The full CSI lIberia Team, with the support and encouragement of Dan Adomitis and the Firestone Company, is on day two of surgery on the most kids ever screened in the history of our organization. The able screening team ( comprised of youth volunteers Anna Koppel and Emmi Brytowski as medical records staff, Patience Kankeh, Denise Hutson, Doris Osuroah, Jennifer Kreiman and Mary Johnson as nurses, Dr.'s Dave Tetzlaff, Kofi Boahene and Steve Muehlstedt on physical examinations, Lora Koppel as clinical lead managing the group, Joel Johnson managing logistics and interfacing with the exceptionally helpful and efficient hospital staff and Sally Lannin on medical records managemnet, photography and youth coordinator) screened a total of 134 on day one and an additonal 60 the following day. This is a record for CSI , and an idication of the increditble need in this part of the world. Sadly, we had to turn away at least an additional 100 patients, many who traveled very far, because of a lack of space on our already 12 hour schedules. Due to the overwhelming need for hernia removal, burn care and othe procedures, we hope to be able to return sometime in the near future to attend to the unmet need.

While we have seen a number of cleft lips and palates, we have also been surprised by the incredible need for hernia work, Also, never before have we seen so many children who have suffered serious burns. Apparently a common style of cook stove in Liberia involves a wok-like pot two feet off the ground, filled with hot oil, We've seen between 20-30 children and young adults who have everything from burned hands, to burns over a large percentage of their body. Those with smaller areas we've been ableto treat;others we have had to turn away due to a lack of time and techonology for the more complex procedures. As this is being typed, Dr. Kofi Boahene is performing an 8 hour mandibulectomy surgery on an 11 year old boy named Joseph who has a large tumor which has covered his jaw and side of his face. Without surgery, the tumor will continue to grow, eventually covering his entire mouth, making it impossible for him to eat. Dr. Boahene is taking a bone from the boy's leg, shaping it with metal reinforcement into the shape of a jaw bone, and inserting it into the boy's face. This procdure is somewhat uncommon even in the U.S. and it is by sheer good fortune that a surgeon on our team happens to have experience with this complex proceedure. Dr. Bob Wood has performed a number of cleft lips,palates, as well as a scalp skin graft on a burned little girl, and repair on a child with burned hands. Dr. Steve Muehlstedt has performed a large variety of general pediatric surgeries ranging from hernias that have grown to a size and location seldom seen in our country, to a child born with a double rectum. Dr. Jason Pope has been efficiently moving from operating room to operating room overseeing the administration of anesthesia with Lynn Randall as well as Denise Blankenship and Beth Janeczko. OR nurses Mary Johnson, Leon Randall and Charlee Kimmes have the operating rooms fully outfitted to manage the range of procedures we are encountering. They are reminding all of us to use the supplies we brought sparingly( anticipating 60 patients maximum) as we need them to strech for use on 160+ patients, most likely.

In the next day or so we will report on the good work of our post operative staff who are working overtime to keep up with the non- stop flow of patients being carried out of the OR's after successful proceedures.