  

Time for a nap before supper. I just do not tolerate being sleep deprived like I used to. This process of getting older has its down side.  

Dr. John Potts