29 December 2005 Liberia

It is very cold here, especially in the morning. Fog blankets the whole town up to ten am. The hospital is about 1.5 km from the compound. I have to travel by van in the morning so I won't be late for the morning meeting. But at noon, I try to walk back to the compound. The drivers always try to come and catch me when I am walking back home. They laugh at me because it is this crazy woman who walks back to the base. The people are kind and they all try to greet me when I walk by. I walk around all the time and talk with them. It is great to talk to people. They have a special handshake here which I find very awkward and a bit rude. It's a handshake with an added snap to the fingers. It is peaceful here and there is no shooting. We have our own house and we are well provided with food and safety. Every morning we buy fresh bread from the market. I do not eat the meat here because it may contain unknown parasites. All our water is filtered. The log designed it so that we can use rainwater. The electricity is only up to 11 pm, so I've tried to sleep early. I start my shift at 8:30am and finish at 12:30pm. There are just too many patients to see and they are with too many problems. Sometimes, I wish I could split myself into three since there is so much work to do in the hospital. Everyone needs medical attention. I've just tried and tried to keep up with the demands. Almost all the patients have malaria falciparum, even the women in need of cesarean section or the children with diarrhea are suffered from this disease. Also, almost all of them are infected with sexually transmitted disease. I had a trauma case that some hunters went hunting for game and thought their companion was an animal. They shot him. I had to put a chest tube in his chest. He was very lucky to survive. We also operated on a woman for placenta praevia. The surgeon here just gave her a local anesthesia. The woman was screaming and kicking under the knife and I felt so sorry for her. The anesthetist and the surgeon were shouting at her to keep her still. The tolerance for pain of people here is high but I feel it is so inhuman. My heart just went out to her. Here, we are doing hysterectomies, myomectomies, and cesarean sections. Pain relief is minimal. All my skills as a surgeon are being used here. I will soon remove a kidney of a 12-year-old boy who fell from a palm tree that was 12 feet high. He had been urinating blood since December 13 and nothing had been done for him upon arrival to MSF hospital. I wish that the operation will be a success and he will survive the operation. Please pray for him. He must be one of the reasons that God brought me to Africa. (Editor’s note: Dr. Lynette B. Dominguez works in the town of Zwedru, which is around 10 hours drive from Monrovia, the capital of Liberia. The infection rates of HIV and hepatitis B in Zwedru are high and it is very difficult to find blood donors. The 12-year-old boy as mentioned above had massive hematuria which was not relieved by non-operative management. The kidney that was removed was severely shattered.) Lynette

Filipino doctor Lynette B. DOMINGUEZ joined MSF in 2005. In 2005, she participated in the MSF Post-Tsunami Relief surgical programme in Aceh, Indonesia. She's now working in Liberia as a surgeon in MSF basic health care programme.