Thursday, November 15, 2007

The possible consequences of the electoral battle in Gbarpolu County by-election

On December 4th 2007, the Gbarpolu County by-election is scheduled to take place. Voter’s registration is all set and ready for the elections. Gbarpolu County was created under the leadership of former Liberian dictator “Charles Taylor” in 2001. Gbarpolu County Capital “Bopolu” was the historic headquarter of the Condo Kingdom which secured the establishment of Liberia as a nation state. Gbarpolu County has a huge number of Muslim populations. The Qua speaking are the dominant ethnic group in the County. Gbarpolu was formerly a very important part of Lofa County, Gbarpolu is known for it dense forest and wildlife collection. The County is economically known for it logging, mining, and agricultural contributions to Liberia.

In this analysis, I will be looking at various candidates and the possible consequences of the electoral battle of Gbarpolu County. I will also be drawing out an in-depth analysis of electoral forces and their orientations in the county.
The electoral race in Gbarpolu will be a titanic struggle between Unity Party Theodore Momo, Congress for Democratic Change Malikee Dukely, independent Kanie Wesso, National Patriotic Party’s Siafa V.G Konneh, and former Lofa County senator Armah Zulu Jallah. Mr. Jallah also ran as standard bearer of the National Party of Liberia (NPL) in the 2005 presidential elections. His NPL won 0.4% vote in the presidential pull and fail to secure or win any seats in the senate or lower house. This by-election will be an important millstone in the current development and political crisis in the newly created county. If Former Senator Armah Zulu Jallah Wins, he will cement his position as the logging company’s choice. Since the 2005 presidential and parliamentary elections, Armah and his National Party of Liberia (NPL) have been very dormant. It was reported in the November 16, 2007 edition of the Liberian daily observer that Armah Jallah is contesting the by-election as an independent candidate. The unanswered questions are; is Armahs’ National Party of Liberia un-acceptable to the people of Gbarpolu? Why would Mr. Jallah abandon the political party “he formed” to run as independent candidate? Is Mr. Jallah the only member of the party?

Many have viewed Armah as a photo copy of his father (Paramount Chief Jallah Lone) who has always been in search of greasing his elbow. During the Notorious Charles Taylor regime, Chief Jallah Lone was seen as one of the bones behind the regime. A year after the 2005 elections that brought the Unity Party to power, Jallah Lone appeared on Star radio to divorce his relationship with Former President Charles Taylor. When asked who crowned Charles Taylor as Dahkpannah, the Paramount Chief overtly announced that Charles Taylor hijacks the Dahkpannah title and now that the former president is indicted and deposited in The Hague, he (Jallon lone) script Taylor of the title and is now the holder of the title.
Meanwhile, if Unity Party Theodore Momo wins, this will start the disintegration of Armah Jallah, Jallah Lone and former Lofa County senator Eddington Varmah’s political influence and clout, and the emergence of alternative leadership in Gbarpolu County. Armah Jallah, Jallon Lone and Eddington Varmah, the three, while differing in personality, share the same beast-men-ship temperament and tyrannical thirst for power.

However, Armah Jallah and Eddington Varmah share additional flow, “a propensity to pocket what belongs to the public”. Their chief political vulnerability is that all three men (Armah Jallah, Jallah Lone & Eddington Varmah) greedily pursue personal fortune, and has no qualms about using their public clouts to pursue wealth for beyond anything which might be called their needs or want. Events recently caught up with former Senator Eddington Varmah who was politically dumped in his home town “Bopolu” during the Unity Party primary. Mr. Varmah was fairly whipped by Theodore Momo.
The steaks are very high and the battle in this by-election has an ominous feel about it. Some analysts are predicting that a compromise maybe reached at the end of the first round. The Armah Jallah group will preferred to hang on a Malikee Dukuly leadership than to hang on a Theodore Momo leadership. Armah Jallah can easily relate to Malikee Dukuly than Theodore Momo or Kanie Wesso. To date, according to reliable sources closed to the National Elections Commission in Liberia, there are 22,502 registered voters in Gbarpolu County. Of the amount, a huge percent is from electoral District #3. That part of Gbarpolu is headed by Representative Dickson Temo Yarsiah. Gbarpolu County Junior Senator Daniel Naatehn is also from District #3. Both Hon. Naatehn and Hon. Yarsiah are driving the “Theodore Momo campaign wagons” in their constituent which is believed to be hosting the majority of the by-election’s registered voters in Gbarpolu County.

Cllr. Kanie Wesso is another candidate from District #3 and is going as Independent candidate. Cllr. Wesso “according to sources from Gbarpolu”, lost terribly during the 2005 presidential and parliamentary elections. According to the sources, Cllr. Kanie Wesso won less than twenty votes in Bopolu and Gbarma. Prior to the 2005 elections, people from Cllr. Kanie Weso’s home District (Belle District) complained about his disassociation with his own people. He was described by one colleague as “very self centered”. The colleague cited few examples: “look! We all went to Belle Yalla when President Sirleaf visited the place. On our way back, Cllr. Kanie Wesso drove his car empty while our elders walk days looking for means of transportation to Monrovia. Will this gentleman be a true representative of our people”? On another occasion, some youths from the district went to his (Cllr. Weso’s) office to try to find out his side of the political issues between him “Cllr. Weso” and Hon. Dickson Yarsiah. Kanie again arrogantly drove the youths out of his office and threaten to whip anyone found in his office to talk about such issue”. Keenly analyze those two instances and tell me weather we “from his own district” should queue up for him.

In the U.S., this author has been fortunate to talk to few people from the Belle District residing in the U.S. The responses from some of the people were reverberating. One of his former school mates narrated. “I called Cllr. Kanie Wesso when I had some legal problems that I needed help with in Liberia. I mainly called him because I felt he’s from my District, my former school mate and even a family to me, but surprisingly, he charged me exorbitantly and was “above all” very rude in the process, I believed he’s not the right person for this job”.
Many believed Cllr. Kanie Wesso has been undertaking development projects in the District only because he was badly whipped in the 2005 elections in which he was running as Senator. The 2005 electoral shuffle is one of the latest changes in the history of Liberia. People who considered themselves as “political brand names” were disappointed when the elections results were announced. During those results, three major things happened: People were surprised their names were not in the winning numbers, people were surprised who won & people were surprised why they didn’t win. Liberians are now getting to know the real patriots from the political opportunists.

During the Unity Party primary in Bopolu, Bartu Dorley was one of those whipped by Theo Momo. Batu’s trouble started during the1997 elections. Bartu Dorley, a close relative of Cllr. Varmah, had spent time out of her home County of Gbarpolu and hardly knew anyone in the county. She contacted Cllr Varmah in search of advice and reunion with her origin. Bartu put a package together for her people in Bopolu. She asked Cllr. Varmah to take the token to her people and inform them that it was a gift from their daughter “Bartu”. A perfect case for a chameleon; Cllr.Varmah transformed himself into Bartu Dorley and presented the token in his own name. When Batu appeared in Bopolu to talk to her people, she was considered a complete stranger. Batu is a very hard working lady but she unfortunately used the wrong medium of contact or reunion with her people. What she probably needs to do now is to work independently to prepare her self for the next general parliamentary elections. Her withdrawal from this by-election race was a very smart one.

There is also rumor of withdrawal of Coalition for the transformation of Liberia’s (COTOL’s) Isaac Manner from the race. In a recent Front Page Africa grade board, COTOL scored a “B”, but others referred to the party as “empty place”. COTOL won 7.8% in the presidential race and secured eight seats in the Senate and seven seats in the House of Representatives. Manner’s reason(s) or plans to drop from the race are still not known but if he does, he will be putting Unity Partys’ Theodore Momo, CDCs’ Malikee Dukuly at the top.

Not much is known about Isaac Johnson. Recently during a workshop in Bopolu, Johnson ‘along with other candidates’ was asked by Gbarpolu County development Superintendent “Mr. Monlonporlor” to remove their campaign vehicles that were packed on Government property in Bopolu. Isaac Johnson cried fetid political harassment by the superintendent but observers says Mr. Johnson is not even the fourth potential person in line for the job.

Unity Party Theodore Momo has built an extraordinary reputation for himself and his party over the years. Theo “a graduate of the University of Liberia” is currently the deputy director of the Liberia Broadcasting System (LBS). Sources closed to the Unity Party hierarchy says Mr. Momo is highly favored by President Sirleaf for his hard work and clean Character. With his campaign team being headed by District #3 representative, Hon. Dickson T. Yarsiah and Gbarpolu County junior Senator Daniel Naatahn “whose also from District #3”, Theodore Momo stands a better chance than all of the candidates in the race.

Congress for Democratic Changes’ Malikee Dukuly is observed by many as “the second potential person in line for the job”. Malikee is from Medina, a Town few miles south of Bopolu City. Malikee Dukuly, Armah Jallah & politically battered ‘Cllr. Eddington Varmah’ are all from the same environs but are politically diverse. In 1998, Cllr. Eddington Varmah unceremoniously walked away from his elected senatorial position to take on a presidential appointment under his political mentor and creator Charles Taylor”. The price he’s eventually paying for his unpopular 1998 political decision is just unimaginable.
Cllr. Varmah’s replacement process started few months after his unceremonious departure from the Senate. In that 1998 primary held in Bopolu, Armah Zulu Jallah was fairly whipped by Gibson Tania but that defeat lasted for few hours. Armah’s father “Paramount Chief Jallah Lone” dispatched a team to Cyril Allen. Allen served as the Party Chairman of the ruling National Patriotic Party at the time. The team was well prepared to kick Gibson Tania out of the race. An identity card was covertly made with Gibson Tania’s photograph, making him “Tania” a member of Alhaji Koroma’s ALCOP. When NPP’s Cyril Allen received report on his desk about Gibson Tania contesting the election under false identity, he “Mr. Tania” was immediately thrown out of the race, putting Armah Jallah in the luxury seat at ease. Jallah Lone’s action was just a repeat of his usual ways. It can be recorded that Jallah Lone was whipped several time in election in Bopolu. In one of those elections, Jallah Lone went against the Late Malikee Siryon. At the time, voters queued behind their choice of candidate and a head count was conducted to determine the winner. Malikee Siryon whipped Jallah Lone several time but Jallah Lone went to Monrovia and returned with Presidential mandate “declaring him the legitimate winner of the election”. Malikee Siryon won several time but was never inaugurated in office.

Armah entered the Upper house but was soon found collecting money from investors that were expressing interest in logging in Gbarpolu County. In mid August of 2003, Charles Taylor was coerced into exile. After his departure, the National Transitional Legislative Assembly ( NTLA) was created as part of an August 2003 Peace Agreement that ended a civil war between the government forces of Charles Taylor and two rebel groups: The Movement for Democracy in Liberia (MODEL), and Liberians United for reconciliation and Democracy (LURD). The agreement also called for the broad-based transitional Government that would rule for two years, ending with the holding of elections in October 2005. The NTLA replaced the bicameral Legislature, which was elected in 1997. That agreement automatically took away Armah’s ax.

Since the departure of their creator “former Dahkpannah”, they have been hunted by the stigma of their political mentor “Charles Taylor”. Armah is likely to pay the price for his past actions and connection to the NPP regime.
During the 2005 presidential and parliamentary elections, Siafa V.G. Konneh Sr ran on the National Patriotic Party’s (NPP) ticket but was electorally manhandled by his opponents.
In the November 16, 2007 edition of the Daily Observer, reporter J. Rufus Paul reported that the Gbarpolu by-election campaign is in high gear and voters are eyeing three candidates. Looking at the number of voters’ registered in Gbarpolu, Bopolu is not a place to determine who the possible choice of the voters is. Armah Jallah and Malikee Dukuly are all from suburban Bopolu so residents of the area are quite familiar with them. As the old saying goes, “the strength of Tamba is limited to Foya”, so Armah, Malikee, and Siafa need to expand their campaign else where to test their popularity.
Secret ballot election is quite deceitful. Because of politicians tricky games in the past, electorates are all prepared to clap for anyone who offered something in return for votes but the real price will be awarded at the ballot box.
With the crammed full electoral field in Gbarpolu, first round winner is just unavoidable. With this predications and analysis, I anxiously wait for the first round results.

Sam K Zinnah
Smyrna, Delaware

Monday, November 12, 2007

CDC responds to Mulbal Morlu

A Statement Released on the Accusation Made Against the Standard Bearer of the Congress for Democratic Change

Today brings to attention the true nature of a handful of thugs, lots and gangs who lack the moral rectitude and face in the Liberian society. These handfuls of men acting under the sunshade of opinion leaders in the Congress of Democratic Change (CDC) have embarked upon a smear campaign, not only against our Standard Bearer Amb. George M. Weah but also the National Leadership of the CDC.

Mr. McDonald Wento who was thrown out of the CDC for fraud, incitement and rebellion has again embarked upon his inherent criminal trait by using miscreants, mendicants and mediocres like Forum for the Establishment of War Crimes Court Chairman Mulbah K. Morlu to defame the hard earned character of Amb. Weah and the CDC leadership.

The life draft of War Crimes Court Mulbah is beset with disappointment and contradictions. At one point in time Mulbah became an evangelist for a church in the Gardnersville community and was said to have been involved in a sex scandal that led to a pregnancy that he heatedly denied. This embarrassment, pair with his religious defense for former Liberian dictator, Mr. Charles Taylor landed him into trouble with his congregation. He had to seek exile in Ghana. While in Ghana, the Mulbah teamed up with one Pastor Bah on the Buduburum refugee camp and earned the religious title ‘General’. General Morlu who resided in the home of his fiancĂ©e Memunah chose to beg her consideration for him to go into matrimony with a lady he met on the internet. The consideration was granted and General Morlu went ahead to marry Queen Sheba, an American and a victim of the September Eleven bombing in the United States of America.

Waterlogged into desperation and utter poverty, General Morlu in his religious garment envisaged this marriage as a redemptive path for his state of grunginess. The marriage was enchanting, as Buduburum became a center of desirability for General as those who know him from Ghana call him. He used this marriage for the establishment of Queen Sheba Foundation that was intended to help impoverished and war affected Liberians seek greener pasture in the USA. Under this gambit, millions of cedes were extorted from both Liberian refuges and Ghanaians.

This long-winded journey to the USA became an optical illusion and disgruntlement was soon to set in as deluge of calorific outburst engulfed the General and Pastor Bah. For safety of his life, General Morlu kept from the camp and took refuge in Accra. While in Accra, Ghana, General Morlu got in contact with Representative Dusty Wolokollie who encouraged and helped him to be in Liberia today. General Morlu made a commitment to work with Representative Wolokollie and his party, the Liberian People’s Party (LPP).

After collecting few cash from the representative, Mulbah became an out of the ordinary in the hands that fed him.

At this juncture, General Morlu began lobbying with stalwarts of the Liberian Action Party (LAP) to serve in the public relations area. To further buttress this point, Mulbah was live on a talked show hosted on Power FM when a female caller from the offices of Cllr. Varney Sherman acrimoniously referred to him as one who went to LAP in search of becoming part of their public relations bureau and succeeded in getting some funds. General Morlu this time headed an advocacy group named and styled ‘’Progressive Action for Change’’ (PAC) that charged Cllr. Sherman and LAP for pre-campaign activities. Again, Mulbah became a deviant to the hands that fed him. Today PAC is a dead concept due to Mulbah’s incessant piggish attitude and faux pas.

No sooner, General Morlu emerged on the mesmeric grounds of the Congress for Democratic Change (CDC). As we drove towards convention in the city of Buchanan, internal political tension for the chairmanship of the party got heated up. The interim chairman L. Horatio Gould faced serious opposition from Mr. Jacob Kabakolle. Morlu was again seen at the cynosure of this political debate. On one occasion, he blended Gould as ‘’the devil from hell’’ and in few days he was seen with Gould and this time chanting the slogan ‘’Jake the snake,’’ an epithet given to Mr. Jacob Kabakolle by Mulbah. Both the hands of Gould and Kabakollie fed him but Mulbah care less to retrospect.

At the primaries that qualified applicants to run on the ticket of the CDC in the general and presidential elections, Mulbah received a devastating whip by Montserrado District #8 Representative Dave Koomey. Being frustrated by this genuine whip, Mulbah went on to the party’s convention vowing for the Assistant Secretary General position in the National leadership.

Again, the delegates punished him with their votes.

As the 2005 general and presidential elections got on its way, Mulbah with the expression of pity beg to operate with Madam Cooper who was elected to head the Press Bureau of the CDC. It was at this point General Morlu was instructed to go on series of operations but to the dismay of his co-workers he began a solo operation. The campaign was ended and we went on to protest the result. We took the cadres, women, elders, lawmakers and revolutionaries with us in the match and the strategy was for C. Mike Doryen (Montserrado Chairman), Sidiki Fofana (National Youth League Chairman), some lawmakers, few elders, the women league and others to keep the peaceful protest in the thematic order of non-jungle justice. Amb. Weah kept reminding us of the legal path which was to take our case to the National Election Commission, the commission whose head, Cllr. Francis Johnson Morris was accused of stealing “the cookies from the cookies jar”. There was serious political tension throughout the 38,000 sq miles of the nation-state Liberia, disarmament has just ended, emotions were high, and the pronounced victors of the presidency and her partisans were not celebrating, as celebration is an integral part of election victory.

Many of our partisans kept the pressure on us to reject a Sirleaf Presidency since she also did same to the late Samuel Doe and Charles Taylor. Some of our collaborators kept quiet, while others demanded a final statement from Amb. Weah. By this time, we were on our way to the Supreme Court and the Liberians state was experiencing bitter exchanges amongst it inhabitants. Amb. Weah is not only a politician and a former soccer legend but we have all extol him as a peacemaker, the reconciler and the true unifier. With these attributes compatriots James Kollie, Samuel D. Tweah, Mulbah K. Morlu and the rest of the CDCEANS kept the most so-called educated elites in our society running for their money.

Understanding the history of the after effects of presidential elections in our country, coupled with the path of blood bath and extreme devastation, we met as leaders of our party with many of our allies and debated. The forum included Dr. Tipoteh, the late Baccus Matthew, Professor Alhaji G.V. Kromah, and Amb. Weah, the CDC leadership and General Morlu who was privileged to have been taken in by Amb. Weah. The forum was climaxed with a consensus to abandon any further legal or political action. The next day Amb. Weah spoke to the press on our decision to save the Liberian state and move on with our lives. We all applauded him as a true patriot and nationalist but today as hunger and hardship have engulfed militant Mulbah, he has decided to become a bag boy to the misfits and detractors of our noble institution.

It is unfortunate that a piteous boy like general Morlu would become so susceptible and go astray to begin alleging that the Government of Nigeria gave three million United States dollars to the Standard Bearer of the CDC to abandon the court action. If there is one Liberian who has a history of defending Hon. Edwin Melvin Snowe and referencing President Sirleaf as a rebel president, the name Mulbah K. Morlu will take superlative over all others.

There are available recordings, newspaper articles and internet reports to show how Mulbah went on the extreme to defend Hon. Snowe. When did General Morlu get to know that Weah traded this position? Is it after he took thugs to the Unity Conference Center to attack the representatives or after he sold Hon. Snowe’s computer and can no more see the honorable man in person.

For the speaker’s election, Hon. Edwin Melvin Snowe had an absolute numerical advantage as lawmakers from every political institution saw him as the messiah. Even the initial fifteen representatives of CDC could never hold as a bloc. We were found in a catch 22 situation and had to live with this bizarre by taking the two immediate deputies to former House Speaker Snowe.

Two months ago General Morlu insulted Hon. Snowe, the hands that fed him and today he has turned on the one he described as “God Sent” and ”manna” for Manneh, the middle name of Amb. Weah.

Today, the Forum for the Establishment of War Crimes Court exists in theory but it remains a pragmatic dead end. Many Liberians embraced this idea as a stand-in to the Truth and Reconciliation Committee but ironically General Morlu is on record to have signed a joint statement with ex-fighters and seeing in open parade with some ex-AFL soldiers which landed him behind bars twice. To have him released, I had to personally get Amb. Weah involve in demanding his right to trial and asking the up led Government to respect his human rights.

As Mulbah K. Morlu remains in a desperate search for political asylum and being the stooge and creature of his creators like the mediocre Wentor and few invisible hands, we will intellectually resist unprincipled men using the CDC as a vehicle for pre-eminence.

Let our friends in the media be cautious that Mulbah K. Morlu and his cohorts are not executives of the CDC and they lack the moral rectitude and political authority they claim to have. The Congress for Democratic Change will be jealously sheltered by its partisans and the few detractors in our midst who think that they will halt the forward march of this party will be sent into deep hole.

Signed: _________________________
Acarous M. Gray
National Assistant Secretary General, CDC

Sunday, November 11, 2007

If it was in my Village

Value which is defined by the “American heritage school Dictionary” as a principle standard or quality considered worthwhile, plays an essential role in the rural African communities. Each of the complicated societies in the African world has its basic value and numerous ways, tribally distinctive, just as more than 800 African languages and cultures. We should also emphasize that traditionally, Africans tend to view human natural as neither inherently good nor evil. According to most Africans (like the people of my village), human nature is simply neutral. Although a good man in tribal Africa is the one who fulfills all his obligations to his kinship circle, human beings nonetheless are fallible and capable of error. To most Africans, the human nature is relatively crumbled or strong. However, it can become weaker or stronger. The most essential part of a man’s judgment in relationships to his being good or evil, generous or selfish, depends mainly on the social outcomes of his actions.
For many years, I witnessed lots of people die from Diseases that could be prevented, cured or simply treated if only there were train medical personnels to handle the issues. On more than five different occasions, I saw people die from a disease that recently appeared in my khakis. I began recollecting memories of past instances where I experienced severe pain in my abdominal. In my Village, when I was much younger and smaller, it was treated with some leaves and salty hot water. After escaping into refuge “in Ghana”, I began reading about different diseases. None of my readings was directed to Appendix. Deep in my khaki pants, near my penis, there was a hidden or extended intestine already developed and waiting to rapture.
Fortunately for me, my appendix relaxed quietly while I was hustling in refuge to meet the expense of my survival and education. Quality health care and Medical insurance was something that never cross my and that of thousands of refugees minds.
On October 9, 2007 at about 7:55 pm, I was rushed to the bayhealth medical center in Dover, Delaware where I was admitted. Few tests were administered to me whilst other procedures were arranged. One of those procedures was the CT scan.
CT scan is a computerized axial tomography scan more commonly known by its abbreviated name, CT scan or CAT scan. It is an x-ray procedure which combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. A CT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments. A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the body.
When these levels are further "added" together, a three-dimensional picture of an organ or abnormal body structure can be obtained.
Few hours after the CT scan, the Medical Doctor ‘on duty’ slowly walked into my room and closed my door. He announced to me that “I had appendicitis”. He quickly noticed the change in my facial expression. As a professional, he pulsed for few seconds to observe my reaction. Minutes later, he asked me weather I’ve ever had surgery before? I responded by saying no? He said “well, you are about to have one done here in few hours”. Where in my Village would I ever have such an opportunity?

What is appendicitis?

Appendix is a closed-ended, narrow tube up to several inches in length that attaches to the cecum (the first part of the colon) like a worm. (The anatomical name for the appendix, vermiform appendix, means worm-like appendage.) The inner lining of the appendix produces a small amount of mucus that flows through the open center of the appendix and into the cecum. The wall of the appendix contains lymphatic tissue that is part of the immune system for making antibodies. Like the rest of the colon, the wall of the appendix also contains a layer of muscle, but the muscle is poorly developed.

Digestion takes place almost continuously in a watery, slushy environment. The large intestine absorbs water from its inner contents and stores the rest until it is convenient to dispose of it. Attached to the first portion of the large intestine is a troublesome pouch called the (veriform) appendix. The appendix has no function in modern humans, however it is believed to have been part of the digestive system in our primitive ancestors.
Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a fecalith (literally, a rock of stool). At other times, the lymphatic tissue in the appendix may swell and block the appendix. After the blockage occurs, bacteria which normally are found within the appendix begin to invade (infect) the wall of the appendix. The body responds to the invasion by mounting an attack on the bacteria, an attack called inflammation. An alternative theory for the cause of appendicitis is an initial rupture of the appendix followed by spread of bacteria outside the appendix.. The cause of such a rupture is unclear, but it may relate to changes that occur in the lymphatic tissue, for example, inflammation, that line the wall of the appendix.)
If the inflammation and infection spread through the wall of the appendix, the appendix can rupture. After rupture, infection can spread throughout the abdomen; however, it usually is confined to a small area surrounding the appendix (forming a peri-appendiceal abscess).
Sometimes, the body is successful in containing ("healing") the appendicitis without surgical treatment if the infection and accompanying inflammation do not spread throughout the abdomen. The inflammation, pain and symptoms may disappear. This is particularly true in elderly patients and when antibiotics are used. The patients then may come to the doctor long after the episode of appendicitis with a lump or a mass in the right lower abdomen that is due to the scarring that occurs during healing. This lump might raise the suspicion of cancer.
How is appendicitis diagnosed?
The diagnosis of appendicitis begins with a thorough history and physical examination. Patients often have an elevated temperature, and there usually will be moderate to severe tenderness in the right lower abdomen when the doctor pushes there. If inflammation has spread to the peritoneum, there is frequently rebound tenderness. Rebound tenderness is pain that is worse when the doctor quickly releases his hand after gently pressing on the abdomen over the area of tenderness.

Symptoms of appendicitis

The main symptom of appendicitis is abdominal pain. The pain is at first diffuse and poorly localized, that is, not confined to one spot. (Poorly localized pain is typical whenever a problem is confined to the small intestine or colon, including the appendix.) The pain is so difficult to pinpoint that when asked to point to the area of the pain, most people indicate the location of the pain with a circular motion of their hand around the central part of their abdomen. A second, common, early symptom of appendicitis is loss of appetite which may progress to nausea and even vomiting. Nausea and vomiting also may occur later due to intestinal obstruction.
As appendiceal inflammation increases, it extends through the appendix to its outer covering and then to the lining of the abdomen, a thin membrane called the peritoneum. Once the peritoneum becomes inflamed, the pain changes and then can be localized clearly to one small area. Generally, this area is between the front of the right hip bone and the belly button. The exact point is named after Dr. Charles McBurney--McBurney's point. If the appendix ruptures and infection spreads throughout the abdomen, the pain becomes diffuse again as the entire lining of the abdomen becomes inflamed.

Complications of appendicitis

The most frequent complication of appendicitis is perforation. Perforation of the appendix can lead to a periappendiceal abscess (a collection of infected pus) or diffuse peritonitis (infection of the entire lining of the abdomen and the pelvis). The major reason for appendiceal perforation is delay in diagnosis and treatment. In general, the longer the delay between diagnosis and surgery, the more likely is perforation. The risk of perforation 36 hours after the onset of symptoms is at least 15%. Therefore, once appendicitis is diagnosed, surgery should be done without unnecessary delay.
A less common complication of appendicitis is blockage of the intestine. Blockage occurs when the inflammation surrounding the appendix causes the intestinal muscle to stop working, and this prevents the intestinal contents from passing. If the intestine above the blockage begins to fill with liquid and gas, the abdomen distends and nausea and vomiting may occur. It then may be necessary to drain the contents of the intestine through a tube passed through the nose and esophagus and into the stomach and intestine.
A feared complication of appendicitis is sepsis, a condition in which infecting bacteria enter the blood and travel to other parts of the body. This is a very serious, even life-threatening complication. Fortunately, it occurs infrequently.

Appendicitis treatments

Once a diagnosis of appendicitis is made, an appendectomy usually is performed. Antibiotics almost always are begun prior to surgery and as soon as appendicitis is suspected.
There is a small group of patients in whom the inflammation and infection of appendicitis remain mild and localized to a small area. The body is able not only to contain the inflammation and infection but to resolve it as well. These patients usually are not very ill and improve during several days of observation. This type of appendicitis is referred to as "confined appendicitis" and may be treated with antibiotics alone. The appendix may or may not be removed at a later time.
On occasion, a person may not see their doctor until appendicitis with rupture has been present for many days or even weeks. In this situation, an abscess usually has formed, and the appendiceal perforation may have closed over. If the abscess is small, it initially can be treated with antibiotics; however, the abscess usually requires drainage. A drain (a small plastic or rubber tube) usually is inserted through the skin and into the abscess with the aid of an ultrasound or CT scan that can determine the exact location of the abscess. The drain allows pus to flow from the abscess out of the body. The appendix may be removed several weeks or months after the abscess has resolved. This is called an interval appendectomy and is done to prevent a second attack of appendicitis.

Appendectomy procedure

During an appendectomy, an incision two to three inches in length is made through the skin and the layers of the abdominal wall over the area of the appendix. The surgeon enters the abdomen and looks for the appendix which usually is in the right lower abdomen. After examining the area around the appendix to be certain that no additional problem is present, the appendix is removed. This is done by freeing the appendix from its mesenteric attachment to the abdomen and colon, cutting the appendix from the colon, and sewing over the hole in the colon. If an abscess is present, the pus can be drained with drains that pass from the abscess and out through the skin. The abdominal incision then is closed.
Newer techniques for removing the appendix involve the use of the laparoscope. The laparoscope is a thin telescope attached to a video camera that allows the surgeon to inspect the inside of the abdomen through a small puncture wound (instead of a larger incision). If appendicitis is found, the appendix can be removed with special instruments that can be passed into the abdomen, just like the laparoscope, through small puncture wounds. The benefits of the laparoscopic technique include less post-operative pain (since much of the post-surgery pain comes from incisions) and a speedier return to normal activities. An additional advantage of laparoscopy is that it allows the surgeon to look inside the abdomen to make a clear diagnosis in cases in which the diagnosis of appendicitis is in doubt. For example, laparoscopy is especially helpful in menstruating women in whom a rupture of an ovarian cysts may mimic appendicitis.
If the appendix is not ruptured (perforated) at the time of surgery, the patient generally is sent home from the hospital after surgery in one or two days. Patients whose appendix has perforated are sicker than patients without perforation, and their hospital stay often is prolonged (four to seven days), particularly if peritonitis has occurred. Intravenous antibiotics are given in the hospital to fight infection and assist in resolving any abscess.
Occasionally, the surgeon may find a normal-appearing appendix and no other cause for the patient's problem. In this situation, the surgeon may remove the appendix. The reasoning in these cases is that it is better to remove a normal-appearing appendix than to miss and not treat appropriately an early or mild case of appendicitis.
All of these are done through advance technologies and access to good medical facilities. At about 3:00 am on Friday “11/9/07”, my surgery was performed without knowing how long, who did the surgery, and what was used. What if this was in my Village, would I survive?
After leaving my recovery room, I landed in the soft hands of “not only an RN” but a professional
To be continued.


Thursday, November 08, 2007

Victoria K. Zinnah's speech at her graduation on September 17, 2007

The administration, distinguish guess, fellow graduates, Ladies and gentlemen.
Today marks a very important day in our educational and career journey as we complete our trainings. On August 17, 2007, we entered this building individually. Today, we are walking out as an extra ordinary class. In my own description, I would refer to this class as “courageous”. You may never know the potential of a person until you delegate a piece of responsibility to them. When we initially entered here, our perceptions were a bit divorced until we began taking on responsibilities.
As you may all know, the responsibilities we are about to shoulder today are very dedicate. The decision we’ve made to enter the field of nursing should not be based on how much money we can make from working but how we can all contribute the building a better healthcare system in America and around the world.
We all sit together today with the primary goal of graduating from Always Care, but do we all have the same goal of working to build a better health care system? That’s one question that I kept asking myself throughout our trainings.

Like many refugees or exiles, I find it very difficult to dismiss memories of my experiences prior to my decision to join the field of nursing. When one flees a war zone, all that one often takes are memories of painful occurrences and otherwise. Many store these memories as images of the world left behind. Some keep them as stories worth telling later on. Images or memories followed us wherever we go and can define and shape our dreams and choices. Sometimes too, the paths we choose in life are strewn with discarded images of our past and our conversations with others are colored by our past experiences.
In 1989, my country “Liberia” was hit by senseless civil war that claimed thousands of lives and properties. During that war, I witnessed infants die in the arms of their malnourished mothers. Epidemics like, cholera, malaria, fever or something that could be simply cured with antibiotic, killed hundreds of thousands of people. After witnessing all of the above and many others, I grew passion for the field of Nursing. It is my dream and aspiration to provide quality health services for people with special need and in all other medical conditions.

Let’s us all be grateful to God for the many protections and opportunities we have access to. Take a look at some countries around the world today. For example; some people in Sudan, Somalia, Iraq and many other countries are denied simple or basic human rights. Here, we have access to them. Many are denied access to food by their leaders, here, we have access to them.
For hundreds of children in some countries, the streets are where they look to find their homes, parents, playground, education, healthcare, and their love. To go without healthcare, is the plight of many people in third world countries. Today, I want to remember my home “Liberia”, one of the most visible symbols of my lifestyle in a way that may seem intangible. I want to take this time on behave of the class to say many thanks to all of our instructors for all the knowledge they have imparted into us. We will always remember you for that and to our family and friends for all the support and encouragement you give us through out this training. Not forgetting my husband who has been there changing diapers while I study, I appreciate you a whole lot.
Thank you and May God bless you all.