Project HOPE Volunteer Team Two Liberia Wrap-Up

The second team of Project HOPE volunteers completed their work at the John F. Kennedy Hospital in Monrovia, Liberia, in April, but the results and reflections from the volunteers are still coming in. By the time Project HOPE volunteers left JFK, the 14 member medical team participated in a total of 645 patient encounters, serviced or repaired 13 pieces of medical equipment and presented health education seminars and workshops to 270 JFK health care workers. But more than numbers, they formed lasting friendships and bonds with the JFK staff and patients. And even on their long journey home most wanted to know, “When we can do this again?” Read some of their success stories…..

Cherri Dobson, a neonatal intensive care nurse from Brentwood, CA worked in the small, very hot neonatal unit while at JFK. Lacking all the advantages of technology that premature babies in the United States have, Cherri spent a lot of her time syringe feeding a 30 week, premature infant with his mother’s breast milk, one drop at a time. She also conducted several neonatal resuscitation and newborn baby care and assessment classes. After one class, she witnessed the meaning of health education on JFK staff. “There was an EKG tech who worked at the hospital for 20 years. She was not scheduled for one of our courses, but asked permission to attend. After all Project HOPE workshops participants were given certificates of participation, I found her out in the hallway with tears streaming down her face,” Cherri said. “After all the time I have been here and all the classes I have attended, I have never been recognized for my work,” she told Cherri. Cherri participated in hands-on care with 16 of the smallest patients at JFK.

Jo Doerr, a nurse educator from Six Lakes, MI worked in the medical ward of the hospital. After completing an interactive class with nurses aids, Jo received a compliment to HOPE when one of the aides asked, “When are you coming back to teach us more?” Jo participated in hands-on care with 36 medical ward patients and conducted several training course for nurses and nurses aides.

Jo and Cherri also participated in a book donation ceremony at the hospital. Volunteers donated nearly $1,000 worth of medical books from their personal collections. The text books, reference guides, ICU management books, pocket guides, drug manuals and CD ROMs were very much appreciated and timely according to the JFK nursing instructors who accepted the books. “The timing could not have been better,” Dr. McDonald, JFK administrator, told the volunteers. “Our next session of nursing school starts in May.”

Nabil Messiah, an ultrasound tech from Martinsburg, WV, with the help of volunteer David Meador made a lasting change at JFK by fixing an ultrasound machine, arranging a good space to keep machine and procuring an examination table. Still Nabil wanted to more. “The examination table was too high for patients to get up on,” he said. So Nabil had a wooden stool made for the patients while in Liberia and left the stool at the hospital for use long term. While at JFK, Nabil helped perform 115 ultrasounds.

Earl Rogers, a Pharmacist from Richmond, VA, was the mission’s longest serving alumni. Earl served on the SS HOPE in it’s 1972 mission to Natal Brazil and served two volunteer missions in the 1990s to Russian and Ukraine to help set up pharmaceutical systems for the newly independent states. After teaching a seminar to pharmacy students and pharmacy dispensers at JFK, Earl was asked loads of questions. At the completion of the workshop, one of the pharmacy students stood up and gave a formal thank you speech. The class also showed their appreciation with a clapping ceremony symbolizing Earl’s long lasting influence on the group. Chief of Pharmacy, Livinius Ujah explained, “When the wind first starts to blow through a tree, the leaves began to rustle slowly. But as the wind works its way through the trees, soon all the leaves are moving vigorously.” Together the class slowly started clapping their hands until they finished in a fast loud crescendo.

Marina Rivera, a radiology tech from Fountain, CO, probably had the hardest time saying goodbye to her group of counterparts, the eight X-ray techs at the JFK hospital. From day one, Marina was welcomed with eager enthusiasm. While the team conducted 268 x-rays in the time she was there, they never lost their enthusiasm and eagerness to learn. A couple of hot afternoons, Marina treated the crew to a short break outside the hospital for cold sodas. On her last day, they showed their thanks by presenting Marina with a green African dress. “We remember everything you taught us,” they assured her. “But we want you to come back.”

Gabrielle Seibel, a nurse educator from Seattle, WA, who worked in the Pediatric ward, was also presented with a hand made African outfit and formal ceremony on her last day at JFK. The staff also proudly showed her the growth charts they had ordered after Gabrielle's presentation on the importance of growth monitoring of children. They also laminated and posted the childhood vital signs chart Gabrielle donated to the department. Gabrielle worked with 42 pediatric patients at JFK.

Nurse Midwives Margaret Canter, from Tallahassee, FL, and Nancy Ward, from Huntingtown, MD, had a week to remember, delivering nearly a dozen babies and working with 63 labor and delivery patients. The first baby Margaret delivered was actually the grandchild of one of the midwives at JFK. Together, the two worked side by side with the labor and delivery staff, modeling compassionate care of laboring women in less than ideal birthing circumstance. In addition to hands-on mentoring, Margaret and Nancy participated in a workshop teaching midwives better techniques for gathering patient information and more accurate pregnancy dating techniques.

Amy Bream, an ER nurse from Denver, CO, and Mary Kennedy, a nurse educator from East Bridgewater, MA, spent two tough weeks in the emergency room of the hospital, helping with severe trauma cases. “I have been a trauma coordinator in the ER for many years in city hospitals, and I have seen a lot of trauma,” Mary said. “But this is one of the poorest places I have been so far. People only come in here with serious stuff.” One patient Amy and Mary will not forget is Darius. After helping the boy obtain the treatment he needed, Amy and Diane posed for a picture with their young patient. “Like everyone else here, he asked to see the photograph after we took it,” Mary said. “But instead of just looking at it, he pulled the camera screen to his face and kissed it and thanked us. The work here we have done has been overwhelming at times,” she added. “And while sometimes you can’t change much, you can see that change can happen with just one person.” Together with Dr. Allen Webb, Amy and Mary worked with 69 ER patients and conducted several important trauma training sessions.

David Meador, a biomedical tech from Wheaton, IL, also had a challenging week in one of the hottest sections of the JFK Hospital. “This has been such a humbling experience,” he said. “At home I’m used to fixing things and I have resources to fix things and get it fixed. It’s just a matter of going through the process. Here they start in the hole, with a broken piece of equipment. They don’t have service literature, parts, supplies or even the Internet or telephone. Still they are expected to keep the equipment running.” Despite the challenges, David was able to make progress repairing an Ultrasound machine, that was put to use immediately, a portable x-ray printer, several pulse oximeters, a fetal doppler machine and several Blood Pressure monitors and crib. David also left behind some of the batteries, fuses and other parts and equipment he brought with him in three 70 pound suitcases. “These are some of the most patient people I have every worked with they manage to keep a positive attitude in technically crushing circumstances,” David said of the biomed staff he worked with at the JFK Hospital. “The people are so appreciative when you fix something. These folks are really working in extreme conditions and I have a real appreciation for what they are doing.” David said he plans to continue helping the JFK biomedical staff from the States. “I will email them back and forth with lots of information…as soon as they get email and probably wind up making them care packages.”

Dianne Bennett, a pediatric nurse practitioner from Miami, Fl, and Amy Bream were favorites in the Pediatric ICU, taking lots of time to talk with patients, provide compassionate care, play and offer one on one attention to the JFK’s smallest patients. “Pediatric ICU is a very serious setting at JFK,” Dianne said. “Imagine no screens for privacy, and small children seeing and observing all the dressing changes and other procedures going on right in front of them. These little eyes are seeing a lot. If I can find a way to add a little bit of laughter, a caring touch and a few smiles to their day, I think it’s healing.” Amy also found the patients inspiring. “After working in the emergency room, I enjoyed working in pediatrics,” Amy said. “It’s strange, even though the kids are in ICU, I’ve never seen one cry. They are so happy to see you, so we smile and hug and dance sometimes hand out candy. Even the parents are happy to see us. It’s a lift for me, before going back to the ER.” Amy and Dianne also taught several well-received health education courses to nursing staff employees at the hospital. Project HOPE volunteers provided hands-on care for 36 pediatric ICU and burn center patients.

Dr. Allen Webb, an ER physician from St. Michaels, MD served as the Chief Medical Officer on the mission. He worked with the administration of the John F. Kennedy Hospital, and worked with Joel Trinidad, Chief Nursing Officer on the mission to turn volunteer assessments into critically needed educational courses. He also met with Liberia’s Minister Of Health and Social Welfare, Dr. Gwenigale, who happened to be an old friend of Dr. Webb. “We reminisced together about our previous working experience in Liberia over 20 years ago. Dr. Gwenigale expressed his appreciation for the team’s mission and hopes there will be more teams returning to JFK.” Dr. Webb said. Dr. Webb spent much of his time working in the emergency room and also led a class on wound care and suturing to some eager to learn nurses. “The mission to Liberia was difficult and challenging because Liberia has had a prolonged civil war that has devastated the infrastructure and seriously set backs the medical system,” he said. “There is a shortage of physicians and teachers of physicians that makes it very difficult to take care of the enormous medical needs of the population. The Project HOPE team assessed the most critical needs at JFK Medical Center and specifically addressed those most basic critical needs in the educational sessions. A very important first step toward improved health care in Liberia was taken by the HOPE team.”

Joel Trinidad, a nurse educator from Wenonah, NJ served as the Chief Nursing Officer on the mission and spent his time rounding the entire hospital, working with volunteers and assessing how to best conduct the educational courses. With the volunteers, he helped plan seminars addressing the most pressing needs of the JFK staff including Nursing Leadership, Critical Thinking and Documentation course, Burn Trauma: Resuscitation & Wound Care course, Trauma Assessment & Care: Head, Spine & Orthopedic Injuries, Gestational Age Training, IV Therapy, Use, and Management, Diabetes and Hypertension and Mental Illness Management. Afternoon on-site workshops in the units included Trauma Rounds/Case Studies, Medical Emergency Rounds/Case Studies, Nurse Aides Rounds/Skill s Review, Wound Care, Newborn Initial Assessment, Pediatric Initial Assessment and Adult Initial Assessment. A five-time volunteer for Project HOPE, Joel said, “I didn’t have as much hands-on patient care as I usually do on Project HOPE missions. But instead, I got a more thorough view of the overall success of the mission. Our volunteers were wonderful and I am sure the results of their mentoring and health education classes will be felt around JFK for a long-time to come.”

Help support other Project HOPE humanitarian assistance and health education missions around the world

--Melanie Mullinax

More Volunteer Photos from Project HOPE mission in Liberia

Check out the Project HOPE Web site for more photos of volunteers at work in Liberia.

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West Africa Mission photos

Project HOPE Volunteers Complete Mission

Project HOPE volunteers completed a successful and memorable health education mission at the JFK Hospital on Friday. After traveling home, for up to 38 hours in some cases, all arrived safely and happy to see family and friends.

While the mission is complete, there are still more stories to tell, accomplishments to acknowledge and photos to post. Check back with the Blog and the Project HOPE Web site later this week for more volunteer stories, more photos and a recap of all the accomplishments of the mission.

Project HOPE Volunteers Celebrate Birth in Liberia

Yesterday I had the honor of watching Project HOPE midwives, Margaret Canter and Nancy Ward delivery a baby at the JFK Hospital in Monrovia. The setting was unlike any other labor and delivery room I had ever been in. Laboring women, and those who have just given birth, occupy six side-by-side beds with plastic coverings draped only by a sheet. If the ward is crowded, sometimes two women share one bed. The laboring women are separated by delivering mothers only by a thin curtain.

There is no air conditioning in the labor and delivery ward, only open windows , making it almost impossible to keep out dirt and grime. When I walked into the ward, I saw a mouse running across a counter. On one delivery table, a young woman was enduing a painful post-natal procedure. Right beside her, another patient, Rose, was preparing to give birth.

Margaret and Nancy were attending to Rose, checking her progress and offering compassionate support. Rose had been in labor for a number of hours and while she was fully dilated, her contractions had stalled. She told Margaret that she had given birth to her first child at home and did not want to come to the hospital to have the baby. Margaret encouraged her to stand up, walk around and move a bit to get her labor going. Nancy rubbed her back and legs. At one point, Rose looked up exhausted and in pain and reached her arm out and placed her hand on Margaret’s waist for comfort.

I had to step over puddles of blood still being cleaned up from a previous patient as I made my way to the corner of the room to take photos. I looked down and noticed a mouse skittering across my shoes. I gently hopped to the side and kept taking photos. Rose was getting close to giving birth when the electricity, as it always does at the hospital, went out. The midwives in the department just opened the curtains that separated labor and delivery to let in the sunlight.

While the surroundings sound incomprehensible, the miracle of a healthy birth is always humbling. Nearing the end of her labor, Rose moaned, waved one of her hands in the air and sang words I could not understand. I know she was in pain, but her melody was magical.

Nancy told me later, “It is so interesting how these women, who have not read books about birth and no one tells them how to do it still naturally figure it out their own way.”

As Margaret began to deliver the head of the baby the whole room filled with excitement. The JFK midwives gathered around, offering their opinions on how to do the delivery. Nancy praised Rose telling her she was doing a great job, and Margaret slowly received the beautiful baby boy and laid him on his mother’s belly. Somehow, I was able to keep shooting photos.

Later, I was pulled into the C-Section room by Ms. Cooper, the head of the Labor and Delivery ward at the JFK Hospital. As she pulled me down the dark hall, I was trying to explain, “I’m not a medical person like Nancy and Margaret, I’ m not sure I can handle this.” She just smiled, opened a door and the operation began. It was over in five minutes, but the doctor insisted I take a few photos of the operation. When the baby was delivered, he had hard time breathing. Nancy helped resuscitate the baby, and soon he was bought into the nursery wailing strongly.

Nancy and Margaret have been working hands on with the midwives at JFK for two weeks. They have personally delivered a dozen babies. They have also witnessed heartache, watching a premature baby delivered who didn’t make it. While they deal with circumstances like this in their jobs back home, the environment is very different here and there was not a lot of compassion shown to the mother. She was not shown the baby, and after the birth she was put in a bed with other mothers who had given birth to live, healthy babies. “In the delivery room, the woman whose baby died was encouraged to be quiet,” Nancy told me later that day. “And she was. So I just went over and touched her and told her how sorry I was. The tears started to come. People just need a human touch and need to be with someone when something like this happens.”

In addition to delivering babies, and teaching classes in prenatal care, Nancy and Margaret are modeling an example of caring and compassion to the JFK midwives. “I have been in a high tech hospital and this experience has made me appreciate what women can do without and have a baby,” Margaret said. “It's not the technology and medical intervention, the things that these midwives aspire to, that will make the difference. It’s the comfort and patient care that will really make a difference. I hope we are modeling a different way to treat patients,” Margaret added. “When we deliver, we are rubbing backs, talking to the patients in a reassuring way, just being tender.”

Margaret, who served on a Project HOPE mission to Latin America onboard the USNS Comfort last year said that she has really enjoyed this land-based opportunity. “When we were on the Comfort, we set up clinics, using all our equipment, all our supplies, pharmaceuticals and all our people. Here, we went into their environment, working alongside actually providers in their facilities, using what they have to use. You really see what they have to deal with and can make health education suggestions based on that.”

Over the course of two weeks, Nancy and Margaret have modeled better patient interaction and taught a few practical skills.. Through health education training, they have provided the midwives with information on how to better date pregnancies using pregnancy wheels provided by Project HOPE, and have shown the midwives different ways to count a baby’s heartbeat during contractions to determine if the baby is in stress. “Yesterday there was time when I was listening to the baby’s heartbeat and three midwives came around to see how I was counting beats,” Nancy said.

Nancy, a first time volunteer for Project HOPE is eager to go on another mission. “It has really been inspiring to see women who can deal with the situation at hand. The mothers and the midwives have such resilience and Ms. Cooper, the director of the Labor and Delivery Ward at JFK is very forward thinking and open for education.”

And while the environment at the JFK Hospital may not be the perfect setting for birth, women sometimes find what they need on thier own. "The crowded unprivate labor rooms actually sometimes add a support system to the women in labor,” Margaret said. “On our first day in labor and delivery, the laboring women were walking the room, kneeling on the floor and moving and moaning in a rhythm in their brightly colored wraps, almost like a song.”

Nancy added, “One young woman looked at me with tears rolling down her cheeks and asked me, ‘Sister can you can take a contraction for me?’ I would have if I could.”

Help support the Project HOPE humanitarian assistance and health education mission in Africa


--Melanie Mullinax

Volunteers Continue to Bring HOPE to Patients and Staff at JFK

Project HOPE volunteer Cherri Dobson flew all the way to Liberia with a baby in her suitcase...a resuscitation baby that is. Today she, along with volunteer Dianne Bennett, used that baby to teach a class of 28 JFK nurses, respiratory therapists and midwives the basics of neonatal resuscitation.

“I have been a neonatal nurse for 25 years,” said Cherri, a first time Project HOPE volunteer. “This has been the most receptive class I have ever taught. I got the impression that they wanted to be there and they appreciated the knowledge. Here they don’t have the resources that we take for granted and they are interested in any kind of information that will help them have better outcomes for their babies."

In addition to teaching several classes this week, Cherri worked side-by-side with her counterparts in the neonatal unit last week, caring for premature babies in very simple medical settings. One of the highlights of her volunteer experience happened when she noticed her counterpart, Carrie, modeling herself after Cherri. “We had discussed anemia in infants and later when I mentioned a baby looked anemic, Carrie went right over and filled out a lab slip.”

Cherri brought several pieces of resuscitation equipment and books on neonatal care to pass out to her counterparts. “When I gave them a neonatal drug formularies book, the staff took the book and began reading it like it was fiction,” she said.

Like many volunteers, Cherri has found her teaching function has also lead to learning. At JFK, premature babies are often feed by hand with a syringe, one drop of breast milk at a time. Cherri was amazed with the preemie’s ability to swallow on his own. “This has definitely been an information exchange experience for me. I have learned different ways to feed a premature baby that are perhaps less invasive that what we do in the United States. I have seen very simple and effective treatments work that I may have considered archaic before. but have now given me the view technology doesn’t always equate to best care.”

The neonatal resuscitation classes were specifically requested by the JFK administration said Joel Trinidad, the Project HOPE volunteer Chief Nursing Officer on the mission. “They deliver a lot of babies here,” Joel said. “Now if a baby is in distress, the midwives rush the babies to the nurse anesthetist, but they want the midwives to learn to treat the babies in labor and delivery.”

Cherri and Dianne emphasized simple techniques that could save a baby’s life such as warming and drying, stimulation, insuring a clear airway and checking for breathing and circulation. “It was very important to emphasize that they could make a difference without medicines and without equipment to save a baby’s life,” Dianne said.

In addition to several health education classes, Dianne, on her second volunteer mission with Project HOPE has also been spending her time in the Pediatric ICU, the Burn unit and the Emergency Room.

A natural at nursing, patients around the hospital, especially children, respond immediately to Dianne's smile, her gentle words and lots of high fives. “Pediatric ICU is a very serious setting at JFK ,” Dianne said. “Imagine no screens for privacy, and small children seeing and observing all the dressing changes and other procedures going on right in front of them. These little eyes are seeing a lot. If I can find a way to add a little bit of laughter, a caring touch and a few smiles to their day, I think it’s healing.”

Dianne is also aware that she is being observed by her counterparts . “Any interacting I do with patients, families and other nurses is a great opportunity to do teaching and hopefully by doing the teaching the patients will get out of the hospital little bit faster.”

When choosing her career, Diane had planned on becoming a doctor. But after watching her Dad go through an illness, she deiced to change career paths. “When my dad was sick, I noticed it was the nurses coming to his bedside making him laugh. The doctors came in and out. I wanted to be a nurse so I could spend more time with the patients.”

Dianne participated in the Project HOPE US. Navy partnership Mission to Southeast Asia Oceania last year on board the USS Peleilu. In contrast, the mission to West Africa has been land based. But the outcome has remained the same. “Like the last mission I went on, this has been a rewarding and eye-opening experience that really makes me appreciate health care in the States and also reminds me how fragile life is,” Dianne said. “We’ve also formed great relationships and bonds with the JFK staff on this trip. There has been a lot of conversation and a great exchange of information. I hope we can continue what we have built on.”

In anther section of the hospital, Mary Kennedy presented her second trauma workshop, this time on burn wounds. In addition to a full schedule of education classes this week, Mary has spent much of her time working in the Emergency Room, one of the toughest departments in the hospital. “I have been a trauma coordinator in the ER for many years in city hospitals, and I have seen a lot of trauma. But this is one of the poorest places I have been so far. People only come in here with serious stuff.”

She has seen multiple serious bone fractures due to all too common car accidents in Liberia. She witnessed serious infections due to tropical illnesses like typhoid and even cared for a man who was injured with an ax.

There is no insurance program in Liberia, and payment is required of patients before they receive diagnostic treatment. “The payment method is weird here,” Mary said. “There have been patients left in the emergency room for days because they can’t pay to have an x-ray for diagnosis.”

Mary, and some of the other volunteers have had the opportunity to get to know Jimmy while working in the Emergency Room. Jimmy, a 6-year-old boy was abandoned at the hospital quite some time ago. He’s been in the emergency room ever since. He can’t walk and has some mental disabilities, but he smiles and responds happily to everyone who walks by. The nurses say he is unadoptable, and although his environment is harsh and heartbreaking to imagine, it’s better than living on the street alone.

Despite the dire circumstances, there are stories of success. Mary, who taught a class in trauma assessment yesterday lectured about the use of different types of fluids and which were appropriate for different types of trauma. Later in the afternoon, when she returned to the ER to work one- on-one with students in the class, a very proud ER nurse came up to Mary and told her that a very sick patient had been discharged from the ER because she had changed his previous IV fluid to a saline fluid. “This man was very sick, “ Mary said. “And while saline was the appropriate fluid, I don’t think that it healed him. But it’s a start,” she said.

Then there’s the story of 14-year-old Darius. Darius came into the emergency room with severe abdominal pain. “He was very very sick,” Mary said. The boy was suffering from typhoid perforation (a common aliment in Liberia) which requires surgery and a long healing period. Yet the boy remained in the ER for nearly two days. Mary, along with Project HOPE volunteers Dianne Bennett and Amy Bream personally sought out a surgeon and had him commit to the surgery that day. The next morning when the volunteers visited the boy in the ICU ward, they asked to take his photograph. “Like everyone else here, he asked to see the photograph after we took it," Mary said. “But instead of just looking at it, he pulled the camera screen to his face and kissed it and thanked us. The work here we have done has been overwhelming at times,” she added. “And while sometimes you can’t change much, you can see that change can happen with just one person.”

Learning and Training Continues at JFK

Since I’ve been in Africa, I have had a lot of teary-eyed moments, like when I held a newborn baby swaddled in a beautiful piece of African cloth…or spent the morning in the pediatric ICU and observed children having their typhoid perforation surgery wounds cleaned… or when I found myself walking behind a large crowd of people holding up a young woman who was loudly grieving the loss of her loved one. But I have to say, I never imagined Project HOPE’s trademark train-the-trainer methodology would rank among my most memorable emotional experiences in Liberia.

For more than a year I have been writing about Project HOPE’s train-the-trainer program which emphasis the sharing of health care knowledge. A concept that has helped HOPE train more than two million health care workers world-wide since 1958, I always understood the importance of the train-the-trainer philosophy in spreading health education far beyond the original health professional trained. But today, sitting in a stuffy second floor medical ward of the JFK Hospital in Monrovia, I witnessed the heart of the concept.

Jo Doerr, a volunteer nurse educator was holding an informal workshop for nurses’ aids at JFK. After brief introductions, the group decided they wanted to learn more about how to safely move patients, especially patients’ bigger than themselves. Using bed sheets, Jo demonstrated a simple method to move patients, in several different directions and even bring them to a standing position without harming their own backs or pulling on the patients’ arms. The method also required only two nurses’ aids, instead of four to move a patient. The enthusiastic students all wanted to take a practice turn.

After several lively demonstrations, Jo turned it over to the nurses' aids to teach other what they had learned. Working together as a team, the nurses' aids coached each other, offered suggestions and helped each other to insure they were practicing all the skills Jo had taught them. The enthusiastic interaction and their obvious pride in being able to teach their coworkers something new brought tears to my eyes. It was a WOW this really works moment.

A second time volunteer for Project HOPE, Jo is a positive and outgoing nurse educator who cannot walk down the street to the JFK Hospital without greeting at least 10 people and complimenting them on their beautiful dresses, their beautiful smiles or asking them how they are doing. She approaches her health education with the same enthusiasm and optimism. “The education component of this mission is about the staff at JFK and what they need,” she said. “Because we worked with them for a week first, we have focused on them making them feel valuable about what they are doing. If they feel that value and share it with others they feel good about themselves, like they are really doing something worth while.”

A nurse educator, Jo has also learned a lot from her experience working on the medical ward of the hospital. “It just amazes me, the knowledge that they have, and how they are able to do the things that they do for their patients with such limited resources,” she said. “I love the smiles of the staff when we handed out the HOPE bracelets. I also love seeing the positive changes, even if they are small. I know the bracelets will remind them of Project HOPE’s mission here, but I also think the word HOPE spelled out on them will remind them of the premier hospital that JFK can one day return to.”

Jo’s workshop was just one of four classes and workshops held today, the start of a full week of education classes.

Earlier in the morning, Project HOPE volunteer Gabrielle Seibel lead an interactive leadership and documentation class for 19 nurses from varying departments around the hospital. “I think the week we had of working in the departments, side-by-side and one-on-one really paid off for this training portion of the mission,” Gabrielle told me. “It was really hard at first to make a connection with our counterparts at the hospital. But everyday it’s gotten better and better. When it came time to plan the training we understood where they were coming from and what the background issues were. The classes we prepared were focused directly on their needs and the needs of the hospital. I think that was appreciated.”

A second-time Project HOPE volunteer, Gabrielle also said that living in the culture for a week while working at the hospital gave volunteers a holistic glimpse into the lifestyle and work environment of their counterparts. “The first week of working with them helped us form bonds and trust so that the training was more like a collegial activity, working and learning together. It’s been a fantastic experience,” she said. “We have been so involved with the group, that we are not outsiders anymore.”

Each day the volunteers work at the hospital, they are learning more and more about the skills of using what you have to get the job done-- an art that their JFK counterparts deal with on a daily basis.

Gabrielle taught her class in a loud cavernous hallway at the hospital. Sunlight and heat filled the room as noise from outside construction and people walking by posed challenges. A planned PowerPoint presentation was scrapped at the last minute because of the lack of a projector. But Gabrielle like all volunteers on this mission took a queue from their counterparts and adapted.
“Sometimes, we tend to think we need more than we do. By not being able to use the PowerPoint, I think I relied more on my listening skills and engaging with the nurses,” Gabrielle said. “I am also beginning to understand the importance of oral history in the culture and how they pass knowledge from person to person using their verbal skills.”

Mary Kennedy also conducted a trauma assessment and care course this morning. Some of the students attending her class had worked the night shift. “I was impressed with the level of participation in the class,” she said. When the power went out, as it so often does at the JFK hospital, Mary took her students to a table and with the assistance of Amy Bream and Dianne Bennett, she demonstrated the “log roll” as a way for nurses in the ER to turn trauma patients. The students immediately left their seat to try themselves.


More photos of Volunteers at work....















Help support the Project HOPE humanitarian assistance and health education mission in Africa


--Melanie Mullinax

Volunteeers Explore Monrovia and its Culture

This weekend, volunteers took advantage of an opportunity to see Liberia beyond the several block section they have been working and living in for the past week. On Saturday, we packed into four taxi cabs for a Liberian-style ride to the U.S. Embassy and shopping market. My cab had a windshield busted in two places and absolutely no shocks. As we bounced and swerved down the unmarked chaotic streets inhaling diesel fumes and other undesirable odors through our open windows, we finally got a look at the real city of Monrovia. Like our little corner at the Urban Villa hotel, the city of Monrovia was bustling with energy, yet signs of the war were evident everywhere. High Rise buildings which must have once been part of a thriving city were gutted to concrete, and five years after the war has ended still remain dark and empty.

Still mothers in brightly colored dresses carried their babies on their backs while balancing food and other items in their heads. Kids played near streets and people sold and bought fruits, vegetables, toiletries and other items at make shift markets set up along the busy busy streets. And everyone seemed to be hailing a taxi or walking rapidly to get somewhere.

The pristine tropical and quiet grounds of the U.S. Embassy in Liberia were quite a contrast to the city of Monrovia. Unfortunately we could not photograph the campus. Our cameras were taken from us and passports checked at the gate.

After lunch at the Embassy we shopped in a market set up on the Embassy grounds. Dianne Bennett and Amy Bream, ever the caring nurses made instant fiends with the children of the village after buying them lollops.

With a police escort, we braved the streets of Monrovia on foot for a quick tour of Providence Island. The only historic site in Monrovia, Providence Island marks the spot were freed slaves from the United States landed in Liberia to form their own city, Monrovia, named after U.S. president James Monroe. Before the civil war in the country, the park on Providence Island had been preserved and boasted a restaurant, small hotel and game building as well as the original well used by the freed slaves who landed on the island. Today the buildings are concrete shells. With so much other rebuilding to do in the country, I am sure the historic Providence Island is way down on the list of priorities.

On Sunday, we traveled through Monrovia to Ce Ce Beach, a beautiful Atlantic coast beach somehow affiliated with the United Nations. The UN has a very visible presence in post-war Liberia and it is difficult to walk down the streets more than a block or two before you see a UN vehicle. On the way to the beach, we passed more rural villages, a huge open air market and a few tiny military posts complete with soldiers and guns manning their posts.

After a much needed weekend of rest, the volunteers are ready for another productive and very busy week at the JFK Hospital. This week, they will turn their focus to specific health education topics that have been designed to meet the needs of the JFK staff. Two congruent session will be held each morning with a critical care tract, a nursing tact. In the afternoon , less formal workshops will include one-on-one training with individual staff members to help reinforce the lessons taught in the morning sessions.

Enjoy the photos of Project HOPE volunteers in and around Liberia.

--Melanie Mullinax

Project HOPE in Liberia Week One in Review

Each morning when I open my eyes it’s still a little hard to comprehend that I am in Africa. But a step out my door unto the busy streets of Monrovia, and there is no mistake that I am far away from the rolling green hills of the Shenandoah Valley.

The streets of Monrovia are bustling with people walking, cars and trucks over-packed with passengers zipping down the crowded roads and motor bikes dangerously zipping in and out of traffic. I am beginning to get used to the constant honking of horns and elevated sounds of loud conversations. Women walk down the streets in brightly colored dresses and it is not uncommon to see baskets of fruit, nuts, sausages, even laundry and other daily essentials carried on top of their heads. Most of the buildings are destroyed or patched together as a result of a civil war that tore the country apart. Any building that is in half-decent condition is protected with rolls of barbwire or jagged pieces of glass attached to the top of concrete security walls. Directly across from our hotel, families live along a dirt road in shacks put together with whatever materials they can find.

Despite the poverty, there is energy about the city and in the people that hints at hope and possibilities. It's that hope of change that has motivated our 14 medical volunteers to leave the "luxury" of their modern day hospitals to work for two weeks in the now rundown and very tired looking open air hospital along Monrovia's Atlantic coast. For a week now, our volunteers have awakened early each morning to eat the only breakfast offered at our hotel-- eggs, a piece of thinly sliced ham, a "hot dog" style sausage, cold white toast and instant coffee. They grab an essential bottle of water and make the short walk down a pot-holed laden road to the gate of JFK Hospital where they quickly disperse into their departments. Some work in the main building, the Pharmacy, ER, Medical Unit, Pediatric Unit and X-ray and Ultrasound departments. Others work in the Maternity building which houses Labor and Delivery, Post Surgery Patients, Intensive Care Unit (ICU) and Neonatal Unit.

This week they have witnessed severe traumas, deaths, infections not commonly seen in the United States. They’ve seen patients denied care for days because of lack of money, met babies living in the emergency room and pediatric units because they have been abandon by parents. They’ve also participated in births, received lots of thanks, smiles and hugs and made lasting connections with their medical counterparts.

They return to the hotel tired each evening and soaked in sweat from the heat of the day. Despite the dire circumstances, they remain positive, enthusiastic and ready to return the next morning to do what they can do help heal patients and restore the JFK Hospital to its pre-war status.

After just the first week of work, Project HOPE volunteers working alongside their counterparts have cared for hundreds of patients. I remain in awe of their commitment to their profession, their compassion for their patients and their willingness to adapt to these harsh conditions.


Here are some highlights from week one:

Dianne Bennett a nurse practitioner spent the week working in the Intensive Care and Burn Units, bringing smiles and encouraging healing to the many children in the department. Using minimal supplies, she cleaned and changed dressings of young children recovering from typhoid perforation surgery, burns and car accidents. But mostly, she offered her counterparts and example of compassionate care and made lots of friends. Cherri Dobson has spent a very hot week working in the unairconditioned and closed-in neonatal ICU unit. There she has been monitoring and caring for two premature babies. She has also made an impression on several full-term babies, placed who prefer Cherri’s caring arms to their cribs. Mary Jo Doerr, a nurse educator spent the week working with staff and patients in the medical unit. Her engaging smile and upbeat personality won the trust of her counterparts as they worked side by side treating patients and assessing professional education needs of the department. She also had the rare opportunity of monitoring two adult tetanus patients. Mary Kennedy, Amy Bream and Dr. Allen Webb spent long hours in the crowded and intense Emergency room. They worked with JFK staff to treat car accident patients, patients with broken bones, life-threatening infections and more. David Meador, Jr., a biomedical repair technician brought smiles to many in the hospital with his fix it skills. He's repaired an ultrasound machine, x-ray printer, pulse oximeters to name a few. His contribution has made immediate impact on patient care at JFK. With help from David, Nabil Messiah an ultrasound technician, has also made an immediate impact on patient care by coordinating the repair of a modern ultrasound machine. After discovering the machine among donated items to JFK, Nabil immediately found a very rare air-conditioned room in the hospital to house the equipment, and negotiated to have a table moved in for examinations. He has already performed 23 ultrasounds on patients. Marina Rivera, a radiography tech has spent a busy week making friends and mentoring the seven member x-ray team. Mixing education with patient encounters, she and her captivated team conducted 86 X-rays in two days. Earl Rogers, a Pharmacist has spent his week working one on one with the Chief of Pharmacy at JFK. He is helping to assess systems to develop a better method for tracking incoming medical supplies and large shipments of drugs. He also discovered a poorly working refrigerator in the ER satellite pharmacy, and with the help of David, he is having the refrigerator repaired to ensure pharmaceuticals that need to stay cold will be properly stored. Gabrielle Seibel, a pediatric nurse practitioner worked in the pediatric unit as well as outpatient clinic, helping the staff organize its charting methods and working with children suffering from Malaria, Meningitis and other diseases. In addition to treatment and working with staff, Gabrielle’s supply of stickers and small toys have brought some fun and laughter into the department. Joel Trinidad, an ER nurse has been working with his counterpart and visiting other nurses to plan for an ambitious schedule of education classes next week. Nancy Ward and Margaret Canter have been working in the prenatal clinic and labor and delivery ward and yesterday had the opportunity to deliver two babies.


Next week, the volunteers will turn their attention to a full schedule of health education classes that have been developed as a result of a week or treatment and assessment in individual departments. Enjoy these photos of volunteers at work.

Help support the Project HOPE humanitarian assistance and health education mission in Africa

--Melanie Mullinax

Health Education in Action at the JFK Hospital

Project HOPE volunteer Marina Rivera only has two weeks to share her 20 years of experience with radiology techs at the JFK Hospital in Monrovia, Liberia. But she's taking advantage of every minute. Read her story.

A retired U.S. Army radiographer from Fountain, Colorado, Marina has worked on some of the best radiography equipment available. But for two weeks this April, Marina has happily left behind the modern techniques of digital radiology to participate in a health education mission as a Project HOPE volunteer in Liberia Africa. She is now sharing her radiology experience with seven counterparts who work at the JFK Hospital in Monrovia. The hospital, struggling to recover after years of civil war in the country, lacks all modern conveniences, even electricity is a luxury. It’s hot, crowded and the x-ray equipment is antiquated.

But Marina doesn’t mind. “I love my job,” she said. “And I am in awe of these guys I am working with. They really want to learn all they can.”

On her first day in the department, she barely finished introducing herself to her counterparts when a trauma patient was rushed in who needed an immediate head x-ray. “I was hoping for something easy, like a chest x-ray first,” Marina said. “But when they brought him in, I just jumped right in. I guess it set the tone and pace for us because we have been non-stop since.”

Working side by side, Marina and her counterparts x-ray up to 50 patients a day. In addition to taking the x-rays, the techs at JFK also manually develop each film. “I studied radiology in the late 80s,” Mariana said. “And while we were being taught manual developing, we were being told we would never use this technology. Now here I am, 20 some years later using the technology.”

While the techs at JFK have received education in x-ray technology, their practical experience is learned on the job. Marina has not only been assisting with suggestions on the right technical settings for each individual patient, but also offering simple practical advice to her counterparts like explaining how asking a patient to put their hands on their hips and hold their shoulders back during a chest x-ray results in a better film, or x-raying a forearm with the palm up instead of palm down presents a more readable “picture.”

Her counterparts eagerly seek out her suggestions. “We want to learn as much as we can about Marina’s techniques while she is here,” said Jackson, one of Marina’s a radiology counterparts at the JFK Hospital. “Then we can learn them and use them after she is gone.”

Marina’s easy going personality is a key to her success with her counterparts and patients at the JFK Hospital. She keeps patients calm and keeps open communication flowing between herself and counterparts as they discuss how to set individual x-ray settings. Often time, even nervous patients crack a smile when they see Marina giving elbow high fives to the other technicians in the room after a successful “shoot.”

Patients at JFK are required to pay for their x –rays upfront at a cost of about $8 U.S. for a chest x-ray. They must return to the crowded dark hot hospital the next day to wait again to pick up their x-ray. “Patients take their x-rays home with them,” Marina explained. “The hospital does not have the capability of storing them here.”

As the only women in the group, Marina also shares an example of compassion with patients, explaining what is being done or offering a gentle touch to a scared child or parent. “Everything we do in here is an educational experience,” Marina said. “Every patient we see, every film we take is an opportunity to teach and learn.”

But Jackson and his six colleagues are not the only ones learning lessons this week. Marina also feels like a student again. “I’m awed by them and their willingness to learn. And I’m learning to. They took me in the dark room and let me develop a film today. They’ve really taught me how to adapt to whatever circumstances your in.”

Photos of Volunteers at Work

It's been a long day walking the dark, stifling hot corridors of the JFK Hospital, trying to keep up with Project HOPE's busy volunteers. Conditions at the JFK Hospital seem impossible to work in to a non-medical person like myself. It's not just the lack of resources that make the hospital setting difficult. I find it hard to listen to the moans of patients in pain, witness wailing grieving family members leaving the hospital, or breath in the smells that permeate the unlit hallways. But the volunteers continue to amaze and inspire me with their positiveness, enthusiasm and willingness to do whatever needs to be done.

Today I shadowed Marina Rivera, our radiographer, as she helped perform dozens of x-rays using antiquated machinery. I was able to participate in the excitement of Nabil Messiah our ultrasound professional and David Meador, our biomedical fix-it guy now nick-named "Scotty" as they discovered and repaired a modern ultrasound machine. I visited Earl Rogers, our pharmacist in the JFK pharmacy and witnessed the improvements being made in pharmacy procedures, and made a quick stop into the infant Intensive Care Unit where Cheryl Dobson, our neonatal ICU Nurse, continues to asses and care for premature babies. Check back for more detailed stories on each of these volunteers and others...but in the meantime, enjoy some photos of Project HOPE volunteers at work today.

--Melanie Mullinax

Meet the Second Team of Project HOPE Volunteers in Liberia

Project HOPE volunteers spent their first day in Liberia meeting a receptive group of professional counterparts at the JFK Hospital in Monrovia. The volunteers were taken on tours of the departments where they will be working for the next two weeks.

I followed our two nurse midwives, Margaret Canter and Nancy Ward along with their counterpart, Ms. Cooper to the maternity clinic and the labor and delivery ward. The conditions were far different from labor and delivery suites now available in the United States. These women labor together in a room with eight beds. There is no air conditioning to make them more comfortable in the humid heat of Liberia and no available pain medication to help them through their labor. The small size of the unprivate labor room does not allow the women to be supported through their labor by any family member. One young girl kneeled alone on the cool tile floor, trying to find the most comfortable position in which to continue her labor. I saw the discomfort and fear on her face. Remembering my own three labors, I wondered how I would go through the painful and often uncertain process without the comforting support of someone else.

Despite the stark surroundings, newborn babies always bring a feeling of hope and two were in the delivery room while we were there. The babies, both with heads full of beautiful black hair were wrapped in colorful Liberian material.

While we witnessed the miracle of newborn life, several of our other volunteers witnessed the death of a young man. While touring the emergency room, a 20-year-boy was wheeled in. He was hit by a car, a common occurrence in Liberia where people often walk on the the sides of crowded roads. The boy was bleeding, vomiting and convulsing, probably suffering from a head injury. The volunteers jumped into to help but the needed trauma equipment was not readily available. The boy died. I wasn't there with the volunteers, but even in their retelling of the story, I could tell even these experienced ER professionals were a bit shaken by their introduction to emergency medicine in Liberia.

While it's clear that the JFK Hospital is lacking almost every modern medical convenience and a lot of medical necessities needed to treat patients, the volunteers were very impressed with the moral, the eagerness and the willingness of the JFK staff to make health care better for their people. A full day of work is planned tomorrow, and everyone seems eager to share their skills with their counterparts, work with patients and learn more

Meet the volunteers...


Dianne Bennett is a Nurse Practitioner from Jackson Health System in Miami Beach, Florida. This is her second time volunteering for Project HOPE. Last year she volunteered on the 2007 Southeast Asia Oceania mission aboard the USS Peleliu. “The humbling experience brought me back to the grass roots of nursing care in its simplest form,” she said of her mission.” I was left with a deep impression of how fortunate we are as United States citizens, to have excellent medical care, equipment, medications and facilities to care for those who need it the most. Yet, how important it is to remember to always give back to those who need it the most.”

Amy Bream is a first-time volunteer for Project HOPE. She is currently employed as an Emergency Room nurse at the Swedish Medical Center, Englewood, Colorado. She is also pursuing an on-line Master of International Health program from Touro University International and anticipates graduating in 2009.

Margaret Canter, a clinical nurse midwife for Tallahassee Memorial Family Practice Residency Program in Tallahassee, Florida is on her second mission with Project HOPE. In 2007, she volunteered onboard the USNS Comfort Latin America mission where she was able to use her Spanish skills as well as her nursing experience.

Cherri Dobson, a first-time Project HOPE volunteer, is a Neonatal Intensive Care Unit Nurse from Kaiser Foundation Hospital, Oakland, California. She also works as a Critical Care Transport Nurse for American Medical Response. She is a NRP Instructor. She is volunteering with Project Hope because she realizes how fortunate she has been to have nursing as a career—“nursing has been very good to me—now it’s time to give back.”

Mary Jo Doerr, a Nurse Educator from Ferris State University in Big Rapids, Michigan is a returning Project HOPE volunteer. She also works at the Michigan Nurses Association (MNA) as the Continuing Education Approval Program coordinator. In the summer of 2007, she volunteered onboard the USS Peleliu on a health education mission to Southeast Asia Oceania.

Mary Kennedy also volunteered for Project HOPE onboard the USS Peleliu on a health education mission to Southeast Asia Oceania in 2007. She is a nurse educator from the Brigham & Women's Hospital in Bridgewater, Massachusetts.