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

Midwife Training Onboard the USS Swift

Mornings always begin at 6:30 for most of us working with Operation Africa Partnership Station. We wake up get dressed, apply sunscreen, spray insect repellant all over us and head to breakfast were we are met with eggs and a warm cup of coffee. Having breakfast in al fresco in the wee mornings in Africa is really quite spectacular. I really hope before the trip is over I can start waking up early enough to enjoy the dewy mornings just before the sun rises because I love mornings such as those.

This morning we caravanned to the Manheam. On the way there some of the medical volunteers got into a discussion about the myths surrounding breast feeding in different countries. Christella, whose parents are native Filipino, mentioned she had recently been to the Philippines on a mission with other Filipino American health care professionals. What was so interesting was the myth behind why women in the Philippines don’t breast feed, they think their milk gets to hot and spoils because they work out in the heat all day long and they can’t feed their children spoiled milk. Obviously breast milk comes in a temperature controlled container so this is not true but still women believe it. She also mentioned that a friend of hers had volunteered in Kenya recently to teach women how to purify water for cooking and drinking. Although this seems like a pretty simple process it was apparently very hard to teach the women in Kenya. They would boil water and use it for cooking or drinking but if there wasn’t enough they would add un-boiled water to the boiled water in order to have enough which would in turn defeat the purpose of boiling the original pot of water. It was hard for them to grasp that they could not add dirty water to clean water and still have consumable water. The longer I hang out with these Project HOPE volunteers the more I learn about medicine and cultures around the world. It is truly inspiring how much they love learning and giving back to the world through their knowledge.

After we arrived at the clinic 5 local midwives joined Robin, Sue, and I in one of the vans and we headed off to the USS Swift while the nurse educators and those who would be helping the clinic by providing basic care stayed behind. Robin and Sue are the nurse midwife volunteers who will be providing training throughout the mission to local midwives in Ghana and Liberia. They were set to teach a class of 34 midwives today, tomorrow and Thursday in a make shift class room aboard the U.S. Navy ship the Swift.

The Swift is not just a military boat it looks like a giant speed boat and is very impressive. You can tell it was built for speed. It isn’t as large as some of the other military ships but still huge and a boat man’s dream. The main eating and sitting space on the boat has built in theater chairs that are super comfortable and in between the two sections of seats is a dinning space. This entire spaced is surrounded by windows that provide a panoramic view of the ocean ahead of it and also television sets for movie nights.

I was awed when I saw the Swift as we drove up to where it was docked. It’s made from aluminum and is almost a charcoal color and has lots of angles. We got out of the car and walked up ramp leading to the hull of the ship where we found our make shift class room. It was a building that looked like our barracks—like a storage unit—in the middle of the hull. It fit all 38 of us comfortably and had windows and ac units. This classroom even had a projector screen. It was as if someone took a forklift, picked up a building from shore and dropped it off in the hull where it was strapped in to keep it from shifting as the ship moves.

When we opened the door to the classroom we were greeted with a loud welcome from the midwives, it was quite a site most of them in their white uniforms and white shoes. One of the Navy officers would later comment to me that it’s funny how the white uniform and white shoes is the universal nurse uniform and that nurses always provide a comforting feeling. These nurse midwives were very eager to learn and get started.

After a formal introduction Robin began teaching the basics of midwifery. She began with a lesson on normal and abnormal labor, followed by a lesson on using the Partograph. A Partograph is a special chart used by midwives so they can track a woman’s labor progress and plan ahead or prevent serious complications. Never having children myself a lot of this information was new to me and I tried to pay attention while I was taking pictures and swaying from the rocking boat.

After Robins lecture she had the midwives do a couple case studies using the Partograph. The seemed to really enjoy working in groups so much that we had to remind them it was lunch time.

The Navy provided us with lunch aboard the Swift.

Lunch was followed by Sue’s lesson on Hypertensive Disorder. Sue and Robin were both surprised with how much these women knew about delivering babies because in their experience with other missions in which they taught women “how to catch babies”, as Robin says, the midwives were so far behind. However, in Ghana the basics lesson was just a review for the midwives. They are all so knowledgeable. In fact because they knew their stuff we ended early enough to ask them about the way they deliver babies to see if it was any different from the U.S. Interestingly enough:
· Only 2 of the 34 women in the class delivered babies in a hospital.
· The midwives not only deliver the babies but also handle the prenatal and post natal care of the women they care for.
· The Ghanaian Government pays their salary and also licenses them.
· They have to renew their license every three years and a renewal requires them to take continuing education.
· C-sections are done in the hospital and are also elective.
· They don’t use epidurals.
· After a c-section a woman remains in the hospital 6 days and after vaginal birth they remain for 7-12 days.
· Annual Ob-gyn visits and regular exams are not common but they do use different types of birth control—such as Norplant, Depo, birth control pills while breast feeding and also condoms.

After the questions a couple of the Navy folks were kind enough to take us on a tour of the Swift, for some midwives this was their first time on a ship so they really enjoyed it. When the tour ended we took them out to the dock to show them the gift-in-kind (GIK)—GIK is donations made in actual products like medical supplies, equipment and medicines—they would be receiving at the Manheam Clinic. The donation comes from Project HOPE and its partners and totals over $1 million dollars.

We ended up spending an hour and a half longer with the midwives because their bus arrived late. They are staying in a hostel because some came from as far as three hours away to attend these classes. They were very patient and we bonded with them. We talked to them about the U.S., our families, Robin showed everyone the family photo album she had in her bag, and someone invited Sue over to have goat since she has never had goat. When we left Sue also mentioned we were invited to visit a clinic in a town two hours away which we may have an opportunity to see. We will actually be off on Thursday because it is the Ghanaian Independence Day and also because the midwives are ahead of schedule which means we will finish the classes tomorrow.

It was a long day today; we barely made it back in time for dinner. The good news is we stopped by the airport to check on Sue’s luggage and it appears to be arriving tomorrow. Better late than never! When we arrived we were told the three working in the clinic on basic care had a great day. Cramped in a small room and with the help of a translator in some cases they were able to see 91 patients today. The nurse educators also had a successful day of teaching even though their projector burned out. They just improvised.

--Marisol Euceda

Help support the Project HOPE mission in Africa.

Visiting a Clinic in Ghana

We woke up early to head to breakfast and a meeting in the mess hall. We were surprised to find a warm breakfast of made to order eggs, assorted local breads, coffee and of course the all important water. It was great way to begin the mission. After a meeting with our project coordinator we headed off to the Manhean Clinic in Tema. The drive to Tema was our first real look at Ghana since we had arrived so late the night before. What a beautiful country. It is truly a developing nation. The roads are good; there are homes and retail buildings being built (slowly) everywhere, women, men and children carry items for sale or from place to place balanced on their heads and music can be heard everywhere you go and there are goats on the side of the roads grazing on anything they can find. Women have brightly colored clothes made of wonderfully patterned cloth and a lot of them carry their babies swaddled close to their body in the cloth.

We arrived to the clinic in Tema, which is a much less developed city, and found one new brightly colored new yellow building on the grounds across from the clinic. The yellow building has no furniture in it but it will be the nurse educators’ classroom. Mercy, a nurse at Manhean, gave us a tour of the clinic. The grounds of the clinic smell a little like a sewer and there are goats roaming freely. It is a U-shaped concrete building without a/c and patients upon patients waiting in the heat to receive treatment. The treatment room is the size of a small office, the maternity ward is a room of 6 small beds with cots, and the scale used for weighing infants is rusted and much of the equipment is old and needs replacing. Because Ghana is a developing nation it still does not have the funds to provide some the basic medical supplies and medicines we have in the United States.

Mercy went on to show us the nutrition center which was a small wood building with two rooms. In one room sat a man grinding corn for corn meal that is combined with supplements. Every Thursday women arrive at the clinic where they are given two kilos of the corn meal to feed their children so they have a more nutritious diet. Mercy, told us they try to feed the children who come in because many times they suffer from malnutrition. While we were standing there a goat and chicken came by both feeding on stuff on the ground.

After our visit to the clinic we spent part of the afternoon trying to exchange money, visiting an internet café to get in touch with our families and then came home to a nice home cooked Ghanaian dinner. While we will be provided breakfast and dinner in the mess hall each day, for lunch we have a selection of Meals Ready to Eat or MREs. MREs are used by the military when out in the field. They are essentially a complete meal in a bag with tons of calories; I believe the bag said 1,200+ per meal. Everything is preserved in cartons in such a way that they don’t require refrigeration or heat but they do come with a just add water heater that is optional if you want a hot meal. Today, I opened up the chicken with salsa MRE. I only ate the Spanish rice and the crackers with jalapeno cheese spread. I needed someone to show me how to use the heater and I still almost burned myself. The whole package contained chicken in a cardboard carton, Spanish rice, M&M’s, a shortbread cookie, crackers, jalapeno cheese spread, drink mix to make your own mocha chino and iced tea. They’re quite an interesting product.

Tomorrow begin the lessons at Manhean taught by the nurse educators and also the midwifery classes on the USS Swift. I will be heading with the nurse midwives to the USS swift where the nurse midwives—Robin and Sue—will be teaching 34 students midwifery techniques.

--Marisol Euceda

Help support the Project HOPE mission in Africa.

Meet Project HOPE's Africa Partnership Station Volunteers

Only a few of us actually knew each other from previous missions but throughout our 14+ hour journey we all managed to find each other—thanks mostly to Robin, who wore her Project HOPE t-shirt so everyone gravitated toward her—and learned a little about what each person was doing on the mission.

Meet Project HOPE’s Africa Partnership Station Volunteers:

Marley Gevanthor
Marley is a nurse educator from Novato, California in the San Francisco Bay Area. She currently works for the Community Health Network at San Francisco General Hospital. This is actually Marley’s second time volunteering with Project HOPE. She was on the first rotation of the Latin American Mission on the U.S. Navy Ship Comfort.

Christella Guzman
This Christella’s first time volunteering with Project HOPE. She is the Lead Clinician at Women’s Community Clinic in San Francisco. Christella is also a Nurse Practitioner volunteer with Seton Medical Center Rota Care Clinic where she provides acute care to uninsured residents of San Mateo

Susan “Sue” Hoffman
This is Sue’s first mission with Project HOPE. She is a clinical nurse midwife from Lyndonville, Vermont and works for Women’s Wellness Center Northeastern Vermont Regional Hospital.

Robin Jones
Although this is also Robin’s first time volunteering with Project HOPE she is an experienced volunteer. She is a clinical nurse midwife with volunteer experiences in places like Liberia and Afghanistan where she says women can’t believe men are actually allowed into the delivery room in the U.S. Robin is from Chesapeake, Virginia and is a part-time faculty at the Medical Career Institute in Virginia Beach.

Dr. Michael Polifka
Dr. Polifika is also an experienced medical volunteer with experience volunteering in Africa, Latin America and Southeast Asia. This is Polifka’s fifth time volunteering with Project HOPE. He served on two rotations aboard the U.S. Hospital Ship Mercy during the Tsunami relief in 2005, one rotation in 2006 again on the Mercy in Indonesia, and last year aboard the USNS Comfort. Dr. Polifka is serving as the Africa mission’s Chief Medical Officer. He is also an ER physician at North Adams Regional Hospital in Manchester Center, Vermont.

Faye Pyles
Faye has never volunteered with Project HOPE but also has experience with medical missions. She recently retired from the Navy where she served as the Primary Triage Officer for Humanitarian Mission to Cambodia, and served on the Primary Care Team providing pediatric assistance in Port Au Prince, Haiti. She was also assigned to be the pediatric nurse practitioner for refugees in Guantanamo Bay, Cuba and was part of the Department of Pediatrics in U.S. Naval Hospital in Naples, Italy. Over all Pyles has over 28 years of pediatric nurse practitioner experience. Faye is from Norfolk,Virginia.

David Vuurman
David is a nurse educator from Plainfield, Indiana. This is his third mission with Project HOPE. He previously served aboard the USNS Mercy in 2005 and then again in 2007 aboard the USS Peleliu. When he is not volunteering he works for the Indiana University Medical Center as the Charge Nurse and in the Neuroscience ICU.

Joy Williams
Joy lives in Medford, Massachusetts where she works for Massachusetts General Hospital in the Department of Radiology. She has over 17 years experience in the ER, four in radiology nursing, three in burn surgery, and 3 years in medical surgery. She has worked with Project HOPE before on the USNS Comfort after hurricanes on the Gulf Coast and again in Latin America in 2007.

--Marisol Euceda

Also Meet Valdez and Julia who joined the mission later in Liberia

Help support the Project HOPE mission in Africa.

Project HOPE Volunteers Arrive in Africa

After getting just about every vaccination known to man and some ugly khaki shorts to go with my Project HOPE t-shirts, I was finally packing so that I could be on my way to West Africa, specifically Ghana and Liberia, with Project HOPE. Project HOPE is a non-profit. More importantly they are a non-profit that focuses on sustainable advances in healthcare across the globe. They teach healthcare workers how to better care for their patients and train other health professionals so the cycle of learning and teaching continues long after Project HOPE has left the country. This is not the only thing Project HOPE does—Project HOPE has programs in 36 countries across the globe in women and children’s health, HIV/AIDS and TB, health systems and facilities, health professional education and humanitarian aid—but it is one of their main focuses and what the HOPE volunteers will be doing while in Africa.

Project HOPE volunteers and Project HOPE staff –myself included—were on our way to Africa to partner with the United States Department of Defense (DoD) for Operation Africa Partnership Station. This is not the first mission in which HOPE has partnered with the DoD. The first time was in January of 2005 when they asked Project HOPE to join them in a disaster relief mission to areas in Southeast Asia that were severely affected by the Tsunami. Asked to fill 200 positions HOPE reached out to the medical community and received over 4,000 volunteer applications. After the Tsunami Project HOPE again went on to help but this time stateside when Hurricane Katrina and Rita devastated the Gulf Coast. The Katrina and Rita missions were followed by another mission to Indonesia to continue caring for those still affected by the Tsunami. Most recently Project HOPE again joined the DoD for a 2007 summer mission to countries in Latin America and Southeast Asia. Now HOPE is at it again in West Africa.
With one suitcase and a cool back pack, that surprisingly held not only my laptop nicely but also a camcorder to record the work we will be doing, I was off to the airport for my 14 hour flight to Ghana. Traveling to Ghana required an almost seven hour flight to Germany and a two hour layover in the European country which almost took an unexpected turn when the volunteers and myself were asked if we would give up our seats for 600 Euros in cash because the flight to Nigeria/Ghana was over booked. After thinking about it for maybe 30 seconds –because that would have been a lot of money in U.S. dollars—we decided people needed us to be somewhere so we should continue our travels. Interestingly enough on our six hour flight from Germany to Lagos, Nigeria the flight attendants kept asking us if we wanted red or white wine or Bailey’s Irish Cream or cognac—don’t worry we all resisted the temptation. After an hour layover on the plane in Lagos we finally took off and landed Ghana an hour later where I and all the volunteers showed up exhausted but extremely excited.

After going through the immigration process rather quickly we proceeded to grab our luggage only to find out Sue—one of the nurse midwives—was missing one of her suitcases. She didn’t get very bothered because the suitcase that did arrive had her most important stuff in it, all of her education materials. When we actually exited the airport we were greeted by the heat and humidity of a country closer to the equator and what appeared to be hundreds of Ghanaians waiting and picking people up. We waited around too for our DoD counterparts to arrive. We than caravanned our way to what would be our home for the two weeks in Ghana. It was dark on our way so we could not get a glimpse at the country until the morning.

Our living space is barebones white and looks like a storage facility with one door leading to the men’s side and another to the women’s located across from what looks like an out of use hanger which is now our meeting place and mess hall. Inside the walls are white paneling and the floors look like they belong in a gymnasium but are not as bouncy. In the middle of the building there are two bathrooms divided by a simple curtain to separate the men from the women. Each bathroom has three stalls and three shower stalls and six sinks. Each room, because we have fewer women all the women got their own room while some of the men had to bunk up, has two sets of white metal bunk beds with blue bedding and eight lockers. These might sound like very basic rooms but we are all really impressed with the accommodations. The rooms are air-conditioned—a plus when you are trying to sleep in 90+ weather—and the showers have hot water and good water pressure.

With our accommodations settled we had a brief meeting went straight to the showers and bed. It seemed and still seems everyone is in high spirits and ready to work despite the weekend long travel.

--Marisol Euceda

Help support the Project HOPE mission in Africa.