Doctor's casebook: Treating Monrovia's wounded IV

Helping Liberians is 'worth the risk'

Andrew Schechtman of charity Medecins Sans Frontieres has been witnessing the tragedy unfold in the Liberian capital, Monrovia. He has sent parts of his diary to BBC News Online.

Staffing the hospital has been a challenge. We have a regular schedule but, with the fighting, we never know when people will be able to come to work.

One of our midwives came to work this morning and I asked her about the trip. She had walked two hours. It was all quiet until the last half hour.

For the last part of her journey, she had run most of the way crouched over as she heard bullets whizzing by overhead. She said she would stop at a corner and peer down the empty side street before rushing across the intersection, not wanting to be hit by a stray bullet.

Shaking

At one checkpoint, one of the armed militia called her over. "You - come!" he ordered. She said she was shaking as she approached. It wouldn't have been unusual if she had been robbed, beaten or harassed at the checkpoint.

Luckily he'd seen her scrubs and had only wanted her to remove some stitches from some of his men. It isn't surprising that many of our staff have chosen to stay in the hospital full time over the past week, just as our team has.

Doctors are discharging people who have nowhere to go

Most of the time we have too many staff here but I'm never sure if we'll have enough people when things are busy. I don't know if there is any way to properly manage a schedule in the current situation. So far, people have been flexible and it has all worked out well.

At least four stray bullets have landed in the hospital grounds today. One fell on the roof and broke an asbestos roof tile. Another passed through the joint of our metal front gate and then bounced off the tire of one of the cars.

A third fell in our backyard, puncturing the plastic sheeting roof of the kitchen and landing on the ping-pong table that we were using as table. It missed the cooks by a few feet.

Today, for the first time, I also heard bullets whizzing past twice. I don't know how close they passed but the sound is not a comforting one. It's not one of those sounds that leaves you feeling that everything is going to be OK.

'She will live'

Amuchee was a 10-year-old girl who'd been hit by a stray bullet. It had lodged in the upper part of her arm but hadn't done any serious damage. I was able to remove it and clean up her wound without too much trouble.

One of the nurses told me that, in the local Bassa language, her name means "she will live." Why would someone name their child this?

Perhaps it makes sense considering that the child was born in Liberia, a country with one of the highest mortality rates for children under five years of age.

Children here die from malaria, respiratory infections, and diarrhoea... or war wounds. But Amuchee would live. "She will live," we said.

One would think eating the same food day after day would quickly grow tedious especially for a food snob like me who was until recently living in New Orleans, a Mecca of good eating.

Every day we eat boiled rice with a bean sauce which tastes like a thick yellow split pea soup.

I like it. I still like it and haven't yet grown tired of it over the past week. For dinners, the cook makes something other than rice and beans.

Unfortunately, all of these new dishes feature canned luncheon meat, a generic version of spam that is made from an assortment of ground-up animal by-products.

There is no way I would eat this back home. I wouldn't even eat this on a camping trip. But for here, it seems to meet the need.

I'm still looking forward to some good eating when I get back home though.

Andrew Schechtman's third casebook