No More "TIA"

The most rewarding part of this year’s trip was definitely teaching the medical students.  They are the next generation of doctors, being trained to rebuild the Liberian health care system.  They are so crucial to this rebuilding that I really feel like I am a part of history-in-the-making.  During my time here, I have taught them not only through didactic lectures, but also by rounding with them and leading by example.  I think that is the best that we can do here.  One day on rounds when I pointed out a medication error (that led to a Burkitt’s lymphoma patient getting 3 days of cyclophosphamide instead of one… OMG!), one of the medical students thanked me later.  I used this error as an example of an error that we could all learn from.  Instead of pointing fingers at who made the mistake, I carefully spoke about our “incident reports” and M&Ms at home… and about how important it is to look at errors in order to figure out ways to prevent them from occurring in the future.  The medical student pulled me aside and told me how happy he was that I spoke about the error on rounds because just 4 weeks prior a cancer patient had DIED due to a medication error.  An error that was never discussed.  An error that this medical student discovered and didn’t know what to DO with it. 

Many of my discussions with the medical students were in regard to delivering proper care for their patients despite this resource-limited setting.  So much of the staff at JFK Hospital still have this air of learned helplessness.  NGO groups call it “TIA” syndrome, which stands for, “This Is Africa”.  When a test doesn’t get done or a nurse doesn’t fulfill your orders, someone will say, “TIA”, with a sigh and a shrug.  Healthcare providers SHOULD NOT have that attitude.  In order to move forward to providing better patient care, they CANNOT have that attitude.  Unfortunately, dealing with daily “TIA” struggles wears one down after a while.  It requires an army of people to stand up and speak out against what is not acceptable for patient care.  I hope that my words and actions will at least have taught this group of medical students that they must hold themselves up to a higher standard than the current health care providers around them.  They are the future and the hope for Liberian health care.  It has been a lot of fun and a privilege to work with them.