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A Sad State of Affairs

Photo on 2014-01-29 at 12.30 PM

What undeniably saddens me the most about life in Liberia is the level of health care available.  Maima (see last blog) was fortunate to have a visiting maxillofacial surgeon available to assess her situation within 2 months of us meeting her. Had that doctor not be traveling through Liberia her other choice would have been a local surgeon who had revealed to me during a conversation that, “[He’s] done a surgery like this before and it went alright but, in the end the anesthetist killed the patient.”

I’m pondering the medical situation here again because of another incident we happened upon recently. After a Sunday spent out of town at the beach, we arrived back in Monrovia just after sunset. As we drove through the dimly lit streets we came upon an accident scene.  A woman was lying face down on the road, bleeding from her head after being hit by a car when she was trying to cross the street. The driver of the vehicle had left the scene and a small crowd was forming.

Kent pulled over and started rifling through our first aid kit while I repeatedly thought to myself  “Please let an ambulance pull up now, please let an ambulance pull up now.”  As I looked up and saw the police car drive by without stopping I realized it was a highly unlikely that help was on its way.

While Kent grabbed a surfboard from the roof he instructed the people with us to move everything in the back of the truck onto the seats so the floor would be clear. They then rushed to the scene, quickly assessed the situation, wrapped her head and loaded her onto the surfboard.  She was carefully brought to the truck and slid into the cleared space. As everyone held her in place I drove to the nearest emergency room.

In those minutes while I waited for them to come back to the truck I considered where we could take her. In my mind our best choice was JFK Hospital not because I thought it was a great option, but because it had the highest odds of a visiting surgeon actually being available when we arrive. When Kent got into the truck and conformed my choice, I knew we were thinking the same thing.

I experienced a less serious, yet very stressful, situation our first year here when Kent had malaria and was rapidly deteriorating. I knew from a previous emergency that I had to think in terms of odds versus quality when I chose a hospital to take him to. In those days hospitals didn’t always have a doctor on hand and, if you went to a place that was decently equipped but small, you could end up waiting a long time for a doctor to arrive.

The women hit by the car would have been a difficult situation in any country, but it reminded me, yet again, of the inadequacies of medical situation in Liberia. It has improved since we arrived in 2007 with many more qualified family physicians available, but its still seriously lacking in specialized care.

We left the woman in the hands of the hospital staff as well as the police that eventually arrived.  We didn’t get the reaction we hoped for where nurses and doctors bustled around the patient, attaching IV’s and monitors and summoning the surgeon to “scrub up” as they desperately tried to save her life.  Instead it was a sluggish reaction, one where they calmly asked us to register her, then slowly transferred her to a bed and waited for a doctor to come. Perhaps they simply knew she wasn’t going to make it and no rushing would change that.

We left our number in case there was anything else we could do and drove home in silence. She passed away that night.

Although the medical system here is poor I am still incredibly grateful for all the family physicians that have chosen to come back to Liberia, for the people who are stead fast in their work to improve the situation, and for doctors that are willing to visit Liberia and share their skills. I know small changes do happen all the time and I look forward to the day when I can confidently say in an emergency situation, “Let’s go to this hospital, they have everything it takes.”

Best Buddies

The Boys

I’d like to introduce you to Roosevelt, Samuel Jr and Alexander (left to right)  – best buddies from the grade one class at the Royesville School. If a picture is worth a thousand words then this one reveals it all.

Meet Roosevelt  – the serious one. He’s seven years old and is often left in charge of his 18 month old sister Geraldine. His dad is a teacher at the school so he can frequently be spotted purposefully striding around the campus with Geraldine on his hip and a farm tool in his hand. Roosevelt is always the one offering advice to the other kids on the best way to execute whatever task is at hand.

Next is Samuel Jr  – the mischievous one. Sammy has this contagious smile that spreads across his face every time he looks at you. He has this lightness to him that comes with being a natural charmer so it’s not easy to get mad at a face like this, even when he is stirring up some trouble. When put to a task he’s quick to get to work though. He comes from a large family where everyone has a job to do and he knows when its time to contribute.

Finally Alexander – the awkward one. Every time he poses for a picture Alex has his eyes down cast or is fidgeting with something on his shirt. Its as though Alex is unsure of his place in this world, which makes some sense, considering his situation. The story is vague, but it appears that his parents gave him to Roosevelt’s family knowing that he’d have a better life with them. Alex is doing great in their care – he’s a kind, gentle boy always ready to tag along with anything fun that’s going on.

These boys are 3 of the 107 students at the Royesville School and 3 of 107 reasons why I love what I do.

Clean Teeth, Nice Smile.

DSC_0005

I still remember the day I was shipped off to the student-training centre at the Wascana School of Dental Hygiene. I was the naïve age of eight; a time when I still believed every bus trip led somewhere exciting.

It was early in the morning on a cold winter day when my classmates and I got bundled up in our puffy winter jackets and ran out into the dark to board the yellow school bus. When we arrived at the institutional looking building with the brightly lit entrance I sensed something was amiss. This was not the kind of building that radiated fun. Suddenly our warm winter jackets felt stifling and we all began to sweat.

I kid you not, that’s exactly how it was and I will never forget it.

I’m remembering this fateful day because the students at the Royesville School just had their first experience with dental hygiene this week. But it was far from traumatic. The most enthusiastic dental hygienists I have ever met descended on Royesville for 4 days with the firm goal of declaring the school a calculus free zone.

When the UOF truck arrived at the school at 7:30 am on Monday the “On” switch was flipped and these ladies went to work with startling efficiency considering their 5 am wake up call. Within an hour the library was transformed into a 3 station dental clinic and the first patients were called in.

The dental hygienists warmly welcomed every child into their chair and cheerfully chatted to them while their magnified eyes loomed over the kids’ mouths seeking out the grave offender – tartar. Implements scrapped, mirrors probed, kids rinsed and spat and clean teeth prevailed.

Every child was instructed to raise their hand if anything bothered them but never once did a hand pop up. Eventually the hygienists started looking for more subtle signs like a flare of the nostrils or curled toes to indicate something might be bothering them. With their lovely sing song voices the ladies would quickly comfort the children, apply a topical anesthetic and get back to work.

For the students at DASE their experience with the dental team was an exciting adventure. They each got at least 45 minutes of undivided attention from a fascinating stranger who adored them, they got to wear really cool sunglasses and they walked away with a free toothbrush and toothpaste. Why in the world would they risk that experience by raising their hand if it hurt?

The end of the week was celebrated with songs and speeches all dedicated to the dental hygienists. Kids clamored into the library holding signs saying “I love my teeth”, “We kicked germs out of our mouths”, “Clean teeth, nice smile – we will never forget you”.

And its true, this past week will go down in history at the Royesville School. It will be a long time before the kids stop talking about the ladies from Oregon Tech. A heart felt thank you to Sharon, Heather, Gigi, Mckenzie, Karla, Doreyela and Minh.

The Shift

Car stuck in puddle

The Rainy Season

Its been raining non stop for two days now. As I kneel on my couch, scanning the sky through the tight black grid of the double-screened windows, I see an endless canopy of dull grey and I realize this downpour will not end anytime soon. Part of me relishes in the luxurious coolness the rain brings and the other part of me really wishes I didn’t put a load of laundry in last night.

This rainy version of the relentlessly sunny Liberia I’m accustomed to is creating a bit of a drying dilemma. My habitual trips home during the season of torrential downpours has left me ill equipped to manage this situation.

At the moment my small living room closely resembles a very poorly run laundry mat. Shirts hang off the back of chairs, underwear lays strewn over the exercise bike, pajamas cling to the standing fan and pants dangle from the ajar doors. I’m surrounded.

This is all part of “the shift” – the adjustments that need to be made each year when I move between two distinctly different worlds. Upon return to Canada, ask me if the transition home is difficult and without a pause my answer will be, “No, of course not!”  I have no problem embracing 24-hour power, safe tap water, cool breezes, amazing fresh food, excellent public transit, and clean air (this is not a comprehensive list).

Now ask me that same question when I first arrive back in Liberia and you’ll get a very different answer.  There is definitely a period of transition when I return to Africa.

It’s the multitude of daily realities that shake me up for a bit. Little things like indestructible cockroaches, teeny-tiny killer mosquitos, relentless kitchen ants, untrustworthy tap water, weird stomach issues, diesel belching trucks, crazy drivers and perpetual sweating (this is not a comprehensive list).

Eventually, after a period of denial, I begin to navigate this new reality and it becomes just normal everyday routine. I even start to enjoy the added challenge life here brings. Trying to outsmart mice, figuring out what erratic maneuver the driver in front of me is going to pull, knowing when to hold my breath – it all makes even the most mundane day a little more interesting.

So while this is transition time is still fresh in my mind, I want to ask you to help me with “the shift” next year. On the last day we see each other in Canada I need you to put your hands on my shoulders, look me straight in the eyes and say, “Remember.” Next you’ll need to take off your shoe and smack it really hard on the ground. Then, come back to the previous shoulder/eye lock and say: “That’s how you kill a cockroach.”