Letters from Liberia

Below is a forwarded letter from my Uncle Ron.
All my relatives are admirable, but Uncle Ron comes in at the top as "definitively unique".
Below is a letter detailing his return trip to Liberia after 46 years....

22 November 2006
Ganta, Liberia

Who would have thunk it!!!

44 years ago, we had just finished our first week of marriage, that ceremony having taken place right here in Ganta, Liberia and 46 years ago, I had put in my first stint of surgical/medical practice as a med student, again right here in Liberia, and obviously if it hadn't been for the first visit there wouldn't have been the second!!

And now that time comes, of course, to comment on whatwe find in our most recent wandering abroad activity. This time it happens on a keyboard, and an internet computer, instead of mail.

The latter has pretty much taken a nose dive here in Liberia, with no dependable mail at this time. Yet there it is a computer sitting in an air-conditioned room at the hospital central office .. and I hear that there is an internet café somewhere on the campus---having not yet found it.

Some things don't change. Intermittent electricity, so we take advantage of it when we have it. For some reason it is on this afternoon, so a good time to run this computer. Mostly it is on several hours in the late morning, so as to run surgery, and then in the evening for several hours, so we can see to eat our rice. And the type of surgery seems to remain the same---hernias, hernias, hernias, or C-sections, and occasional obstructed labor and a ruptured uterus.

I delivered twins via C-section last week- a boy and girl- I know one busy mother now!!

Medically, there remains still the problem of malaria---lots of that, and now of course also, comes the more modern adjustment to AIDS - lodes of that too, like everywhere. One local nurse is in the ward with aseptic meningitis superimposed on AIDS. No way out of that one, I am afraid.(P. S, : She died)

They have had a couple years to get the hospital backto running again, as of course, here too, there has been war and all the bad things that go with it, here in Africa - houses were burned, raided, plundered, hospital itself had been closed for a time, all the foreigners had left. We have 100 yards from where I sit now in one of the mission houses, a UN camp of Bangledeshies with AK-47' s on the ready, trying to do their part to hold the country together after 2 decades of mis-rule, and plundering by local war lordsand politicians.

What is new about that you say, weare always hanging around places like that... True enough, but this is Liberia, where way back when, we said that these folks would never follow the fate of Congo, etc..but they did.

We said that there would never be murder, mayhem, etc., here, but there was...on a big time scale. Recently there is an attempt to get the Ganta nursing school program going again. Jewell helped get that very program started here in Ganta, back in 1960. We lived with the student nurses after marriage, acting sort of as "house" parents to them, and we ate with them.

Getting it going again has not been without pain, as local church politics has it would appear gotten in the way of a smooth take-off. We are gifted with an over abundance of students, for the size of the hospital and the number of instructors---things look good on paper. In fact this afternoon there in a meeting underway with students and instructors, trying to iron some of the problems out.. sort of like goingto Iraq.

Easy to get into, hard to get out.

We have certain church officials dreaming grand thoughts, of a new hospital complex, and fancy names over the door. Their own preferably, but from our point of view, not enough thought of how to run it, once open. There is no question trouble ahead on this subject. Hospital, we have 3 doctors, all Liberian, one surgeon, one young generalist (who is taking onsurgery also), and an ophthalmologist doing his thingin a new building but taking call at the main unitwhen he has to.

This week the surgeon is taking sometime off, and that is what I am doing here---Covering anyone who wants to take off a bit. The surgical unit is the same as in 1962, one room is air-conditioned, the other about to be, when they ge tit installed- a gift from the Liberia president who came by to visit the other day. Lights are very tired, but mostly work, one has multiple bulbs burned out. Instruments are hand-me-downs, when the place was looted a couple years ago, even surgical things disappeared. I find myself once again looking in old boxes and dirty shelves for what I can find. I found a box today with some dental forceps in it, scattered around misc. medical junk. Misc. instruments mean that even a D and C, can be an experience in innovation. Gowns vary from good to bad, so I wear my usual plastic apron, sleeve guards, and orthopedic gloves, considering every patient a potential AIDS patient.

Anesthesia is mostly spinal, or if necessary ,general, using mostly IV drugs. Laboratory is of course marginal, but they are tryingto get a blood chemistry unit working---the unit is here, but there are no reagents. They do blood transfusions, as part of their routine, using mostly family as donors. They do cross-match and HIV testing.

28 Nov 2006
Days pass quickly it seems. 4 c sectionsyesterday, some things don't change in Liberia one for retained twin-dead one for CPD-live infantone for abruption placentae, with dead child of course one for arm presentation of 7 month old fetus. Instruments essentially not present, mostly of various vintages and quality, no Kochers, minimal number of hemostats, Some cast material, but no way to take a cast off, n ocast saw, of any sort including hand, or oelectric, hence no way to get a circular cast off. They do have a man here who has had some experience, he says with casting, etc., but doubt much interest onthe part of the doctors, and I shant be here long enough to make a difference. We did put on a splint yesterday.

1 December 2006
Fairly quiet day today, one c-section, wards are mostly quiet. It does get quiet here, tis a good thing, to give some time off for people. You probably know that Jewell got malaria a few days ago, but today seems to have gone fairly well. We hope for a better day tomorrow, and this weekend may turn out, no guarantees, to be quiet. I did get a note from Tanya today, and also a letter from Tatiana. Still not sure what is going on there, when I try to reply. We shall see how this month goes, and whether we are still useful, come January, ie might come home a couple weeks early. Our hosts have a bit of family coming and I don't know if that will be congested.

Will see on that, too. This is sort of an ongoing letter, so will get it off as it is, before this month passes too.

Cheers, Dad

PS- 4 December, I too contracted malaria over the weekend. It sure knocks the stuffing out of one!.
Anyway we are hanging in there.

Ronald A.Dierwechter, MD,FACS,FICSPOB
28 Storm Lake, Iowa, 50588, USA

Needless to say, Uncle Ron, now in his 70's, has always been, and in my mind will forever be, a true man.

More later -
sinam