A new role in Tapeta

     I haven't posted for a few days because the situation here has been a bit unclarified since I arrived in Tapeta.  I came over here with the intent of just 'filling a stethoscope" and simply being a doc in the ETU (isn't that enough?).  Sadly, I had to put on my Heart to Heart Board of Directors hat and assume the responsibilities as the Chief Medical Officer in the ETU in Tapeta.  Sometimes you plan the situation and sometimes you have to react to it.  Things being as they are here, I have extended my deployment through early April which is the end of Heart to Heart's contract with USAID.  Jo, College Park and HCA have graciously (but maybe not excitedly) accepted this extension.  I wasn't exactly packed for 3+ months but that is ok, I can work with it.  I just ask for your support and prayers.

     My duties are much different.  Basically, I am responsible for the smooth functioning of a very complex clinical operation.  I have to approve, modify or establish procedures to ensure that all potential Ebola cases are evaluated and treated in a safe and efficient manner (with much more emphasis on safe).  I am stepping into and operation that has just started and am learning the personalities and evaluating procedures for effectiveness.  I also have supervisory responsibility of all the administrative and logistical aspects which impact our clinical operations (basically everything).  I hate to quote Donald Rumsfeld on anything but he did have a point about there being known unknowns and unknown unknowns.  I am still discovering what I don't know.  But I am getting there.

     I haven't said much about the location.  Tapeta is a city of 90,000 people but no restaurants that an expat could trust.  They do seem to have an adequate supply of Liberian beer.  It can be a bit hazy and cool early in the morning but quite hot and muggy during the day with temperatures in the mid 90's.  We are currently in dry season and it is dusty.  Rainey season starts sometime in April.  

     Our cooking staff provides food for about 150 people each meal and the food is quite good compared to what is available in other ETU's.  I won't say that there is currently much variety, but it is plentiful, safe and satisfying.  Sleeping accommodations are about what you would expect for a higher grade of housing in a poor country.  It works (mostly), but certainly with no frills.  It is very safe and the local population is quite happy that we are here.  Everyone waves at you as you walk around.  

     Liberian English is pretty difficult.  One thing that I have noticed is that it is more difficult the farther that one travels from Monrovia.  I find myself repeating back what a Liberian says as a method to make sure that I comprehend what they have said.  Still sometimes I only pick up half of what they say.  People have discussed how English is becoming a world wide universal language.  Well, I am experiencing the opposite effect, how English is evolving into another distinct language.  

     Again, thanks for your support and prayers.