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[©Copyrights belong to their authors]

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What's new

Landing International Airport in Monrovia (there is also the City Airport, although I think it is years since nobody uses it except, perhaps, the Blue Helmets UNMIL), the first thing I hit this time was the absence of the dark. There were some lights down there! I think this is the main novelty of this 2010 Monrovia: the current. Still lacks a distribution network, but there are a myriad of small generators that power companies, homes, markets. Monrovia is now a city lit up.

When walking through the streets of Monrovia three years ago, I played with my friends to "What would be your priorities if you were the mayor of Monrovia? ". I had proposed to wire the entire capital and to provide free internet to everyone. In my naivety I had thought about the electric current (I make the anesthesiologist, not the logistics), but I see that someone has noticed before me this truism.

The second new thing is the market center. Three years ago there were some street vendors in the streets of the center and then the market proper was at Waterside, at the mouth of Mesurado. Now this market has expanded and has invaded all the streets of downtown and beyond. The streets are always full of holes, blackened buildings and crumbling always in the background, but in the first floor there are banquets and colorful umbrellas sellers of every kind of product. It matters little that the fish is from Mauritania or eggs from India (to the face of food per kilometer zero), no trade.

In third place I put the new American Embassy as a symbol of all buildings that are growing slowly. Well, this is not just slowly, is an impressive site that may have never seen here, complete with a double fence in concrete. It is developed exactly opposite each other: if the first occupied a quarter of the center, this takes care of two other quarters. What if they do not know, but at least they create jobs ... not I think it is a veritable industry has developed industries, given that import everything from the States, but better than nothing.

In my small way, again there was the hospital, the type of mission, my house with running water, the area of \u200b\u200bthe city that made me fall in love with Tubman Boulevard: I never thought I could fall in love with a four-lane road. Since then I discovered that my digital camera also makes movies, I spent all morning glued to the window to return people, machines, lights, sounds, colors. I miss the smells. I'll talk to Steve Jobs because developments in appropriate technology.

was the new team of colleagues: the two gynecologists, one English and one English, and pediatrician, English. All three professionally and humanly beautiful. An aesthetically, but that mission would be if there were someone to fall in love with a little '?!

I would say that once again there to report also the softening of Hugo, which has since become a father is moved to leave!

known and there have been reassuring and Club beer, of course, you.

Now just because I have to go get ready for my farewell party.

When I arrive in Italy, according to tradition, the last post with budgets and greetings.

PS: Mary, the child of four years with an oesophageal stricture to have ingested caustic soda (which is fed with a tube growing from the belly), which few months is the mascot of our hospital, he finally obtained the documents to go to Germany, where an NGO is in charge of the intervention to put a new esophagus. Considering spending the day drinking sweet drinks, then, not being able to swallow, spit where it happens, the only concern that remains is how to make them understand that the plane can not spit coke on the passenger side.

PS 2: Yesterday I called for a Caesarean section. I waited a bit 'before going into the operating room to allow time to organize my kids. When I arrived they had prepared everything as is from several weeks to tell him to do: drip, oxygen, suction, suction and drugs with the labels on the syringes, laryngoscope, pipe ... I have looked at the expression of a child who set food before her mother to come home ... And then I met said: "Have you seen Dr. Louis that we have prepared everything?". It matters little that will come back next week to make their head, at least leave with the feeling that I could change something.

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Racism

I wanted to write a scholarly dissertation on racism, beginning of "Bloody Oranges" that the dossier "DaSud" non-profit organization has recently published report on the condition of slavery laborers immigrants in Italy (Rosarno, just to understand). But I do not have the strength. The day was long and time is getting late. But I'm happy.

Some time ago they committed a theft within the hospital, depriving my fellow gynecologists ultrasound.

Surveys showed that some of the guards were involved, people who normally are part of the staff of my local NGOs. So it was decided to outsource security to an outside company.

The first morning I arrived in hospital, a guard stopped me and asked me to inspect my backpack. I looked stunned, not understanding how my complexion and my shirt could not be considered enough of a pass and, of course, I pulled straight. Now we have become friends now, and every morning and every evening after having shaken hands with African way, with snapping fingers, I check my backpack with books and computers.

I had the same reaction when they told me I had to take an exam to get permission to work, "So, I am a European doctor, white, come here to give you a hand and you also have to create me of difficulties? ".

Then I tried to put myself in their shoes: If a foreign doctor wants to practice in Italy, they shall be order and not part of the EU where the best of the exam was in the worst repeat the degree course.

There's nothing to do. Racism is within us, we have it in the genes a bit 'all. Sometimes it is manifest and said, sometimes take subtle forms, temptresses.

also want to bypass the rules because it feels better and therefore not justiciable. Perhaps the best way to control it is to be aware, without denying

other considerations. I think that there has been a civil war here, the cruelty were COMESSA, child soldiers, the rapes, with 300,000 deaths. Then I look and I see people introno always kind, caring, friendly, affectionate, sincere. And I wonder how it is possible that in certain contexts, the man becomes a beast.

Then I think of our Italian history of the last hundred years, the concentration camp of Bolzano and Trieste, the civil war broke out after the Second World War, years of lead, the massacres of those terrorist mafia , slavery Rosarno style, just to name a few. And here you understand where I going with this.

Ah, a couple of days ago was the anniversary of Hans and Sophie Scholl and Christoph Probst, three of the founders of the White Rose. So I close the circle!

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New Hospital

There are constants which arise in each mission, because they are part of the spirit of my NGO. Among these there is always the background, the presence of a new hospital.

Yesterday I was in the yard where the Swedish architect is conducting a fast-paced restructuring of a building to convert it to the hospital and was pleasantly surprised by the quality of the work (hospital, of course, not in Swedish). Without a doubt better than the current structure.

It's like a gift of a few hundred thousand dollars that we do at the Liberian Ministry of Health before leaving the country permanently in June. If it can serve as a reference, the President, in an interview with the NYT said to earn $ 7,000 per month.

The plan provides for the transfer of assets in the second half of March and the ' official opening of the new JN Jr Davies Hospital on April 2.

The health workers will change the contract, to pass under the central government, with a salary that will be a third of what they earn now.

Someone will be out of work, as one of the drivers who join us daily in the hospital, with whom I chatted a bit 'last night. He said, however, happy because in recent years has managed to buy a home and have worked for us should be enough to a new location easily. A little more satisfaction.

The old hospital will be returned to its rightful owner, a doctor of Liberia. Thanks to the money that we have paid in recent years to the rent, we will open a private clinic, in company with his wife who does the work of the World Health Organization official to support the introduction of free care in a small southern African country.

the "Medical Board" they forgot about me and now I will not do some more investigation. Not that he cared particularly. I'm preparing some lessons for the "Physician Assistants" of Pediatrics, a professional figure halfway between the nurse and the doctor, who will be the cornerstones of clinical activity in the new hospital, as in many other countries South. Pending that, in a bit 'of years, including the Liberia will be able to churn out his "doctors".

Meanwhile I am going to start my last week. I seem to have just arrived, but maybe it is. Good Sunday!

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Politics

I'm sitting by the ocean, bare feet in the sand, the sun setting on the horizon, the wind comes from west and raises whitecaps. While sipping my Club, four soldiers dell'UNIMIL (United Nations Mission in Liberia) jogging shirtless on the beach, with their shimmering plates dangling neck.

It is pleasing to some 'sea breeze after a day that began with two hours of flood-style African and continued with a stifling heat. Mac survive the humidity of this place?

Today I held the first lesson for my four brave nurse anesthesia: I showed him pictures of my week of observation result and even if will not come to any change in their work, at least I know that you are fun.

He died Patrick, one of the little children that every day medical care for burns from boiling water, the first due to trauma in childhood. When I saw for the first time in the operating room, I have recommended to the English surgeon, who showed very sweet to him, not too fond of that child would not have been saved: I talked more to me than to her. There is always something of a mystery that leads everyone to choose from among many, a particular patient. There is no rational reason, communicate. Sometimes we discover otherwise involved.

The infant mortality rate in our hospital is 10%. Cause of death as malaria. Then measles, various infections, malnutrition. Neonatal mortality is 30%, but goes given that we are a referral center to give birth and then come to us only on more complex cases, say those who start already on the wrong foot. About measles epidemic is about to burst, but the government refuses to launch a vaccination campaign for now because the dead are too few. Each has its own problems.

My beloved Ellen Johnson-Sirleaf may be ousted by the possibility of running for a second presidential term. The National Commission for Truth and Reconciliation has suggested that the president, along with 50 other prominent figures, be banned from public office for 30 years, with the suspicion who have financed armed groups during the years of civil war.

seems that Sirleaf will manage to re-apply, which enjoyed strong that he made in 2005 the first elected female president in Africa. What it does have the Americo-Liberian Mandingo and one of the 16 ethnic groups in Liberia, a predominantly Muslim, and almost all the economic power of the country: the United States and Islam go hand in hand in Liberia. Although there is no oil here.

Meanwhile I learn with incredulity to the latest statements by our Prime Minister on the selection method to be used for human trafficking between Albania and Italy: I am surprised that has not provided more objective criteria than the banal "pretty girls", such as height, eye color, the bra size, the presence of tattoos or piercings . Or the number of times an Albanian girl was raped before they agree to be landed directly on one of our sidewalks. I hope to deal with them about it.

I'm fine, thank you!

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Churches

Now, at least you mind you!

in my job description is written by hierarchical point of view I refer to the Project Coordinator (Field Coordinator, FieldC) but from the functional point of view I refer to the Parent Company Doctor (Medical Team Leader, MTL) and the Medical Coordinator (Medical Coordinator, Medco).

I state that in this mission, Medco also plays the role of Head of Mission (Head of Mission, HOM), which is the highest authority in this field, that also covers the role of MTL FieldC and that, to make matters worse, the two (HOM / Medco and FieldC / MTL) are husband and wife.

The two warnings (to allay Mirco) are that the first meeting I turned to the FieldC like Medco, after I had been talking with her and be with the HOM and then, to address an issue that I wanted, I overtook everyone and I sent an email directly to the headquarters Athens, without informing the FieldC.

That said, the work proceeds. I spent a week to keep my anesthesiologists and take pictures that I will from next week to show what they do well and what they need to improve. Yesterday morning (Friday, I do not know when you read this post because the Internet does not work) but I had an attack of obsessional neurosis autistic and I've flipped all the cabinet with the anesthetic material to clean and tidy. My "boys" looked at me like I was in the grip of fury mystic and did not comment, except to say, the job is done, it was nice to have a closet in order. Well, you could do it you, my friends ...

Meanwhile, to celebrate worthily the Saints Cyril and Methodius, patrons of Europe, I thought I'd find a church along Tubman Boulevard. The result was surprising, not so much for the churches, but to the churches: Baptist Church, Catholic Church, Lutheran Church, Presbyterian Church, Methodist Church, Seventh Day Adventist Church, Church of Jehovah's Witnesses, Church of Antioch Church of Bethlehem, Bethlehem Temple Apostolic Church, Church of Grace of Calvary Church of Christian Science, Church of the Soldiers of Christ, Church of the Revelation Church of the Congregation of the Faith Mission Church of God, Community Church of Grace Church of God Church Israelite Church of Christ the King Church of the Lord Jesus, the New Home Baptist Church, New Creation Church, Episcopal Church, Church of God in Christ, African Methodist Zion Church, Church of the International Alliance , Cathedral of Faith Church of the Word and holy, the Temple of Faith Church, Victory Church, Church of the Triumph of God Church of Jesus Christ of Latter Saints Generation of Hope Bible Church, Church of the Wonderful Temple Apostolic Church of the Life of Faith, Church of Ministers of the Life of Christ, Church Road for a Better Life, Church of the Heavenly Refuge, Church of Glory, the Salvation Army Church, Church of Fire and the Voice of Pentecost Church.

I would have expected a "Church of the beer-drinking club," but I have not found ...

For completeness of the survey, some of the signs put up outside places of worship is specified "Inc.", which is the same abbreviation is used for the Nike or Apple. I somehow doubt that is these churches are not just all run by disinterested men of faith ...

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Tubman Boulevard

Congo Town. It is called this because many of the freed slaves from the Caribbean came from the Congo and moved here once they arrive in Monrovia.

The sky is overcast, like every morning, the 'sultry air already.

Take an expanse of red earth, disegnateci over a long strip of asphalt, four lanes, two for each direction, but also on occasion in three and one in the opposite direction. Add to that the cars battered yellow taxis, many, the important thing is that they sound the horn as much as possible, that there are at least seven people on board and to stop suddenly to the side of the road to charge a passenger more; mammoth truck with discharges that appear to chimneys; bus abandoned decades ago by some South American company; terrain of the United Nations and NGOs all you can imagine, some cycling and lots of motion (you can stand up in three, the important thing is not to the helmet).

them and tap the edge trees and buildings.

Four types: shacks with tin roofs, small brick houses, including some internet cafes that do not understand where she gets the connection, modern buildings, usually branches of banks and mobile phone companies, and skeletons of buildings, mostly works started and never finished, now covered by vegetation.

Disseminateci a myriad of shops, outdoor patios in some, others equipped with battered wooden shelves and a faded umbrella, which sell everything from phone cards, cans of gasoline, food, chargers for mobile phones, leather sofas, tires and wheels car (usually no more than a dozen tires of different sizes and as many wheels), bags, bread baskets, wicker, banana and citrus fruit, toothpaste, meat skewers, mattresses, water tanks, flip flops, plastic bags of cloth, colored T-shirts (no Rugo, not the Liberian national football team ...).

Now add in the people: children who are washed in tubs, men walking on either side or in the middle of the road, wheelbarrows, carts, women with pots on his head, students with their blue uniforms and yellow Many waiting in vain outside the schools because they arrived late and can not enter, workers waiting of a ride, outdoor barbers and lavamacchine.

definitely missing something, but the bulk is everything.

This is Tubman Boulevard, the road that connects my house to the hospital. A sort of long walk along the Liberia of today, full of contrasts indescribable but more and more active every morning keeps me glued to the car window. Yes, alas, the machine: the "security guidelines" do not allow this stretch of road on foot. And because in a week I received two calls, wait on the last day before break this rule. I can not enjoy a piece of Tubman Boulevard Live!

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The Guardian

is long, is in English, but, above all, is terrible. For those who feel she could read to the end, it helps to understand something more (or maybe less) of this country, where women die from complications of clandestine abortions.

http://www.guardian.co.uk/society/2009/aug/02/liberia-women-rape

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My project

This morning I finally recovered my luggage. I was in the office of Brussels Airlines in Mamba Point, Monrovia center (where I lived the first time, this time I'm on the outskirts, in a place called Congo Town), and I could take two interesting differences compared with three years ago: there are many machines and many more several banks. I do not know if you can define its own signs of improvement, but I'll tell you when I got an idea about a bit 'more of the situation. A road was closed because they were resurfaced and the driver assured me that the president himself (or as some will remember the name Ellen Johnson-Sirleaf) is handling the project, with the same pride with which we speak of someone Mr. B. and the bridge over the Strait. About mister B.: last night, drinking my beloved beer Club (Monrovia Brewery Inc.) under the beautiful African night sky, a colleague of mine asked me how to carry Kenyan sex scandals of our premier. Hurrah!

Meanwhile, I understood a little 'more about the meaning of my mission.

Abstract: My NGO has several sections and each of these in recent years has implemented a project in Monrovia. The first time I came, I worked in a hospital run by the French section, which plays any type of surgery and was closed shortly after my departure to coincide with the resumption of activities the main government hospital in Monrovia, JFK Memorial Hospital.

remain two problems: firstly, the JFK is not sufficient to address all the needs of more than one million people living in Monrovia, continue to be no other doctors. The relationship is always one doctor per 100,000 inhabitants: Thirty doctors, one more one less, throughout Liberia. There are still training for a new class of doctors and those who can not go to study abroad and then return to work in Liberia. Several NGOs then, and among them was the English section of the mine, have extended their presence to try to give a little 'breathing the state structures. After several postponements, now also my current hospital, the Benson Hospital, is gradually reducing its activities, focusing mainly on training of local staff in a few months will begin to work independently in a new hospital, built in partnership between the Ministry of Liberian NGOs and my health. The date for the transfer of assets and for the final closure of the project is scheduled for June.

service Anesthesia was maintained over the past four months by nurses, aged between 55 and 63 years, which come out fairly well (at this point one might wonder what need to have studied for ten years if the same work can be done even by those who have spent less than half, but here we open a chapter on the development of anesthesiology and the role of the anesthetist in the northern countries of the world that is beyond the scope Liberian this outing). Sometimes, however, encounter some problems, especially in the management of patients in emergencies and fragile, so it was decided a program in two stages: a first anesthesiologist came here in November and has been involved in doing some 'theoretical training, the cooling studies that have addressed the 4 nurses several years ago. To me it is to complete the journey by doing a little 'monitoring and identifying and acting on main shortcomings of each of them to enable it to improve. That is so very interesting, but from practical point of view I do not know what we can really do in three weeks (there were four, but the first now has gone from Athens, travel, interviews and so on). Unless they postpone me home early, because the Liberian bureaucracy has grown at least as much traffic Mamba Point and now, to work here, will also have a state exam before a committee of the Ministry of Health. I will let you know when it will be, so mom Board will light a candle as she used to before my exams!

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Monrovia

Arrived! For reasons that escape me my luggage refuses to cooperate and stopped in Brussels. It should arrive Saturday. I have a toothbrush and change of underwear, otherwise I would survive. If anything, the question is who stands beside me, not mine. I just hope the Felino salami that I put in my suitcase arrives still edible.

First impressions are very exciting, albeit with a good dose of disappointment.

This morning a little 'red tape (work permits, security guidelines, logistics and cultural briefing, ...). In the afternoon we will visit the hospital and begin to understand if the project that I rely on (training and supervision of nurse anesthesia Liberian, because of shortage of doctors, anesthesiologists are engaged in) is realistic or not. I'm going to do the interview with the Head of Mission.

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Atene 2

I ended talks for the departure: the project is getting more interesting, but I will explain in the next few days. I will be working to advance more than Benson Hospital in Monrovia, a hospital obstetrics and gynecology, just not to feel too much difficulty.

This afternoon I turned a bit 'Athens, which, contrary to the opinions collected before departure, I found it fascinating. A little 'a bridge between East and West, very hospitable, dirty enough to make a living city. The new Acropolis Museum is an architecturally stunning facility, although the third floor is dedicated to the Parthenon, is virtually empty, waiting for my beloved British Museum decides to return the marbles brought away by Lord Elgin 800. Justified by saying that the Greeks are unable to retain dignity is now very hard.

Segnalo the publication of two interesting reports.

The first is the authoritative work site in the UK "Forget Dinner" (subtitled "and go straight to bed"), through a careful survey of the its members has ranked first in the "work 'sexy' imaginary erotic female firefighter. Physicians in second place. Better than nothing.

The second is by MSF Italy ( www.medicisenzafrontiere.it ) and d is titled "Beyond the Wall. Travel between the centers for immigrants in Italy."

is the picture of reality that we live inside places of detention for migrants without a residence permit and transit for asylum seekers in Italy: CIE (Centre for identification and expulsion), CARA (Reception Centres for asylum seekers ) and CDA (center). The report investigates the socio-sanitary and living conditions in these facilities. MSF has, until now, the only independent organization that wrote a report on these centers. Just read the abstract to get an idea.

What else? Tomorrow morning departure to Brussels, from there fly to Monrovia, where he will arrive in the evening. A resent from Liberia!

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Atene 1

Here Athens everything ok, except that you were night I ate at a restaurant biological "herb balls" that, considering the lethargy that still covers me, probably did not contain only the coasts and spinach ...

Meanwhile, a few hours later than me, my luggage has arrived and I'm happy. For the rest of the talks, visa and vaccinations as practice.

Given that my nephew Carolina (6 years) asked me "Why do not you go to help children in Haiti?" I waved at Malpensa airport in Milan anesthesiologist a friend of mine who was leaving with my NGOs in Haiti itself, the surgeon in Hong Kong when I was in Gaza Last year I wrote on Facebook to get information that will leave for Haiti in mid-month, Fiammetta wrote a comment on my blog (honored, as will have something else to think about these days), my friend neonatologist Bridge , on a mission to Haiti, I wrote that the anesthesiologist of his hospital is too crazy to work I will devote another thought to the Caribbean island so longed for.

Then, as James points out, accept that not everything depends on us.

few days ago, I discussed with My friend David on the proposal by Minister Frattini to cancel Haiti's debt to Italy. In the latest issue of International (831, 29 January 2010) I found this little article that seems to offer an interesting contribution to this issue of foreign debt.

"In an effort to help Haiti, the International Monetary Fund (IMF) is using the same policies in the past have made the country poorer and more fragile. The IMF has announced another loan of one hundred million dollars to the island. But the loan is granted by section deferred credit Fund, to which Haiti is already $ 165 million. These loans are granted under certain conditions, including higher prices for electricity, the containment of public wages and inflation. According to the proponents of debt relief, the IMF used the crisis and the debt as leverage to impose neo-liberal reforms.

History repeats itself. The impoverishment of Haiti began when slaves and gens de couleur free formed an alliance to rid the country by the French in 1804. But in 1825, Haiti was again a slave: the foreign debt. To prevent France and other Western powers to impose the embargo, agreed to pay 150 million francs in compensation to the owners of slaves. To do so, he borrowed million francs by French banks, German and American. In 1947 he paid about 60 percent of its debt. In 2003, President Aristide asked France to return the sums paid. A few months later, he was removed by a coup and forced to leave the country under the threat of armed Americans.

From a report by the Center for International Policy in 2008 indicate that in 2003 Haiti has spent 57.4 million dollars in interest on debt and foreign aid for education, health and other services amounted to only 39.21 million. In other words, despite the apparent kindness of strangers, Haiti has always returned more than he received. Richard Kim, The Nation. "