Escripts--September 29, 2016--Looking back, looking forward

Here I (Rick) am, sitting in the airport in Frankfurt, Germany, making the transition again-- from the USA to Liberia; from advocating, fundraising and praying from afar to working, interacting, and collaborating side by side; from the beginning of autumn to the end of rainy season. I’m really happy Debbie and I get to travel together this time! From this vantage point, right in the bend of the road, it is a pretty good view looking back to where we’ve come from, and a pretty good view forward as well, so let me share the view from here with you.

Looking back….
Dr. Rick’s Ride turned out to be a lot of fun! I think my biggest surprise was how many people spent so many hours assisting with this project—I am so grateful! Seven different riders joined me on different legs of the 3-day ride, 165 miles from Springfield to Wayland, to Lowell, to Worcester (Massachusetts). Someone drove the “back-up car” for first aid and mechanical help along the way. A gracious host at each of these stops (assisted by others they recruited) put together an opportunity for me to share the burden God has placed on my heart for the current challenge of HIV in Liberia. Many prayed, listened, and donated. Thank God for answering so many prayers! We had a very safe ride. 164 donors have given over $20,000 so far for the ELWA Hospital HIV/AIDS Education Project, and more is coming in. The total need is $200,000 over 5 years.

Looking forward….

October is going to be a busy month in Liberia. I’ll be working with Rachelle, who heads up our HIV/AIDS Care Team at ELWA, to get the initial activities of our project going: expanding and promoting our monthly support groups; selecting, training and deploying our community outreach team; and working out the details of supervision and reporting on the project’s outcomes.  Debbie will be working on publicity for the dedication of the new ELWA Hospital building, coming up on October 22^nd. And both of us will be finding ways to pitch in and help with all the administrative details needed to make the move to the new building a success.

HEY!
If you missed Rick's talk on HIV-AIDS in Liberia you can watch it on YouTube.  

Please continue to pray with us!
Pray for God to guide and direct the new efforts to reduce deaths from HIV.
Pray for the dedication of the new hospital facility to be an event at which God is glorified as Samaritan’s Purse and SIM join hands in meeting the health needs of our patients in the name of Christ.
Ask God to provide the needed staff and volunteers to provide top-notch, compassionate care at our new facility

Dr. Rick's Ride!

For all those of you who weren't able to make it to one of the Dr. Rick's Ride's presentations on the HIV/AIDS challenge in Liberia, Here it is on Youtube! : ) (This was the talk at Trinitarian Congregational Church in Wayland.... thanks to Ken Keyes for the awesome video work/powerpoint integration!) Enjoy....

https://youtu.be/KfkzdNy1tcg

Flat tires

So, I was inspired back in May to do a 160 mile bike ride across Massachusetts, to raise funds for HIV care and prevention in Liberia—It’s coming up soon, September 8^th to 11^th!  I’ve been doing a lot of cycling to train and get ready. One day in early August, I was doing a 30 mile ride, and just a few miles into it I had that unmistakable experience… I hear a noise, a little “thunk” as I run over something. And then I notice that there’s a little more resistance to forward progress. I start to feel the road a little more. At first I look down, and everything looks OK, and I think it’s just my imagination. But then the bike starts to slow down, and I’m really feeling the road, and I look again…. yep, my back tire is flat. Suddenly my progress has halted, and I have to stop and fix my tire. No problem, I have a spare tube and a little toolkit. I stop, find a safe place by the road to get the tire off the rim and pull out the tube. I get the tube changed and pump it up, pop it back on the bike and get on my way again. My hands are a little greasy now, but I’m thinking it’s not so bad… just puts me about 15 minutes behind what I was hoping for, but I have the time. So I’m continuing on, having a good ride, getting a little past the half-way point, and “pop” I hear the sound again, this time from the front tire. Now this is worse luck than usual! I look through the stuff in my bag, and realize I don’t have everything I need to fix another flat. I call Deb to come and pick me up.

If this was a one-time occurrence, that would be one thing. But over the last month, I’ve had 7 flat tires! Some in front, some in back, different places around the rim, so it’s not that there’s something stuck in my tire. I’ve ridden well into the thousands of miles over the last 6 years, and I’ve probably had a flat tire about once a year. Could God be sending me a message? 

I must admit, at first I thought it was because I’d had a couple early mornings where I had gotten up and gotten straight on the bike without having my usual time of Bible reading and prayer. I took it as God telling me: “Put me first”. So I made sure from then on to first have my time with Jesus before taking off on a morning ride. But that was about 4 flats ago….

As I’ve been reflecting on this (I’ve had lots of time to reflect… each time I find myself by the side of the road, changing another tube!), I think God has put this little inconvenience in my life to help me understand a few things. He’s saying, “Rick, if you have something worthwhile you are working on, that you feel called to do, burdened to do, convinced from the core of your being that it’s the right thing to do, are you going to let a few flat tires discourage you? Nope, you’re going to press on. Does another obstacle, another disappointment, another delay mean that I have turned my back, that I don’t want you to persevere?  Nope. I’m telling you that I want you to dig deeper.”

But most of all, I feel like God is letting me know that the highest priority in life is not reaching a destination or accomplishing a great achievement. It’s walking with Him. It’s allowing each disappointment, each delay, each difficulty to draw me closer to Him.

Weekend call...

Quite a weekend…. I’d arrived late Wednesday night, spent the day Thursday organizing and distributing the meds and supplies I’d brought with me. Friday I met with the medical staff and with our SIM Liberia Director.  Saturday morning I took over as the on-call physician at ELWA Hospital, covering our 50 bed facility for the weekend. One of my local colleagues helped me with rounds on Saturday.  And then, about 11:30 AM, it all started….

Amelia (not her real name) is a 32 year old mother of 3 who had not been to ELWA before. She came from 25 minutes down the road—the rural area between Monrovia and the airport. She told us she’d never had a day of formal education. She was 9 months pregnant, and had severe abdominal pain starting around 10:00 in the morning. There were no fetal heart tones, and she had significant vaginal bleeding. The abdomen was so tender that it was difficult to really get a good exam.  I talked with Amelia, her sister, and an Aunt who had helped get her to the hospital. I told them she’d need an urgent operation, as it looked like the placenta had separated from the uterus and we needed to get the baby out and get the bleeding controlled, though it looked like the baby had already died in her abdomen. 

After the surgical team made their preparations, I scrubbed in and got ready to start the case. I’d been hoping for an easy first weekend—maybe a c-section or two, but let them be healthy ones with good babies. Not this time. As we entered the abdomen, we encountered copious clots and blood—I reached my hand in through the incision and explored, and realized this was not an abruption, but a uterine rupture—the baby had been expelled through a tear in the lower uterine segment, along with the placenta. We extracted the stillborn baby and the placenta and brought the uterus into view—there was a stellate rupture extending in 3 different directions. With some skillful help from Gideon, the assistant, we pieced the uterus back together and repaired it in 2 layers. After a transfusion, Amelia’s BP stabilized and she was able to go on the postpartum ward.

Sunday morning I was awakened at 5:30 by a call from the ER—a pregnant woman had come in, short of breath, with O2 saturation of 57%. When I arrived, she looked like she might give up the ghost at any moment. Her heart was massively enlarged, she was in pulmonary edema, and she was full term. I silently prayed for her as we gave her oxygen, lasix, hydralazine, and IV digoxin. Miraculously, she gradually stabilized, and later in the day delivered a full term baby girl who unfortunately appeared to have brain damage from her prolonged hypoxia. 

Add to that a couple other challenges—a vacuum extraction on a woman whose baby had apgars of 5, 5, and 7; and a c-section on a patient attempting a trial of labor after prior cesarean. 

All these women survived, and two of the four had good neonatal outcomes. If these women had been pregnant just 18 to 22 months ago, during the worst Ebola epidemic the world has ever seen, it’s quite likely that all 4 of them would have died or had even more complicated deliveries, due to the closure of most health facilities here. Timely, skilled maternity care is a lifeline in a place like Liberia—a very fragile lifeline. One of our priorities is to extend that lifeline to as many women as possible, as well as training local midwives and physicians in quality emergency obstetric care. I’m so grateful to practice as part of teams, both here in Liberia and in Worcester, that make women’s health and maternity care such a priority!  

The answer to his own prayer request

One of the first people patients meet when they check into the clinic at ELWA hospital is William Pewee. He receives their clinic card with a warm greeting and a smile, then hands them their medical record before they join the line to see a provider. If they have a question, he will help, because he wants people to feel cared for when they come to ELWA.  In fact, before he was employed in the records room, Pewee was a volunteer  who led devotions and prayed with patients on the wards.

    In the midst of the Ebola crisis, Pewee shared a request at the monthly ELWA prayer meeting for the patients in the Ebola Treatment Unit, that someone would encourage them in the Lord. For obvious reasons, volunteers could not enter the unit to lead devotions. That night, he dreamed that a man in a white gown came to him saying “we are coming for you, so get ready,” meaning that he might die, but he argued and wrestled against him.  He had recently read the story of King Hezekiah, and he told the man he was a preacher and wanted more time like Hezekiah was given.

    The next morning as he got ready for work, he felt the chills of a fever. Although he did not think he had been exposed to Ebola, he knew he should be careful. When he arrived at the hospital, Dr. Fankhauser saw his bloodshot eyes and put him in the “suspected cases” ward of the Ebola unit. 

    The Ebola test was positive, but his case was not typical. Although he experienced bleeding from his nose and ears--one of the scarier symptoms--it subsided after a few days. In the end, his sickness was very mild and he never even had the diarrhea that weakens most patients.

    After just four days in the ETU, Pewee felt better. But he realized that his prayer request was very relevant, because dozens of people were dying around him.  People were truly afraid, especially at night when so many seemed to pass away. So he became the answer to his own prayer request and “opened a revival,” as he puts it.  Late every night, after the last medications were administered, the patients who were strong enough gathered to read the Bible and sing and pray.

    While he was recovering, he met a familiar face.  A surgeon and former medical director of ELWA Hospital, Dr. John Dada, was admitted to the ETU. Dr. Brown asked Pewee to look after him, and call whenever there was a concern. But sadly, even as he seemed to be improving, the beloved doctor suddenly died.  Losing Dr. Dada hit the ELWA staff very hard.

    SIM recognized that many people would be affected by the traumas they faced in those months.  They organized a program to train local facilitators of “Trauma Healing Groups” who would learn about the emotional impact of trauma and the road to healing.  Eighty facilitators were trained in July 2015. There is such a demand for these groups among those who have been touched by the Ebola crisis and other past traumas in Liberia that more facilitators will be trained in May.

    Pewee participated in the first trauma healing workshop.  Although he was able to reach out to others in the middle of his own Ebola experience, he said the program helped him to understand and cope with his own lingering emotions: "it helped me come down," he says. Losing patients he prayed with, watching the body bags leave the ETU was a painful experience that has stayed with him.   

William Pewee’s job at ELWA may seem like a small one, pulling and replacing files all day. But for him, it is a way to show the love of Jesus to someone who may be having a difficult day. He is one of the wonderful staff that we get to work with at ELWA--so many of them have a story to tell of God’s faithfulness. 

And I’m excited to share that it is going to be my new assignment with SIM-Liberia to tell these stories. I am now the Communications officer for our field, a job that I began during my trip in February.  I’ll be doing my best to fill the role from the U.S. with occasional trips to Liberia as our family situation allows.  I hope that you will be encouraged to hear more about the way God has been working in Liberia through these stories.

Praise God for the power of the Resurrection in our lives and in our world!

Debbie 

Thank God for Life

 

 

 In Liberia when you greet people, “How are you?” they often respond, “Thank God for life.”  I’ve always appreciated that answer—it says so much:  God is in control, God has given me life, this day is a gift from Him and I want it to honor Him.  That answer is even more real to me now.  
     September 1 was the one year anniversary of Rick’s diagnosis of Ebola virus disease.  It is hard to believe that life is so normal now, considering the possibilities that this day held for us a year ago.  While Rick waited for the result of his test, and began to feel the effects of the virus taking hold, he felt the strong arms of his heavenly Father holding him close.  For my part, I took long walks and shed many tears, trying to imagine life without Rick, but completely sure in my heart that God would carry me through.
     As the news broke, we were caught up in a tidal wave of evacuation plans and media attention, and held afloat by the prayers and acts of kindness of our family, friends and community.  We have often said that for a few days, Rick was probably the most prayed for individual on the planet.  There are no words that could ever express our gratitude for the way our family was loved through our crisis, so we wish to just say thank you and God bless you.
     We admit that the story of the Ebola epidemic reveals many uncomfortable realities of our world today, including apathy towards the crisis from the developed world in the early months and the social inequalities exemplified by the evacuation and treatment of the Americans who contracted the disease. But there were no guarantees because our times are in God’s hands.  By His mercy and thanks to the amazing professionals at the Nebraska Biocontainment Unit, Rick recovered fully. We trust that in some way, God has used him in the battle against Ebola in West Africa, which is hopefully in its last days.  Although Liberia has been Ebola free for much of the last 5 months, Sierra Leone and Guinea are still reporting a few cases each week. But now there is promise that a vaccine could finally bring this epidemic to an end, and prevent future ones.
      However, that vaccine will not prevent a crisis like this from happening when a new disease or virus emerges to sweep through West Africa or another region. Strengthening the healthcare systems in countries like Liberia is the real “vaccine” that will prevent a future crisis.
     This week, SIM has invited missionary and West African healthcare leaders to meet in Ghana for a conversation about how the mission and its partners can help strengthen healthcare resources in the region. Rick couldn’t be there, but you know his heart is with them.  Please pray along with us for these Christian leaders who desire to change the realities that caused African families to lose their husbands, fathers, wives, mothers, brothers, sisters, and children in the last year and a half.

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! 

Some Family News

     We have not shared any family news in long time, and a lot has been happening, so I’m going to use this update to catch you up.

     We had two graduations in May. Caleb graduated from high school.  He will be attending Lesley University in Cambridge, MA next year, where he is signed up to study Illustration.  We feel that Lesley is a great fit for him, and hope he will thrive and grow there as he discovers his talents and interests.  He is going to be working at Worcester Art Museum this summer as an assistant teacher for their children’s classes.

     Jared also completed his program in Heating, Ventilation, Air Conditioning and Refrigeration (HVAC-R). He really toughed it out over the winter, traveling every day to Boston on the commuter rail. He is applying for entry level jobs in his field, which is always a tricky process. 

     Max has been living at home since Rick’s illness, and just got a job as a restaurant server. It has been good to have him on hand, especially when Rick is away. 
     Our family has talked and dreamed of visiting Europe for many years (it was always so close, as we traveled through on the way to Liberia) and the timing seemed just right this year to make it happen.  We spent about two weeks in central Italy and France at the beginning of June, just ahead of the crowds and the heat. We saw the sights and the museums until our legs felt like rubber, but we feel like we made the most of it.

   Probably the most powerful day of the trip was the day we spent touring Utah and Omaha beaches in Normandy and visiting the American cemetery. Our guide told stories that made us think “God was there.” 

     Rick left on June 29 for Liberia, and will be there through most of July.  The SIM Liberia team is slowly transitioning back to normal operations.  Our new country director, David Writebol, returned in June along with his wife Nancy (the Ebola survivor) to take up his new position.  The other missionaries are also getting back.  Dr. Fankhauser and his family have been there for several months already. They all recently enjoyed a visit from Dr. Kent Brantly and his family.  In addition, work has resumed on the new ELWA hospital complex.

As the team and staff at ELWA come back together, please pray for them. As we learned after our evacuations from Liberia due to civil conflict, you don’t just pick up where you left off.  Things happened in the interim that might have changed everything. It takes grace and patience and understanding to put the organization back together.  

Also, please continue to pray for EBOLA TO END in West Africa. It was just about a year ago that the first Ebola cases came to ELWA Hospital. Sadly, after over a month of zero cases, at least one death due to Ebola was reported in Liberia this week. Twenty to thirty cases continue to be reported every week in Sierra Leone and Guinea.  The ongoing situation is no longer in the news, but efforts to contain and end this epidemic continue to require attention and resources in the region.

Thanks for your ongoing support and prayers for us, our family and the ministry in Liberia.
For the Kingdom, Rick and Debbie

A Good Read

I just finished reading this lovely little book, the personal story of Louise Troh, who invited her long lost love Eric Duncan to come to the United States to build a future together, only to lose him to Ebola disease within a month of his arrival.  I loved it. And I hated it.  You will get to know a true Liberian woman if you read this book. She is an iconic Liberian "mother" but she is also honest about ways in which she has not been perfect.  On the other hand, her story reveals to us how our media-saturated culture of outrage has dehumanized those who get caught up in a situation like hers -- spewing vitriole and hostility, spreading gossip and outright lies, making them victims of our fears.  It's shameful.  It also raises uncomfortable questions about the royal treatment that the other (dare I say, white and/or American) patients, including Rick, were given compared to the abusive scorn directed at Ms. Troh, Mr. Duncan and their families.  These are questions that we all need to confront, confessing that injustices exist. I'm so sad that she lost a chance at love because he did not get the level of treatment that was made available to us.

A shining light in the midst of this story was the loving care of the Wilshire church for Louise and her family.  It was an example of the way the body of Christ is supposed to be. Her own courage to rise above the hurt and wait on God for justice and provision is a testimony of her trust in God, though some might accuse her of being too passive. I would maintain she could not have chosen a more powerful way to speak against injustice and prejudice than to tell her story in her own voice (with the help of a journalist who seemed to understand and respect her)  without polishing her words to sound like a civil rights activist.  Reading her story, I shared her pain and her anger-- I experienced her journey as a war refugee, and a struggling and misunderstood immigrant, and matriarch of a close-knit family building a life as new American citizens. Perhaps if more of us knew people like Louise Troh personally, or even through a book like this, we'd see more progress in dealing with the injustices that continue to exist in our society.

http://www.amazon.com/My-Spirit-Took-You-In/dp/1602862893/ref=pd_rhf_gw_p_img_1
Look for my review. 

An unexpected opportunity

There is something wonderful about the look on the face of a young, enthusiastic physician as they learn something new. 

I’ve gotten to see that look a couple of times during this visit to Liberia. We have three new Liberian physicians working with us who have just completed their internships and are presently in a six month emergency obstetric and surgical skills training program. We call them our post-interns. They will spend three months with us and three more at another hospital. Then they will be deployed to a rural hospital post for a two year term of service.  This system is part of the tuition-free medical education program in Liberia.

 

A couple days ago I led a mini-training session about the management of bleeding after childbirth; this coming Tuesday I’ll be teaching them again on the use of insulin in diabetic emergencies.  Today they were getting some words of wisdom from our Medical Director Dr. Jerry Brown before starting rounds. 

If you know me, you know that training doctors is my passion. While much of what we do and know is contained in books and articles, there is a lot of personal experience and nuance that gets passed on from doctor to doctor, during rounds, “curbside” consultations, and case discussions. I am again moved and stimulated to continue to pray and trust God to help us establish a Family Medicine residency program here at ELWA. 

Counting the days.....

About a month ago, Liberia reported a week in which no Ebola cases had been diagnosed. May 9 is the target date for Liberia to be declared Ebola free, with no diagnosed cases for 42 days. People presenting at hospitals with fevers and other symptoms continue to be screened for Ebola and hundreds of tests are still being run each week, so the vigilance continues. Sierra Leone and Guinea are making some progress as well: only 12 and 21 cases were diagnosed in those countries in the last week, with large increases in testing taking place showing that more people are interacting with the Ebola intervention program.  We’re all praying for the numbers to really drop off soon, just about a year after the world began to understand what was happening in West Africa.  

Rick headed back to Liberia on Thursday, April 16^th for a few weeks before our graduation season begins (Caleb from high school and Jared from his HVAC program). He will fill us in on how things are running at the hospital now that regular services are ramping up.  The day before, Samaritan’s Purse officially re-launched the new hospital construction project. Meanwhile, SIM missionaries are returning and assessing the status of their ministries. Everyone is ready and willing to be back to work.

 

We’d like to update you on the fundraising that we have been doing since Rick’s first trip to Liberia.  We are hoping to raise $50,000 this year for three ELWA Hospital projects.

 

The first is the ELWA Hospital Benevolence fund to assist patients who cannot pay their hospital bill.  So far, $2,400 has come in for that project. 

 

The second fundraising goal is to purchase some lab equipment as a part of the ELWA Hospital Transition Project.  $6,550 was given for that project, which should allow the Hospital to acquire some laboratory equipment in the near future. Rick hopes to determine what is needed while he is in Liberia and take it back with him in July.

 

Finally, in anticipation of the need for more and better trained physicians in Liberia, we are raising money for the Family Medicine Residency Program that Rick hopes to develop at ELWA Hospital.  Almost $7000 has been given to this project in recent months.  Therefore the total so far is $15,950.00. Thanks to those who have given to these projects. We have been overwhelmed with your generosity towards the Liberian people and the work of ELWA Hospital.

 

If you would still like to give to these projects, all the information is posted in this blog post

 

More news from Rick in Liberia soon!

God first, and the Nebraska Biocontainment Unit Team second

Last weekend, Rick and I traveled to Omaha to help the Biocontainment Unit Team celebrate the 10th Anniversary of the creation of the unit at Nebraska Medical Center for the treatment of patients with highly contagious diseases.  For 9 years, a team of nurses, infection control experts, lab techs, and doctors trained and studied without caring for a single patient.  And finally, on September 5, 2014, they admitted their first patient.  Yes, that would be Rick.  As he said in his comments, he put the "Bio" in "Biocontainment" 

 

This was Rick's room

It was a special time to be able to thank all of the team members who did so much to save Rick's life. They are really an exceptional group of professionals.  Since Rick left, they have had two additional patients.  They have also become a resource to other hospitals all over the USA in preparing to handle an unexpected contact with an Ebola patient.  They have traveled around to evaluate newly established isolation units and invited thousands of doctors, nurses and administrators to Nebraska to learn the essentials of setting one up.  We are so impressed by them.  They are also heroes of the Ebola epidemic, because they make it possible for volunteers to go to West Africa to serve in such a high risk situation.  Even this month, they were monitoring a small group of workers who had an exposure in Sierra Leone while they went through their 21 day observation period. Today is their 21st day, and none of them became ill.

 

Most of the leadership team

We really thank God for the team of doctors and nurses and support people who took care of Rick in Nebraska. It was super fun to go back and see them again.  They were all so pleased to see that Rick had gained weight and had his color back--- "You look good" was the most frequent comment.  We shared memories of good moments in the midst of Rick's illness: homemade Runzas by Nikki's mom, Kendall's chicken soup, and a midnight air guitar dance party that had not previously been exposed. We got to meet Nebraska Governor Pete Ricketts, who was bursting with pride in his state and his people. It was really fun to be a part of their celebration.

 

But most of all, it was good to take a moment to thank God for what he has brought us through.  As they say in Liberia "Thank God for life!" 

   

http://www.ketv.com/news/dr-rick-sacra-returns-for-biocontainment-units-10th-anniversary/32046142

 

It's All Grace.

Last weekend, we had the privilege of participating in the 58th Annual Missions Conference at Black Rock Congregational Church in Fairfield, Connecticut.  Black Rock has been supporters of former SIM-Liberia missionaries Jon and Pat Shea, so they were familiar with the work of ELWA in Liberia.  We were welcomed there as if we were long time friends. 

Rick preached the morning message on Sunday, which he had to do 3 times!! God gave him a challenging word to share from Philippians 1:29-30: "For it has been granted to you that for the sake of Christ you should not only believe in him but also suffer for his sake, engaged in the same conflict that you saw I had and now hear that I still have."  In the sermon, he told a very powerful story of one of the ELWA staff who contracted Ebola and spent his time in the ETU ministering to others that we haven't told in another place.  I listened to the sermon all three times and the story still got to me on the third time through it. The story starts at 18:35.

March 8 - Missions Conference: Engaged In The Conflict from Black Rock Church on Vimeo.

Thanks for tuning in.  Also, thanks for praying for us in these great opportunities that have come up-- to share God's word, to encourage the church in missions outreach and to keep the Ebola crisis in West Africa in the prayers of His people.

For the Kingdom, Debbie and Rick

Thanks to all!

It was cold outside, but warm and friendly inside at First Congregational Church of Holden on Friday night.  A big thank you to Pastor John Barber (who recounted some of our history with him) and the hospitality crew at FCCH who took care of everything with regards to the facility. I think that over 200 people attended from all over the state.  The music by Michael Borkay and the "Five Golden Rings" from Trinitarian Congregational Church in Wayland, MA was enjoyable and suited the theme of the occasion.  Rick shared some moving stories of his time in Liberia and gave us a glimpse of what Liberia has been through in the last year. 

You can watch the video of the entire program here:
Rick Sacra's presentation at First Congregational Church of Holden
It begins at about the 7 minute mark

The evening concluded with a fundraising appeal.  If you would like to give to the projects Rick explains in his presentation you can use this link:
 
https://web.simusa.org/Give/projects.php
enter country: Liberia, keywords: ELWA Hospital and select “All”

Choose any of the following:

Benevolence 082876-091:  this project will provide assistance to patients who cannot afford to pay their hospital bill

Family Medicine Residency 095213-091: this project will be used to start a Family Medicine Residency program to train Liberian doctors

Hospital Transition 095212-091:  this project will allow ELWA to replace lab equipment that is urgently needed.

 

Rick has set an ambitious goal of $50,000 for these three projects.  So far from Friday evening, we have received gifts of over $3000.  Thanks to all who responded so generously. God bless you!

 

Here are some photos from the evening -- we should have recruited a photographer to get more photos than we could do on our own!

Pastor John Barber of FCCH





Michael Borkay

A Capella Group from TCC -- "It is Well with my Soul"

Arthur David surprised us - another Liberia missionary, with the Church of Christ.



Joe and Jemimah Teh, co-workers from Liberia

 

You want to be there!

We have invited a special guest for Friday evening!
Michael Borkay was our neighbor in Liberia, but he lives in Charlotte, NC now.
When Rick was sick in the hospital in Omaha, this recording was a huge encouragement to him and  Michael will be here to sing it on Friday evening.

Also, Rick's brother Doug is bringing his a capella group from Trinitarian Congregational Church in Wayland, MA.

We hope you can be there!!
Friday, February 27, 2015
7 pm
First Congregational Church of Holden, MA
1180 Main St.  Holden, MA.


 

ELWA Hospital Fundraiser

You are invited to an evening

with Dr. Rick Sacra

7:00 PM  Friday, February 27, 2015

 

Rick will share stories and insights

from his trip back to Liberia

after his recovery from Ebola virus disease

 

First Congregational Church of Holden

1180 Main St. Holden, MA

 

 Free and open to all with an opportunity to give

to SIM projects for ELWA Hospital in Liberia

Help raise $50,000 to jump start its recovery from the Ebola Crisis

If you cannot attend, you can give through the following link: 

DONATE to ELWA HOSPITAL

enter country: Liberia, keywords: ELWA Hospital and select “All”

Choose any of the following:

Benevolence 082876-091:  this project will provide assistance to patients who cannot afford to pay their hospital bill
Family Medicine Residency 082876-091: this project will be used to start a Family Medicine Residency program to train Liberian doctors
Hospital Transition 095212-091:  this project will allow ELWA to equip their new facility which is under construction

 

P.O. Box 7900 Charlotte, NC 28241

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!!