October 23, 2014
 

  Other
 

Emergency Medical Care for Cholera Epidemic in Kono & Koidu, Sierra Leone

 

SUCCESS!! We recently shipped a 20-foot container (arrival July of 2013) packed with equipment & medications, including: an ultrasound, x-ray unit,  2 defibrillators & 220 spinal anesthesia trays & more ... The clinic gets to keep the container for use as a medical storage unit. (thank you Clear Lake Regional Medical Center & American Tank & Vessel  & Heart to Heart International!)  We also purchased a brand-new Welch Allyn video colposcope (Valued at $9,000) for cervical cancer screenings at the soon-to-open Women's Center in Kono, thanks to Dorsey Kastetter's generous donation!  

   
  
 
 

 

Thanks Medical Executive Committee!

A special thank you to Clear Lake Regional Medical Center's  Executive Committee, which recently donated $20,000 to World Missions Possible's Sierra Leone 2012 & 2013 Medical Outreach
 
 

      WMP is a Texas-based, non-profit 501c3 organization dedicated to healthcare support and humanitarian outreach through various aid projects. The group sponsors medical, vision and surgical teams, provides disaster relief, and builds community facilities. The organization has serviced 16 countries in 11 years – including Bulgaria , Burundi, Costa Rica, El Salvador, Ghana, India, Nicaragua, Mexico, Sierra Leone, South Africa, Swaziland, Togo, Uganda, USA, Viet Nam & Zambia.

      The funds contributed by the Medical Executive Committee will be used for an upcoming trip to Sierra Leone, West Africa. With a population of approx. 6 million, Sierra Leone endured an 11-year civil war that resulted in the mutilation of thousands of men, women and children by Rebels of the Revolutionary United Front (RUF) in an attempt to terrify people into supporting the rebels.
      “"This wonderful donation from the CLRMC medical staff is critical in helping us bring
life-saving care to this healing nation. The staff's generous funding will bring
in medication and personnel to combat the current deadly Cholera epidemic that
has killed 200 and sickened over 12,000 people already," said Roxane Richter, WMP President.

      The Medical Team ofWorld Missions Possible will be providing numerous services on its trip to Sierra Leone this year, including medication , equipment and tretament for Cholera victims, as well as  the critical training of medical staff in adult & pediatric resuscitation & life support, ultrasound and trauma care training, and free vision care.

      Dr. Thomas Flowers, the organization’s Medical Director, added that the donation from the Medical Staff would be used to purchase supplies like antibiotics, surgical instruments, splinting material, sterilization containers, medications, laryngoscopes, intubation sets, vital sign monitors, and much more.

Thanks GHEP!
A special thank you to Greater Houston Emergency Physicians Group (GHEP), which recently donated $5,000 to World Missions Possible's Sierra Leone 2012 &2013 Medical Outreach
 

 

UPDATE:::: September-October 20112

            As you see from the attached photos, we were busy working with three facilities: The Jennifer Wright Pediatric Clinic (serves 2,000+ patients per month in Freetown); Wellbodi Amputee Clinic (serves 2,500+ patients per month in Kono) and the 300-bed Koidu Government Hospital (Koidu). The pediatric clinic is located in the capital city, which has been the hardest hit region for Cholera, with many people flocking to the clinic with diarrhea, vomiting and other symptoms of Cholera. The
western area of the country where the capital city of Freetown is located has been the most affected location with more than 50% of total cases. This year has been the worst epidemic in their 15-year history with agencies reporting 392 deaths and 25,000 confirmed cases since Feb. of 2012 in Sierra Leone and neighboring Guinea. Twelve of the 13 districts in Sierra Leone have been affected since the beginning of the year.
 .
                  Aside from our Cholera outreach,over 750 pounds of medications, supplies and equipment, including an ultrasound, 2 vascular dopplers, surgical instrumentation, splints, an enteral feeding pump, etc., etc…-- as well as hundreds of IV catheters, 900 packets of Oral Rehydration Solution (ORS) and 8,000+ doses of Azithromycin and Doxycycline for fighting Cholera. I did forward you a complete list of our donations of equipment & supplies via email. We also brought new cables and were able to repair the clinic’s EKG and vital signs (that WMP donated in 2011). The WMP team also provided 300 patients with free eye care includingcorrecting refractive errors of hyperopia, myopia and presbyopia. During the clinics, patients were offered the assessment and free medication, treatment or referral of cataracts, pterygiums, corneal ulcers, glacoma, etc., as well as free prescription eyeglasses.
 
 
         As for training, WMP trained both Koidu and Kono healthcare staffs on ultrasound (OB/GYN and trauma assessment) usage, intubation, Pediatric Advanced Life Support (PALS), pediatric S.T.A.B.L.E. ( a neonatal education program that focuses exclusively on the post-resuscitation/pre-transport stabilization care of sick infants) and CPR. The medical team director, Dr. Thomas Flowers had one live interview about healthcare and our free medical outreach on the national Sierra Leone Broadcast Corp. (SLBC) radio, the only national radio station.  

 
November - December, 2011
          We had a very successful trip for our 1st medical & eye mission to
Sierra Leone, West Africa.
 
   
          Staff at Wellbodi Alliance Amputee Clinic, Kono. There were 2 docs (Dr. Bailor Barrie & Dr. Dan Kelly), 4 nurses and 4 community health care providers that WMP trained in vision screening, refractive eye exams, and splinting.
 
         During our 13-day trip, we treated 300 patients and we started the 1st and only eye clinic available in the eastern region through WellBodi Alliance’s Amputee Clinic in Kono (Koidu).

         We saw loads of cataracts (approx. 40%), an unreal amount of pterygiums (approx. 75%), some really bad corneal ulcers (approx. 10%), and glaucoma. One kid had some eye trauma, and one kid had a splinter deep in his eye that Tom took out. We had a local nurse anesthetist come by and perform conscious sedation and Tom did surgery without Lidocaine, using a needle taped to a Q-tip. The picture of the boy shows the “vital signs monitoring” that they do by simply taping a stethoscope to the person’s chest… wow. The saddest case by far was a 4-month-old girl born with 2 congenital cataracts; I have to wonder what her future will be like.

 

  

          On our very 1st day there, we met with the 1st lady, Her Excellency, Mrs. Sia Nyama Koroma First Lady of the Republic of Sierra Leone. She was very excited to hear about the solar-thermal autoclave invented at Rice University that will be set up and donated through World Missions Possible, Wellbodi and Rice next year for Koidu Government Hospital through her charity. 
 

         During our visit, we trained both the staff at the Amputee clinic and also several nurses from the Koidu Government Hospital on eye anatomy, disease, trauma, and eye health, as well as correcting refractive errors of hyperopia, myopia, presbyopia, and astigmatisms. We trained both staffs and donated over 350 pounds of medications, supplies and equipment, including a manual focometer, 540 pairs of eyeglasses, and a vital signs monitor.  During the clinics, we offered the assessment and treatment or referral of cataracts, pterygiums, corneal ulcers, glacoma, trachoma, etc., and the distribution of prescription eyeglasses. Tom also offered the docs and some of the nurses a short course on treating certain traumas, including splinting and advanced wound care. 

        
          During our days of clinic, I was soooooo grateful for my new toy – a Welch Allyn autorefractor. I bought it just one week before the trip, but I couldn’t seem to get the “feel” for its beeps and whistles…it’s rather ticklish. But after the 1st day, the machine & I melded and it was absolutely fabulous, especially when I had a lot of kids that were waaaaaay to young to use the focometer (manual device seen on left). (All the little “pikin’s” [child] said was “fine”…).
 
         The picture below is of a child suffering the obvious effects of 
malnutrition  :  angular stomatitis, or cracking in the lips and corners of the mouth that is caused by a deficiency of the B vitamin riboflavin;   hair dyspigmentation, a condition – found primarily in tropical regions – where children's hair takes on a reddish-orange color due to protein deficiency;     sparse, thin hair created by a deficiency in protein, zinc and iron; and  anemia, which reflects iron deficiency.
    
 
 
 
 
 
 
 
 
 
 
 
 

         The hospitals there are, even for West African standards, beyond ill-equipped… but healthcare staffing may indeed be their #1 problem. As an example, the Koidu Govt Hosp. with over 140 beds, has no equipment, not even one working O2 tank. (I did see 2 suction units and one IV pump, but the nurses didn't know if they worked!)

 

         When we walked into sterilizing room with sterilization nurses, they stood in front of 5 stovetop autoclaves (glorified pressure cookers really, that boil for 35 minutes to sterilize). But later we found out that only ONE stovetop autoclave worked (others are broken). They heat the autoclave with an antiquated propane tank.

 

         The 2 functioning O.R.'s they use for 15-20 surgeries a week have no electric or running water and zero equip ---- not even an O2 tank or one monitor of any kind. If they have an emergency c-section at night, they use a diesel-powered generator... The sad part is they have an ultrasound and an x-ray in boxes that no one knows how to set up or use.   

 

         There is a Methodist Eye Hospital in Kissy, about 20 minutes outside of Freetown, and it's the only real eye hospital outside of Connaught Teaching Hospital in capital city. The surgeon in Kissy said there are only 2 ophthalmologists in the country right now and there are 5 "cataract nurses" that also are performing cataract surgeries in the country. There is only 1 hematologist and 3-5 OB/GYN’s in the entire nation.

 

 

         Sierra Leone itself was surprisingly beautiful --- very lush, muddy, and the rains come on quickly and are extreme, sudden downpours! I certainly would hate to see what the “rainy season” (late July- Sept) looks like, the roads must be impassable. Getting around the country can make a sane person rather insane…frustrating, and the absolutely worst traffic jams I have ever witnessed (rivaling Cairo). You have to take an overcrowded and crazy ferry to get to/from airport in Lungi, which is, in itself, a wade into cultural waters that hits you smack upon arrival, jetlagged or not, no matter. The Krio (native language) is quirky – a pidgin English with expressions like “Go fast, small, small”, and kids are “Pikins” and you ask for “dem book yonder dah.” I cannot think of anything good to say about the food, so I won’t!! The main meal is “ko-kri” which is rice (main staple) topped with cooked potato leaves fried in palm oil.       

   

 

         In another exciting note, we got to tour the “Africa Mercy” of Mercy Ships.org…it was a huge organization of 400 crew members (60% medical; 40% other) from 40+ nations. They had 6 OR’s, dental and eye clinics and they run “specialty” sessions for cataract operations, etc. Mercy Ships was showing the award-winning “Pride of Lions” documentary that highlights some of Dr. Barrie and Dr. Kelly’s work with amputees in Kono.

 

         We also had 2 interviews (one live & one taped) on the national Sierra Leone Broadcast Corp. (SLBC) radio…the only national radio station. But we were able to talk about wearing sunglasses with U.V. protection & they invited everyone to the free clinics. People also called in with questions about their eye problems…it was fun as 2 nurses translated into Krio for us.  

 

 

 

         Pictured below is the happiest moment of the trip. The day before we left, we decided to donate our vital signs monitor (that everyone was soooo in awe of….!!!) to WellBodi Alliance’s Amputee Clinic in Kono --- see the happy expressions on Dr. Bailor Barrie and Dr. Dan Kelly!! Dr. Barrie said of the monitor: “This is my heart. We will take great care of it. And when you come back, it will be working and in good order, you’ll see.” 

 
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Maternal Care Outreach, Sierra Leone

 
For a woman, Sierra Leone is one of the most dangerous places on earth to give birth.

In this tiny West African nation, a shocking one out of seven women dies during childbirth. If she lives in a rural area, she may not have the emergency transportation she needs to seek medical care from a midwife or hospital – and if she is lucky enough to get to medical care, she may not have the $3.50 she needs to pay for her medicine and treatment.

In Sierra Leone:

  • 50% of the country lives on less than $1 day;
  • Prior to the 11-year civil war (1991-2002) that left over 50,000 dead, the nation had 500-600 doctors – now there are less than 100; and
  • Sierra Leone has one of the highest rates of maternal mortality on earth: 1 in 7 women die in childbirth, compared to 1 in 4,000 (average) in developing nations

Thousands of women bleed to death after giving birth. Most die in their homes. Some die on the way to hospital; in taxis, on motorbikes or on foot. In Sierra Leone, less than half of deliveries are attended by a skilled birth attendant and less than one in five are carried out in health facilities.” – Amnesty International

To help combat this appalling lack of healthcare, World Missions Possible is set to launch a “Mobile Maternity Care-A-Van” outreach in Port Loko, northern district Sierra Leone, in an eight-village wide rural village span (Santigiya, Mapeh, Kholea, Sanya, Dentheh, Kipolo & Kontehya) in Kaffu Bullom area…. But we need your help! Please review our list of needs and also ask your local OB/GYN, doctor, clinic, neighbor, or church member to look at our list of basic needs and see what they can do to help.

BASIC "Mobile Maternity" Equipment:

1.    Blood Pressure Cuffs & Stethoscopes

2.    Hand-held *hospital-grade thermometers (1 tympanic & 1 adult digital = $640): (Recommendation: Welch Allyn “First Temp GENIUS” (approx. $390) takes very accurate temps, esp. kids 100+-degree temps) pediatric tympanic thermometer. Recommendation: Welch Allyn “SureTemp” (approx. $250) for reliable adult temp.

3.    Hand-held vascular Doppler & gel.

Example: Nicolet Elite 100 Non-Display Doppler (approx. $500)

DOPPLER STOVETOP STERILZER

(The purpose of a doppler is to find and confirm the fetal heartbeat by measuring blood flow – this can indicate a possible miscarriage or if the baby is in distress (like low oxygen), which can lead to fetal damage or death.)

4. Oxygen Delivery: O2 tanks, O2 tubing, nasal cannulas & O2 masks (infant and adult)

5. Stovetop (non-electric) Autoclave for sterilization ($350) (The ALL AMERICAN Non-Electric Cast Aluminum Dry Steam Sterilizer model 1925X and has a 25 quart liquid capacity.  These sterilizers have been made since 1930 and there are several million in service all over the world: Fast, 35 minute sterilizing cycle: Calibrated Gauge that shows when sterilization cycle begins. Any outside heat source can be used such as a hot plate or stove top. Lubricated Metal-to-Metal Seal which means no gaskets to wear out.)

6. Suction: 50 Delee suction cathetersfor suctioning baby’s airway at birth ($ 120)

 Continued “Basic” Needed Supply List:

o   BVM - infant & adult ambu-bags 

o   Umbilical cord tape

o   Exam gloves (Nitrile or heavy grade for HIV patient care)

o   Stainless steel vaginal speculum(s) 

o   Infant scale

o   Pregnancy & HIV testing supplies 

o   Sanitizer

o   Oral rehydration salts

o   Masks: N95 Particulate Respirators for protection against tuberculosis

o   Stainless steel forceps, clamps (Kelley), suture holders & scissors (episiotomy)  

o   Suture: 2-0 Coated Vicryl, Vicryl RAPIDE or Vicryl PLUS Antibacterial

o   Sharps/hazardous waste containers

o   Sterile O.R. towels

o   I.V. supplies: 18 & 20 gauge IV catheters, tubing (macro drip)

o   10 ml syringes

o   20 & 22 gauge 1 ½” needles

o    Sterile bulb syringes

o   Battery-powered suction unit

o   MEDICATIONS      Rx

o   Prenatal vitamins

o   Lidocaine (injection)

o   Antibiotics (injection): Rochephin, Amoxicillin, Keflex (500 mg)

o   Antibiotics (tablet): Zithromax, Rochephin (250 mg)

o   Ophthalmic (Erythromycin) eye drops


To get started, we approximate the cost for all “basic” equipment for the Mobile Maternity Care-A-Van to cost no more than $ 2,000, and the cost for “basic” levels of supplies to be $1,500. The average salary of a licensed and qualified nurse/midwife in the country is $4,500 a year, and the cost of a used van for the transport of the nurse and/or the patient to receive life-saving medical care is approx. $10,000.

Any & all supplies and/or monetary donations are welcome & 100% tax-deductible. Please make your donation to: World Missions Possible.

“Mobile Maternity Care-A-Van” Program Goals:

  1. A significant (and quantifiable) decrease in infant mortality (rates of death) and morbidity (having disease or ill health) in the Kaffu Bullom region (Port Loko district);
  2. A significant (and quantifiable) decrease in maternal mortality and morbidity in the Kaffu Bullom region (Port Loko district);
  3. A substantial increase in maternal nutrition knowledge, HIV & STD transmission, including nutrition during lactation, and infant nutritional standards;
  4. A decrease in mother-to-infant transmission of STDs (causing blindness, illness and/or death) such as neonatal chlamydia ophthalmia and gonococcal ophthalmia (with the introduction of ocular prophylaxis of erythromycin minutes after delivery).

           We hope this report has touched you to reach out to help save the lives of our sisters and their babies in Sierra Leone. World Missions Possible has operated in 16 nations for 11 years and has an outstanding record of fiscal, social, and cultural integrity. If you’d like more information on the project or to talk with either the president or medical director of World Missions Possible, please call us at any time.