Dear Praying Friends,

If you followed the news over the last month, you have heard that ELWA hospital has been at the center of the Ebola crisis in Liberia.  We are praising God for his mercy to our missionary colleagues, Dr. Kent Brantly and Nancy Writebol, who have been completely healed from the Ebola virus.  They have been reunited with their families and are taking some time to rest and recover their strength. 

The healthcare system in Liberia has had to go through a complete reboot after every single hospital in the city of Monrovia closed down to be decontaminated with bleach water as a result of Ebola cases landing in Emergency Rooms, outpatient clinics and medical wards. When I arrived on the 4^th of August, ELWA hospital was in the middle of this process.

On August 6^th, Dr. Brown, the medical director at ELWA hospital, opened the doors to Obstetrics patients. When the patients started arriving, they had often been to several other hospitals and traveled for hours seeking care. More than 35 cesarean sections were performed to save women and their babies in the first 20 days—sometimes two or three a day.  This past Sunday when I was on call, several women presented for care in various stages of labor and three wound up requiring C-sections.  One of them was a teenager with a full term pregnancy who had developed eclampsia, a combination of elevated blood pressure and seizures that would be detected in advance if she had been able to attend her regular pre-natal clinic.  She was brought by her family, sprawled across the back seat of a taxi, unresponsive and still seizing occasionally. We had to give her a general anesthetic and perform an emergency cesarean.  She is doing well now with her baby and will soon go home.

There are other medical emergencies that cannot be neglected much longer. Last week, I had a phone call from a friend to appeal for their neighbor, a 13-year-old girl who was very sick with severe abdominal pain. They had been to several hospitals but none was able to accept her.  The family was desperate.  Dr. Brown, who is a general surgeon, agreed to evaluate her even though the hospital was only open for obstetrics. Her exam indicated peritonitis, an infection in her abdomen, which would definitely require surgery.  We waited all day Sunday for Dr. Brown who was busy caring for critically ill Ebola patients in the treatment center. Finally he came to see Lisa at around 8:30 p.m. after what had already been an exhausting day. It was clear that her surgery could not be put off, so we started operating at about 10 p.m. and ended after midnight.  Dr. Brown found four separate holes in her intestine—perforations due to a typhoid fever infection.  Each hole had to be repaired and then her abdomen had to be washed out.  I spent the night on the pediatric ward monitoring her progress post-op, as she was quite ill with fever and difficulty breathing after the surgery.  Today I am happy to report that Lisa is improving and slowly recovering (she is pictured here.)   But she is just one of so many people in Liberia who are at risk because of the Ebola tsunami that swept through an already fragile healthcare system.  

We are getting news now that a couple other smaller facilities in Monrovia are opening, allowing ELWA Hospital to open soon for additional services without being overwhelmed with a huge flood of patients. On Thursday, the 28^th, we held a training session for all of our staff to review new triage procedures and infection control techniques to help protect us from unknowingly getting exposed to the Ebola virus.  We hope to gradually increase our services over the next couple of weeks to include children and adults, but we must first make some changes to our building to allow us to triage everyone before they enter the hospital grounds to check for any signs of Ebola Virus Disease (EVD).  A large shipment of personal protective gear arrived yesterday from our partner, Samaritan’s Purse. This has been one of the key issues in reopening—ensuring that we have adequate protective equipment.  So we are praising God for that!

Meanwhile, the number of people contracting Ebola continues to rise. WHO predicts the final numbers will be in the tens of thousands.  The isolation and treatment wards on our property are packed and patients continue to come. While I am not involved in the units, Dr. Brown is passionate about ensuring they provide the best possible care so he is dividing his time between facilities. Thankfully, many people are surviving if they come when they first show symptoms.  We rejoiced greatly that one of the ELWA nurses was released from the unit last week.

Please continue to pray!  Here are a few requests:

1.   That the international response to the Ebola epidemic will be vigorous!  Right now, the systems put in place like ambulance transport and even the burial teams to dispose of bodies are overwhelmed.

2.   Pray for ELWA’s ministry at this time, that we would be able to make a difference for Christ in the lives of those who are sick.

3.   Pray for the ELWA staff, for safety and protection from infection with Ebola. 

4.   Pray specifically for Dr. Brown and for Joe Wankollie, our SIM-ELWA Deputy Director who is running the whole show at this time. They are carrying a very heavy load.

In His Strength,  Rick