My friend and medical partner Dr. Polifka has sent another journal entry. This time he’s in Africa. In addition to his adventures in practicing medicine in difficult circumstances, he’s finding a voice as a writer. Now he’s also ‘practicing ‘ by teaching others. “teach a man to fish….”
Dr. Michael Polifka’s medical journal from:
Monrovia, Liberia
March, 2008
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Michal Polifka on medical mission
in Nicaragua
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Our Project HOPE team of 12 was transported from Ghana to Liberia on the stealth-looking U.S. Navy ship, appropriately named the Swift (actually it’s a modified inter-coastal ferry). The rusted, gutted, semi-sunken ship at the wharf in Monrovia that prevented us from docking was premonitory of the difference in the condition between the two countries. The drive to the city from the dock area made it absolutely clear.
The four lane thoroughfare was more pot hole than road and managed to fit seemingly three lanes of traffic in each direction, a large majority of which were aged yellow taxis. At each window a passenger hung out head and arm trying to get a bit of relief from the 95 degree heat. The snail’s pace traffic allowed me to see that each taxi typically had seven to eight passengers within, and occasionally with two more sitting in the back, legs covered with the partially closed trunk as if it was a lap blanket. The shops along this commercial street selling hardware and building materials were open, but the hand painted signs suggested that this relatively recent. But the real commerce was on the sidewalk in front. Small tables with local vegetables shaded by bright colored crooked umbrellas, women in colorful patterned lapas with matching head scarves squatting next to the fish they are selling while fanning away the flies, a rusty wire mesh hangs shirts and pants dusty from the road’s proximity, there are wheelbarrows filled with brassieres, a wood plank is lined with shoes all are but minimal obstacles to the hundreds of people, bundles in their arms baskets on their heads, weaving about them in their own pursuit of the day’s buying or selling. As we enter the city center the fact that civil war ended but three years ago is even more apparent. The ground floor storefronts with hand painted signs suggest the short duration of the current enterprise, but hanging laundry and small cooking fires in the bombed out charred concrete shell in the second and third floors open to the sky tell the real story of the chaos just ending.
The following day we go to our work site, the John F Kennedy Medical Center, for orientation and a tour. Literally and figuratively a shadow of its former self, once the medical state-of-the-art, shining star of Western Africa, a third of the buildings on the campus are more bombed out concrete remnants from senseless destruction during the fourteen year civil war. The rest are all in bad need of lots more than cosmetic repair. Poorly lit, at times dark, hallways lined with over filled benches served as waiting areas for various outpatient departments. As typical for the third world, patients came very early in the morning and waited all day for the possibly of being seen. Some areas of the hospital seemed and adequately supplied and staffed. The physical therapy department was staffed with well trained therapists who had adequate equipment, either older things in good repair or ingeniously things made for locally available material, as well as supplies for their very busy prosthetic limb clinic. The emergency room, the intensive care unit and the general medical floor were quite the opposite. Typically out of daily supplies like gloves, and with medical equipment both in short supply and often non-functional, the quality of care was certainly affected. I didn’t see one heart monitor in the six bed open ward optimistically called the ICU; of the two oxygen concentrators in the entire place, the one I witnessed didn’t function when needed; there are but two ECG machines; the lab results were often delayed for lack of reagents; the one x-ray machine in the hospital was a portable one and gave poor quality films, and on and on.
I then met with the Chief Medical Officer of the hospital to find out how we could best help. Dr. Robert Dennis, a plastic surgeon practicing in the U.S. for the past 20 years had been recruited by Mde. Sirlief, the country’s recently elected president, to return to country of birth and head up the hospital’s effort to return to its former state of prestige. I told him that with medicine we had with us, I was prepared to supplement the hospital’s general outpatient clinic by seeing patients as we had done in Ghana or help in anyway else. “Education” is what his professional staff of interns, medical students and physician assistants most needed he said. Therefore, I would spend my time running teaching rounds on the medical floor in the mornings and mentoring them as they attend patients in the outpatient clinic in the afternoons.