Augustine is one of the smartest hardest working Liberians I have ever met. I met him when we lived in Liberia. He was a nursing assistant at JDJ Hospital where I used to donate my time on Saturdays. Seeing his potential, I quickly hired him into the IRC and for almost 2 years we became the Batman and Robin of medical quality assurance. Believe me, this was more exciting than it sounds.
Liberia has 150-200 doctors in the whole country. That'sa doctor to patient ratio of 1 to 25,000. The ratio in the United States is 1 to 350. Accordingly, 10% of all children don't live to celebrate their 5th birthday and 1 in 120 women die during childbirth.
I've decided that Liberia needs another doctor and his name is Augustine. He might as well get the title since he is single-handedly running and literally feeding the JDJ diabetes clinic.
Contribute to Augustine's medical education and watch his development as a medical professional here.
1.15.14
Augustine didn't get into medical school-- twice. He started pharmacy school and I said what the hell. Pharmacy is boring and honest, Liberia doesn't have a regular supply of drugs unless you mean the black market. Not a promising career at all.
I haven't given up. I am having Augustine take a diagnostic MCAT test and just sent him Princeton review books through my friend Michelle. The thing is the guy is so dastardly confident I can't imagine what is wrong. But medical tests are medical tests. Medical entrance is dependent upon medical tests so we will know a lot more soon.
The new test date is this May. There is still time.
7.4.14
Augustine's test for admission into medical school is anytime now. He's registered, the test is in July but there is no public announcement about the actual date. This tells you something about Liberia. I've sent Augustine all of the MCAT tests from the past six years and wired money so he can study while out of work. Augustine lost his job last December. "You better get in," I joke, "I can't afford you much longer." I have decided that Western Union is a price gouger.
Its kind of strange talking about the MCAT in the "Liberian context" as international health bureaucrats like to say to absolve themselves of responsibility. The MCAT is an American medical exam but Liberia uses sections derived from it. In the U.S., good performance on the MCAT is one of the many criteria for admission into medical school. In Liberia, so few people are qualified to take the test, the top forty MCAT scores is the sole criteria for medical school admission. My experience is that you study for this test by taking the test over and over again. You identify the concepts you don't know from missed questions and tackle them directly. Oh, and you try to enjoy the process.
Meanwhile Ebola Virus has just killed one doctor and two nurses at Redemption Hospital. Our own dear Dr. Jude is under quarantine. Dr. Jude is the man I tried to convince to take over my job as Health Director for the International Rescue Committee - Liberia before I left in November of 2012. He refused because he still had unfinished business at Redemption. The death toll from Ebola, which Doctors without Borders declared last month out of control, has risen above 60. Thank goodness that both Dr. Jude and Augustine are still safe. Let me rephrase, Augustine has to get in.
3.16.15
Of course the medical school test that Augustine took last fall has yet to be corrected. The Ebola epidemic put all sane activities permanently on hold and of course we started with the Liberian Medical Education System as a base-line. Thank goodness we were able to get Augustine back on staff with the IRC. Check that, he got himself back on but at least I was able to facilitate a few introductions.
To amuse me, I still make Augustine go to the medical school behind Catholic Hospital periodically to see if there are any updates, even though the answer is always the same: Check back in a month. IRC is a wonderful organization but sometime I feel international aid is a dead end for national staff. Besides, having doctors constantly come in from the outside to support Liberia's medical system cannot be part of any satisfactory master plan. Most of these doctors end up leaving before they can even get close to understanding the dynamics and environment of the workplace necessary for being effective. There are no guarantees but the likelihood of a Liberian physician making a long term difference here exceeds that of a foreign one any day.
11.15.15
Augustine just left the U.S. After two years of trying, he finally made it. Lesson #1. Anything is possible, even with U.S. Embassy services. Lesson #2. If you intend to visit the U.S. as a foreigner, best have more than $100 in the bank and a job.
My main reason for bringing Augustine here was to reward him for all the work he's done on behalf of the kids, to let him see another context and its contents to help him assemble his personal and professional data points and to give Augustine his first vacation! I know, the last point is hard to believe, especially relative to someone like me.
Suffice to say, Augustine had a great visit. I will write more about this visit in depth shortly, but one recounting: When I asked Augustine what he liked most about his two and a half week time in the U.S., he said without hesitation the American Public Health Association conference in Chicago for the "quality of presentations" and the "diversity of efforts" being share. Augustine never ceases to amaze.
11.20.16
Augustine is rethinking whether he can become a doctor. The Ebola epidemic devastated Liberia's medical education system. It's been over a year since Liberia was declared Ebola "free" but the nation's only medical school is still closed. And the Director just quit for Ghana. And at its peak, the school only graduated 14 students a year.
I want Augustine to pursue his dreams but dreams in Liberia are often deferred. He could go to Uganda or Ghana for medical training but the former is really far and expensive and the latter very competitive and its quality unknown. What to do?
Augustine talks of business school or public school but I am unconvinced what these degrees give him. He will do more research on the options and get back to me. In the meantime, Augustine continues to work for the International Rescue Committee (IRC) on emergency response to infectious disease threats. Sometimes it feels like in Liberia that its Ebola or nothing.
12.8.17
Augustine ended work with the International Rescue Committee (IRC) May 2017. He had worked for the IRC for six years. Though I understand all good things must come to an end, I was frustrated that the IRC couldn't find a place for someone as smart, experienced and hardworking as Augustine.
Augustine now is doing some international health contract work and of course managing the diabetes clinic. My new idea for him is to help me advance the case for electronic health data management in Liberia given the scarcity of doctors and almost 100% reliance on paper and pen for medical record keeping. This combination produces medical error rates in the 50-80% range and as you can imagine very high rates of preventable tragic death.
So Augustine's clinic is currently running the Walking Doctors Electronic Health System! It is the only use of electronic medical record keeping and linking, let alone decision support in the entire country. After a short period, we will package our results into a proposal to help support the clinic, Augustine (until that dastardly Medical School reopens) and the need for impactful health technology designed by folk who have worked and lived in Liberia.
