Volunteers Complete Liberia Mission

We're home! All safe and sound and with memories of a wonderful experience in Liberia.

The week of classroom instruction was fantastic. The morning and afternoon classes were well-attended -- more than 20 students each session every day -- and the discussion was lively. We presented 45 "certificates of training" to our students. We got to know many of our colleagues outside the classroom, as well, while working on the floors of the JFK Maternity Hospital.

Amanda was able to reinforce the classroom instruction on resuscitation by actually resuscitating a "preemie" who had been delivered by C-section a few hours before.

We also had several opportunities to teach the TNIMA students, who were very eager to have us visit their classrooms. Altogether we had nearly 400 teaching encounters in the short time we were on campus.

Everyone asked when we were coming back. We told them we hope it's soon!

On our last night aboard the Swift, there was a reception for the President of Liberia, Ellen Johnson Sirleaf. The volunteers were thrilled to be introduced to her and spend a few minutes speaking with this remarkable leader. "It was the thrill of a lifetime," said Amanda, who is originally from Liberia.

The next morning, we disembarked at 0600 and watched the Swift sail away. Then we began our marathon journey home, starting with an overnight flight from Monrovia to Brussels, and from there some of us went to New York (JFK Airport, naturally) and Atlanta. We all brought home a piece of Liberia in our hearts.


Thanks for reading…Tom Stanton

HOPE Volunteers Provide Education to Eager Students at JFK in Liberia

On Labor Day – a propos! – the “Hopies” began presenting a midwifery “training update” course at the JFK Memorial Medical Center. We have 45 “students” – 23 midwives, 17 nurses, and 5 nurse-midwives – with experience ranging from 3 to 27 years of practice. I’m going to call them students even though they are professionals in the truest sense and we have learned from them each day.

The group is split into morning and afternoon sections and meets in a well-ventilated conference room about 30 feet by 15 feet, located in the mental health resource center on the ground floor of the Memorial Hospital. Just down the hall, classes are held for the first-year midwife students of the Tubman National Institute of Medical Arts (TNIMA). TNIMA was founded in 1945, and 30 of our students are alumna. Most of those 30 have 11 years or less experience, a handful have 20 or more years’ experience. Only two have between 11 and 20 years experience – that decade was a time when civil conflict was at its worst, when studying to save lives most difficult.

At the far end of the building is the School of Nursing. We walk past it every time we go to and from the Maternity Hospital. The faces of the students there reflect an atmosphere of learning and eagerness to progress. Of all the students we’ve met, none are more eager than 18 of the first-year TNIMA class. They waited for our afternoon session to end today (Wednesday) so that we could teach them the unit on newborn resuscitation. I have a feeling that isn’t the only class they’ll want us to teach them. I was touched by how several of them said to us, “God bless you for coming here to teach us.”

Speaking of units, here’s the curriculum the Project HOPE volunteers are teaching in addition to newborn resuscitation: determining gestational age, antepartum hemorrhaging, hypertensive disorders, Apgar scoring, partogram, shoulder dystocia, malaria in pregnancy, active management of the 3rd stage/postpartum hemorrhage, and more.

We had a guest speaker at today’s resuscitation sessions – Dr. Venee Tubman, a pediatrician from Boston Children’s. She’s the granddaughter of the T in TNIMA; he was the president of Liberia. She is here as a volunteer for two months and has a highly engaging personality. Everywhere I look, there are positive people here!

Thanks for reading…Tom Stanton

Labor (and Delivery) Day Weekend in Monrovia

The Project HOPE team arrived at JFK bright and early on Friday morning. The first stop was a meeting with Dr. Wilhelmina Jallah, the head of OB/GYN at the Maternity Hospital, and her nursing supervisors.

They are very happy to have us here. Dr. Jallah explained that the hospital will be undergoing a total renovation starting in a few months, courtesy of the Japanese government. The Japanese also carried out the original construction. The Chinese government is funding a renovation project in the Memorial Hospital, and there is a year-round Chinese medical presence as well.

After the meeting, the Hopies spent several hours working on the units. On the main floor there is an emergency room and an OB/GYN clinic, which were both very busy all day, as well as the labor and delivery room, which is one large room with 7 beds. On the second floor there is an operating room, where Kathleen observed a C-section that went perfectly, and the post-partum and NICU units.

The hospital has a spacious dining room for the doctors and nurses, and they graciously invited us to join them on weekdays for lunch. Chicken (not too spicy), eggplant parmesan, rice and beans (spicy) were on the menu on Friday. All very good!

After lunch, we went over to the Memorial Hospital for the APS (Africa Partnership Station) Donation Ceremony. There were 10 trucks lined up outside carrying the pallets of donated goods that had been transported on the Swift. There was a red carpet and a receiving line with Navy, U.S. Embassy and Liberian government officials awaiting the arrival of Her Excellency Ellen Johnson Sirleaf, President of the Republic of Liberia. We walked the carpet, shook hands and went inside. The hall was decorated in the colors of the Liberian and American flags – red, white and blue. The Liberian flag has 6 red stripes and 5 white stripes, representing the 11 counties, and one large white star on a navy blue field. (As in Texas, there are many businesses and products called “lonestar” this or that.) There were balloons hanging from the ceiling and an entire wall was draped in crepe paper. A live band was playing local pop music. Reggae beat.
Some of it was English; some in a dialect that I still have to figure out. There was a press contingent of a dozen reporters and cameramen.

When Madame President entered, a man blew a horn painted red, white and blue. Mrs. Vera Cooper, the acting administrator of the medical center, gave the welcoming statement, then there were remarks by the U.S. Embassy Chargé d’Affairs and the acting Minister of Health, followed by remarks from President Sirleaf and a ribbon cutting.

It’s clear from this level of attention that JFK is a high priority for the government. One can imagine the entire complex being restored to its former glory and becoming a beacon of hope for the population.

It’s very satisfying for us as Project HOPE volunteers to be part of the vanguard.

On Saturday, we spent some time in the morning preparing lectures and then we went to the Maternity Hospital after lunch. Amanda, Jen and Kathleen worked in the ER and on the wards; the clinic isn’t open on weekends. We got back to the ship around 4:30 and about an hour later the military medical team finally arrived. Their transport had been delayed 3 days, giving them “bonus” stays in Italy, Spain and Cape Verde. As fun as that sounds, we’re glad we took commercial flights from the States! It would have been hard getting ready for the course to begin on Monday had we lost all those days.

Sunday was a “cultural” day. The ladies went to church with Amanda and her family and the Navy provided a BBQ with a live band on the pier in the afternoon and evening.

Happy Labor Day! It will be labor and delivery day for us…Tom Stanton

Greetings from Monrovia,Liberia!

A team of Project HOPE volunteers arrived here by airplane on Wednesday afternoon -- with all of their luggage! They will be supporting the Africa Partnership Station 2009 mission for the next two weeks.

Amanda is originally from Liberia and is excited to be coming back for the first time in more than 10 years and for the first time ever as a nurse here. Jen and Kathleen will be team-teaching a midwifery course. All will be helping write protocols for several departments in the maternity hospital at the JFK Medical Center. Read the volunteer bios!

JFK is a large campus -- at least 20 acres -- on the Atlantic coast on the south side of the city. There is a sign posted at the main gate expressing condolences to the Kennedy family on the passing of Senator Kennedy. The largest building is the Memorial Hospital -- four stories high with many windows that allow refreshing breezes to enter the wards. It opened in 1972,while the maternity hospital opened in 1981 and is about to undergo a major renovation in a few months. It's obvious all the facilities are still recovering from more than two decades of national conflict, which ended only a few years ago. The hospital's motto is "embracing the past and carving a new future." We hope our work here will help brighten that future.

The Hopies have settled in to their home away from home -- the HVS2 Swift, a "wave piercing catamaran". We won't be testing her capabilities, though, as we will be docked at the pier for the entire mission. The Swift has been deployed since July,delivering medical supplies to several West African countries. Liberia is the only port of call where medical services will be provided -- a team of about 25 military health care providers is joining us on Friday night. They will be working at other sites around the city and in the countryside.

We're looking forward to a ceremony tomorrow at which the president of Liberia will speak.

Stay tuned! Tom Stanton

Check back as we continue to document Project HOPE volunteers as they work around the world......and please support our dedicated medical volunteers.

Rotation Two Volunteers Complete Work

It hardly seems possible that more than six weeks have passed aboard the Comfort. It seems like all one day. As we steam for the liberty port in Cartagena, we all can look back, with pride and humility, on the opportunity we’ve had to provide quality health care and education, and hope, to the tens of thousands of people in Haiti and the Dominican Republic and on the beautiful islands of Antigua & Barbuda. The numbers speak for themselves—and when you break them out by categories they’re staggering, with new records being set every day during the last week before we “pulled the hook” in St. John’s Harbour. Before we arrived, many of us were wondering why we were even going there, since it’s not a country one thinks of as being underserved. We were anxious about how we’d be received because of rumors—which were not wholly unfounded—that we might not be able to do any surgeries on the ship for a variety of political reasons. What we found turned out to be quite the opposite. The government officials and local doctors and nurses warmly greeted us, and we were busier than ever, as borne out by the numbers. The operating rooms handled as many surgeries as in Haiti, and did it in one day less. The icing on the cake was that Nurses’ Week was celebrated while we were there, and this provided many opportunities to socialize with the local nurses who worked side-by-side with, and were taught by, the Comfort’s nurses. And, as always, there were many, many compelling cases of patients’ lives being changed because of the care they received. One night, to give just one example, at the customary “1900 Confirmation Brief”—the meeting that recaps the day’s events and gives us the plan for the next day—one of the doctors showed a video he made of an interview with an elderly patient. I didn’t write down her name, unfortunately, but all of us will remember her story. She had cataract surgery on both eyes, having been blind for more than five years. She expressed her gratitude for having her sight restored…and for being able to see her young grandson for the first time. There were a lot of moist eyes when the video ended.

So now we’re underway to Cartagena. Everyone’s excited about taking liberty. Even while enroute, we’re able to do some fun things that not every humanitarian volunteer gets to do. Such as, yesterday some of us got to drive the boat and go on a tour of the engine room. Anyone who thinks scullery is the hottest, dirtiest job on the ship needs to spend 30 minutes down there!

I’m not sure if I’ll have a chance to blog again from Cartagena. If I don’t, I’ll sign off now with a wish that everyone who’s reading will think about doing something for another person in need every day—even a smile counts! No matter where you are or what you do for your “day job,” you can provide someone with hope.
--Tom

Restoring Sight in Antigua

One of the anesthetists showed a video at last night’s Confirmation Brief. It was an interview with an elderly woman who had 2 cataract surgeries this week and had been blind for 5 years. She spoke with gratitude of how she was able to see her grandson for the first time onboard Comfort. There were many moist eyes in the audience.

Project HOPE volunteers serving in Antigua.

--Tom

Project HOPE Volunteers Experience Record Breaking Days and Technical Breakthroughs

Monday and Tuesday saw record-setting days at the clinics on shore and a technical breakthrough onboard Comfort, and were packed with special events. Where to begin?

The breakthrough was a video conference of a surgery on the Comfort that linked to doctors at Walter Reed. I’m told this is the first-ever ship-to-shore real-time video conference. There was only a 0.5 second delay between what the surgeon on Comfort was seeing and what the doctors at Walter Reed saw. This opens the door for some exciting possibilities. When the medical department on the ship needs a specialist who isn’t onboard, all they have to do is get the specialist to a video room. It will also make surgical screens at the mission clinical sites more efficient by allowing the doctors on the ship to “see” the candidates at the sites one minute, and still be able to get the OR the next minute to do surgery. This will cut down on a lot of the “dead” time getting from the ship to the clinic and back.

The special events – it’s Nurses’ Week. Our educators have been doing training with the Antigua Nurses Association and with student nurses. Many local nurses and students came aboard Comfort in the afternoon for a tour of the ship and some cake and ice cream on the mess deck, and then a group got together for a church service and opening ceremony last night.
Another special event was a visit from the Governor-General of Antigua & Barbuda – the Queen’s personal representative – as well as the Prime Minister and other high government officials. When they toured the ship, they greeted many of the patients by name. It’s a small island, after all!

And finally…the numbers. On Monday, our medical providers set a record for the number of patient encounters on the mission to date, and then on Tuesday broke the record. I didn’t get ashore either day, but I saw everyone come back in the evening, with faces that showed how pleased and proud they were of the work they’d accomplished…and they were tired! Same goes for the providers onboard. We have a total of 150 surgeries booked for the mission, so they are very busy, too! We sent a team by helo to Barbuda on Tuesday. The island has a population of only 1500, and we saw 500 of them that day. And…for the mission we passed the 100,000 health care encounter milestone yesterday.

So Continuing Promise 2009 is on a crescendo…looking to wrap up in Antigua & Barbuda this Friday on a high note!

--Tom

Photos of Volunteers at Work in Antigua

Linda, Sandy, Tom and Kelly are joined by the "Three Amigos" -- Captain Ware, Commodore Lineberry and Captain Finger -- at the ceremonial turnover of gifts in kind in St. John's, Antigua

Ken, Kelly, Elie, Linda, Sandy, Jan and Darlene muster in CASREC, going ashore in Antigua.

This is how they got ashore. The Coral Ark is easier to embark and disembark but she is SLOOOOOOOOW. Gives us more time to work on tans and enjoy the ever-changing colors of the water.

Lynn, Susan, Michele and Jane good to go for the first day of medical education and training in Antigua.

Dr. Darlene Lee consults with a pediatric patient and her mother in Antigua.

Dr. Ken Iserson and a family in Antigua.

Kelly Magee kept schoolkids smiling at the main clinic site in Antigua.

Jan Auerbach triaged hundreds of patients per day in Antigua.

Sandy Larson with a happy patient.

The Prime Minister and Minister of Foreign Affairs of Antigua & Barbuda gives the opening declaration for the Continuing Promise mission in his country.

Project HOPE Volunteers Begin Work in Antigua

Greetings from Antigua!

The mission here officially began on Wednesday with an opening ceremony in the Multicultural Center. The Prime Minister, the country's Chief Medical Officer and a representative from the Ministry of Health, Social Transformation & Consumer Affairs spoke and then toured the clinic, which was already up and running. A plaque near the entrance of the Center says it was partly paid for by the People's Republic of China...this underscores the diplomatic aspect of Continuing Promise. The Center is just across a channel from the BLZ (boat landing zone). I could throw a baseball from the BLZ to the parking lot, but there's no bridge across, so we take a 5-minute bus ride through the shopping district. Also interesting about the Center...it could be unprecedented in HOPE history as a clinic site...it's air conditioned!!! After the opening ceremony, the AF Band performed outdoors, and the crowd got loose when to Bob Marley songs. The educators, vets and Seabees also began work on Tuesday. The were no big lines for the training like in the Dominican Republic (yet) but the students were very receptive. Yesterday, several Hopies attended the GIK turnover ceremony, met many people from local humanitarian organizations, and stayed on shore to work in the clinic. We enjoyed a leisurely cruise back to the Comfort on the good ship Coral Ark. I stayed aboard Comfort today. As I type this, I can hear the mess hall filling up, so the first group must be back from shore. Have a good weekend everyone!

--Tom

Volunteers Complete Health Education and Care in the Dominican Republic

Happy Cinco de Mayo!

We finished the mission in the Dominican Republic on Friday. Everyone worked incredibly hard to the very end. On the last day alone, there were almost 1,400 patient encounters. While it’s not about the numbers, everyone can be proud of the fact that we saw more patients and taught more students -- in less time -- than in Haiti. The unofficial totals for the country were:

• More than 11,000 patients triaged – including a case of leprosy in early stages
• 206 surgeries in 7 operating days – 30 per day in the 5 OR’s
• 1917 dental encounters
• 4780 students taught in 213 sessions

On Saturday night, Captain Ware sang the praises of all the educators…students had lined up all week for the sessions like it was a Hannah Montana concert (whoever she is)…and one of our own, Project HOPE volunteer Michele Okamoto, was honored as the ship’s Person of the Day.

On Sunday morning, we were visited by the Robert Peary – a refueling ship. The Navy term for refueling at sea is UNREP, or underway replenishment, and it’s simply an amazing thing to witness two huge vessels going side by side in perfect sync for more than two hours. The Comfort took on 500,000 gallons of fuel and the Witch Doctors executed a flawless VERTREP, moving 182 pallets of supplies from the Peary’s flight deck to ours. The ship’s Master, Captain Finger, said he’s done these for 30 years and hasn’t seen a better one.

On Monday, we steamed for Antigua. Most of the crew got the day off, sleeping in and enjoying brunch. In the afternoon, there was a Steel Beach Picnic on the flight deck that was a lot of fun. The highlight was the rain-shortened AF Band concert. The horns were tight and Keisha, the singer, should be on American Idol. She is that good!

Well, we “dropped hook” in St. John’s Harbour in beautiful Antigua about an hour ago, and we just went to flight quarters. The first “serial call aways” have begun, summoning the crew members who are moving our stuff to the sites on shore, and the first helo is taking off as I type. The table and walls are shaking, so I’ll sign off for now!

--Tom

Photos of Project HOPE Volunteers at Work in the Dominican Republic

Elie Malloy charting in the ICU onboard the USNS Comfort

Elie Malloy and Lisa Boatright in the ICU

Lisa Boatright with an ICU patient aboard the Comfort

Dr. Knaster's farewell speech

Boatswain Butch escorts Harry, Lisa, Jan and Judi to the boats

Bon voyage dinner for NGO volunteers. Hopies on right: Harry Knaster, Suzie Piperno, Lisa Boatright, Emily Desrosiers, Jan Eames; on left (next to Big Daryl): Judi Knickerbocker

Enjoy--Tom

An Interview with Project HOPE Volunteer Medical Director Dr. Harry Knaster - Onboard the USNS Comfort

Last week, I sat down with Project HOPE’s on-board medical director, Dr. Harry Knaster, to reflect on the mission in Haiti and take a deep breath before doing it all again in Santo Domingo. Here are some excerpts from the interview.

Dr. Knaster is living his dream on this mission. His career began in Boston, where he provided primary care in a community clinic while working on his master’s of public health degree at Harvard. His plan was to move next to New Zealand and teach epidemiology while pursuing his PhD, but he and his wife decided to stay in the U.S. when they were expecting their first child. He became a residency director in Northridge, California, and later went into private practice in Monterey. Once his children were grown, his wanderlust resurfaced and he began traveling by single-engine plane to Baja California to provide services to remote villages there. When the Indian Ocean Tsunami struck, he journeyed to Aceh and worked in the emergency room of the only remaining hospital facility. He saw the USNS Mercy in the harbor, took a tour of the ship and learned about Project HOPE. Last year, he served as the Project HOPE medical director on the USNS Mercy and visited Port Moresby, New Guinea and several islands in Micronesia.

What attracted you to Project HOPE and your first mission with the Pacific Partnership 2008?

I really liked the philosophy underlying the mission, the idea and expectation of the Navy and NGOs working together to provide a safer and healthier place for people in need.

And so you came back for more of the same on this mission?

I met (Project HOPE's) Dave Eddy and (U.S. Navy's) Captain Ware during the Pacific mission, and enjoyed working with them and knowing that they were dedicated to the same vision as I had formed while on board the Mercy.

Could you describe your duties as medical director?

First, there’s the need to oversee that quality of care is provided and that everyone on the team is doing the job they’re trained/expected to do. It’s also very important to make sure no one is working beyond their physical and emotional capacity. I’m their representative and voice at various levels of decision-making on board as the mission proceeds. And I am also facilitating communication between the caregivers and the non-professional community to insure that care giving needs are being met. And I do some educating when the opportunity is there.

You personally saw hundreds of patients in the six days you were ashore at the clinics in Port-au-Prince, Haiti.

Yes, and I have to say that there has been a major emphasis on this mission in ensuring quality encounters, as well as seeing as many patients as possible.

Did any of your encounters stand out as especially rewarding?

My translator, Joselyn, and I were seeing our last patient at Cite Soleil. She was in her mid-twenties and appeared thin, however, not especially ill-looking. As we had been doing with all our other patients, I introduced myself, as did Joselyn and asked the young woman what was the reason she was seeking medical attention. Her answer was not unlike so many other patients- “I have backache, my stomach aches and I have headaches”. Joselyn and I looked at each other and then looked again at the patient and saw something that didn’t feel right. This woman had something wrong……but we weren’t sure what it was but we both knew it wasn’t related to her initial complaints.We asked some more questions that gave us information about her home life and soon learned that she was the only person cooking, cleaning and caring for at least four other younger siblings and was married to an older man who literally kept her a prisoner threatening her with physical harm if she did not do his bidding. Tears finally came to her eyes as she described her tormented and helpless life. Upon hearing this, Joselyn took out her cell phone and called an agency that protects abused women. She was not able to get through to them, so she took her name and phone number, promising to call her to insure the referral.

Though I do not know the outcome of this encounter, I was fortunate to have the opportunity to work with a bright and empathetic translator who was able to uncover information that would in other circumstances be lost ‘in translation’.

Thanks very much for these insights.

--Tom

Distinquished Guests Visit, Volunteer Work in Dominican Republic Continues

Distinguished Guests and Project HOPE Staff in Dominican Republic Visit with Volunteers onboard the USNS Comfort

Tuesday, April 28 We had more distinguished visitors aboard the Comfort today, including the Ambassador of Ecuador, Jose Villacañas, representatives of the Order of the Knights of Malta – who have supported Project HOPE’s land-based operations in the Dominican Republic since 1996, and many staff and volunteers from the HOPE office in Santo Domingo.

Commodore Lineberry greeted the delegation in the CASREC. Dr. Knaster answered the Ambassador’s questions. The visitors were able to see the entire hospital and capped off their visit with a group photo on the flight deck.

Meanwhile, the Hopies continued their great work treating patients at several sights on the beach as well as on board.

As of April 27, Project HOPE volunteers and their Navy Counterparts have
· Treated 4,658 patients
· Total educational interactions 1,369

in the Dominican Republic

--Tom