Saturday, July 18, 2015

Community Health Survey

Last Saturday afternoon was bright and sunny after a rainy morning. Because I had the day free, I had contacted a few friends to let them know I might be visiting. First I walked up Rock Hill across the main road from ELWA, to visit old family friends Tom and Bindu. It’s always so wonderful to get off the compound into the community, to greet people as they’re sitting on their porches or working in their gardens. I was encouraged to see that the city had run water pipes up to the top of Rock Hill and now residents can fill 2 buckets of water for 5 Liberian Dollars (about 6 cents US) at any of several stations like this one: 
This setup solves a major problem for the community. In the past, during dry season, people would have to walk 15 minutes to get to reliable wells where they could draw water. The money goes to pay the city water bill.   
   My visit to Tom and Bindu was a house call of sorts—Tom’s foot was hurting and he was having difficulty getting around.  So I did an exam and recommended some treatment that would help him recover. I enjoyed some nice sweet potato greens, rice, and fresh mangoes and bananas that Bindu had fixed, and caught up with everyone in the family.  
   Getting out in the community is more than just a chance to see old friends and greet people. It helps me to understand the context which has such an impact on peoples’ health. As I walked up the hill, I noticed a lot of big holes full of water in yards and near the road. Many of the residents of Rock Hill make a living by breaking up the rock (with hammers) around their houses into gravel for road and construction projects. The holes are left behind after they have dug out the rock. During rainy season, these holes fill with water and become a drowning risk for toddlers and kids who wander away from their caretakers and fall into them unobserved. Bindu told me that each year there are incidents of drowning in the community.  What a heartbreak it is for those families when a tragedy like that could be prevented.
   On Sunday morning I was on duty at the hospital. An elderly man who had died at home during the night was brought in the back seat of a car. The family needed a certificate from the hospital stating that he had not died from Ebola, so that they could take the body to a funeral home.  The man had not been ill, and there were no signs to suggest Ebola. As I was filling out the paperwork, I overheard some of the family members saying that others in the home were not feeling well. When I inquired about it, I found out that all the others who had slept in the house were dizzy or disoriented. I asked about generators and learned the family had been running a small generator in a utility room inside the house. I immediately asked the family to have the others who weren’t feeling well brought to the hospital, and we treated 3 of them with oxygen for carbon monoxide poisoning. This is another common safety issue that occurs in Liberia: there is no utility power for most Liberians, so they purchase a small generator to provide household power.  The generators are not always vented properly and cannot be left outside for security reasons.  There isn’t a system of enforcing building codes for most residences, and people don’t always understand the safety precautions they must take with a generator. 
   I don’t want to give the impression that people are simply careless with these matters – the truth is that safety costs something.  You have the rock available to help provide income but then what do you fill the hole with?  You can’t use the money to build a safety fence-- you need it for important things like school tuition. You find a way to buy a little generator and a liter or two of fuel for each day so you can have lights, but you can’t afford to build a proper exhaust system. And the generator will be stolen if you run it outdoors (or it might be raining). We don’t realize that safety is a benefit of affluence.
   In spite of that reality, I feel compelled to try to raise awareness when I see things like the water-filled rock holes and carbon monoxide poisoning.  ELWA Radio airs a program called “Appointment with the Doctor” which is a forum for educating listeners about health issues.   Yesterday I recorded a radio program about these two community safety matters. I am praying that our listeners will be able to share information and ideas with their neighbors and help communities in our area become safer!