Robertsport trip

This past Friday and Saturday I joined a group heading to the gorgeous beach of Robertsport. It's about a three hour drive, up the coast from Monrovia.

We ordered up 5 taxis for the 20 campers. It cost $22 US per person round trip.

We picked up some fuel for the trip. Some fuel stations have funnels, some use siphons.

About 2/3 of the distances is fairly good pavement. Every so often we have to stop at check points of Liberian police. The drivers have to all get out and talk in the guard shack. Bribes are still common. People who had gone last year remarked that there were many less UN manned check points. The last 1/3 is not paved and is dotted with about 20 small bridges. That's where the story of this photo comes in. Since it's the dry season, the road is very dusty. With 5 cars following each other too closely... yes you guess it, one car slowed for the bridge crossing and the vehicle behind it did not see it and bumped it. The car went off the bridge - not one got hurt. The Pakistani UN troops stopped and gave some of the people in that car a lift. Later they went back and pulled the taxi out.

Our tents are under that large tree.

Robertsport is now a small town of fishermen. The fish in the evening and early morning.

Walking about 3/4 of an hour up the beach brought us into town. We found some cool sodas.

There are lots of these craps running around on the beach - they are quick.

It rained and thundered hard over night. Some campers had hoped to sleep outside, but had to run for cover.

Island Hospital, Monrovia

Once again my Kiwi OR nurse friend on the Mercy Ship asked me if I would like to go to Island Hospital run my Medicine Sans Frontiers (MSF) in Monrovia. The doctors there had requested the help of our general surgeon on board, Dr Bruce Steffes from the States. They had a young boy of seven who had come to the hospital several days before we got there with a skin infection on his back between the shoulder blades. This infection had spread very fast down his back just above the buttocks. The general surgeon had dealt with many cases of Necrotising Facitis (flesh eating disease) before and did quite an extensive dissection with cautery (http://en.wikipedia.org/wiki/Bovie) and a scalpel to get rid of the dead flesh. One cool trick of the cautery knife or tool is it's ablity to seal blood vessels. A number of times when he was cutting with the scalpel, small blood vessels would be severed. He would ask for a small clamp and hold the vessel closed. Then he would touch the clamp with the cauterizer. This would fuse the vessel closed.

The child went to the intensive care unit after the surgery which took about an hour and a half. We have heard back from the hospital that the boy is doing well and will survive this terrible ordeal. We will return for a visit on Thursday the 20th March to review his wound and perhaps book him for surgery on the ship at a later date. Due to the nature of the infection a lot of flesh needed to be removed so the surgeons on board will have to do some skin grafting to cover the defect.

Written by Dan courtesy of Kylie

That's me on the right - notice perspiration at waist height - it was hot in there!

Screening day

The medical screening took place at the newly renovated Samuel K. Doe stadium. This is the early morning line waiting to see the nurses and doctors. We are seeking these type of pateints:

Maxllio facial - such as cleft lip and tumour removal
http://en.wikipedia.org/wiki/Cleft_lip_and_palate

Plastic surgery - release of burn contractures, and skin grafting

Orthopedics - repairing clubbed feet, old bone fracture repairs
http://en.wikipedia.org/wiki/Club_foot

General - hernia repairs and goiter removal
http://en.wikipedia.org/wiki/Goiter

Patients that have gone through the first stage at screening and are waiting to see the surgeons.

Cleft lip

Lipoma (benign tumour) on the back of his neck
Burns

Taking blood samples

Having a green card means he has a date for surgey

Having fun

Hilarious.

Founder of Mercy ships, Don Stephens, with a patient.

Donating blood

Last night I answered the phone in my cabin and a voice asked me if I would give blood. I registered a sample weeks ago, and now one of our patients was in need. I went down to the lab and the technicians wisked Rachel and I (2 units were called for) off to the recovery room. There I laid down, and my blood was taken, just like the many times I've done at home. A small difference was they had a scale to weigh the bag - at 450 grams I was done. Then I watched the nurse walk to the other side of the room and hang up my bag of blood and start intravenous line on the patient.


The lady needed blood after Vesical Vagina Fistulas (VVF) surgery . This is an abnormal connection between the urinary bladder and the vagina provoking constant leakage of urine in women. Mostly this is caused by prolonged obstructed labor which can last up to seven days or more.


I watched the blood drip through the IV and thought of how I have given many things to people, but this was amazing. I've never seen the person recieving my blood back home. The doctor told us that our hemoglobin count is usually around 15, the patient's was 3.

(Hemoglobin carries oxygen around the body in the blood to all your cells. So yeah, it's pretty important.)