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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.”