Field diary: Liberians lack clinics, education to tackle malaria

 

 

24 April 2009

Amy Waddell is Merlin's Communications Intern. Having spent six months working with the team in our London Head Office, she's now based in Zwedru, Liberia until September. This is her first diary from the field.

It was meant to be a routine trip, visiting four of the ten clinics Merlin supports in Liberia's remote Grand Gedeh County. Bumping along dirt roads for hours, I gazed out at the dense, green bush and tried to keep up with the debate about European football - the Liberian man's passion – going on around me.

We were just pulling back onto the main road, after an hour at our first clinic, when the Merlin ambulance sped past. It had been called out for a little girl with malaria at Toe Town Clinic, an hour and a half away.

Hurrying to reach its young patient, the ambulance didn't stop for the man on the approaching motorbike who frantically flagged us down. His Liberian English was too quick for me to understand, but our driver Broh was on the radio straight away, warning the ambulance of an accident up ahead.

As we rounded a bend, we saw a mass of colour - perhaps 20 people littered the road. A woman sat complaining of pains in her neck; a little girl looked lost; and a three month old baby sat happily flapping his arms in the midst of the mess. My eyes followed the skid-marks to where a yellow taxi sat upside-down on its roof in a pool of orange mud.

I sat in our jeep feeling useless, as I watched my Merlin medical colleagues, Emmanuel and Arthur, efficiently giving everyone the once over. Apart from a bad cut on one woman's arm, everyone seemed remarkably unscathed.

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The team decided the ambulance should take those involved in the accident back to Zwedru hospital – the only hospital serving Grand Gedeh's 185,000 population - while we would continue with our clinic rounds, picking up the malaria patient from Toe Town Clinic en route.

Little Jescea was gently passed into the back of the jeep as Emmanuel attached a drip to the seatbelt fastened above her.

We set off down the road as fast as Broh could drive, dodging potholes and puddles. I kept turning round to check on Jescea, lying unconscious in her mother's arms. Her mother and I could only look at each other, neither of us able to speak the other's English or Krahn.

The only time any of us spoke was when we saw a black snake, perhaps a metre long, slithering off the road. "Did you see that?" Broh asked. Wide-eyed, I nodded.

Deadly waiting game

A tense two hours later, we stopped off at Zai clinic. Jescea's drip-line was filling with blood and she had started convulsing. Linda, Zai's officer in charge, was in the back of our jeep before I knew it.

She tied a surgical glove around the top of Jescea's left arm to raise a vein and transferred the drip. She tore injection after injection out of packets to administer glucose and Diazepam, to try and stop the convulsions.

We hurtled towards the checkpoint on the outskirts of Zwedru, Broh pressing the horn until the guards dropped the barrier, allowing us to drive straight through. Pulling up at the hospital, we rushed Jescea to the emergency room.

Broh, Arthur, Emmanuel and I stumbled back into the jeep. It was 4pm and I was exhausted but in awe of the way the team, the ambulance crew and the clinic staff had responded to what the day had thrown at them.

Days later Emmanuel came and found me in the office: "Our patient didn't make it."

He told me that because most people live so far from a clinic and have no way to get there, they wait for the fever to pass. It's that wait which often proves fatal. He also said many people don't use bed nets, even when they have them, as they don't understand the causes of malaria.

I thought of Jescea's mother and wondered how she was coping with this devastating news. Malaria is the biggest killer of children under five in Liberia. Jescea was four and a half.

Emmanuel shook his head. "Our people are vulnerable and isolated because they are not educated in health," he said.

 Find out more about our work in Liberia