Most quiet and relaxing evening

This has been the most quiet and relaxing evening for me so far in Monrovia. Four people left yesterday. John and Mike are on emergency OT in the hospital. I'm off duty today. Other people are not around and I'm alone in the compound. I just finished dinner on my own. The cook prepares the food before he leaves, and all we have to do is warm them up before serving. I had my supper on the balcony, enjoying a relaxing breeze from the Atlantic Ocean. This afternoon we admitted a woman with a suspected ectopic pregnancy and abdominal pain. We did the ultrasound study and a pregnancy test. As our gynaecologist, Charlotte had just left and the patient was stable at that time, the medical director decided to send her to Benson Hospital. There was also a woman transferred yesterday with a ruptured uterus to Benson Hospital. It was near five o'clock in the afternoon, and I was off duty so I took this opportunity to go with the ambulance and visit the hospital. Benson Hospital is located to the East of Monrovia city. It is about 10km from our hospital. It is a Mother and Child Hospital operated by MSF-Spain. It also looks like the hospital was converted from an unused school. The hospital's main service is mother and child healthcare, so it is located in a residential area of the city. MSF-Belgium has another M&C Hospital in the North, also close to the residential area. Mamba Point is in the West, closer to town. We mainly concentrate on medical and surgical emergencies. There are two obstetric beds for emergency use. We also perform emergency cesarean sections. You can find that the different MSF operational sections would have their services collaborating and complementary to each other, providing the widest scope of services to the people here. These three hospitals already provide nearly 70% of the hospital beds in the country. There is another government hospital called John F Kennedy Hospital. It provides a complete scope of services but patients have to pay. Sometimes MSF-F does refer patients for their care, but MSF has to pay the bill. For example, we referred a case of dental root abscess this morning and some orthopaedic cases earlier. I saw this JFK Hospital on my way back to our hospital. The outside looks quite good. It is much better equipped than ours. I also saw a notice of the Mercy Ship on the Benson Hospital notice board. Mercy Ship is an American medical ship providing free reconstructive or cataract extraction surgeries. She comes to Liberia a few times a year. Recently, we have had a child of eight months born with congenital cataract blindness. We referred her to Mercy Ship. We need to book in advance. Together with some private health service and many other NGOs primary health care services, these constitute most of the health care support in the country. John just shared his impressions with me this afternoon. I think he has the same kind of feelings and cultural shock as I had on my last mission to Kenya. He told me that although he does not feel himself great or a saviour to the people here, yet he still feels he is important here. After being at Mamba Point one week, he feels that the whole mission here is great. It is built up from so many people's hard work and commitment. We surgeons are only small part of it. Although our work is important, without the support of administrative, nursing, resident doctors, the staff, even the drivers, our cook and even the water tank, we could not survive here and our work and expertise would not materialise I agree with him entirely. We are part of the whole piece of a machine. Losing any part if it, the machine would not function. On the way to Benson Hospital I passed the town centre and Capital Hill. It was about five in the afternoon and very busy outside. The traffic was terrible. Our ambulance could have priority and sometimes we would even drive in the opposite lane. I found some UN Police patrolling the street, controlling traffic. There are many buildings left with burnt and ruined markings of the war scattered all around. The newest and tallest building in Monrovia is the headquarters of the UN Mission in Liberia. Next to it is another new and modern building belonging to the Liberian Ministry of Foreign Affairs. The Parliament and Presidential Office remain in the most traditional colonial buildings. Au Yiu Kai