A Team Effort

"For the body does not consist of one member but of many....God has arranged the members in the body, each one of them, as he chose." 1 Corinthians 12:14,18

Dr. Jerry Brown thanking the ELWA Hospital staff

Monday morning, February 9, was my last morning at the hospital—in just a few hours I would be headed for the airport. We held an appreciation program with breakfast for all the ELWA Hospital staff after our morning chapel gathering, to recognize those who had served so courageously during the worst of the Ebola crisis.  Along with Dr. Brown, our Medical Director, I was asked to say a few words. As I spoke, thanking our nurses, midwives, aides, and cleaners for coming to work during the toughest times in August, September, and October, my mind went back to a meeting with health care planners from an international NGO.  They wanted to know: “What allowed ELWA to remain open when other hospitals closed?”  The health system collapse was one of the greatest unanticipated consequences of the Ebola epidemic. It led to many deaths due to malaria or obstructed labor or pneumonia—illnesses which have nothing to do with Ebola, but which went untreated because hospitals and clinics were shut down.  ELWA Hospital was one of the bright spots, remaining open and caring for the sick through the most difficult months of the crisis.

 



you know Rick loves babies

Also on Monday morning, we discharged little Noah (not his real name) from the hospital. Noah, a five week old baby, had come in about 12 days earlier with severe vomiting. He couldn’t keep anything down. He was hungry and was breastfeeding vigorously, but after every feeding he would vomit all of it up. He wasn’t making dirty diapers any more. He had lost weight and become dehydrated.  One of our doctors suggested he might have pyloric stenosis—a thickening of the muscle around the outlet of the stomach into the small intestine, which leads to blockage of the flow of nutrition. The best test for pyloric stenosis is an ultrasound exam, and I’ve developed reasonable ultrasound skills over many years of scanning and learning on the job. I went to the office and found our big two-volume ultrasound text, and read about pyloric stenosis. With the ultrasound machine, you can measure the thickness of the muscle in the pyloric canal (the outlet of the stomach) to confirm the diagnosis. As I scanned little Noah, one of my colleagues joked with me about doing the scan with the ultrasound in one hand and my textbook in the other. I told him this was not the first time I would be doing this, nor would it be the last! We got some clear images showing that little Noah did indeed have pyloric stenosis and would require surgery. 

 

God has blessed ELWA with some truly gifted staff. Dr. Jerry Brown, our medical director, is one of the few residency trained surgeons in the country. We also have some highly qualified anesthetists, one of whom is especially skilled handling infants.  So after coordinating the schedules of all the staff who were needed, the child had a successful operation about 4 days after admission. As we monitored Noah through his recovery, I realized we were one of only a few institutions in Liberia that could pull together the resources to successfully diagnose and operate on this little baby.  

 

After the surgery, little Noah improved quickly. He nursed voraciously and started gaining weight.  His mom and dad were so relieved!  Finally on my last day in country, he would be going home! 

 

This takes me back to the question that was asked by the visiting international health care coordinators:   After the reopening of the hospital on August 6^th, how did ELWA manage to stay open when other facilities were having repeated closures?   As I see it, there are two reasons. The first is that our staff are mission driven. They are motivated by the example of Jesus Christ and his call to care for their neighbors who are in need —their belief in God is no mere intellectual assent or religious ritual, but real, where-the-rubber-meets-the-road faith that strengthened  them to do this difficult  and fearful work and leave the results to God. And the second answer has to do with little Noah: when you put all the pieces of the puzzle together, you can accomplish so much more than any one of you could accomplish on your own. That synergy, the teamwork that results in the ability to give a couple their baby back who surely would have died otherwise, makes the work so satisfying. This, too, can motivate people to come to work, when they know they are a critical piece of the puzzle that saves lives.

ELWA Hospital staff at morning devotions



 



 

At the White House

Last week, Rick received an invitation to attend an event at the White House in honor of those Americans who have been a part of the battle against Ebola in West Africa.  As it happened, he was already flying through Dulles Airport, outside DC, the day before so he could simply stay there an extra day before coming home. He warned them he was coming from Liberia, but the CDC gave him a letter that said he was not at risk for Ebola, since he has antibodies against it.  No problem, they said.

So this afternoon, Rick stood on the podium with the President and many members of the US Health Corps and other volunteers who have worked in West Africa in the past few months. The President stated that the help the US gave was effective, and would continue for another 90 days.  He also recognized that ongoing help would be needed to help rebuild the fragile health care system of these countries.  This work was not charity, he noted, it was in the self-interest of the United States to help eradicate Ebola and prevent another crisis of this nature. 

You can listen to his remarks at Ebola Update Press Conference Feb. 11, 2015
The press conference begins at 39:00 and there is a shout out to Rick, specifically at around 47:55. He got to shake the President's hand at the end, but on the video it cuts for some reason.

Cool, huh?  Even cooler, I will be picking him up at the airport in just a few hours.  Won't he be surprised at the snow? 

More from Rick in a few days. Thanks for praying!!

Survivors

Last week, I had the privilege to greet a group of about one hundred Ebola survivors who were meeting at the ELWA Hospital chapel—the very structure that, 7 months ago, was Monrovia’s first Ebola Treatment Unit.  The group was diverse—elderly, young people, even little children.  Some educated, some not.  Roughly equal numbers of men and women; some dressed up in nice clothes, some in t-shirts, shorts and flip-flops.  Some were clearly feeling happy just to have survived Ebola, with smiles on their faces, while others looked like they were still experiencing some of the trauma and stigma of Ebola-- faces downcast, not making eye-contact.  As I met them, tears welled up in my eyes. These people had gotten through Ebola just like I had, but here in Liberia, where the resources, staff and treatment available were so much more limited.  
To read the rest of the blog, follow this link to CNN: Doctor's notes
















Dr. John Fankhauser with Barbara (in the green blouse), one of the survivors from the ELWA-2 ETU who was a nurse at ELWA, and other ELWA hospital staff.

You can listen to her story at Barbara Ohoh



Reflections from Rick's first week in Liberia

I’ve been here 10 days now, and spent last weekend on call at ELWA Hospital, the 55 bed facility that SIM runs just outside Monrovia, Liberia’s capital city.  The news here is good – the Ebola epidemic really seems to be coming to an end.  But in the healthcare setting in particular, its effects will be felt for many months to come.  

Many outward changes have been made at ELWA due to the Ebola crisis.  All patients, staff and visitors now enter the hospital compound through a single gate where people must wash their hands with bleach and have their temperature checked before entry.  Bleach is everywhere throughout the hospital.  Staff members with sprayers wash down the floors multiple times per day and are on hand after surgeries or other exposures to blood or body fluids to decontaminate staff before “doffing” their gowns and gloves. Temporary buildings have been erected to house our outpatient clinic because our old clinic became part of the Ebola Treatment Unit, ELWA-2. But for the most part, ELWA Hospital is up and running, and most beds are full.  

The new screening entrance to the hospital.

 

For me personally the first week was about confronting the reality of death.  Many patients die in the hospital—this should not be a surprise, right?  But emotionally it is a challenge to face mortality so frequently. 

We counseled several patients about their metastatic cancer this week, presenting them with the hard information that the cancer had progressed beyond a stage where anything could be done from the medical point of view. We talk with these patients privately, off the busy ward; then, along with the hospital’s chaplain, we pray for them if they wish. The comfort and compassion we offer, along with an honest explanation in plain language, are important hallmarks of the work we do. 

To read about Rick's other patients over the weekend, please go to
Doctor's notes: American Ebola survivor back in Africa, dealing with loss

First Days Back

Here is an update from Rick, covering his first impressions and activities back in Liberia.  The post links to CNN for the rest of the blog.  We pray that through the publication of his blog, people will gain a greater understanding of the needs of West Africa in the aftermath of the Ebola crisis.

 

 

Wow!  It's 9:30 p.m. Sunday (January 18) and I am beat. Might fall asleep. Guess I will find out how the Patriots did in the AFC playoff tomorrow (the game would have started at 11:40 p.m. local time). I arrived here in Liberia Friday evening, January 16, after a 26 hour trip (three flights with a long layover in Brussels), with my seven pieces of luggage, filled mostly with donated drugs and supplies for ELWA Hospital, the ministry SIM runs just outside Monrovia.

 

I've spent some time catching up with our SIM Liberia country director, Will, who just got back here from the UK about five days ago, and Dr. John, my colleague who has been anchoring the hospital medical staff throughout the Ebola crisis.

 

Because I wasn't due to report for work until Monday, we decided to clean the apartment where I had stayed in August, as it had been unoccupied since I left.

 

Read the remainder of this blog post on the CNN website:

Doctor's notes: American Ebola survivor is back in Liberia
 

Keep on praying for Rick and the SIM-Liberia and ELWA team!  Many transitions ahead.

 

 

 

 

Off he goes!

 

After a couple days of publicity and packing, Rick boarded the plane on Thursday and arrived safely in Liberia on Friday evening.  He spent Saturday and Sunday catching up with our country director, Will Elphick and his wife Jenny, and with Dr. John Fankhauser who has been the primary missionary doctor at ELWA Hospital through most of the Ebola crisis. Tomorrow it's back to work. But he is hoping to find somewhere to watch the playoff game tonight, even though it might mean staying up most of the night....yea, not sure he is going to make it through that. Maybe the first quarter.

Here are some photos from the week.

Rick will be blogging from Liberia in the next three weeks.  His blogs will appear here, but will link to the CNN website for the last few paragraphs, so don't be thrown off.  We are praying that many people will read the blogs and continue to pray for the Ebola crisis to end in West Africa. We also hope that people will understand more about the ongoing needs for health care infrastructure in Liberia and other vulnerable parts of the world through Rick's story. 

Getting Ready

5 days and counting.  The boxes of drugs and medical supplies have arrived.  Rick and Jared are making the most of the Patriots' game breaking down packaging to get as much as possible into Rick's bags.