We are all exhausted. Most of us started the day tired after a long week and I wasn’t the only one planning a low-key weekend.
Worn out though we are, there are few complaints. This is what we are here for after all. And we would do it all again tomorrow if we had to.
Usually we receive no warning of the imminent arrival of bomb blast victims. They normally arrive in a cloud of panic; chaotic screaming ensues and staff members run to man their posts. This time we are prepared. From the time of the phone call it should be twenty minutes before they arrive, not much time to ready the Emergency Room but I am surprised at how much gets done. We clear the resuscitation room and triage area, we prepare IV bags and bandages and then we prepare a queue of stretchers outside.
We all knew that late in the dry season, malnutrition would peak. But this week it hit us hard. Our outreach teams had difficulty coping. The hospital was temporarily over-run. Dr. Johanna, our MSF doctor from Sweden, told me the hospital “looked like a refugee camp”. The team and myself surveyed the hospital grounds. Two patients shared a bed in some circumstances; the area we use for children’s play was covered with mattresses on the ground and patients ; and our tent used for epidemic infectious disease was filled with malnourished children … Quickly, we started making plans to deal with the increased numbers.
Being able to go to the hospital at night requires a proverbial blade, its attachment and a handle. Practically speaking we need drivers, cars, petrol, guards and radio operators to make it happen. We need nurses on duty, who first discover something is wrong. We need logisticians who ensure there are generators to give light to the hospital at night. We need non-medical team members to also order key medications that I or other medics might prescribe at night. We need a coordination team in the capital to reach an agreement with the Ministry of Health that we can work here in Amtiman. And we need donors and supporters who generously give to make all of this possible.
Late at night we need a doctor. But we need a lot more too.
I have never seen burn patients like we have had here over the winter. Often the burn victims are, again, women and children, as the women prepare the meals over open flame stoves and the children play around their mothers. We often had multiple victims from the same families. While we do our best, we lost quite a few of the patients to infections or they were simply too badly burned to survive. All we can really do is provide sterile dressings, increased calorie foods, and hydration. It has been hard to watch, and I am glad this season is pretty much behind us.
Certainly, the most difficult part of this mission, for me, has been the child deaths. Of course, everyone dies, but I am not accustomed to so many pediatric deaths.
On this Earth, some children have access to life-saving medications, and others do not. This unfair imbalance means lives of equal value are treated unequally. Our MSF action seeks to make a dent in this injustice. It is unfair and tragic that children like Oumere die so early in their lives.
I learned a lot about closing a project in Liberia. It’s always difficult, but it’s important to maintain the capability to be the first responders in conflict zones and not have our resources tied up providing primary care. You get attached to the staff , you get attached to the patients, but it’s important that MSF is able to maintain the capacity to do what we do.