Saturday, July 18, 2015

Late Night Thoughts on Pluto & Monrovia

I have been drinking a fair amount of alcohol tonight here in Monrovia, enjoying the company of some remarkable people at a dinner in the city center. We drove from there to our flat in Congo Town, about five miles away, where I sit and write this now.

The ride back along Tubman Boulevard was quiet as we listened to an extended BBC news report of the Pluto fly by of NASA's New Horizons spacecraft. I haven't actually seen many of the new pictures of Pluto given limited bandwidth here; mainly I check my email, and splurge on New York Times headlines every second or third day, but generally avoid the stories with high-resolution graphics as my internet access cuts out during the download.

Nevertheless, even listening to the radio program, it is hard not to feel a sense of wonderment at the magnificence of the event. This icy piece of rock, that circles the sun at an unimaginably long distance from our home, has become linked to us in a new and profound way; we are just a little more a part of a bigger and more amazing environment as a result of some electronic signals emanating from a piece of metal about to leave the Solar System. It is humbling. It is wonderful. It inspires awe.

Earlier today I stopped by the John F. Kennedy Hospital to check in on my resident. I didn't actually find him, but instead saw a 17 year-old who had been in terrible respiratory distress two days ago. She has an enlarged heart and had retained fluid around her lungs. I couldn't tell you the cause, though I have a few guesses--but without the resources to order the proper tests, they will remain only guesses. One of the residents--a true star, every bit as good and frankly better than many of even my high-quality residents back home--had taken the fluid off her lungs the previous two days, so that when I happened to wander in this afternoon, she had smiled for the first time I had seen her.

Her future remains tenuous, but for the moment, she thrives, and that has filled me with a certain hope, not merely for her, but somehow for Liberia, a country that has gone through much over the past year and yet moves ahead with hope and ambition. Along Tubman Boulevard, going from Congo Town to the JFK Hospital, there's a Coca-Cola billboard advertisement that wasn't there during the outbreak. It is simple. It merely shows a man, maybe my age, emerging from a car door, looking straight into the camera with a content appearance. "I'm confident of better days ahead," reads the caption.

I tend to brood, but perhaps tonight I am as well.


Friday, July 10, 2015


Thirty--that's the total number of Ebola cases in the three affected countries of Sierra Leone, Guinea, and Liberia, the latter country having been Ebola-free for months, with its first reported case on June 29th from some still entirely unknown means of transmission (the "dog hypothesis" I think is finally losing some steam since its remains tested negative, for which the dog population in Liberia is breathing one major sigh of relief).

Thirty cases--that's up from twenty last week. Hard to know, given an outbreak that is now longer than 18 months in duration, longer by far than anything previously known, whether that 20 to 30 is an uptick or just represents random statistical fluctuations at the end of the outbreak's tail. But given that the number has gone up and not down, and that we now have Liberia back in the mix (with cases not too far from where I sit typing this right now), it certainly isn't cause for celebration.

Thirty cases--a number of cases that hardly anyone except the hard-core international health junkies are paying much attention to these days. As this MSF doc laments, the news cycle moves on.

But thirty cases of Ebola is still an international emergency. Before January of 2014, the announcement of 30 cases of this disease would have dominated world headlines. This is especially true for a region the size of the current outbreak; thirty cases in a village would have gotten the world's attention only a few years ago. Now this news has to fight for coverage.

But make no mistake, as long as these cases simmer, it remains everyone's business.