The news from Liberia just gets better and better. Hospitals and clinics have reopened, the government is back to work, schools are reopening this week and next. There have been no new cases of ebola for several weeks. Our work continues, seeing patients in the temporary clinic and out in the communities every day. Last month we were awarded a second grant from Global Giving for our work during the ebola crisis - keeping our communities safe and healthy. The first grant provided funding for ebola education and purchase of materials to build hand washing stations. This latest grant provides funding to hire and train ten new community health workers, including funds for uniforms, health kits, and bicycles. Dr. Chris has already started the search for these next ten trainees.
A Ground Breaking Ceremony held on January 7 has been followed by rapid progress on the foundation walls for our new Medical Center. All of the workers are local, from the communities we serve. Cement and soil blocks are being build on site and all the materials for this construction phase are being purchased locally. Half of the blocks required for the foundation and walls are complete. In ten days this phase should be fully complete.
So many young men have been put to work, new construction jobs created, new skills being learned. Our construction management consultant, Building Goodness Foundation in Virginia, continues to watch over the construction team. Every phase of the construction has been improved with their assistance - overall design, site planning, drainage, roof ventilation, solar power. This building will be like no other in Kakata. Detailed photos of each step are sent being sent, sometimes daily. They are reviewed, discussed, and frequent conference calls are providing guidance at every step. Plans are being made for mission teams to come and teach the skills needed for the more challenging construction phases.
The goal is to have the walls build and the roof completed before the raining season begins in May/June. About 80% of the required capital has been raised, we still need to raise over $100,000. The first Global Giving Bonus Day this year is Wednesday, March 18th at 9am EDT! Matching at 30% up to $1,000 per donor per project. There is $60,000 available with two $1,000 bonus awards - for the highest number of individual donors and $1,000 for the most money raised. This is a great opportunity to double your donation.
Right now everybody is focused on Ebola. Liberia's government has set a highly ambitious goal of zero new ebola cases by December 25. Like everyone we're doing all we can in terms of prevention - educating people, placing buckets. Last month we authorized the purchase of another 1000 buckets with a continuing goal of placing them in every school, church, mosque, and marketplace in Margibi County.
When the hospital reopened last month we reopened our clinic treating fevers, malaria, diarrhea, sore throats, wounds, typhoid, STIs, and deworming just as we have always done. Our emphasis continues to be on community health, keeping people and communities safe and well. Sometimes we see potential cases of ebola and make the referrals necessary for treatment. Dr. Chris has been hosting the Heart to Heart International Leadership team at her Monrovia Guest House, as they respond to the need to build and staff additional ebola isolation facilities. We are continuing to work with communities to allow the ebola teams in to do what they need to do. This crisis has brought urgency and attention to our work, but it hasn't changed the work.
There continues to be a scarcity of health workers everywhere in Liberia. Dr. Chris is one of only three doctors in Margibi County. The other two work for the goverment at C.H. Rennie Hospital. Our Community Health Workers serve as the primary health care providers for patients in and around Kakata. Community Health Workers provide health education, they lead the vaccination and immunization campaigns and provide first aid to community members when they are sick. They encourage pregnant women to seek health care and mothers to seek postnatal care. They are the first responders. We are moving forward in 2015 to more than double the number of trained Community Health Workers from 8 to 18.
Last week we finished the grading work required to set the foundation for our new Medical Center facility. We are now able to share the drawings for this beautiful new facility. Building Goodness Foundation has been supporting our work to design and construct a beautiful, new space over the next twelve months. Their knowledge and experience have already provided so many benefits to our Liberian team. Job skills are critical for community development. Even though we primarily do work in healthcare, one of our goals in building this facility is to use local labor and to train as many men as we can in world class construction skills so that when our facility is complete they can continue with a valuable trade.
Like the government our plans for the coming year are also ambitious - build a new Medical Center, double the number of trained healthcare workers, keep Margibi County healthy and safe. With your help we have accomplished so much in the past three years. We look forward to putting this ebola crisis behind us and with your continuing support, moving forward! Please remember us on Giving Tuesday - December 2.
The first case of ebola in Liberia was reported in March 2014. At that time it seemed the crisis was far away from Kakata, something reported in the news, rumored about town, with little impact on our daily work. We continued to treat patients with very high fevers, diarrhea, vomiting, muscle pain, headaches, malaria, sore throats, injuries, pregnancies, and chronic diseases. We talked about ebola and took precautions, but we were treating these cases long before ebola came to Liberia, and continued to treat them after ebola became official.
Between March and July, we worked in the clinic and out in the communities treating 2,173 patients and de-worming 3,736 kids and adults. We provided glasses to 150 patients, took care of 107 pregnant women with prenatal visits and after delivery care, and provided clothing to 85 adults in desperate need. We provided 125 health kits to children; provided toothbrushes and talked about dental care. Every day our health workers rotate under a tree in the yard providing health education on various topics to the patients who gather there. In addition to the patients under the tree, we provided classes to over 1,200 women and men out in their communities in community centers, churches, schools and other gathering spaces. We have been talking about hand washing and sanitation for 3 years. We also provided health education with regular medications to everyone under our care for chronic diseases, such high blood pressure, diabetes, sickle cell, and epilepsy. Health education is provided to every patient we see.
When the local hospital closed and the government shutdown in July, our clinic was overwhelmed by all the patients coming to us. Senator Oscar Cooper provided us with disposable PPEs immediately when the first ebola case was reported in Kakata. Ebola was real, it was in Kakata. The first report turned out to be a false alarm, but within a month, we lost 11 nurses from the local hospital and 3 local pastor's wives, caregivers to members of their churches. Dr. Chris and the staff knew many of these people personally, members of our community.
Even though the government has discouraged travel, the population of Margibi County has grown from 135,000 to over 200,000 in the last 90 days. Kakata, being centrally located, has seen a surge in population from both rural areas and the city, as people seek a safe place with their families. We see new faces in our outreach every day. People are very anxious to hear what we have to say. The Ministry of Health provided us with pamphlets about ebola and we were able to make copies for widespread distribution, but more than half of these people are not able to read or write. Flyers and pamphlets are of little value for them. They have questions. We talk in the language that they understand. They are encouraged to pass on what they learn to relatives and neighbors not able to attend or who live in other areas of the country. We believe that we have reached more than 136,000 people with an ebola message since March.
We were not properly equipped to handle the increasing patient load after the hospital closed. There was no place to refer patients. The government imposed restrictions on large groups of people gathering. Dr. Chris decided to close the clinic, both to comply with government restrictions prohibiting people traveling and gathering and for the safety of patients and staff.
Although the clinic is closed, we continue to serve those serious cases coming to our doors. We continue to provide refills of medications. We hold daily training sessions and community meetings, continuing to take our messages to each of our 34 communities. In the past 3 weeks we have purchased 200 buckets, 200 large bottles of bleach and soap to build hand washing stations. Four buckets have been placed at main entrances and exits of each community, so that people can stop and wash their hands. Our next goal is to permanently place additional buckets in each school, day care center, church, mosque, garage, and market place.
Our emphasis continues to be on community health, keeping people and communities safe and well. The message on ebola is just a fraction of our message. This crisis has brought urgency and attention to our work. We continue to talk about fevers, malaria, diarrhea, sore throats, typhoid, and STIs, watching hands, nutrition, and deworming. We continue to work with groups to provide clean water.
Throughout this crisis our health workers have continued to provide outstanding and faithful service. All of the health workers in Kakata ran away from their post, but we stayed and did the work necessary. We will never be able to repay these dedicated staff members for risking their lives during this whole ordeal. They are still at work in the communities daily.
At our Board meeting Saturday Dr. Chris provided an update on the worsening situation in Liberia. She spoke of her challenge in continuing to serve the 34 communities in and around Kakata throughout this unprecedented Ebola outbreak. We’ve all heard on the news how the country's health care system is collapsing with hospitals closing, medical workers fleeing and people dying of common diseases because they are afraid to seek treatment
Addressing the nation on July 30, 2014, the President of Liberia, Ellen Sirleaf, laid out the government’s plan to manage the crisis - “Operation White Shield”. She said all schools, which were closed last week, will remain closed until further notice. Non-essential staff at all government ministries and agencies will observe a compulsory leave for the next 30 days. Afflicted communities are to remain quarantined with enforcement by the military and police.
Liberia is considered the least-equipped of all of the countries affected by the Ebola outbreak, which now also includes Nigeria as well as Guinea and Sierra Leone.Security forces have been ordered to ensure that these measures are observed with new military checkpoints blocking movement from quarantined areas. Unfortunately, Dr. Chris reports that much of the food is grown in the quarantined areas and food shortages are expected soon. In addition the local water system was recently compromised and water supply has been shut down for several days.
In response to government orders, limiting travel and people gathering, and in consideration of the safety of our HWHL staff, Dr. Chris has halted operations involving direct patient contact at the clinic. CH Rennie Hospital, the local Regional Referral Hospital, remains closed, so the closest location open for isolation of Ebola patients is the private employee clinic at the Firestone Rubber Plantation over 10 miles away. Since so many hospitals in Liberia have simply closed their doors because they don’t have adequate supplies to protect their staff, nobody is getting medical care, whether they’re pregnant, sick with malaria or having a heart attack.
Dr. Chris has shifted focus of the staff to prevention and public education with a renewed emphasis on sanitation by setting up as many community sanitation stations as possible. Buckets, which sold for a dollar a week ago, are now being sold for $35 dollars apiece and are in short supply, as is clean water. Since Liberian Customs has virtually stopped incoming goods and supplies, we are asking for immediate financial assistance to help Dr. Chris provide buckets, soap, safe water, and bleach to assist the local population. All materials must be purchased locally.
The public health situation in Liberia is grave.
100% of financial assistance we receive for this effort will be used in direct support of the Kakata community.
Please consider a donation for this effort.
Thank you and God bless,
As you can see from the picture above, work continues for the construction of our new Medical Center. We have completed the security fence, which completely surrounds the Medical Center property, allowing for materials to be properly secured during construction. Brick production will continue as fast as possible during the rainy season with completion of the facility expected late next year. All bricks are being made onsite - only about 55,000 to go.
Architects from our construction partner, Building Goodness Foundation (BGF), are planning to visit Liberia in July to review progress and discuss building details with our Liberian contractor, LUCE. One goal is to transfer key building skills to as many local young men as possible during this construction project. BGF is planning to bring construction teams during critical phases - foundation, roof, plumbing, electical/solar, finishing.
A Community Garden Workshop was held in May to teach basic skills. Portions of the garden are beginning to produce crops regularly, helping to feed our workers. Many plots are available. The local community is being encouraged to participate.
Partnering in TeleHealth
Earlier this year Dr. Chris began working with the University of VA (UVA) Center for Telehealth to explore potential applications in Liberia. The UVA Center for Telehealth draws from its broad experience in providing access to healthcare in rural communities to foster global relationships to treat illness and to advance healthcare education in a growing number of places around the world. In addition to the link between Kakata, Liberia and Charlottesville, VA a link has also been set up with Mbarara University Science and Technology (MUST) in Uganda.
For the past year UVA has been working with colleagues in Uganda to create a Global Classroom for collaborative research and training. This collaboration takes many forms, which include Resident Case Conferences, guest lectures, and undergraduate research exchanges. Providing these resources to our clinic in Kakata offers huge potential to provide local continuing education courses over the Internet, to provide access to medical information from digital medical libraries, and to facilitate exchanges between doctors, nurses, clinics, hospitals and other centers of medical expertise.
Last month several patients benefited directly from consultations on "difficult to treat" wounds. Many wounds seen in Liberia are severe, healing poorly or not at all. Not only is Dr. Chris able to consult with colleagues remotely in order to resolve these difficult cases, but her ever-expanding team of Community Health Workers also have been able to share local treatment methods used in Liberia with the staff in VA. These intereactions are providing new insights to the challenges and solutions for treatments where resources are limited to local sources. Meetings and live presentations are currently scheduled twice a month.
Our accountant, James, has been invited to VA to participate in technology training in October, all expenses paid. He is currently working to computerize all of our records and teach the Community Health Workers how to enter patient data.
It's rainy season, so the focus moves closer to Kakata as roads flood and transportation becomes diffcult. There is more time for hiring and training. Mission teams are now visiting two or three times a month bringing critical medical skills and dental resources. Operating funds are short. We need your help to keep growing - for staff, medicine, supplies, and fuel.
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