Life goes on

oktober 24, 2008


It’s Sunday again and I actually have the day off! I’m spending the day at the house and just enjoy doing absolutely nothing for a change. Strange feeling! The house is in the nicer quarters of the City and I’ve only heard gunfire in the vicinity a couple of times… I have my own room and the ground service is fabulous; housekeeping, laundry and food are all taken care of by the logistic side of the Organisation. They have the explicit orders to do everything possible to enable us in the medical team to do our work as efficiently as possible – I wish the administration at my hospital at home had the same instructions and goal! The food is exceptional and delivered to the Hospital every day. The mission does not offer any hope of losing weight and I have to get the recipe for that homemade pizza!

The mission has tight security rules, but we are allowed to leave the house during daytime as long as we clearly indicate our association with the Organisation with T-shirts and logos. Kidnapping is a major source of income for some elements of society, so all movements and whereabouts must be declared and approved ahead of time, and we shall always be reachable

In the busy city of Port Harcourt, there is no social security and no one but us will take care of you if you don’t have the money. So when receiving a case it was never  an option not to treat the patient.

Preparing for a case I decided on a battle plan based on our airway algorithm from home. I prepared the equipment at hand and told nurse P what was happening in case I needed help. Anyhow, I was confident that I could open her mouth once she was asleep and muscle relaxed.

I was wrong… Her jaw remained locked rigid, but on the positive side was that she indeed was easy to ventilate and somehow I managed the airway with the help of a bougie – again, I don’t know if I did right or wrong and in retrospect I wouldn’t do it again, at least not without prior discussion, more equipment and, most of all, a red button…

Since my last post I have been joined by a French nurse anesthetist, and that has really changed things. We take turns for calls and just to have someone to discuss with makes all the difference. It’s only a couple of weeks left of my mission, but now I can for the first time relax a little and even get some administrative work done! Just like home reports have to be written, statistics compiled, and inventories made. Life goes on…

In my next post I’ll try to wrap things up and answer all your questions. Keep ‘em coming!

Getting ready for Nigeria!

augusti 14, 2008

Dear all!

This is my first attempt at a blog, but I’ll do my best in the challenge to convey my experiences and impressions from my six week mission with Doctors Without Borders, or MSF (Médecins Sans Frontières), in Port Harcourt, Nigeria. I’ll try to keep it short and down to the point so you surely can find the time to read it, but bear with me as this first post is a little longer! I’ll try to keep you updated every week, but I can’t promise anything. Also, please let me know how I’m doing and give me feedback for improvement!

When writing this first entry I’m still at home in Sweden. I’m working as an anesthesiologist at a university hospital (Karolinska Sjukhuset) in Stockholm, and I’ve been in the pipeline for a long time to go on a mission with MSF. Finally it’s becoming a reality and all my training and preparatory courses are done with.

The reasons for me to volunteer with MSF are not in any way complicated nor with a belief of doing something heroic or altruistic. I volunteer with MSF for the same reasons I’m working back home: with a strong wish of doing something meaningful and helping people in need. However, and in contrast with my work at home, I think my ambition will be much more condensed with MSF and the results hopefully more obvious. At home we have next to endless resources and there is always a fully manned and equipped team to help me if I need – this will not always be true in the field with MSF! I strongly sympathize with the ethics and charter of MSF (more of this later); but, again, I don’t see any fundamental difference from my humanitarian work back home or my coming work in Nigeria. It’s the same humans, with the same medical and humanitarian needs. Maybe I’ll soon find out how incorrect and naïve my vision is…

Now for some background so you’ll get an idea of the MSF world! My hospital at home has an annual budget of 1213 million Euro (yes, 1.2 billion Euro!). With those more than a thousand of million Euro there are 15000 employees that annually deliver 10000 babies, perform 60000 operations, and do 1.5 million consultations. MSF on the other hand has a total worldwide budget of 568 million Euro. However, in spite of less half of the funding, MSF manages to annually employ some 30 000 people in more than 70 countries, deliver 100000 babies, perform 64000 operations, and do 10 million consultations. Those already quite impressive figures become even more impressive realizing that much of the work is done in a setting with extremely poor infrastructure and social and/or political instability. I feel honored to become a part of that work, but before anybody at home gets mad I must also emphasize that I really value and cherish my work at home! My friends and colleagues deliver first class health care and they are all a great bunch to work with. After all, if that was not so, I don’t think I would be ready for my mission with MSF. Thus, gang at home: keep it up, you are the best!

So – what am I up to? In less than a week I’m off to Teme Hospital Trauma Center in Port Harcourt, Nigeria. I don’t have the setting 100% clear, but I think the expat crew will consist of me, an anesthetist nurse, a general surgeon and an orthopedic surgeon. Together with logisticians and coordinators we make a total of 10 expatriates in the mission.

The Teme Hospital is active in a very turbulent city with a large number of victims of violence. I’m told there are around 20 knife or gun traumas every week; the city also has its share of “ordinary” traffic, work and domestic traumas. I’ll describe an ordinary day at work as soon as I can, but I think I can safely assume that the days will be very long and extremely challenging.

Speaking of challenge; I conclude this first entry by stating my two goals of my mission, each of equal importance: first I’m determined to do my best. For sure I’ll have to learn, for sure there will be times when I feel insufficient or frustrated due to a lack of resources, knowledge, or energy. However, I’m determined to nevertheless do my best and to be able to say to my patients, colleagues, MSF, and (most importantly) myself that I always did my best. I leave it to others to evaluate if my best was enough; at least I’ll rest assured knowing that I can’t do better, no matter the outcome.

The second goal might seem unrelated, unimportant, or even irrelevant; but in reality it’s not: I’ll try to learn to juggle seven balls during my mission. Considering the expected workload and my determination towards the first goal, I’m sure I need lots of stress relief, rest and recreation; I can’t think of any better or more effective than try to improve my juggling skills! While I’m determined to fulfill my first goal, I will merely attempt the second – we’ll see how well I succeed in my mission!