Friday, March 28, 2008

Project HOPE Volunteers Complete Last Day at JFK Hospital

Today was our last day of work at JFK Hospital. This part of the mission was much harder than the Ghana part. The people here are so warn out, the resources are lacking and the medical education is too, but they have improved so much in such little time that there is really a lot of hope here that JFK will once again be the referral hospital of West Africa.

I sat in on a meeting today in which Joy discussed leadership with the head nurses and doctors. It was interesting to hear the concerns they have are also ones nurses and medical staff encounter in hospitals in the United States. There needs to be some sort of accountability for those nurses who don't come into work on time or at all. When the meeting was over Joy and Dr. McDonald talked a while and Dr. McDonald said that in 2006 the hospital was run by nurse's aides and now it has plenty of nurses, that in and of itself is a great improvement and in such short time.

Project HOPE is exploring the the possibility of opening a permanent office in Liberia soon. It was announced by Ambassador Booth on Wednesday. I think it is HOPE's wish to keep moving this hospital forward in order to give the people of Liberia a good medical facility and the medical students a good education. Many of our volunteers have expressed their willingness to come back to Liberia for a much longer time. We all see the need is very great here. Just walking on the campus with the empty buildings and the ones that do work not fully equipped, you see that people are needlessly dying because the resources aren't there.

We as a team have bonded over the past month. When Julia and Valdez showed up they bonded with us too. Bringing those two on was a wonderful decision. I believe most of us had never been to Africa and none of us to West Africa and so we leave with a new outlook on medicine, and on what we see in the news about Africa and a new perspective of what we have in the United States. We are very fortunate to have the things we have and when you come to places that are war torn like Liberia you realize you really shouldn't sweat the small stuff. I know this easier said than done.

This has been an exciting and tiring trip and I hope to return to Liberia one day soon and find it even more improved. We hope we left a good foot print here and that it is built upon.
On a personal note I want to thank Project HOPE for letting me part of this mission and I want to thank the volunteers and also all the great military folks we worked with for letting me invade their space with my camera and also write about them in this blog. They are all truly such wonderful people with such patience and giving hearts.

I leave this blog to my colleague and friend, Melanie Mullinax to continue as she heads to Nigeria with a new set of volunteers and adventures. As we—Project HOPE—continue to go out on these missions we will continue to update this blog from whatever point on earth we visit as long as the internet permits.
--Marisol Euceda

President of Liberia Thanks Project HOPE and U.S. Military

Today was a very exciting day. Even though the GIK donation from Project HOPE was delivered yesterday, this morning we went to a ceremony to thank all of those involved in Africa Partnership Station and Dave, Sharon and I got to go. My function there was to take pictures. As we drove to Redemption Hospital there was a big banner hanging welcoming Ambassador Booth and Madame President Sirleaf to the hospital for the ceremony.
When we walked into the hospital they checked my backpack because of all the high officials that were going to be there. Not only was the Minister of Health, Minister of Defense, and Ambassador Booth going to be there, President of Liberia, Ellen Johnson Sirleaf would be speaking too.

There were a ton of reporters there so I was trying to find a good place to stand so I could get pictures because I knew as soon as the President walked in the door I would be pushed out of the way. While we waited and Dave and Sharon mingled with all the right people we were treated to some music sung by a children's choir from Trinity United Methodist School. All of the children were dressed in yellow shirts with a green and white paisley sash across their chest and navy blue skirts or pants with navy blue socks and black shoes. They sang really well and looked to genuinely be enjoying themselves. Every once in a while I would hear their director yell "smile, smile" and then he would begin to dance as they sang. They sang Christian songs and had only a bongo player to accompany them as they sang.

President Sirleaf and Ambassador Booth finally emerged from the hospital after touring the wards. She came out in a traditional outfit that was black and purple and sat in the center of the first row with Ambassador Booth. As the ceremony began the children's choir group sang a selection and that was followed up by the U.S. Military band playing the Star Spangled Banner and then the Liberian National Anthem. It was really cool to see everyone rise and see all the military men in uniform salute throughout both songs.

Seven people including Sirleaf spoke during the ceremony and the theme seemed to be the same throughout. It was interesting to see that all the American officials read written speeches while only one of the Liberians did. Also every time someone said something funny a trombone would go off as the crowd laughed almost like a drum after a comedian tells a joke. Everyone thanked Project HOPE and APS for all the work they have done and the Minister of Health called for his own people to donate to more of their time for the good of the country.

President Sirleaf also echoed the Ministers remarks and thanked APS for all their services and bringing HOPE. Saying about the Swift "this is a different kind of a vessel. A vessel with soldiers no doubt as we see them all dressed in their attire. But a vessel that brings hope building upon the Project HOPE, a vessel that brings service, a vessel with people who also join our people in sacrificial service to those who need that service most. We want to extend to each and every one of you our hand of friendship and gratitude for what you've done in coming to join us and responding to the needs of our people."

After the ceremony ended she was walking right past me so I extended my hand to say hello and thank you and she shook it. Of course I have no picture because I am the one with the camera and I had no one to take it but I was still wonderful to shake her hand and witness her give a speech within a couple feet of me. She is truly an inspiring woman.

...And Volunteers Conitnue Work at JFK Hospital

When I returned to JFK I was met by the Midwives—Sue and Robin—who were going to present Dr. McDonald and the midwives with 60 textbooks Robin had bought to bring back to JFK as she promised the last time she was here. I went with them over to the school on campus and Robin and Sue both gave something to the school. As I stood in the room, that is actually a library, I noticed a lot of the books are really out of date (some from the 60's) so the books they donated will come in really handy.

After the book donation I went again on my rounds looking for the volunteers in their respective places. I found Christella in the women's clinic in the yellow building. She was working with a really nice doctor. I walked in the door and smelled smoke, cigarette smoke but thought it was coming from outside the hospital but then I was informed by the doctor working with Christella—who was also at this point sniffling from the smoke—that it was coming from the office of a foreign doctor who apparently smokes all the time. I was really disturbed by this because he was seeing pregnant women and he was making the entire clinic reek of cigarette smoke. But there was nothing we could do because we have no authority so I just passed on the word that this was going on and hopefully someone tells him to take it outside.

Later Christella told me that she had actually spent part of the morning trying to find the appropriate place for a seven year old girl to be seen. Apparently the girl's mother had lost a child at birth, and then her 16 year old died gruesomely in the war so she had always been very protective of her daughter. She took her to work with her the other day and a man raped the seven year old. I know I mentioned before most women in this country have been raped but it was still shocking to hear a seven year old had been raped. The little girl was at the clinic but Christella felt she should be seen by pediatrician who specializes in such cases. After taking her to Faye and then back to the women's clinic Christella was so disappointed to find out that there is a rape clinic for women but nothing for children because there are no resources for it.

Tomorrow is our last day working at JFK and we leave Liberia back to the U.S. on Friday night. Hopefully we will be back. I know a few of the volunteers want to come back and hopefully we made a difference.

--Marisol Euceda

Thursday, March 27, 2008

Meidcal Donations Arrive at JFK Hospital

Today the GIK arrived at JFK. I walked over to the receiving area with David Eddy and Caleb so that I could take pictures. I thought the shipment would be completed in the morning but it kept coming all day. When I was in the outpatient clinic taking pictures of the primary care team I heard more rumbling down the road and saw three big Liberian military trucks come in with the GIK. The boxes of stuff arriving was heading to the store room in JFK and also to the Ministry of Health's warehouse. One of the forklifts caring the boxes actually got stuck on its way to the store room.

I spent most of the day wondering around to the different locations on campus where our volunteers were working. In the large hallway of the JFK the nurse educators were holding a class for what seemed to be about 80 people. At one point Christella was also there taking a break from weighing patients at the HIV clinic. Tuesdays and Thursdays JFK holds an HIV/AIDs clinic.

From there I went back to primary care to take more pictures of Dr.Polifka working with patients and med students. A med student had come to him with an EKG and he was showing them how to read it.

Then I wandered over to pediatrics to see Faye. A couple of minutes after I arrived the power went out and it was really dark in the room because there are no windows in the room. However, Faye is always prepared so she pulled out two flashlights, shortly after the lights did come back on.

I went back to the physical therapy clinic and found Julia and Josephine working with a little girl who suffered some paralysis in her arm when she had meningitis. The girl seemed to be about 3 but wasn't talking, she just sort of cried out. Julia and Josephine were trying to get her to reach for a rattle but Julia soon noticed the girl would not respond to the sound of the rattle just the sight of it. She thought she might have some hearing loss so she went behind her and clapped really loudly twice but the child did not even flinch. The little girl had hearing loss so she wasn't reaching once the object was out of her sight line.

I guess Tuesday wasn't as exciting as other days. I just walked around visiting all the volunteers and taking pictures. I also interviewed Sam for some quotes. He is a really nice guy with a really interesting story. He wasn't always a physical therapist. He was once a physician's assistant and volunteered to become a physical therapist when Handicap International came into train physical therapists. Because of the war many people suffered amputations due to trauma and now the biggest cause is motor vehicle accidents so the need for physical therapists to get people using prosthetics correctly and training people to walk again is huge. Sam and Josephine are the only two physical therapists at JFK and they see patients suffering from paralysis due to stroke, amputees, and children with club feet and anyone else with a debilitating issue.

I hope to have something about the PT clinic written soon. It has been a fascinating place to watch people work because it is all about how you move.

--Marisol Euceda

Wednesday, March 26, 2008

A Day in the Emergency Room of the JFK Hospital in Liberia

It's the first day of our last week in Liberia and the end of our four weeks of providing care and education in West Africa. The hours are just starting to fly by. Today I got a late start because I was looking for Joy's camera and couldn't find it so by the time I made it out the door I had missed the van heading to JFK hospital. So Natalie—doctor with the navy—and I walked to JFK. Again it isn't a bad walk but crossing the street is like playing frogger, luckily there was a cop directing traffic where we needed to cross the street so it was easy to cross today.

When I got to JFK I went to look for the primary care team because I had to tell Dr. Polifka about an interview but I couldn't find them. I later found them in the conference room where Cornel Moritz was giving a lecture to the medical students about diabetes and periodontal disease. I left my message and headed down the road to the physical therapy clinic to watch Julia work.

When I arrived at the physical therapy clinic Sam and Julia had just finished casting the legs of a baby with club feet. He was the cutest little baby and was just wailing because of the casting. They were casting his club feet in hopes that it would slowly rotate his feet enough so that he could have surgery on the Mercy Africa Ship. Because Liberia doesn't really have anyone to do club foot surgery they cast and recast the babies' feet which can gradually rotate the feet. It was cute to watch as the mother wrapped him up to carry him on her back and as she left all you saw were two little white cast sticking out from under cloth carrying him.

While I was in the physical therapy clinic Sam, Josephine, and Julia saw one more baby with a club foot, two stroke patients, a patient with a back ache and also a young man who was being fitted for his prosthesis. With the stroke patients they did a couple of exercises to get the paralyzed muscles moving again. For the back ache patient Julia showed Josephine how to nudge the vertebrae that was causing the trouble so it wouldn't bother him anymore. Later a young man with a leg amputated showed up to try his prosthesis. He was unable to walk in it last time because he had an open wound. He put the prosthesis on and was a natural at walking in it. His balance was wonderful and it was amazing to see he was doing so well on the prosthesis.

I left the PT clinic and headed over to find Dr. Polifka for his interview. As I was waiting for the phone call I heard a woman wailing just outside the outpatient clinic. I watched from the window as she wailed, and threw herself on the ground. Slowly a crowd began to form all trying to comfort her as she wailed. I couldn't understand her but her pain and anger came through.
After waiting for the phone call for a while and learning a little about heart murmurs—Dr. Polifka was showing the med students he was working with how to listen and treat a heart murmur—I headed over to the ER to see Joy.

The ER is very small and makes me a little uneasy because you see all sorts of trauma come through the door. Joy worked for many years as an ER nurse so she was trying to help as much as she could. The ER at JFK looks very dingy and has a very distinct smell. As I walked in a man had just come in with a neck injury because he had been a motorcycle accident, next to him was robust woman who actually looked to be ok. I kept thinking maybe she needed to be in the outpatient clinic but who knows. Next to her was a girl who looked to be about 14. She had an IV in her arm and a doctor was trying to clean her face up. She had been hit by a car and had a skull fracture. Behind the three of them was another room with three stretchers, that room was really smelly. In the room where three men, two of them had head injuries and the conscious one appeared to have some burns that the nurse was dressing. Joy and another nurse tried to put an IV in one of the men. He was restrained to the bed but still very strong and didn't like having the IV needle in him so it took multiple tries and needles to get the IV in him.

Joy later told me the men on the stretchers were actually placed on the stretchers incorrectly with their feet on the end where their head should be and their head where their feet should be. She tried to explain this to the local nurses but they just weren't getting it so she eventually just had to show them by having them help her put them correctly on the stretchers. When they finally saw what she was talking about they were awed because they didn't know you could lift the patients head up on the stretcher, this way they avoid aspirating.

A volunteer had a similar incident with a patient. The patient had come in earlier and the volunteer sent her to the x-ray department to get a chest x-ray. Later the patient came back to the volunteer and told her she had gotten her x-ray but she didn't feel any better. The volunteer had to explain to her that the x-ray is just to figure out what was wrong with her and not treatment. It's the small things that we often assume everyone knows but in a country where health care and education isn't available you can't assume.

I tried to stick around the ER as long as I could but the smell and the crowdedness really got to me so I headed up to the ward to see Dave Vuurman. Dave was in the general medicine ward on the second floor to the hospital doing rounds. While I was up there we wandered into a room with one patient, a very frail old man who was unconscious and whose mouth kept making a smile in his sleep. He was in the ICU, even though there were no meds for him and they didn't really know how to treat him, because he was too weak and needed constant care.

The nurse also kept saying she had malaria. She knew she had malaria because of the fever and weakness she felt but didn't want to take the malaria test because she was afraid of the needle prick. I guess once you've had malaria so many times you know what to look for, Faye did say that 95% of the pediatric patients at JFK leave with a malaria diagnosis.

After running around JFK all morning I headed over to the administration hoping I could get a good internet connection to send photos back to Project HOPE in Millwood. Sending photos from Liberia is really challenging because the connections here are so bad. Usually one photo will take me about 15 minutes to upload and send. I sat in the conference room with the med students and before long a male med student struck up a conversation with me. He was really nice and was asking questions about what I do for Project HOPE and where I was from so I talked to him for a little while. I got back to my work but every once and I while I would look up from my laptop and he would be staring. It was really funny and sort of uncomfortable at the same time but soon it was time to go so I packed my stuff up and headed out the door to meet the team.

Outside I noticed some of the nurses had not yet arrived. When Joy, David and Faye finally came out the hospital they told us a child had just died of malaria. The baby girl had been brought into the hospital by her grandmother and she had been ill all weekend. When she was brought in she had severe diarrhea and a very high fever. They rushed her to the emergency room. Joy said as soon as she saw the little girl she knew it was too late but they tried to save her. The baby just couldn't take it. They told the grandmother she had passed and the grandmother just shook her head in disbelief and then said she had to go get the girl's mother who was at work.

Later I asked Joy how she was doing and she said she was ok, that it is a reality of practicing medicine in a country like Liberia. The ER doctor, who is actually a medical student from an American university, seemed to take it pretty hard. According to Joy, Rachel was upset and frustrated. If only her family was able to get the baby to the hospital a day earlier or even hours earlier she may be alive today.

Tonight during our meeting I found out our gift-in-kind (GIK) donation of over $4 million in medicines and medical supplies will begin arriving at JFK tomorrow morning so I will be taking pictures of the GIK as it is unloaded. Some of the GIK will go directly on the shelves of the JFK pharmacy and some will go to the Liberian Ministry of Health for distribution in Liberia.

On Wednesday, David Eddy, Sharon Steel and I will be going to Redemption Hospital to attend a ceremony to thank the folks participating in Africa Partnership Station. I am told the President of Liberia will be at the event as well as some other high ranking officials from the Liberian Government. -- -Marisol Euceda

--Marisol Euceda

Tuesday, March 25, 2008

More photos of Project HOPE Volunteers in Liberia

Project HOPE volunteer, Joy Williams, a radiology nurse from Massachusetts General Hospital helps and trains in the emergency room of the JFK Hospital in Liberia.

Julia Chevan is a Project HOPE volunteer from Florence, Massachusetts where she is a physical therapist and a college level instructor and professor at Springfield College in Springfield. Here she works with a baby with club feet at the JFK Hospital in Liberia. During this mission, she is working side-by-side with the only two physical therapists at JFK in the rehabilitation center. Chevan is assisting with patients and providing hands on training to the physical therapy team.

Project HOPE volunteer, Valdez Bravo is a biomedical equipment technician from Portland, Oregon. He currently works as a medical equipment repairman at the VA Center. In Liberia, he is volunteering his time to assess what equipment is needed at JFK and Redemption Hospitals, as well as fix equipment that he can, and train others on repairs.

Monday, March 24, 2008

Easter Sunday in Liberia

Sunday was Easter so a lot of volunteers woke up early and headed to church. Liberia has a large variety of Christian religions. Joy and David went to a Methodist church with one of the drivers and his wife. Christella and some of the military folks went to catholic mass and Robin, Sue, Julia and Valdez went to Rock Church—an evangelical church. All the services ran about 2 hours. I stayed in but should have gone with Robin's group because it seemed like they had a really neat experience at Rock Church.

Robin had previously been in Liberia with Physicians for Peace where she first met the bishop of Rock Church. She was really excited that she was going to be able to go to Rock Church again and made Bishop Cox a prayer shawl out of really pretty multicolor yarn. She had been knitting it since Ghana. At service a baby was being dedicated and the bishop asked Robin to help with the dedication. She didn't know the baby's family but agreed to help. She took the baby into her arms and was asked to give it a blessing which she did.

The whole group later went on to visit the clinic which was created by and is run by the church. Sue, Robin and Julia were all impressed by the clinic. It has a delivery room, operating room, electricity, and running water. It sounds like JFK and the small clinic are like night and day.
The group that went to Catholic mass enjoyed themselves too. Obviously the sermon was about the resurrection of Jesus Christ but the father tied it into the rebirth of Liberia as it begins to come out of the civil war. They also said the service was really festive because a dance group of children came down the aisle dancing.

After church a few of us headed to CeCe Beach. There were a lot more people there than the other day when we had visited the beach. There were lots of families and music going. There were men on the beach playing volleyball and soccer. In Liberia there is a big Lebanese population and they were also out on the beach.

I sat on my towel with my iPod on people watching. At one point there was a little boy attempting to through a Frisbee but he just couldn't get it and little girl carrying buckets of salt water from one place to the next. It's funny how little kids get a kick out of the smallest things and aren't afraid to try new things because being embarrassed never crosses their minds. It was a relaxing afternoon and I got lots of sun even though I just sat out there with my shorts and tank top because I didn't think I would need a swimsuit on this mission.

Actually there are a lot of things I wish I had thought of to pack besides the mosquito spray, sun screen and my khaki shorts and Project HOPE shirts. I should have definitely brought some cold medicine and extra hair bands. Also, I am beginning to miss looking nice—I miss my make-up and nail polish. I didn't bring any of my items that make me look a little better because I thought I would surely be labeled prissy and I didn't want that, I wanted to be taken seriously. The result is now I don't want to be in any pictures because my hair is wild and I don't like the way I look. I know this really superficial thing but it's been almost a month since I got to look pretty and girly. It's funny people look at my picture on the blog and don't even realize it's me. Joy the other day as we were looking at pictures on my computer said "she's beautiful" and I replied "that's me." The other day I finally borrowed Faye's nail polish and felt a little better about my toes.

Sunday was also Caleb's birthday so for dinner I joined him at the sushi restaurant in the hotel. The sushi restaurant or the other hotel restaurants are our only choices for food besides the MRE's. Who knew you could get decent sushi in Liberia. The Living Room—the restaurant's name—looks like something you would find in Washington or any big city in the U.S.A. and has Filipino sushi chefs. I was a little weary at first about eating raw fish here but it is quite tasty and I am not sick so that's a good sign.

Tomorrow our last week in Liberia and of the mission begins and it will fly by. I can't believe I will be on my way home with everyone else on the same plane on Friday night. It should be a fun flight, it will be really hard to say goodbye to folks when I arrive at Dulles but I hope I can keep in touch with the friends I have made and hope to see them on future HOPE missions.
--Marisol Euceda

Saturday, March 22, 2008

A Day of Rest for HOPE Volunteers

Today is Marley's Birthday and we have the day off so we are all had breakfast and a quick meeting then headed downtown to Broad Street to check out the local crafts. However, because of the holiday the streets were actually quite empty and the stores closed. It was very deserted. In the U.S. we never close anything for Good Friday or the census—the two big things going on today—and here even the UN Drive store was closed. We did find some folks open for business so we spent about an hour and half looking around. They make such beautiful stuff out of ebony wood and also really beautiful clothing items out of brightly printed material. I didn't buy a whole lot because I don't want to have too much to carry home and also I have over a thousand photos from this trip to remind me of it. I hope to make scrapbook when I get home.

I do believe I will be ready to get home to those I love by next Friday. I can't believe how quickly the time has flown by but I miss the small things. This is by far the most exciting assignment I have had and the most demanding. It is non-stop work, I follow people around all day in this crazy humidity and heat and then come back to the hotel and have to write about it, check my email, download pictures, try to send the writing and pictures back to USA via the internet that is really slow and then I can rest. I will be ready for a day or two off when I get back.

On our way back to the hotel from the market our driver took us up a hill to look at the ruins of hotel that will apparently be rebuilt. It was surrounded by the UN Peacekeepers. As we drove up the hill on the left I noticed a building that looked like a governmental building you would see in the Washington, DC except it was only a shell because the windows were all gone, the white of the building now had black smoke stains it was very haunting to see this beautiful building. You could imagine people probably coming and going at one time and now it just sat empty and probably unstable.

Once we got to the top of the hill there was an old hotel with a circular drive with a fabulous view. We didn't get out of the car but you could tell it was probably one a great hotel and now like the building I saw on the way up was just a ghost of what it once was. As you drive through Liberia you see a lot of these ghost buildings and mansions. Squatters live in some and some of them just sit empty all victims of the 14 years of civil war. I find myself wanting to take a photo tour around the city. I asked what weapons were used during the war because it was clear they had used some bombs and I was told the actual weapon of choice was the machete which just sounds so terrible.

The driver also took us to look at the beach. The beach in Liberia looks great from far away but if you get close you smell and see how gross it is because people actually use the bathroom on the beach which is why we call it "poo poo beach." An avid beach lover this is really hard for me to comprehend because the beach is a favorite place for me but people here due what they can because they don't have running water and sometimes bathrooms.

We drove past a giant building on the beach whose windows had all been blown out. It was another ghost hotel—the Hotel Africa. It looked like a hotel you would see on Miami Beach, right on the water with a lot of rooms, it was definitely the largest building I had seen in Liberia. Then we drove past some shanties. After driving past shanties we wound up at a beach resort type place. It wasn't as nice as the CoCo Beach Hotel in Ghana but it was nicer than poo poo beach because it was privately owned and maintained. There were tables under grass huts and waitresses to take your order. It was really beautiful on the beach but I wasn't sure how safe it was to get in the water because of the garbage and stuff on the coast in Liberia. Once you got passed the privacy fence you could see fishing canoes next door and some fishermen were on their way out to see. It is really weird to be on a nice privately owned beach when you have to drive through a shanty town to get there. You really began to see the imbalance. These places are set up for tourists because the local people can't afford to spend money in these resort beaches. And the resorts buy the beach property sometimes making it impossible for the locals to enjoy the beach. This really bothers Joy. Joy was born in Jamaica and lived there for many years before her family moved to the US. She says that in Jamaica many of these resorts have bought up all the beach land so the locals have to pay to use their own beach and they can't afford it and they can't afford to buy property on the beach because a house on the beach there is now going for about a million which only foreigners can afford. In the end the locals end up working at these places but unable to actually use them.

We headed back to our hotel and had lunch. I and a few others stayed behind while some went back to the beach. Later a couple of headed over to play soccer with the local kids or at least that is what we thought. I was just going to take pictures and hang out. We walked a couple blocks from our hotel down a neighborhood of ghost mansions. All the houses in the neighborhood were really big, and probably estates at some point. We arrived at the soccer field and it was actually in someone's huge back yard. A famous soccer player that played in Europe owns the house. His name I believe is Weah. He is away in the U.S. studying politics but lets the children play in the back yard which faces the ocean. You couldn't see the ocean because of the fence but you could hear it. However, today the kids weren't playing the teens were. Our guys right away seemed a little intimidated. This is a soccer culture so it seems everyone here plays really well even though they play barefoot or in socks because they can't afford shoes.

They let our guys join their teams. At the end of the game I think it was actually tied and everyone seemed to have a wonderful time. It is amazing catching a game of soccer on a camera because you can see the flexibility of the body. Also it was nice to see that even though we are from such different places those who love soccer are the same the world around. You don't have to talk or even know each other as long as you play soccer you're understood and in.

Earlier in the day we made up an excuse meet at 7:00 pm so we could surprise Marley and Caleb –his birthday is Sunday—with a birthday cake at the hotel restaurant. Once everyone gathered out came the cake with two giant sparklers and both their names on it. We all sang and had some really good cake.
--Marisol Euceda

Thursday, March 20, 2008

A Day of Work at the JFK Hospital in Liberia

It took all I had to get out of bed this morning. Not because I wasn't feeling well, I am definitely better today than I was yesterday, but because I actually watched television news last night which means I stayed up past 11 PM. Anyways, I finally dragged myself out of bed, got dressed and headed down to have breakfast and get ready to go. As we headed out we discussed whether we wanted to go to the diamond mines, about 4 hours away, this weekend. Some of us did want to go but the security risk is too big so we will not be able to go. But this morning we went to the U.S, Embassy compound to cash some traveler's checks. The drive to the embassy was the most of Monrovia I had seen since we are staying at a hotel within walking distance of the hospital. We had to drive thru town on bumpy roads in need of repair to get to the embassy. There were lots of people and it sort of reminded me of Old San Juan in Puerto Rico except there were lots of destroyed buildings. You could tell it was their metropolis but the buildings weren't skyscrapers.

When we got to the embassy we had a little incident. Christella, was very excited about going to the embassy that she took a picture of it as we pulled up so her disposable camera was confiscated. The embassy here is huge and it seems like a giant American subdivision because it has its own pool, ocean view and tennis courts. I guess most people live on the compound because it is safer.

After the embassy we went into the town to try to change Euros into American dollars because one of the military guys with had some of those. We drove to the Ecobank and it took forever for him to exchange his Euros because he needed six signatures once he got into the bank. While we waited for him in van I asked someone to run out and get me some of the local newspapers because I was hoping Project HOPE would mentioned. We were featured in one of the newspapers. What was funny is that they said our chief medical officer was the military public affairs officer and that the cornel/dentist was part of Project HOPE but it was a very positive story.

When we finally arrived at JFK it was close 11 AM, much later than I would have hoped but I still had a full day work to document. I made my way up to the third floor of the hospital with Faye and Christella where we joined the clinical rounds. The med students were examining an older woman and asking her questions about what hurt and seeing if she could walk and sit up on her own. She obviously needed more tests but at JFK they don't give any tests until the patient or the patient's family pays for them up front. They also have to pay 4,000 Liberty or the equivalent of about $66 dollars to be admitted into the hospital because otherwise JFK would not be able to function so even though it sounds harsh that they have to pay for this stuff upfront I understand why they do it. Because of the payment policy the lead physician was telling the students that they need to make it a point to come see their patients during visiting hours and explain to their families that they need more tests to be done to find out what is wrong with them and that they required them to pay upfront for those services. It sad but as I said before the hospital just doesn't have the budget to pay for the tests some the patients need.

After the rounds we went down stairs to the outpatient clinic where the primary care team has been working side by side with med students, nurses, interns and residents. This area of the hospital is one large room that has been separated by blue tiled walls and white sheets to protect the patient's privacy. Each room has a door leading to the main waiting area on one side and the sheet on the other. Then there is a large counter space with one working sink in a lot of windows. The windows are kept open and the fans going but it is still hot. However, because of all the windows it is actually one of the brightest rooms in the hospital.

I usually try to stick around the outpatient clinic to take good pictures but it has been hard because it is actually pretty cramped and as I said before the people here aren't really excited about having their picture taken which I totally understand. It is really hard to get my part of the work done down there but as long as the docs can get their work done that's all that matters.
About an hour later I headed over to the physical therapy clinic to see Julia. And it wasn't as busy as I would have assumed but I learned that the best time to go to the PT clinic is in the morning. Many of the physical therapy patients come from longer distances and take public transportation which is cheaper in the morning than in the afternoon. While I was in the PT clinic a there was young woman practicing to walk with her prosthetic and she was getting around very well. It was really nice of her to let me take her picture.

I headed back to the administration building to see if I could get some good internet and send some pictures. The internet in Liberia is completely unreliable and slow so you have to find the right time to log on. Luckly, I was able to send some photos but it took about four times as much time as it would take in a place with decent connectivity.

I finally figured out where Valdez is working so I headed over to the medical equipment grave yard to see what he was up to. What I found was a work room full of tools and gadgets the local equipment repairmen had created to help them with their job. It was like walking into science class. Valdez was showing one of the men how a blood oxygenator works. This is one of 8 pieces of equipment Valdez has fixed since he arrived. Behind Valdez's work station was a line of other equipment he had to repair or take a look at including a ventilator which had just been donated by the Japanese. He had to take a look at the ventilator to make sure it was ok to go. Valdez will be working there with another biomedical equipment technician from the Africa Mercy Ship next week.

As I was heading back to hang out with the primary care team I ran into Christella who was on her way to the physical therapy clinic. She was going to let Julia show Sam some new maneuvers using her body since her hip had been bugging her. Christella apparently hurt her hip last year while taking a kickboxing class had some pain when she jogged so she was happy to volunteer. Sam was able to do and exam on Christella and asker questions about the kind of pain she had. Also, he and Julia had to try to recreate the pain Christella has in order to properly diagnose her which meant maneuvering her leg until she felt the pain. Turns out she has a tear so then Julia showed Sam how to pull Christella's leg just right so they could readjust the area so it wouldn't hurt anymore. I don't think I described it too accurately here but it was pretty cool. Julia had a good metaphor for what she was doing. She said it's like when you have a pebble in your shoe and it's bothering you so you move the pebble to the toe of your show so that it won't bother you anymore.

After the physical therapy lesson we both headed to the administration building conference room where Dr. Polifka was going to give an EKG reading lesson to the med students. We spent about 30 mins trying to figure out why the projector wasn't reading the computer only to have Christella lean over and open the shutter on the projector and fix the problem. It was really quite funny.

Dr. Polifka began his lesson emphasizing that reading an EKG takes years of practice. When Dr. Polifka asked the class how many of them had actually seen an EKG before only one hand was raised. It was apparent that this lesson would be difficult for them to follow because they had such little training. In the teaching staff at the hospital and our primary care team are trying to not only teach and train the med students at JFK they are also trying to broaden their thinking skills because diagnosing a person requires asking the right questions and asking that the right tests be done. Not everything in Africa is caused by malaria or HIV/AIDS; they really need to get the bigger picture. Not being from the medical profession it never occurred to me how important those critical thinking skills are to the profession.

Just before we headed home Dr. Polifka asked what time we should show up on Friday because we knew there was a holiday. And we were told that the hospital would be in minimal operation, by that I mean there would only be about 2 of the med students coming in to do rounds so there was no point for us to come in which meant we had the day off on Friday. Believe it or not the volunteers usually hate days off because they want to work as much as they can while on these missions because the time is so limited so many of them had actually wanted to come in on Friday and do rounds.
--Marisol Euceda

Wednesday, March 19, 2008

Volunteers Busy at Work in Liberia

I can't believe we are already at Wednesday of our first week in Liberia. After a day in bed, because I was pretty ill and still am slightly, I woke up and went to breakfast in the hotel. Our breakfast at the hotel is complimentary. It was a pretty nice spread of eggs, toast, sausage, croissants and cinnamon buns. It was very American. Oh, and they have Tang. I love Tang but haven't had it since I was a kid. Just a quick side note, every time I come into the café to order food and sit at a table I get absolutely no service. I am not sure why but I don't. Maybe I don't look nice enough. Who knows but it's a bit annoying. Other than that the food is pretty good.

While we are in Liberia the nurse education teams are working at different hospitals and swapping so that they both work at both hospitals. This week the nurse educator team is at Redemption Hospital. From what I was told this is the charity hospital and is much worse off than JFK.

The midwifery team and the primary care team are now working out of JFK, so I too went to JFK. JFK is still a little of a maze to me so after a walking to the wrong building I finally asked someone where the midwifery training was going on. The midwifery class was now being held in a large hallway with plenty of ventilation because they have been getting over 70 students at day for each class. This class had actually been held in a much smaller space with only one AC working which was a bit much for everyone involved. Apparently there are two working ACs in the room but only one remote so when they would turn one AC on the other would go off so there was never enough air in the room. Because JFK cannot afford to send all the healthcare professionals who deliver babies down to the class at the same time some come in the morning and then a new batch arrives in the afternoon. In the class there are physician assistants, midwives, nurses and just about any other person in the hospital staff that works in the business of giving birth.

The primary care team is doing two things while at JFK. In the mornings they are doing rounds with the physician assistants and medical students. These rounds are providing the medical students, residents, interns and physician assistants with more hands on training, our primary care team is there to instruct but the staff at JFK actually does the work. In fact Dr. Polifka will be holding an EKG reading class because many don't know how to read the EKG. In the afternoon the primary care team sets off to outpatient clinic of the hospital to provide some care. There too they work side by side with the hospital staff.

Today some media stopped by the hospital because they were unable to make it yesterday. They interviewed Project HOPE's David Eddy, some midwifery students, the Cornel with the dentists and then Dr. Polifka. Everything went very well and they all seemed really interested in what we were doing. Throughout our time in Liberia media are expected to drop by a couple times. The military public affairs team and embassy public affairs team here have been very wonderful about getting the message about the whole mission out in Liberia and they know so much about what Project HOPE is doing.

Today I went by to visit Julia, a Project HOPE volunteer, a physical therapist who who joined us on the Liberia mission. Julia is working with Sam—one of the local therapists. Together, they were seeing an older gentleman with a ssing left leg. After visiting with the patient Julia and Sam taught the gentleman how to wrap his leg so that the shape is one that will mold and work better with the prosthetic he will be fitted for. Most, if not all, the patients she will see here will be patients who lost a limb or had an injury due to trauma.

Tonight after dinner Christella asked Julia how her day was and she replied "every day is a good day."

This environment is so different. The heat seems to be worse and so does the humidity than Ghana. The people are much more subdued. When I walk by a line at the clinic they don't tell me they are in a hurry or ask me questions they may just say hello or watch me walk by. In Ghana there is no way we would have been able to walk down the street in Accra without about 10 people trying to sell us stuff but today Christella and I walked home and were only asked to buy something when we got to the gate surrounding our hotel. We even crossed Tubman Street which reminds me a little bit of the game Frogger because you have no crosswalks or lights just people trying to cross the street and avoid traffic. There are people from all over the world here; maybe it seems that way because the UN is here and there is a lot of foreign investment going on in Liberia. However, their love of soccer seems to be the same.

CarolineTeeter from Project HOPE, who has been in Liberia since November, started a soccer league. Some of the kids play barefoot on a dirt field, but they still play. Yesterday, APS dentist team and environmental and preventive medicine team, veterinarians and Project HOPE volunteers went out to the field to play soccer with the kids in the league. While they played the dentists provided some dental screenings, a lesson on oral hygiene and also free tooth brushes and toothpaste to the kids as they rotated off the field. The game ended in a tie.

I haven't been in Liberia long but I can say that being at JFK is draining but people here are working really hard to make the hospital what it once. You walk around the campus and see ruins of what was once a great institution. Most halls in the buildings are dark and sinks don't work but the hospital is still open and the people continue to push through. The people in this country have been through a lot and it shows. People here lack not only the resources but also the training because the civil war made education so unstable—as I mentioned earlier it has taken many doctors 10 years to get through medical school because of the war. Project HOPE has already expressed an interest in developing long term programs at JFK and hopefully it happens.

Tuesday, March 18, 2008

Two Volunteers Join Team

With Liberia we have added two more volunteers to our team, which I met for the first time today.(I was sick their first day with the PH team.)

Valdez Bravo
Valdez is a biomedical equipment technician from Portland, Oregon. He currently works as a medical equipment repairman at the VA Center. He is here to assess what equipment at JFK and Redemption Hospital can be fixed, since many of the medical machines at these hospitals have been ruined do to surges in electricity in Liberia, and to fix equipment. I actually ran into him today as he was taking pictures of equipment that was in disrepair so that he could put a game plan together. Also he already fixed a centrifuge and a blood bank refrigerator at Redemption Hospital.

Julia Chevan
Julia is from Florence, Massachusetts. She is a physical therapist with over 22 years experience in physical therapy and is also a college level instructor and professor at Springfield College in Springfield, MA. She is working side-by-side with the only two physical therapists at JFK in the rehabilitation center. Chevan is assisting with patients and providing hands on training to the physical therapy team.
--Marisol Euceda

Project HOPE Volunteers Arrive in Liberia

After two days aboard the HSV Swift we were finally arriving in Monrovia, Liberia. I and two volunteers woke up really early to attempt to see the sunrise from the ship. It is quite an inspiring view to look stand out on the flight deck of the ship and see nothing but ocean and feel the breeze blowing while you look out. It was cloudy today so didn't see the sunrise but we could see lights because we could the see the shore of Liberia.

We were getting off the boat at 9:00 am along with the Africa Partnership Station dentist, Seabees, veterinarians and the environmental and preventative medicine team. As we got closer the military sent two of its small boats out with men. This was done for security. One boat covered the front of the Swift and the other the back. Gradually we pulled into port were we were told that a tug boat had to guide us in because there are 11 shipwrecks in the port of Monrovia. There was actually a ship that had been wrecked that was washed ashore onto a little peninsula as we came in and we were suppose to dock next to another shipwreck. The shipwreck we were suppose to dock next to looked to be a cargo or oil ship and its middle was submerged in the water. Its hull was completely rusted while on its bridge you could still see remnants of while paint. On our other side was the Mercy Africa. The Mercy is actually a boat that belongs to non-governmental organization Mercy Ships. My understanding is they come in to port on this giant ship with volunteer families who live on board and provide humanitarian aid to different countries. I read somewhere they were inspired by the SS HOPE—the first peace time hospital ship—that Project HOPE retired in 1974. The Mercy Africa looks like a cruise liner and some of its inhabitants came out watch as we pulled in. I'm hoping we get to visit with the Mercy Ship volunteers at some point.

Media was waiting for us on pier ready to interview some of us as we came off the boat and possibly get a tour of the boat but after a while the Swift began to go backwards. We then realized that we were not getting off the boat as we had originally planned. Because of reasons unbeknownst to me it was decided the Swift would not dock but that the tugboat that was guiding us through the harbor would ferry us to shore. That meant we had to gather all our belongings and bring them to the back to the back of the hull so that it could be placed on the tug boat after we boarded. To board the tugboat we had to tie the tugboat as tightly as possible to the Swift which still left a gap between the two ships of about three feet that we had to jump over to get onto the tugboat. This is something I had to also do when I visited the USNS Comfort in Nicaragua last year. After everyone was on the tugboat a line formed so that we could pass everything we needed down to the tugboat. After everything was loaded we untied ourselves from the Swift and headed for shore while the Swift headed to its next destination. We waved from the tugboat and they all waved back.

When we arrived on shore we again had to jump to get off the boat. Dr. Polifka, Cornel Mortiz and me got off the tugboat first so that we could greet the media. Everyone else got off the boat after and again formed a line to get all the luggage and boxes off the ship. We were met ashore by half a dozen reporters. Dr. Polifka did a good job again addressing the reporters' questions. After we were done we headed to out of port in vans with an escort as the lead car (side note: the van I was in was playing Kenny Roger's greatest hits, I wonder if the driver really likes Kenny Rogers or thought we would) and to the hotel that would be our home for the next two weeks. I wasn't feeling well but thought I was just tired from being up so early.

In Liberia we were again met with lots of traffic. As we drove down the road there were buildings that were not whole anymore because they were destroyed. We drove past a staircase that led to what looked to be the foundation of a building that was no longer there. The people as Marley put it "looked burned out." You didn't see many children around and the ones I saw were digging in a trash pile. There wasn't much trash on the street because it seemed everything was taken to that pile. Like in Ghana were met on the road by folks trying to sell us stuff but they weren't as aggressive. I noticed there were lots of tire shops but I am assuming it's because the roads are so bad. I also saw a couple holding hands which is something I didn't ever see in Ghana. The van also passed a very large illustrated sign about rape counseling for women to get help. In Liberia most women have been raped.

We finally arrived at our hotel. While here we are doubling up on rooms to save money. My roommate is Christella. Our room is nice. It has two twin beds a mini fridge, a desk, TV and standing shower. There are no elevators in this hotel so we had to haul our entire luggage upstairs. According to the other folks staying with us the higher you go up in the building the worse the rooms get so Christella and I got lucky with first floor rooms.

After we settled in we went downstairs to have lunch. There is a cute little café owned by the hotel. This is where we are having breakfast and dinner every day but we are still having MREs for lunch. The food seems to be pretty good. Liberia still has power surges so while we were at lunch the power went out for about 5 minutes. When lunch ended we headed over to the JFK hospital where most of our work will be done.

The JFK hospital is actually a big campus but most of its buildings are now useless because of the 20+ years of neglect and civil war and it some of its entrances are surrounded by barbed wire. At JFK we first stopped at the conference room in the administration building where we were briefed by Project HOPE's in country director for Liberia—Caroline Teeter—about the current situation in Liberia and security measures. Below are some highlights:

· This is a post conflict country with UN peace keepers in it. We saw a lot on the road as we drove in.
· The infrastructure is poor. The water and electricity grids are just beginning to function but most of the sewage still winds up in the ocean.
· Because of the war it took physicians 10 years to complete medical school.
· There are only two functional operating rooms in the hospital.
· Before the war there was a population of 300,000 in the Monrovia area now there are 1 million. Around JFK hospital there are 20,000 squatters.
· Physicians are old and want to retire but they can't because there is no one to take their place.
· There are suppose to be 1,000 doctors for the amount of people in Monrovia but there are only 51.
· There are no pediatricians in the country or anesthesiologists.
· 27 buildings at JFK have been destroyed.

As for security there is a curfew. No one is allowed to be out between two and six AM. We were told not to walk alone especially if you are a woman. And we are not allowed to take cabs because they can be very dangerous. We are also supposed to get a security briefing from the UN at some point this week.

At this point in the day I am starting to get pretty congested but don't think anything of it as we are off to tour the rest of the hospital. We first stopped in the maternity ward. The building was hot and dark because there weren't any lights. The areas with lights and AC were kept closed because the AC was running. These areas were the critical areas of the hospital like the OR. We got to see some new babies in the nursery which in was just a room with different types of cribs in it. We visited the fistula ward. If you don't know what a fistula is look it up, it's caused by prolonged labor and isn't pretty. I am not going to go into detail here but most of the women in this ward will stay until they can be operated on which can take months and most of them have been abandoned by their family. As we walked from ward to ward I couldn't help but notice all the old hospital furniture lined up in the hallways. It seemed to be a grave yard of old equipment.

We then headed to the ER. As we walked up we noticed a stretcher that had been turned on its side in and sat in front of no parking sign. We walked and again it was hot and dark. There was a child in the ER that had been abandoned and in the hospital since August. Apparently most traumas are seen due to burns or automotive accidents. We saw one woman whose thighs had been burned. They were all shades of pink and she had been in the hospital since October of 2007.

The pharmacy was our next stop. Project HOPE has built some shelves in the pharmacy for all the medications that have been donated to the hospital. There are some medications they offer for free to their patients.

After the pharmacy we headed to the physical therapy wing. It had a couple of pieces of equipment and also an obstacle course for patients. We were told they are trying to encourage people who need physical therapy to come in but that it's hard because most people don't have the transportation to get there. We also got to see the prosthetics work shop they have on campus. While we were there a woman was making a prosthetic from the knee down. It was like walking into shop class but they were making limbs.

Next we saw the cholera unit. On our way there we walked past the remains of a building as I got closer I saw a plaque. It was a community health center built in 1990 that had been completely destroyed. All that sat was its empty shell. The rainy season in Liberia brings cholera. At the height of the cholera epidemic the hospital will see up to 500 patients a week. The cholera wing is small building with again no AC or electricity. As you walk into the different rooms you have to step in some padding that contains chlorine so you don't get cholera because anything you touch can carry cholera. The beds in this wing all have one hole in them that the patients can use the bathroom into bed pans. Cholera gives you what they call rice water diarrhea which is incontrollable. These patients are then hooked up to IVs for dehydration.

Project HOPE just donated IVs for the upcoming cholera season in May. They are expecting 2,000 patients with cholera. There is even an overflow are which is just a tent with the beds set up. As we left the cholera wing we had to wash our hands in a chlorine solution.

That was the end of our tour and we loaded up the vans to head back to hotel. It turns out this part of this mission will be very different. We have a physical therapist and bio medical technology engineer—to fix the equipment that has been burned out— with us. Also, the nurse educators will be and primary care team will be doing hands on teaching on Mondays and Fridays, going up to the different wards to work with the nurses and medical students.

At this point I am feeling pretty ill. I went to dinner and left with headache and cold. This sucks because this is not the place to get sick, there is no one who can fill in for me and the media is going to be at JFK Tuesday. It's been an eventful day and hopefully I can get to work tomorrow.
--Marisol Euceda

Saturday, March 15, 2008

The boat took off this morning around 8:30. It was great to go up to the helicopter landing and watch it get started. This boat doesn’t require a tug boat; it can get its self out to the ocean on its own which is pretty cool. There were some dolphins following the boat when we got further out at sea and we are all still trying to get our sea legs. This boat is no crusie ship so you feel it move a lot more. Because I am now confined to the ship for the next couple days I don’t have much to write about. Maybe I will get some rest. I’ve had scratchy throat for two days so I guess I should take this opportunity to sleep in a little. I think most of the volunteers are resting up so they are ready for Liberia. As the boat took off this morning we all looked at the place we were leaving behind. I think most would love to return. It has truly been a fantastic experience.
--Marisol Euceda

Friday, March 14, 2008

Project HOPE Volunteers Travel to Liberia

Today we woke up early, packed up our stuff and said goodbye to our cooks and drivers and headed to the HSV Swift. We are taking the Swift to Liberia and will be on it for three days. The Swift already has a crew of about 44 people on it and it isn’t a really big boat so we will be sharing rooms aboard it. All the Project HOPE women are in one cabin together. The cabin has 15 beds in it. These beds are stacked against the walls in threes so you can pick the top, middle or bottom bunk. The Project HOPE men are either in overflow—which is rows of beds stacked up in the hall. There is a laundry room on the ship so we will get to do some laundry while aboard the ship and they are feeding us. We will also be able to watch movies on deck. The Swift leaves Ghana tomorrow around 9:00 am and won’t arrive until Monday morning in Liberia so I have a feeling we will all be a little stir crazy by the time we get there. After we settled in a few of us went out in town with some of the soldiers before we had two days of just being on the boat. It was fun to go out and Joy bought a great Ghanaian painting but after a while our tiredness kicked in and we just wanted to head back to the boat. Most of Saturday is suppose to be pretty calm but the waves are suppose to pick up late Saturday and Sunday which may make a few of us sick. So here we are leaving tomorrow and looking forward to what lies ahead in Liberia. I think it may actually be a shock for some of us, including myself. Ghana is a poor country and sometimes you can’t believe how some people have to live here and there were things and places we saw that shocked us a little but everyone who has been to Liberia keeps telling us how much worse off Liberia is. Ghana has been a humbling and educational experience and I am sure Liberia will be the same.
--Marisol Euceda

Thursday, March 13, 2008

Project HOPE Volunteers Leave Ghana

Today was our last day of work in Ghana. We are a little bit saddened because over the last two weeks we have formed many friendships with the people who we’ve worked with. It really was a great pleasure for us to work with the folks here. They all were very eager to learn and translate when we needed them too. They were very dedicated to everything we were doing.As soon as we arrived to the clinic today it got hectic, for me anyway. Today was the big media day. Although they were not set to arrive until around 10:00 am at the clinic they arrived at 9:30 because of some last minute schedule changes. Twenty media people showed up to interview some of the volunteers and military personnel and take pictures of everything that was happening at the clinic. We began the media event by talking a little about what we were doing in Tema. Dr. Polifka was our spokesperson and he did great. He handled all the press questions very well. We then escorted the press around the clinic so they could see all the work going on. The clinic was full of patients and the spaces the dentistry and primary care group were in were really cramped so we had to show them around the clinic in groups of five. It seemed to all go very well. Everyone’s message got out. I just hope the reporters who showed up actually write something about the work we’ve done while we were here. Like Dr.Polifka told the reporters “We are privileged to be here. If you like what you see, all we ask is that you invite us back.”After the media event things went back to normal at the clinic. Mercy wanted to show the Project HOPE volunteers the local hospital so we were packing things up by noon which actually means we start telling patients we are closed at noon but they keep coming in until about 1 pm. Once we loaded up the van we headed 15 minutes down the road to the hospital in Tema. Again like the other hospitals I had seen since we arrived in Ghana this one was actually not in bad shape and was made up of buildings connected by outdoor corridors. We went by the emergency room first. It wasn’t what I had pictured. I thought I would see tons of people in the waiting room and on stretchers but surprisingly it was a slow day in the ER. By late afternoon they had only seen 5 patients. While at the hospital we stopped by the maternity ward, the male ward and also the main lobby of the hospital. The main lobby functioned as a non-emergency 24 hospital unit. It accepted patients around the clock for various illnesses. This part of the hospital was packed and noisy. The patients were separated according to the type of doctor they needed to see. We left the hospital and headed back to Manhean Clinic to drop Mercy off and make our way back to Accra. However, when we arrived Mercy had a surprise for us. She had the entire staff sit around us and they presented us all with gifts. These gifts were absolutely beautiful; you could tell they had put a lot of thought into them because everyone got something different but so perfect for their personalities. The women got traditional dresses in various bright colors with different symbols. The men all got brightly colored shirts. It was really nice of them. Another surprise was that Mercy had arranged for the head nurse of the Tema region and the head nurse in the Ghanaian Health Ministry to also be there. They offered us many thanks and praises for the work done and told us we are welcome to come back anytime. The volunteers were all really flattered by everything. They even put on their gifts to take a picture with the entire clinic staff. So we left very sad and hoping to be back again soon. We made many friends at Manhean and we exchanged many e-mails. We hope to keep in touch with all of them.
--Marisol Euceda

Monday, March 10, 2008

Project HOPE Volunteers, Committed to Improving Health

Today is Sunday which is a day of rest except I have to again go to the internet café to do work. But that's ok because I like what I am doing.

While at the internet café I try to catch up on any mentions of Project HOPE in the news. I found our press release on a website with comments from readers underneath it. I believe everyone has a right to free speech and therefore can think and say what they want. These comments were all negative about the work we are doing in West Africa. One says that the U.S. "poaches and entices qualified doctors to the U.S." and the other says that charity does no good and we should stop insisting that it will. I guess since I know the team on the ground and have been with them when they work it stung a little to see those comments. I am not saying that what Project HOPE does is the solution that will bring all the relief to West Africa, but I know the volunteers and even the military folks out here—dentists, veterinariens and others—have their heart completely into what they are doing here. Every day they come back to the ERF tired but happy to have done a good job. In fact some of them hate having down time. They want to be helping people as much as they can. Everyone is here to help in any way possible.

Also Project HOPE isn't just coming in and not leaving something behind. While here we are teaching midwives—who do so much of the health care here—how to be better midwives so they can train other midwives so that the cycle of learning and training continues. The same goes for the nurse educators who are covering topics as complicated as diabetes to as uncomplicated as bite wounds. The primary care team is leaving behind lessons as well. They have been working all week with translators. These Translators aren't just there to help with the language they are also nursing students learning from what the primary care team is doing.

So this mission and others like it may not be the end-all of Africa's problems, but it is a start and why would you be so negative towards someone who trying to help one person at a time.

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

--Marisol Euceda

Sunday, March 9, 2008

A Visit to the Rain Forest

We woke up early, really sprayed ourselves down today to head to the rainforest. It was a three hour drive to the Gold Coast—where the midwives are actually headed on Monday. On the way there we passed many different shanty towns along the road. Some of the shacks are built out of wood planks while others are made of mud and straw. There are also many cement brick homes in the construction process. You can tell homes take a while to build in Ghana because it seems people build as they get the money so it could be 5 years before they have a completed home.

We finally arrived at the rainforest where we actually got a discount because we are an NGO. We’ve gotten some discounts when people had figured out who we were. For instance Robin and Sue started a conversation with one of the owners of the internet café, Busy Internet, and all of the Project HOPE team got free hours on the internet. At the rainforest we began an uphill climb. The climb wasn’t too rough. We knew we had to eventually cross a rope bridge but we had no idea what we were all in store for.

The rainforest itself was beautiful and green with lots of bird noises and we even saw an of army ants. Many of us stopped to stare at the ants before were reminded how they can devour a cow in minutes, so we moved. Once we got to the top, seven, yes seven, wood and rope very narrow bridges all connected and wrapped around the canopy of trees awaited us. Joy was a little worried about the heights but she kept moving. They were I think 18 meters off the ground. The bridges could only fit one person behind another because they were so narrow and they all creeked and swayed when you got off balance. It was absolutely beautiful up there and was worth the climb. I got some great pictures of everybody up there.

After the hike we headed to lunch at the Coconut Grove Hotel. We had wonderful local fish and hung out looking at the beach. It was interesting to see goats on the beach and also how at the hotel the beach was clean and beautiful but just down the street the beach was picturesque but was littered with trash. At the hotel it seemed like a completely different world from the rest of the coast which was so very poor. Joy said it best when she said “the difference between the have and have nots.” We left the gold coast shortly after and encountered massive traffic on our way home. When we got home we all were still full from our wonderful lunch and most of us headed off to the shower and bed. There we were met with a power outage on the women’s side of the barracks. We made the best of it, it was actually kind of funny.

--Marisol Euceda

Saturday, March 8, 2008

Project HOPE Volunteers Spend Another Busy Day in a Ghanaian Clinic

Friday arrived and the midwifery class was over so Robin, Sue and I were off to a hospital on the Gold Coast of Ghana. However, first a few of us had to stop at a bank to cash some travelers checks which ended up taking a lot longer than anticipated because of traffic. But it had taken days to find a bank that would cash travelers checks so we had go. This made us so late getting to the clinic in the morning. We didn’t arrive until 9:30 am when we usually get there around 8:30. Already people were lined up waiting to be seen by Dr. Polifka, Faye and Christella and the nurse-educators—Joy, Marley and David—got straight to work teaching because the class was set to end early. This also meant that the midwifery trip had to be postponed until Monday because it would take us three hours to get to the hospital and it would be too late. We have to be back in the city by 7:00 pm every night for security reasons. Luckily we could get a hold of the nurses we were going to visit and reschedule.

In Ghana distance usually isn’t the problem. The two lane roads and insane traffic are the problem. There are little taxis weaving in and out of traffic and buses crowded beyond capacity everywhere. Very few of us are brave enough to sit in the passenger front seat because it is so scary to watch the driving. It’s funny to listen to everyone catch their breath after we narrowly miss another car. There are always tons of people out, all hours of the day, walking alongside the traffic and between cars selling fruit, water, candy, tummy trimmers and other various things. It’s almost as if all the tummy trimmers from the 80’s that didn’t sell wound up in Ghana. We have three drivers. They drive us around in mini-vans and are all pretty young. Joseph, Ebenezer, and Matthew are all very nice to us and answer all any questions we have about things we see as we drive along the road. They even taught Christella how to say good morning and thank you. Although they speak English in Ghana there are also 12 different dialects.

Well, because the midwives and I were unable to go to the hospital as we had planned, they headed back to the compound early afternoon to get some rest and hit the internet café. I stuck around and walked around the clinic taking pictures and listening in on the nurse educators classes. The clinic is a little building with people waiting outside in the heat. Its perimeter is surrounded by makeshift shacks that people live in. At any point in time you see children running around playing and goats grazing on the dry grass. This is the dry season in Ghana. It is really hot with a lot of humidity but never any rain to break the heat, so there isn’t anything that is really green. In fact the floors in our barracks, shoes and socks are often coated in red dirt at the end of the day from being outside. We are all amazed at how the Ghanaian women keep their clothes always looking so clean and bright because most of the time we can’t. As I walked around the clinic I felt a little uncomfortable taking a picture of people waiting because some looked so miserable and in pain. Most of them had been sitting there for hours waiting to be seen by the “American Doctors”. I would walk by and they would all say hello, ask me questions and then say they were in a hurry as if to ask me when they would be seen. It was hard to tell them there was nothing I could do to help them because I was not one of the doctors. It’s not that the doctors weren’t working fast enough but that a lot of the cases being seen were so grave and they were using translators because of all the dialects so it was taking more than just five minutes to see each patient. Our volunteers really want to give quality care since they are only here for two weeks. And honestly in three days they had seen over 300 people. This impressive considering each volunteer providing care has a different specialty.

Dr. Polifka is an ER physician, Faye is a pediatric nurse practitioner and Christella is a nurse practitioner with experience in women’s health. The other night I interviewed Dr. Polifka for an article I am writing about his work with Project HOPE and the two big suitcases of $1,200 of prescription medicine, which he personally brought with him, and he said “I’m impressed by how sick some people here are. When I was working in Latin America in a day I would see 50 to 60 patients of that maybe 10 percent were really sick. Here 60 to 75 percent are really sick, many with active malaria, TB, typhoid fever and all the diseases associated with poverty.” Around eleven in the morning Nii Adjei Kraku II—the Chief of Tema, where the Manhean Clinic is located— showed up for a ceremony. We were officially handing over the over $1.2 million of medical supplies and medicines we had donated to the clinic. The donation included items from U.S. pharmaceutical companies such as Merck & Co., Inc., sanofi pasteur, Abbott Laboratories Fund, McNeil Consumer Healthcare, GlaxoSmithKline, Bristol-Myers Squibb Co., Schering-Plough Corporation, 3M Company, Hospira, Inc. and Codman & Shurtleff, Inc., a Johnson & Johnson Company.

We had one reporter there from the Ghana Broadcasting Corporation. She interviewed Dr. Polifka, the Chief and others. The Chief was extremely grateful for the donation and said he would make sure all the medicines and supplies would be used properly and invited all of Project HOPE to his palace next week. Hopefully we will actually get to visit his palace. I think the volunteers would really enjoy hanging out with the Chief for a couple hours. A few of them took the opportunity to get their pictures taken with the Chief and his staff.

While at the clinic I also visited the nurse educator’s class. The class was full of enthusiastic nurses learning everything from diabetes, CPR to the Heimlich maneuver. Joy first demonstrated on Marley while David talked and then the nurses were given the opportunity to try. It was very fun to watch. After the class was done they all received a certificate of training for completing the three day course. They were so excited and clapping for each other. They were even excited about the pencils we handed them. Many of them gave Marley and Joy a hug but were a little shy to hug David. Towards the end however, David finally got some hugs and everyone laughed and clapped. It was such a nice group. Some hung around after the class and continued to ask questions because they were so interested in how they could help their people.

Nursing doesn’t seem to just be a profession for these Ghanaian Nurses. They are extremely passionate about what they are doing and really want to make a difference. While we waited for the physicians to finish up their last patients, Joy, Marley, David and I hung outside with some of the children that were hanging around the clinic. They were so funny and would pose when they saw a camera. Then we would show them the camera and they would point to each other in and giggle. They were so amused. Joy gave them gum, so we have a feeling more children will be around on Monday, and we shared some bottled water we had in the van with them after we put some orange drink powder in them. The immediately started sharing everything amongst each other. You could tell which ones were related because they would protect each other. There was a little girl who looked to be about three years old in the group and she was terrified of David. He is rather tall so we think she was scared of his height. He tapped her on the shoulder to help her get her gum open, she turned around looked up and ran towards her brother. Later David sat down next to her on the clinic stoop, she didn’t notice him for about two minutes but once she did she again moved. It was so cute.

The primary care team finally came out after seeing over 120 patients and we headed home.

--Marisol Euceda

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