Saturday, February 4, 2012

Final day of Liberia Mission Jan/Feb ‘12!

Bags were packed and left for wonderful George Pezzimenti of Firestone who has done an A+ job of keeping us safe, sound and on time, with a can-do attitude that is a joy to be around. An extra hour or two to sleep this morning guaranteed smiles on all our faces.

Let me describe the scene as physicians came to make final rounds on the ward before the Farewell Program and lunch with hospital staff. All the children who had received surgery were in varying states of packing to leave, or eating breakfast, or slowly waking up. Their mothers or grandmothers or fathers were sitting at the foot of their beds. When the doctors arrived, one mother started singing in her bold a cappela, a well-known Liberian hymn of thankful praise. Within ten seconds every parent, who two days ago was unknown to every other parent, united in a groundswell of a hand-clapping hallelujah tune they’d all learned at their own parent’s knee or in some simple hall of worship. They were united in having children who have suffered, and now have benefitted from CSI’s presence at Duside Hospital.
As everyone who is a parent knows, most mothers and fathers would rather bear their children’s own suffering than have to watch them grimace while trying to urinate for years, be mocked for having a “split lip”, or have to wear a loose loin cloth instead of pants because of a huge hernia. They were certainly going to let everyone know about it with their booming voices all singing the same song in unison! There is something so pure and glorious about how the women here show joy, whether it how they laugh at a child’s funny gestures, or celebrate having their name drawn at our Farewell Raffle for staff. As they sang, the clapping became louder, hips were swaying, nurses were all in, and every child was grinning from ear to ear. It was a sight those who were there will never forget, and the sort of simple spontaneous show of emotion that makes countries like Liberia such a joy to visit. Being part of a CSI mission allows us to jet propel ourselves into the most private corners of the lives of our patients and their mothers/aunts/grandmothers/fathers/grandfathers/friends or nobody’s who have accompanied them to the hospital. What an unparalleled privilege.

The Farewell Ceremony included thoughtful closing words by Dr. Lander highlighting the transfer of skills that has taken place on this mission. A surprise presentation of a ceremonial robe to Lora Koppel for all of her contributions to the children of Liberia touched her immensely…” This is the highest honor of my entire professional nursing career,” she noted. A highlight for many was the presentation of the inaugural Mission Volunteer plaque, which went to Mr. Jackson, a hospital custodian, who worked tirelessly throughout the mission making spaces, and faces better wherever he went.

On all counts, the mission was a success. Everyone boarded the bus relatively healthy, and each bearing a beautiful oil painting of Liberian scenery, given by Wadei Powell and her Firestone/Duside team. The partnership, between CSI, Duside Hospital, and especially because of Firestone, allows our Liberian missions to line up exactly with CSI’s objectives.

Farewell beautiful faces and hearts of Liberia! 

Thursday, February 2, 2012

Last Day of Surgery: Thursday at Duside

Some of the first names of the children here are spectacular: Precious, Faith, Joy, Prince, Marvelous, Handful, Princess, King, Miracle, Godgift. How can one not smile when a child named Wonderful grins at you?

It is a very busy final day of surgery with hopeful families and their children waiting for their name to be called. I just spoke with a father who has tried for 3 years to get his son’s hypospadias repaired. The first year he waited in screening and learned we didn’t have an urologist on the team, the second year he was cancelled at the last minute because one of our surgeons became ill. Finally Jason is heading into surgery – father and son just walked out the door with one of our nurse anesthetists and everyone in pre-op let out a huge cheer!

We awoke this morning at 5:30 a.m. to a fabulous first: torrential rain falling on the metal roof of the Guest House. It is rare for it to rain this time of year, and it was a welcome cleansing of the dusts of summer south of the equator. Every evening during our stay the Guest House we have been treated to the fare of a different country: Thai, Lebanese, Moroccan, International, Liberian Seafood (featuring a 4 foot barracuda, the head of which was consumed by team member Patience - of Liberian heritage), and tonight is Chinese. We are being treated so well by the Firestone staff!

Over the course of our stay here, the team screened 120 patients; of those 99 will have received surgery by the end of today. We have made a concerted effort on this trip to focus on training the Liberian professionals at the hospital. It has been far more important for the surgeons to teach the Duside doctors how to perform certain procedures than to rack up as many surgeries as possible. As a result, spirits are especially high and as Steve Muehlstedt said so poignantly tonight at dinner, "this has been an experience of true teamwork".

And the patients are very happy, albeit sore. Without exception when I have asked a patient's parent if they have any suggestions for CSI on our future trips, they say something to the effect of “thanks be to God for you people”. Shown also in this blog entry is a mother and son who both received cleft repair, courtesy of a combination of Tim Lander and Duside's Dr. Sherman. We are amazed at the patience of the children who wait a long time to be called into surgery, especially those who are scheduled later in the day. No bickering over toys, no impatient parents, no fighting to jockey for position; just complete resignation to the process and a willingness to wait however long it takes for a chance to get the expertise of the “doctors from America”.

After discussions with Dan Adomitis and hospital administrators, it looks highly likely that CSI will return to Liberia in November of this same year, instead of waiting until January ’13. Because of this, we are boxing up supplies and storing them in a locked closet after taking inventory of what we are leaving behind.

Final post tomorrow after we get fully packed, make rounds on the patients and celebrate the successes with the Duside staff. PS- this added after dinner; the kitchen staff surprised us with a Thank you cake:) As I said before, we are spoiled.....

Wednesday, February 1, 2012

Wednesday in Liberia

While two in our group visited orphanages, the rest of the team had a very busy day at Duside hospital. Dr. Dave Vandersteen started his day with a male 7 year old patient who has a penis but was born without the rest of his genitals; upon opening him up, he is in fact 100% female. Dave sought counsel with Duside's Dr. Sherman, and met mid-surgery with the mother who gave support to make "him" a "her". So he continued surgery and Joe emerged as Jolynn. In his 21 years of practice he has had girls really be boys, but never the opposite. In the U.S. this would have been detected at birth.

Dr. Sherman completed a cleft surgery on a 23 year old woman (with very little support from Dr. Lander who has been training the Liberian physician all week). An added bonus is that Dr. Lander operated on the woman's child yesterday, so a mother/child cleft repair has been part of the week.

Clinical lead Katie Houle has been wonderful in this first time role for her. And all members of the team are in absolute sync, handing patients from one stage to the next with near perfect precision.

Lora Koppel, Katie Stewart and Sally Lannin went to Orphan Relief and Rescue where Debbie, the coordinator, headed up the assembly of 70 belated Christmas 'bundles' to deliver to two orphanages. Included in each bundle was an apple, pencils, a silly band, a ball, a sucker, candy cane and toothbrush. Attached to this blog entry is a picture of a child with his 'bundle'. Prior to opening their Christmas gifts, the children serenaded us with "We Wish You A Merry Christmas" and "Away in the Manger". Also attached are a number of pictures taken at both of the orphanages. In all honesty, the latter orphanage in particular was hard to see: 30 children, 12 of whom are under 2, being supervised by two elderly women who never stood up the entire time we were there. And when we gave each child their Christmas bundle, without exception we heard a 'thank you'. Also included is one of the boy orphans wearing one of Dr. Dave Tetzlaff's daughter's t-shirts which we donated. In addition, when we come to these orphanages word spreads to the nearby village and "outside" children can be seen peering jealously through the concrete blocks.