A Day of Work at the JFK Hospital in Liberia

It took all I had to get out of bed this morning. Not because I wasn't feeling well, I am definitely better today than I was yesterday, but because I actually watched television news last night which means I stayed up past 11 PM. Anyways, I finally dragged myself out of bed, got dressed and headed down to have breakfast and get ready to go. As we headed out we discussed whether we wanted to go to the diamond mines, about 4 hours away, this weekend. Some of us did want to go but the security risk is too big so we will not be able to go. But this morning we went to the U.S, Embassy compound to cash some traveler's checks. The drive to the embassy was the most of Monrovia I had seen since we are staying at a hotel within walking distance of the hospital. We had to drive thru town on bumpy roads in need of repair to get to the embassy. There were lots of people and it sort of reminded me of Old San Juan in Puerto Rico except there were lots of destroyed buildings. You could tell it was their metropolis but the buildings weren't skyscrapers.

When we got to the embassy we had a little incident. Christella, was very excited about going to the embassy that she took a picture of it as we pulled up so her disposable camera was confiscated. The embassy here is huge and it seems like a giant American subdivision because it has its own pool, ocean view and tennis courts. I guess most people live on the compound because it is safer.

After the embassy we went into the town to try to change Euros into American dollars because one of the military guys with had some of those. We drove to the Ecobank and it took forever for him to exchange his Euros because he needed six signatures once he got into the bank. While we waited for him in van I asked someone to run out and get me some of the local newspapers because I was hoping Project HOPE would mentioned. We were featured in one of the newspapers. What was funny is that they said our chief medical officer was the military public affairs officer and that the cornel/dentist was part of Project HOPE but it was a very positive story.

When we finally arrived at JFK it was close 11 AM, much later than I would have hoped but I still had a full day work to document. I made my way up to the third floor of the hospital with Faye and Christella where we joined the clinical rounds. The med students were examining an older woman and asking her questions about what hurt and seeing if she could walk and sit up on her own. She obviously needed more tests but at JFK they don't give any tests until the patient or the patient's family pays for them up front. They also have to pay 4,000 Liberty or the equivalent of about $66 dollars to be admitted into the hospital because otherwise JFK would not be able to function so even though it sounds harsh that they have to pay for this stuff upfront I understand why they do it. Because of the payment policy the lead physician was telling the students that they need to make it a point to come see their patients during visiting hours and explain to their families that they need more tests to be done to find out what is wrong with them and that they required them to pay upfront for those services. It sad but as I said before the hospital just doesn't have the budget to pay for the tests some the patients need.

After the rounds we went down stairs to the outpatient clinic where the primary care team has been working side by side with med students, nurses, interns and residents. This area of the hospital is one large room that has been separated by blue tiled walls and white sheets to protect the patient's privacy. Each room has a door leading to the main waiting area on one side and the sheet on the other. Then there is a large counter space with one working sink in a lot of windows. The windows are kept open and the fans going but it is still hot. However, because of all the windows it is actually one of the brightest rooms in the hospital.

I usually try to stick around the outpatient clinic to take good pictures but it has been hard because it is actually pretty cramped and as I said before the people here aren't really excited about having their picture taken which I totally understand. It is really hard to get my part of the work done down there but as long as the docs can get their work done that's all that matters.
About an hour later I headed over to the physical therapy clinic to see Julia. And it wasn't as busy as I would have assumed but I learned that the best time to go to the PT clinic is in the morning. Many of the physical therapy patients come from longer distances and take public transportation which is cheaper in the morning than in the afternoon. While I was in the PT clinic a there was young woman practicing to walk with her prosthetic and she was getting around very well. It was really nice of her to let me take her picture.

I headed back to the administration building to see if I could get some good internet and send some pictures. The internet in Liberia is completely unreliable and slow so you have to find the right time to log on. Luckly, I was able to send some photos but it took about four times as much time as it would take in a place with decent connectivity.

I finally figured out where Valdez is working so I headed over to the medical equipment grave yard to see what he was up to. What I found was a work room full of tools and gadgets the local equipment repairmen had created to help them with their job. It was like walking into science class. Valdez was showing one of the men how a blood oxygenator works. This is one of 8 pieces of equipment Valdez has fixed since he arrived. Behind Valdez's work station was a line of other equipment he had to repair or take a look at including a ventilator which had just been donated by the Japanese. He had to take a look at the ventilator to make sure it was ok to go. Valdez will be working there with another biomedical equipment technician from the Africa Mercy Ship next week.

As I was heading back to hang out with the primary care team I ran into Christella who was on her way to the physical therapy clinic. She was going to let Julia show Sam some new maneuvers using her body since her hip had been bugging her. Christella apparently hurt her hip last year while taking a kickboxing class had some pain when she jogged so she was happy to volunteer. Sam was able to do and exam on Christella and asker questions about the kind of pain she had. Also, he and Julia had to try to recreate the pain Christella has in order to properly diagnose her which meant maneuvering her leg until she felt the pain. Turns out she has a tear so then Julia showed Sam how to pull Christella's leg just right so they could readjust the area so it wouldn't hurt anymore. I don't think I described it too accurately here but it was pretty cool. Julia had a good metaphor for what she was doing. She said it's like when you have a pebble in your shoe and it's bothering you so you move the pebble to the toe of your show so that it won't bother you anymore.

After the physical therapy lesson we both headed to the administration building conference room where Dr. Polifka was going to give an EKG reading lesson to the med students. We spent about 30 mins trying to figure out why the projector wasn't reading the computer only to have Christella lean over and open the shutter on the projector and fix the problem. It was really quite funny.

Dr. Polifka began his lesson emphasizing that reading an EKG takes years of practice. When Dr. Polifka asked the class how many of them had actually seen an EKG before only one hand was raised. It was apparent that this lesson would be difficult for them to follow because they had such little training. In the teaching staff at the hospital and our primary care team are trying to not only teach and train the med students at JFK they are also trying to broaden their thinking skills because diagnosing a person requires asking the right questions and asking that the right tests be done. Not everything in Africa is caused by malaria or HIV/AIDS; they really need to get the bigger picture. Not being from the medical profession it never occurred to me how important those critical thinking skills are to the profession.

Just before we headed home Dr. Polifka asked what time we should show up on Friday because we knew there was a holiday. And we were told that the hospital would be in minimal operation, by that I mean there would only be about 2 of the med students coming in to do rounds so there was no point for us to come in which meant we had the day off on Friday. Believe it or not the volunteers usually hate days off because they want to work as much as they can while on these missions because the time is so limited so many of them had actually wanted to come in on Friday and do rounds.

--Marisol Euceda