Health Relief for Children of Timbo, LiberiaLiberia Medical Outreach Date: October 9-18, 2010
The Picture of Health Foundation Inc. (POHF) sponsored the medical team consisting of Dr. Donovan Christie, Jackie Christie, NP (Nurse Practitioner), Linda Laprade, RN (Registered Nurse) and James Hill, Medical Technician to collaborate once again with Hope Christian International Foundation (HCIF). The HCIF team consisted of the Founder of John Yeedia, his wife, Elisabeth Yeedia, Walter Needham, a retired construction engineer, Oliver Sutton, a mortgage broker, Charles Phillips, an investment consultant, Craig Leiber, a retired aeronautics engineer and his wife Karen. Together we embarked on a mission to provide medical, evangelism and construction relief to the people of Timbo, Liberia. We were also accompanied by the missions Pastor, Dennis Russell from Victory World Church in Norcross, GA, who came on the trip to evaluate the church input into helping to build the first school in the Timbo village.
Our preparation for the trip consisted of an order of medication worth over $5,000 from Blessings International and a $2,000 order of Malaria medications. Dr. Murray, POHF Board member donated 500 toothbrushes, toothpaste and floss. Dr. David Rearick also donated 6 cartons of Metagenics vitamin packs. We were prepared to treat 600 patients in 3-4 days of clinic.
The flight from Atlanta to Liberia had only one stop in Accra, Ghana. So, the total flight time was 15 hours with an hour and a half layover. Previously, we had to fly to Europe with an 8 hour layover, so we were excited that our journey was cut by a third of the time. While in Accra, the airport baggage clerk removed two of our bags that we would later have to return to the airport to retrieve as they had vital supplies such as injectables and syringes.>
We arrived at Roberts Airport in Monrovia Sunday afternoon to a packed airport as the sky cab attendants are very aggressive in obtaining your business. We had hired a 7 passenger Toyota Land Cruiser, a 5 passenger Toyota 4 runner and a small pickup truck to transport our supplies from the airport. We started our journey to the Eternal Love Winning Africa Missions house (ELWA) arriving there at about 5:00pm and settling into our rooms. After, we went to a restaurant owned by a retired engineer who lived in Colorado. He emigrated just after the war and bought land to build a restaurant and hotel right on the beach. We had a wonderful grilled sole fish with rice and other tasty dishes and then retired back to the ELWA house.
On Monday morning we were up early since our biological clocks were still set to Eastern Standard Time. We had much to do before we headed out to the jungle of Timbo. My first stop was to the ELWA Hospital located about a half a mile away from the house. Our plan was to secure government issued Malaria medication from the hospital but discovered that we had to secure this type of aid well in advance. We did provide the information required so we could complete the process for free malaria medicine to non-governmental non-profit organizations (NGOs).
While still in Monrovia, we went to the Supermarket and brought 8 cases of milk protein formula (144 cans), one case of cod liver oil and 200 adult doses of amquine (local malaria medicine made in China). We then stopped by the airport to retrieve the bags we left during our layover. After locating the bags we headed to Timbo with our caravan consisting of the two SUVs and a cargo truck carrying our luggage, and 7 volunteers from Victory World Church in Liberia.
Pastor Barchue and his worship crew, Mamie, Jonathan, Daniel, Tavis, Meo, and Dorothy had their luggage and instruments, (keyboard, drums, guitars and amplifiers). They rode in the back of the truck. The truck was very old probably built in 1975 and did not seem appropriate for a long trip on a bumpy dirt road. Not thirty minutes into our journey did I get a call from John that the truck had broken down, the axle and a shock absorber had burst.
We did not want to arrive in Timbo in the middle of the night so we decided to stop at a half-way point in a town called Buchanan, just 3 hours away. The cargo truck was done for the night. John went back to the truck and arranged for another truck to pick up Pastor Barchue’s crew and our cargo. This would delay us 3 hours. We stopped at a Total gas station in Buchanan and inquired about a hotel for the entire team. I negotiated a reasonable rate at the Spark Hotel where every room can accommodate two people. The proprietor of the Hotel is a man from the Middle East named Nasim Nasser. We rented 8 rooms at the Spark Hotel to ensure rooms for our drivers as well. John and the rest of the team arrived later that night. The accommodations at the hotel were pretty good. We had heated running water from the faucet, and air conditioning. There was also a restaurant in the lobby where we enjoyed dinner and breakfast the following morning. We were up by 6:00am and ready to travel on to Timbo village. The replacement cargo truck had not stopped in Buchannan but continued to Timbo with Pastor Barchue and his team of volunteers.
October 12, 2010
We arrived at 10:00am and hurried to set up our clinic in the newly constructed church/school building. We put flat pieces of wood on cement blocks to create a pharmacy station and unpacked many of our drugs and supplies. We had two tables built, one was used as an examination table and the other for check in and triage of patients. We used the benches to create a waiting area for triage, evaluation and management and pharmacy. The two Liberian nurses Meo and Dorothy performed the triage function, while Mamie and Jonathan assisted with crowd control. Linda, the RN provided the clinical pharmacy support, James, provided all the dressing changes, injections and assisted with procedures. Jackie and I were the only two providers. We thought we would have a third provider, a Liberian doctor, but he never showed up with his team. We got started about 1:00pm and worked non-stop until 6pm. We saw 103 patients in 5 hours. Every patient was examined. The most common conditions were Malaria, pneumonia and bronchitis, dysentery (diarrhea) from many causes including typhoid, skin infections including fungal and bacterial lesions, and malnutrition.
Pastor Joseph, of the church in Mary’s village (John Yeedia’s mother) was instructed to hand out 600 numbers to people in and out of the villages. They came from miles all on foot bringing everyone in their hut with them. We saw families of 6 and 7 people routinely. Since they live in the same environment and drink from the same creek, eat the same food and are bitten by the same insects they all have similar diseases. The most common complaint was fever at night, “the body hot” or “the body cold”. This symptom of chills and fever at night is a classic sign of Malaria. Other physical signs of Malaria include “eyes swimming”, skin itching, yellow eyes, enlarged liver and spleen, deeply amber urine or blood tinged urine. It is obtained from mosquito bites where the malarial trophozotes is injected into the skin and enters the blood stream. Since we had no diagnostic lab to confirm any diagnoses we used our physical examination and history to confirm and treat these patients.
The next most common diagnosis was dysentery. HCIF and Victory World Church in Norcross had sponsored the drilling of two wells in order to provide clean water for the villagers. Only the people who live directly in Mary’s village benefited from the wells. The majority of the patients drank from the same creeks that they bathe in, wash their clothes and used as a toilet. This practice has created a reservoir for parasites (worms), Giardias, Amebias and bacterial (Typhoid, etc) gastrointestinal infections.
Many patients presented with cough and colds. This is caused by the inhalation of the smoke from wood burning trees. Rice is harvested in these villages and they would typically burn down trees as the basis for harvesting. In addition all meals are prepared on outdoor coal burning fires that are in close proximity to the huts where they sleep.
Approximately 98% of the children we saw had no shoes. They would run around on the cold ground and injure themselves on sharp edges of stone, sticks or rocks. Hundreds of them had insect bites especially on the legs. These bites got infected and caused extremely high cases of impetigo, cellulitis and abscess. We were exhausted by the time the 6:00pm deadline hit. Pastor Joseph secured some men to watch the supplies in the church and we headed back to the Missions house which was several hundred yards away from the church.
The Mission house had several improvements since the 2009 trip. We now had a generator so we did not have to use our flashlight after dark. We had bunk beds, 3 in one room and 2 in the other and one in the hallway. There was still no running water and we had to carry water in from the well to bathe and for toilet but it was still an improvement from the past. It was quite packed in the house as 13 people slept there every night. Elisabeth prepared us a spaghetti and meat sauce dinner and we prepared ourselves for a full day of clinic the next day.
We got an early start on Wednesday morning. I barely slept a wink and the sounds of the night interrupted my sleep. Whether it was the sounds of other members of the team, the motor of the generator, or the thunderous showers, it was very hard to sleep and I truly missed my ceiling fan. I was hot most of the night and a bit preoccupied with the flying insects. Oliver Sutton brought two nets that we were able to put across the windows to slow their entrance into the house. I got up at 5:45am Liberian time and read. With only one bathroom and 13 guests you have to be strategic about bathroom time. We had oatmeal and bread for breakfast, a short devotion and got to the church at 8:30am.
To our surprise there were not many people waiting for us. The oldest man in the village had died and many of the villagers were paying their respects to him. Within 30 minutes of setting up, the church was packed with patients. We saw 82 patients between 9:00am and 1:00 pm. Many of the patients seen that morning were adults. We had not prepared to see many adults as our primary mission was to treat the children. A significant number of the adults had high blood pressure, osteoarthritis and of course Malaria. We quickly ran out of high blood pressure medicines as I had only ordered 2 bottles of losartan (100 tablets) and one bottle of amlodipine (100 tablets). We had hundreds of adult vitamin packs consisting of omega 3 fish oil, anti-oxidants and multivitamins donated by David Rearick MD. We also had several bottles of calcium, magnesium and vitamin D supplements which we used for arthritis and osteoporosis.
The most unusual case of the day was a 19 month old girl with pox like lesions all over her body. Now I know that small pox has been eradicated so I was not worried about an outbreak. The lesions reminded me of an inherited condition called Von Recklinghausen Syndrome. The mother reported that they started to crop up on the child’s body since the time she was 3 months of age and now covered her body totally. There was nothing I could do to help her with this condition.
After a break for lunch we then saw another 96 patients from 2:00pm to 6:00pm. Our grand total for a little over a day and a half was 280 patients. We had touched so many patients already and really felt privileged to be doing God’s work. Elisabeth prepared for us fried fish, rice and beans and cucumber salad. Food never tasted so good.
October 14, 2010
I woke up at 5:45am to thunderous showers. It rained the whole night. I read until about 8:00am and noticed that it was still pouring rain. I started to worry that we may not have a clinic today. How would the villagers get to the church? Many of them must walk for miles to get there and the news had gotten around that we were there with medicines, vitamins, toothbrushes and formulas. That thought was interrupted when John’s sister, Sara who slept in the ‘’family house”, along with the crew from Monrovia reported that the house was flooded with water. She said that no one in the house slept all night as the torrential rains poured on the leaky ceilings all night. Pastor Barchue and his crew had indeed slept very little but the flooding of the building was slightly exaggerated. Three of the rooms were still pretty dry but the front room was flooded. I put my boots on and went to the house to find most of the crew sitting on the veranda. We decided to cover the leaky section of the roof with a tarp that was being used for plant shade.
We had a team meeting since it was still raining heavily t 9:30am, 30 minutes after our anticipated start time. Everyone agreed that we should go to the church and set up and see who made it there despite the downpour. We were ready by 10:30am and as soon as we were fully set up people just came pouring in. We had prayed for another successful day but never imagined this volume of people. Within two hours we had already seen 50 patients and it never slowed down all day. James performed an incision and drainage of a large groin abscess in a 12 year old boy. The procedure drew a large crowd as the boy screamed and had to be held down by several of our helpers. I performed several knee injections for osteoarthritis. James also administered many injections of ceftriaxone, promethazine and dexamethasone. Jackie worked tirelessly matching my production patient for patient. She would see over 300 people by herself over the 4 days of our clinic. It never fails to amaze me just how much energy you get when you look up to a never shrinking crowd of people who so desperately want and need your help.
Many of the patients had left early in the morning and had braved the rainstorm so they could be seen. Many of them however did not have numbers. We had to limit the amount of patients we saw without a number because we did not want to run out of medication and supplies without seeing the ones with numbers. Our early morning fear of not having a productive day due to the rain was not realized. We had our most productive day as we worked into the evening and saw 216 patients for the day. We hurried back to the missions’ house and ate dinner prepared by Elisabeth. That evening, Pastor Dennis preached at the evening service and performed an alter call where many people accepted Christ.
October 15, 2010
In 2 and ½ days of clinic we had treated over 500 patients and distributed thousands of dollars in medications, vitamins, toothbrushes, toothpaste, milk protein formula and cod liver oil. We had performed wound care, intramuscular and intra-articular injections, incisions and drainage of skin abscesses, and treated hundred with dysentery, typhoid and Giardias, malaria, pneumonias, malnutrition and skin infections.
Our concern on our last half day of clinic was to treat about 75 patients and leave the village by 1:00pm and head back to Monrovia without causing a riot with our departure. The need is so great and many people would have traveled miles and not received the care they needed. Pastor Barchue and 3 of his team members had left at 5:00am with our driver Rapala. They had to leave early for school the following day. Rapala was to secure additional transportation for the rest of the team in Buchannan and to come back by noon to pick us up.
We got to the church at 9:00am and it was packed with about 100 people. The crowd was noisy as people were jockeying for position on the seated line. Many of them had no numbers but had heard about our mission and also wanted free medicines and formulas. We got down to business and worked hard. Our pace increased beyond the previous days to average about 35 patients seen per hour. Every one of them was examined briefly but consistently. Many of them were families with the same diagnoses. We ran out of most of our medications except for some antibiotics as we were able to see 150 patients in 4 ½ hours. Our safety was secured when John got the local soccer team to provide security. We cut off patients at 1:30pm without any violent incident. They were very appreciative of our service. The balance of the medication was donated to the local clinic in Timbo beach.
Our transportation arrived by 2:00pm and we were packed and ready for our trip back to Buchanan. We opted to stay another night in Buchanan and not get to Monrovia at night. This would give us an opportunity to relax and make the return trip more enjoyable. We stopped on our way through the Firestone Development and photographed the rubber tree plants being harvested. Firestone Inc., a multibillion dollar company was thriving in this very poor country, while the majority of the citizens of Liberia were suffering. We arrived in Buchanan at 6:30pm that evening and our old friend Nasim Nassar put us up at the Spark hotel. We enjoyed jollof rice with chicken, a local favorite. James, Meo and Rapala ventured out in the evening to check out the local entertainment scene in Buchanan but came back to the hotel after one hour.
October 16-18, 2010
We eat breakfast in the restaurant consisting of an egg wrapped in pita bread and headed out to Monrovia. Our driver was a former police officer in Buchanan and had experienced a lot in this war torn country. He was captured by the rebels and his life was spared by a rebel leader who he knew prior to the coup. He really believes that the current President Ellen Johnson is doing a good job trying to rebuild the country. She still has much opposition as former rebel leader Prince Johnson, a cabinet member has vowed that she should only serve one term. The United Nations has a very strong presence in the country because of the threat of another coup.
We arrived at the ELWA mission house and arranged to go into town for some shopping. The shopping area in downtown Monrovia is packed with vendors. We purchased some wood carvings, jewelry and Liberian attire as gifts and had Chinese food for dinner. The following morning we went to Pastor Barchue’s church where the singing was lively and the worship inspirational. Pastor Dennis and I spoke to the congregation and thanked them for their participation in our mission. Pastor Barchue delivered the message on being spiritually sound. After church, I bought ice-cream from a street vendor for all the children of the church. Each cone cost about thirty cents in US dollars so for about $30.00 I became quite popular with the children. They enjoyed the treat and we bid farewell to Pastor Barchue and his team. We headed back to the ELWA mission house, loaded up the SUV’s and went to the airport for our long journey back to Atlanta.
This trip was very inspirational and just confirms how a small team from Atlanta, GA can have such a huge impact on the lives of 650 people living in Timbo village. Many people came back to thank us when we were leaving the village. The injections of antibiotics had already started to work as many fevers had resolved, diarrhea had stopped and wounds were healing. Children were receiving better nutrition with vitamins and omega 3 oils at least for a short time.
The school will start in the church building in Timbo village the following week, as John had just gotten the approval from Rivercess County. God was truly working miracles in Timbo village.