Medical Missions Africa

For the past few years, Physicians for Peace has been working in partnership with the government of Eritrea and The George Washington University Medical Center to bring post-graduate medical education to Asmara. Last week, a dream was realized for The Partnership for Eritrea, as the Orotta Medical School graduated its first class of doctors and pediatricians, a priceless contribution to the health care system of a country affected by years of conflict. 
President and CEO of Physicians for Peace, Brig. Gen. Ron Sconyers (USAF, Ret.) attended the graduation, which marked an important milestone for medical education in Africa. He shares his thoughts on this experience:

I have just returned from Eritrea…after a most stirring and historical experience. 

 

When Dr. Horton conceived Physicians for Peace, it was his vision to build international peace and lasting friendships by bringing America’s best medical talent together with the medical talent of the world’s underserved to not only heal and teach, but through “people to people”  outreach, create unwavering friendships, regardless of politics, geography, religion, or other artificial boundaries.  What  transpired this  past weekend sets the standard for Dr. Horton’s vision of medical diplomacy. 

 

Picture this:  the dais at the graduation ceremony of the first class of Eritrea’s new medical school.  Eight dignitaries prepare to convey degrees on 31 medical doctors and 8 pediatricians.  Four of those about to honor these students are directly affiliated with  Physicians for Peace;  three are from Eritrea, a country with “not so good” relationships with America (but life long friends of PFP);  and one from Cuba (and new PFP friend), who in fact is the Dean of Eritrea’s Orotta School of Medicine…another country with severely strained relationships with its neighbor to the North.  But here they stood, as friends and colleagues, in the name of medicine.   No politics, no animosity. Just a common cause of bringing the best medicine to a nation’s people. 

 

In 2001, PFP, under the leadership of Dr. Haile Mezghebe, of Howard University (and personally recruited by Dr. Horton)  began a series of medical missions to Eritrea that opened doors and hearts to the way of PFP.  And then in 2005, PFP joined forces with The George Washington University Medical Center to establish the Partnership for Eritrea, bringing the first post graduate medical education to this nation…in the face of severe challenges and uncertainty.

 

Today, 31 new Eritrean doctors and 8 new Eritrean pediatricians begin their lives anew, fulfilling their aspirations to serve others.  And Physicians for Peace yet again demonstrates that if you heal a man, you heal only one, but if you teach a man to heal, you heal many.  Today, thousands will be healed in Eritrea.   

 

We can take great pride in our work there!  While it remains unfinished, this is a milestone of watershed proportions. 

 

As I gather more of my thoughts, more will follow.  But just know that what has been accomplished in Eritrea is game-changing.

 

Congratulations to all!!!  

Ron 

Find out more about The Partnership for Eritrea at www.partnershipforeritrea.org

Watch local television coverage of the event:



You can help us improve health care in developing countries through international health education by supporting our training programs and medical mission trips in Africa. 

Make a donation today!

Women helping women: Physicians for Peace volunteers with patients at Segou Hospital.

Laura Gwathmey and Laura Fine-Morrison are traveling with our VVF surgery team on the ground now in Segou, Mali. Here is their latest report, which shares their observations of both the patients and the staff they have encountered at Segou Hospital: 


Our work here in Mali makes us realize how lucky we are to live in a country that allows women equal status. Here, women have little control over their lives. Most of the patients we've encountered have scarring from female genital mutilation. One member of our team, the only female doctor on staff at the hospital, told us the story of her own experience with FGM. As a child, she was subjected to the practice, and decided very quickly that she would not want her own child to suffer as she did. Unfortunately, the Malian custom is that the husband's family gets to decide the fate of a female child, not the parents. Despite our team member's best efforts, her husband's mother decided that the practice would be contined with her grandchild, our teammate's daughter, at the age of 2. In reality, our teammate told us, she could accept it only knowing that uncircumcised girls, as they are known in Mali, never get the opportunity to marry or have a family. The choice is stark: genital mutiliation or a solitary life. 

 

We're here hoping to change that through our actions. Many of the patients we've seen require hysterectomies because of their extensive and prolongued conditions. Those for whom we recommended treatment all told us that they must ask their husbands before they can consent, and their husbands must sign the consent form, not the women themselves. As I write, one man is traveling to Segou to give consent for his brother's wife to receive a hysterectomy. As you can imagine, many husbands do not give consent, and their wives must live with an incomplete solution to their conditions. Through the actions of our all-women surgical team, working with local Malians, we hope to show that women can still be desirable and feminine while actively serving as role models.

- Laura Gwathmey
 

My experience of the hospital staff is that they care very much about their patients. The nurses and doctors joke around with them when appropriate, to put them at ease. A nurse or anesthesiologist will talk gently with a patient, and may touch her on the shoulder or arm if they see that she is nervous during surgery (in most cases the patients are not under general anesthesia.) And they work hard to educate patients about their treatment options as well as how to care for themselves post-operatively. 

 

How hard it must be for the staff, then, to have to work under conditions that often don’t allow them to provide their patients with very good care. The patients come in malnourished and often lack funds for food and medications post-operatively, including pain meds and antibiotics. The staff are tired, as they get very little time off  (doctors, for example, work 7 days a week; nurses work 5 days per week but are on call every 3rd night, which they must spend at the hospital). And the staff are well aware that what is available medically in other parts of the world is far greater than what doctors can offer here.

 

One doctor came over to me in the hospital break room while I was writing. He sat down next to me and asked what I was writing. When I told him, he said that what I wrote was very true. 

And he said things are going to get better. How did he know, I asked him. His response was that one has to be optimistic in life. Things will get better, he repeated, before walking out to attend to his next patient.

 

- Laura Fine-Morrison
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In May 2009, Physicians for Peace sent a team to Segou, Mali (Read about the first mission to Mali.) to help with efforts to address the widespread problem of VVF. (Read more about VVF and our surgery program.) Last week, Physicians for Peace volunteers returned to Segou to help more women get the surgery they need to heal this devastating condition. 

You can help mothers in poverty by supporting our volunteer medical missions in Africa. Donate now or visit www.physiciansforpeace.org to find out how to make a medical donation to our gifts in kind program.

Today was another successful surgery day in Mali.  We saw 6 patients, each of whom required extensive surgery and reconstruction. We also encountered a patient from our May mission who had returned to accompany her friend for fistula repair! She was completely cured and had encouraged her friends to travel to Segou for the same care. What a treat to see how our mission had changed her life! She was outgoing and talkative, unlike many of our current patients, who are shy and say little. Since the surgery, she seems to have come out of her shell.  

 

There is so much more work to be done.  I've included a photo of the welcome sign that the hospital and the Millennium Villages Initiative made for us.  We will be here through November 17 and seek to complete the daunting task of reconstructive surgeries for 50 patients.  Wish us luck and please keep checking back for more updates!

 

Laura

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In May 2009, Physicians for Peace sent a team to Segou, Mali (Read about the first mission to Mali.) to help with efforts to address the widespread problem of VVF. (Read more about VVF and our surgery program.) This week, Physicians for Peace volunteers returned to Segou to help more women get the surgery they need to heal this devastating condition. Laura Gwathmey, student of International Studies at Old Dominion University, is traveling with our medical volunteers to report on the progress of this mission. Check the blog for regular updates.

You can help mothers in poverty by supporting our volunteer medical missions in Africa. Donate now or visitwww.physiciansforpeace.org to find out how to make a medical donation to our gifts in kind program.

 

An important focus of Physicians for Peace Maternal and Child Health Programs is treatment and prevention of VVF and RVF (vesicovaginal fistula and rectovaginal fistula.) These serious complications of childbirth occur during prolonged labor, resulting in serious tissue damage to the mother. The condition occurs more often in developing countries where women become pregnant at a very young age. Read more about our VVF Surgery program.

In May 2009, Physicians for Peace sent a team to Segou, Mali to help with efforts to address this widespread problem. (Read about the first mission to Mali.) This week, Physicians for Peace volunteers returned to Segou to help more women get the surgery they need to heal this devastating condition. 

Laura Gwathmey, student of International Studies at Old Dominion University, is traveling with our medical volunteers to report on the progress of this mission. She sends her first update:

 

Greetings from Mali!  We've arrived in Segou and begun setting up at the hospital today. The staff and the Millennium Development office had arranged for a welcome banner for our group! I'll be sure to send pictures soon. We also began pre-screening fistula patients today. We expected approximately 30 patients, but when we arrived, we found 57 waiting for us and many more on the way. Apparently, the patients from Physicians for Peace's May 2009 mission were so pleased with their care that they passed along the word, and we have more patients than we can handle! We're also seeing a greater variety of patients than previously - we've had many fistulas, but also many children, one with complications from genital mutilation, and several male prostates.  Several of the women have been living with fistula for years; we met one woman today who has been living with fistula for 20 years! They have traveled for days to reach us and sleep on hospital grounds awaiting treatment. 

We also met with the governor of the Segou region and several local health officials today, pleading our case for greater support and assistance for the people of Mali. All of the officials agreed that there is much work to be done to help prevent and treat cases of fistula.  

 

We begin surgery tomorrow morning at 7 am and will continue until dark. Each day seems to bring a new challenge and a new heart wrenching story.  

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You can help mothers in poverty by supporting our volunteer medical missions in Africa. Donate now or visit www.physiciansforpeace.org to find out how to make a medical donation to our gifts in kind program.

Thursday, Nov 5, 2009

 

Greetings from Nigeria!

 

This week wasn’t nearly as exciting as last week - No births at the clinic. We did see a woman who said she had been leaking fluid for two days. She wasn’t in labor so we referred her to the hospital, after we found her husband who was off working in a neighboring field. She went to the hospital on Tuesday for induction of labor. Today she returned to the village with her beautiful, healthy baby!

 

A woman we referred for an ultrasound last week found me and gave me the report. When we examined her we could only feel the baby below her belly button and we heard the baby’s heart beat on the left and right side. Not sure if the baby was lying horizontally or there might be twins.  The report came back that the baby is transverse (horizontal).  She is about 8 months pregnant. We will watch her closely - if the baby doesn’t turn head down we will refer her for a Cesarean delivery.

 

Our babies from last week came back for weight checks and vaccines. The little girl who weighed 2.3 kg at birth was down to 2 kg so we reviewed breastfeeding with Mom. This is her first baby. She came back the next day and the baby had gained. No signs of dehydration. Mom brought me a bag of ground nuts (peanuts) as thanks. My “grandson”  gained .25 kg. I gave his mom a bag with powdered milk (for her, not the baby), another protein based beverage powder and 4 cans of sardines. After all her blood loss, we want to build her back up. We are encouraging greens and liver also. Maryam #2 gave me another bag of ground nuts and 6 bars of soap. I was overwhelmed - they have so very little. 70% of the people in the village are living on less than $1/day, and they are giving me gifts!

 

I have been walking every day and said I wanted to walk from Pampaida to Saulawa. Everyone kept telling me it is too far, too hot, etc. Yesterday, Dr. Ojo left to go to another clinic to get vaccines for our new babies (we don’t have a refrigerator). I got bored waiting for him - and decided to trek to Saulawa to help with the prenatal clinic. Several people stopped on motorcycles and offered me a ride. Thank you, no! I did it. I walked 9 kilometers. I think I probably sweat 3 liters, but I did it! Dr. Ojo started teasing Banke (she is 25) that the elderly woman is more fit than she is! I could be their mother, but elderly? Though 48 is the typical life span here, and  I am 52.

 

This weekend, I am taking Dr. Ojo and Banke to dinner. There is a Chinese buffet, but they want to go to Chicken Republic. I will let you know if it is like our KFC! They also want to go to a photographer and get a formal picture of the three of us. “The Pampaida Birth Team." Also, Banke and I plan to go to the market this weekend to see if I can find something for Matt’s (my son-in-law) wall. He is a history/geography teacher. Also my “sister” Joy wants some Nigerian fabric for a quilt.  So we will go exploring. 

 

I am counting down the days until I go home - in 8 days I will be on the plane. It will be a bittersweet farewell. I have made some lifelong friends here. Mary, from Physicians for Peace, is already starting to talk about my next trip. Right now, I just want to spend some quality time with my family.

 

Not sure if I will write again before I return. I promise to post lots of pictures when I get back.

 

Blessings!

Robin

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Robin Jones, Registered Nurse and Women's Health Care Nurse Practitioner, has been writing about her experiences in the Millennium Village of Pampaida in Zaria, Nigeria. If you would like to make a donation to help mothers in poverty and support volunteers like Robin on our medical missions in Africa, visit our web site at www.physiciansforpeace.org. 

Greetings from Nigeria!

 

We couldn’t go to Saulawa for clinic today because the ambulance driver was no where to be found and no one knew where the keys to the vehicle were. I was resting from our first delivery, when Banke woke me around noon and said we had another woman in labor.

 

Her name was also Maryam.  She is 20 years old and this is her 5^th pregnancy. It seems she only has one living child, and we never did find out what the circumstances were of the deaths of the other 3.  She has a 4 year old daughter.

 

She was dilated 5 cm and Dr. Ojo said her bag of waters had ruptured 2 hours earlier. We started monitoring her contractions and the baby’s heartbeat every 30 minutes. We are committed to being more diligent with the partograph. It was decided that we will have Banke “catch” this baby. Maryam was on the bed. The contractions were only 2 in 10 minutes, so we decided to walk a bit. These women make very little noise during the labor. I would occasionally see a grimace, or more likely I would see her just bend over when she got a contraction. Around 4 we checked her progress - only 8 cm. She is going slower than we expected. Dr Ojo decided to go play some soccer.  We told him to be sure to be back before dark to start up the generator so we could have some light.

 

We just hung out walking with Maryam, setting up our equipment and patiently waiting. At around 8, we checked her again - only 9 cm. Hmm, time to consider a plan. Baby’s heartbeat was beautiful. We felt Mom might be anxious, so we would be patient. (And still no driver or vehicle keys) Around 10, I noticed Maryam had some vaginal bleeding - a little more than we normally see. Baby looked great, but she really wasn’t pushing effectively. As the head moved down, Banke assumed the  “Catcher’s” position. She did a beautiful job! At 10:35 pm, a beautiful baby boy was born. No lacerations, either. He was a nice 3.5 Kg (7 ½ pounds). I took him and did the ‘baby stuff’ while Dr. Ojo and Banke took care of Mom. The placenta delivered intact 10 minutes later. 

 

Around 11, Banke was cleaning instruments, Dr. Ojo was in the hall chatting with family, and I went to check the Mom. She was lying in a pool of blood. She was starting to go unconscious. We put in an IV, gave her 10 Units of Pitocin in 500 cc of IV fluid rapidly to contract the uterus and drained her bladder with a catheter. So glad the class this week was on Post Partum Hemorrhage. We responded quickly without wasting any time. Mom’s pulse and blood pressure stayed normal. We put the baby to breast, elevated Mom’s legs and continued to monitor closely. The uterus firmed up for a short time, but the bleeding continued. We decided to give another drug - Misoprostel to firm up the uterus. This worked very nicely.  We reexamined the cervix and birth canal for any tears that might have been missed. None.

 

By around 2:30 things had calmed down. Maryam’s pulse and blood pressure remained stable and the bleeding had become normal. In all, we estimated she lost a little over a liter of blood.  Everyone was exhausted. I told the others to go to bed for a couple of hours and I would stay up. The generator ran out of fuel at 4:17 am. So my checks were done by lantern light.  The baby nursed again.  Maryam was resting comfortably.

 

Dr. Ojo relieved me at 6. When I went back to check on them at 8, Maryam had gotten up to go to relieve herself and had eaten some food.  She is pale and will be on iron supplements for a while.  God was definitely with us. We have no doubt if she would have stayed home to deliver, she would not be alive today.  We are hoping that this will encourage more women to come to the clinic to deliver.

 

That is the story of Pampaida ‘s second delivery! The training prepared us for this emergency. We are reminded to always be alert and ready to respond in a systematic, calm manner.

 

I have claimed this little boy as my African grandson. I will post pictures when I get back home. 

 

That’s all for now.  I need sleep!

 

Blessings!

Robin

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Robin Jones, Registered Nurse and Women's Health Care Nurse Practitioner, has been writing about her experiences in the Millennium Village of Pampaida in Zaria Nigeria. If you would like to make a donation to help mothers in poverty and support volunteers like Robin on our medical missions in Africa, visit our web site at www.physiciansforpeace.org. 

I am finally able to write of the first ever birth at Pampaida Health Clinic, New Millenium Village, Nigeria!

Maryam is a 17 year old mother with her first pregnancy. The team tonight consisted of Dr. Ojo, Banke, the nurse, a CHEW-community health worker, and me. Maryam had her mother-in-law, aunt, husband, a niece and nephew and about 5 other men in her entourage. The men and children quickly found a bench or position on the floor and went to sleep.

We timed her contractions. This was something I hadn’t done in about 8 years. I had really become dependent on the fetal monitors for telling me when contractions we occurring and how long they were lasting. She was having 2 contractions in 10 minutes. They were only lasting about 30 seconds. We started a partograph to frequently record information on the labor. The baby’s heart rate was wonderful and the head was well down in the pelvis. Maryam’s blood pressure was a little high at 142/90 and she had a little protein in her urine. We would have to watch her closely.

Around 1 am, we saw much more restlessness and quiet moaning. Maryam would grab her back during a contraction. I started apply pressure on her lower back or squeezing her hips to help relieve her discomfort. The two men were busy playing video games on their cell phones. I guess some things are just universal!!!

We let Maryam push as she felt the need. No coaching, yelling or bright lights! So nice. The baby’s head slowly came out. The rest of the baby followed quickly. Time of birth 2:12 am Oct 27, 2009! We dried off the baby girl. She had a  nice strong cry. Banke and I tended to the baby. Her Apgars were 8 and 9. This is a scale to determine how well the baby is adapting to life outside the womb. She was doing great! We  tied off the cord with a fine string that had been soaked in alcohol (Spirits). Dr Ojo checked to make sure there were no more babies and gave Maryam 3 tablets of Misoprostel. This is a drug to help contract the uterus, deliver the placenta and prevent excessive bleeding. 

For the next two hours we continued to monitor Maryam and the baby.  They were doing well, so after cleaning up we went to bed at 4 am. I woke up at 6, checked Mom and baby were doing well. 

We had breakfast, saw 28 women in prenatal clinic and then went to discharge the new family. We did a discharge physical on both mother and baby and taught Maryam, her husband and the mother-in-law what to expect, when to return if certain signs developed, how to monitor the baby for dehydration and how to take care of the umbilical cord. We will see the baby back in 1 week. We will check her weight. Her birth weight was 2.3 kg - just a smidge over 5 pounds. She will get her BCG vaccine (to prevent TB), a Hepatitis B vaccine and her oral polio vaccine. Ideally, she would have received these right after birth but we have no refrigerator to store the vaccines so we have to get them from the clinic in Ikara and carry them in a cooler. Maryam will return for a check in 2 weeks.

We were all exhausted. So after pictures with the family, we sent them home in the ambulance (Maryam wasn’t quite ready to travel on the back of a motor bike), we all went to take a much deserved nap.

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Robin Jones, Registered Nurse and Women's Health Care Nurse Practitioner, has been writing about her experiences in the Millennium Village of Pampaida in Zaria Nigeria. If you would like to make a donation to help mothers in poverty and support volunteers like Robin on our medical missions in Africa, visit our web site at www.physiciansforpeace.org. 

Here is the lastest news from Robin Jones, a Registered Nurse and Women's Health Care Nurse Practioner, who is currently leading a team of Physicians for Peace volunteers on a mission to Zaria, Nigeria, to assist with work being done there as part of the United Nations Millennium Village Project. The core mission of the project is to help underserved regions of sub-Saharan Africa reach the Millennium Development Goals for ending poverty and improving maternal and child health by 2015. Physicians for Peace volunteers are working with local clinics to assist in midwifery education. This is an exciting look at the work being done daily to improve health care for women and children in this region...

Thursday, Oct 15, 2009

Greetings from Pampaida!

Wow! What a week! Monday, a woman came to the office in Zairia. She was introduced to me as a Midwife/Lecturer at the local Training Hospital. Dr. Woje asked that we meet and have open discussions and perhaps I could lecture with the students one day. We traveled over to the teaching hospital, where I was introduced to the Director of Midwifery and the Principal (Dean of Nursing Education). A meeting with the Faculty has been arranged for Friday (tomorrow) morning. I have also requested to spend a day following a midwife. I have drafted a list of questions for discussion. Also, I will ask their help in developing a Safe Childbirth Checklist.

Monday afternoon, in the middle of a rain storm, we headed out to Pampaida Village. There were 17 of us crammed in a small van, plus supplies. I did wear my seatbelt (ALWAYS!) The driving is a bit crazy. They use the horn all the time.

I settled in my room. I have a bed net here. No mosquito buzz attacks in the middle of the night. Banke, one of the nurses, has the other room on the women’s side of the quarters. She also does the cooking. She is an excellent cook. I have had French fries, fried yams, fried plantain, beef stew, spaghetti, rice, beans, greens, and melon and custard. My stomach hasn’t adjusted to the greens just yet. A sauce is made from sun-dried tomatoes and red peppers. It is put on rice, meat, vegetables and spaghetti. I am really enjoying the food. This morning for breakfast I have spaghetti with sardines and hash brown plantain. I was finally able to convince Banke to let me wash dishes. I told her the cook should rest after the meal and allow the ones she served, to serve her.

In clinic at MV1, Maru-a village Health Worker, has learned to do tummy checks. She measures the uterine height and also assesses how the baby is positioned so we know where to listen for the heart beat. She learned very quickly. Next week, I will work with Banke.  The Doppler is a hit with Dr. Oje. He works with the Doppler and I follow with the fetoscope to perfect my newly learned skill.  We have discussed the need to maintain the fetoscope skill as it is not dependant on batteries, nor does it have components that can break. The problems with technology...

In the late afternoons, Banke and I have been strolling through the village. The small children- toddlers are still frightened of the white skinned woman! The rest of the children flock around as they love having pictures snapped. I have to be careful - sometimes there is shoving to get attention and the littler one are pushed to the ground. I took pictures of the settlement-cooking, bedrooms, shops,etc. I have finally learned what millet is. It is a grain that grows on a stalk that looks similar to bamboo.  The grain grows on the top, similar to the tops of the corn stalk. When it is harvested, they beat the stalk to remove and collect the grain.

Today, we had our first training session. We discussed the reproductive system, fertilization and fetal development and prenatal care before the computer died. I have 4 students, one of which is a male. Lots of great questions were asked. We will continue on Monday.

I have enjoyed sleeping with a mosquito net. When I arrived back in Zairia, I was told they are going to put one up here also.  Not sure if it was the open spaces of the village or the net,but I certainly slept well there.

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Monday

Oct. 19, 2009

As another week begins, we will be heading out to Pampaida in the next hour. I will do another lecture today.  We will wrap up prenantal care-maybe even a quiz. Then we will go over the components of labor. Tomorrow, I will be working with Banke in the clinical setting-doing ‘tummy checks’.

This weekend was much better than last weekend. I spoke with Jeff on Friday via Skype, so the feelings of homesickness weren’t so bad.  Saturday, I did some laundry. Boy, did I take my washer and dryer for granted!  I used a bucket and a large bowl to wash the clothes.  I ran out of bottled water so I boiled the municipal water (when it was on). Even after 20 minutes of boiling there was still a dirty looking sediment. I only used it for cooking. I couldn’t bring myself to drink it.

I read 2 books this weekend and did some knitting.  My exercise routine is up to 20 laps around the compound, 30 toe touches, 50 sit-ups and 50 leg lifts a day.

Yesterday, Dr Woje and his family came by to take me to church.  The message was on willingly doing God’s work. Another timely message. The Sunday school lesson was on daily Bible reading and study.  Mrs. Woje (Hannah) was very disturbed that I only brought my little New Testament. She has lent me a Parallel Bible and also given me a Study Booklet.  She has invited me to go to a Revival Convocation in Kaduna the last weekend of the month. She is going to be the boost I need to become more disciplined in reading/studying the Bible!  After church, I was invited to have lunch with the family at their home.  I helped cut up cabbage for cole slaw.  The meal was wonderful-rice with the spicy red sauce, curry, fried plantain, cole slaw (not quite like ours) and paw-paw. It was my first time trying paw-paw.  It is almost like a cross between the mango fruit, papya and cantaloupe. Very good!  Dr Woje extended an invitation that I stay in their guest wing on the weekends. I thanked him, but declined.

His wife has a water filtering business next door to the house.  They take the municipal water and filter it through sand and ultraviolet filtration, then bag it in small bags. People bite a hole in the corner of the bag and can enjoy clean water. Quite impressive!  He dropped off about 50 bags last evening.  I will take about half out to the village with me.

I transferred another 180 pictures from my camera. Maybe Friday, the IT guys can show me how to attach/send them. Or I can figure out Flickr. 

Signing off until Thursday afternoon when I return to the city.

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Friday, Oct 23,2009

Greetings from Nigeria!

 

This was a very busy week. I taught Monday and Thursday. We covered labor and delivery and complications. They have grasped previous concepts well. I continually quiz them on things we have already covered. Prenatal clinic days  are Tuesday and Wednesday. The male student, Tajudeen, did  "tummy checks" with me on Tuesday. He did a very good job.  He also taught the  pregnant women about condom use. I know...too late to prevent pregnancy, but they are encouraging condom use to cut down on the HIV incidence. He always asks the most questions during class.

 

We had a little girl that the doctor thinks might have sickle cell disease. She was dehydrated, febrile and didn't make a sound when they put the IV in. By late afternoon, she had perked up and was eating without vomiting. They will send blood for Hgb electrophoresis.

  

On Wed, at the other clinic, we saw 52 pregnant women! The nurse was gone to a conference so the doctor and I were busy. We took Maru, another nurse, with us. One woman said she was 4 months pregnant, but we couldn't feel anything on palpation. Did a pregnancy test which was a very faint positive. So we will see her back in 4 weeks. Either she is newly pregnant or had a blighted ovum. Another thought she was 6 to 7 months but had no uterine enlargement above the umbilicus. There was a lot below-either twins- I heard heart tones in the right and left quadrants or the baby was transverse. We referred her for an ultrasound.

  

After clinic, I showed Maru and Tajudeen how to clean up - wash the exam table, doppler, tape measure and scale with alcohol. They are using hand sanitizer between each patient. I have enough to last a couple of months. We had an assistant clean cobwebs, wasp nests and mouse and lizard droppings from the exam room in Saulawa. I wanted to do it, but the doctor vetoed the idea. The clinic is scheduled for a renovation, but we need to have it as clean as we can for the sake of the patients.

   

I have been doing a lot of walking - through the village or just down the road. It feels good to move. I have watched the men play football a few times. (soccer) They sure are good at heading the ball and also lots of fancy footwork - even barefoot or in flip-flops. There is certainly that sense of competitiveness. I guess that is a universal trait among males!!!

  

Banke, my housemate in the village, is coming by to take me to the market today. I want to get some material and have an outfit or two made. It will be my first trip out. I need that. The weekends are the worst as far as homesickness goes. Today is the halfway mark. Part of me wants to leave today and the other part knows there is still much to do. 

    

We have 9 women at term at Saulawa clinic so I am hoping we are around for a couple so the nurses who haven't done deliveries get some experience before I leave. The goal is to have the women come to the clinics to deliver. I warned the doctor that change takes time. If the nurses can train the TBAs (Traditional birth attendants) in warning signs and when transfer to the clinic or hospital is appropriate, they may be more successful with their goals.

  

I showed my Breech delivery/Shoulder dystocia video yesterday. Dr Woje informed the staff that I would leave the video so they can review it whenever they want. Guess I will get another when I get home! I have been able to utilize my teaching powerpoints from school. Most of the time my computer battery lets me get through the lecture.

  

Banke has asked me to let her take notes from the powerpoints in the evening when we have generator power.  I will probably download my powerpoints on Dr Woje's computer or a flash drive if he has one. Also, he has asked me to download the soft copy of "A Book for Midwives." I told them we believe in See one, Do one, Teach one - so I expect everyone to pass on the knowledge they are obtaining.

  

I will talk with Bala today to see if he can arrange a visit with Biya Dogon before I leave. Dr Woje doesn't know the name.

 

That's about it for now. Have a great weekend!

 

Robin

_______________________________________________________________

We thank Robin for her excellent reports from the field, internet access permitting! If you would like to make a donation to help mothers in poverty and support volunteers like Robin on our medical missions in Africa, visit our web site atwww.physiciansforpeace.org.

Day 5 -

Greetings from Nigeria!
 

   The internet was down when I came to the office so I thought I would write as soon as it was available..

The little girl I saw yesterday after having a febrile seizure from malaria is improved today. Praise God!

 

I have been able to cook the soup mixes I brought.  I cook on top of a gas canister that has a stove grate on top.  It is sufficient. I will take my soups and oatmeal packs to the village, just in case the local food doesn't agree with me. The one local meal this week didn't!

 

One of the secretaries went shopping for me yesterday. She was able to get me a sheet- I had been using my shawl from my shalwar kamiz (Afghani outfit) to cover up. There was more to be covered than the shawl could accomodate! When the electricity goes out, I have been using a little pen light to get around. Now I can even read! She also got me a case of water.  I drink one bottle during the day, then really load up in the evening. That way I have the western toilet  vs. the squat toilet.  I look forward to my daily splash bath. The cold water feels wonderful.

 

Today, Dr. Woje and I will choose teaching topics.  He has also asked me to come up with a Safe Childbirth Checklist to post in both delivery rooms. So any of my fellow midwives, please feel free to send me ideas, anything you have used . You,too, can impact birth in Nigeria!

 

Barbara, another secretary, will take my laundry back to her home in Kaduna and wash things this weekend for me. She has invited me to spend next weekend at her home. We will shop for cloth and have her neighbor, a tailor, make me some clothes. Yeah!  You know how much I love wearing ethnic clothing.

 

I have been invited to worship with the doctor at his church on Sunday. I am sure it will be very upbeat and exciting. Many of the people here in the office listen to Contemporary music. It is great and makes me feel  like I have a family here.

 

I am starting to acclimate. I think it is in the high 90s to low 100s each day. Evenings cool off nicely-so the sheet is great to have. I am getting to sleep between 1 and 2 am.  The internal clock has been hard to readjust.

 

The people have been friendly. The babies are starting to warm up to me a little. They aren't screaming as long when they see "the ghost."

 

Peace on Earth Begins with Birth,

Robin

Day 6-7

The weekend was rough. I had a major case of homesickness. Everyone cleared out of the office by 3. The office was locked so no internet access. I was alone in the Guest House and there are bars on the window . And everything is inside a guarded, locked compound. Great for safety, but talk about feeling like I was in prison.  I had plenty of opportunity to review the book and outline my lecture for the week. I will actually start on Thursday.

  

Plenty of time for reading. I read 3 books over the weekend and started knitting a prayer shawl.  I finall broke down Saturday and called my husband, Jeff.  It was so good to hear his voice. Sunday, Dr. Woje and his daughters arrived to take me to church with them.  It was a wonderful time of study, singing and worship. 

 

This morning, one of the Midwives from the Training Center came by at Dr. Woje's request.  We then went to the University Training Center where I was introduced to the Principal and the Director of  Midwifery Education.  We have arranged a meeting on Friday with all the Midwifery Instructors and myself for some Cultural Collaboration.  I am  hoping to "follow" a midwife for a day or two and actually witness a few births with them.  I have already mentioned that I would love their input on developing a Safe Childbirth Checklist for the delivery rooms at Pampaida.  We talked about all the midwives who are retiring. I suggested, perhaps they would be interested in apprenticing some of the CHEWS and TBA s in the village.  I think involvement of the Nigerian midwives would be a great way to go rather than me coming in and explaining the way I learned.  I am so excited to see what natural birth looks like - wasn't able to do much when working with the physicians!! They like to manage labor and childbirth.

 

Everyone has been very welcoming. I did give a copy of "The book for Midwives" to the Director and principal with an inscription. "Looking forward to collaboration with you for the health of mothers and babies" signed Physicians for Peace.  We will be tight on books. I have 7 left. I will make sure the nurses who will attend deliveries get one. I have asked Dr Woje to disperse the rest to the CHEWs as he sees fit.

Peace on Earth Begins with Birth,

Robin

 

Many thanks to Robin for taking the time to send such great field reports from our volunteer medical missions! If you would like to make a donation to help mothers in poverty and support our medical missions in Africa, please visit our web site at www.physiciansforpeace.org.

More news from Robin Jones on of our Maternal and Child Health medical mission trips on the ground now in the Millennium Village of Pampaidas in Zaria, Nigeria...

Day 3 - 

 

No water or electricity when I got up at 7 am.  Breakfast of bread and butter with tea.

I arrived at the clinic. Dr. Woje loves the “Book for Midwives.”  I will check e-mail and then we will leave for Pampaida. 

 

It was about an hour ride to MV1.  I was with Dr. Oje doing ANC (antenatal care) The woman gets her record, goes to the lab for urine dip and anything else required. Then she sees the doctor. She is asked how far along she is, and if there are any concerns.  She then goes to the exam table.  We did raise the head to prevent vena caval syndrome.  Fundal height is assessed. All moms today were close to the “month" they said they were in. If > 28 weeks the fetal heart tones are assessed with the fetoscope. I even heard them. I took the Doppler but forgot the gel .  They assess the conjunctiva for pallor and assess the ankles for edema. The weight is obtained in Kg.  Today the women ranged from 40-60 kg. They are told when to make their next appointments.

 

On the initial visit the mother is screened for Blood type and Rh, VDRL HIV and now they are starting to screen for Hep B.  After the 1^st trimester, they are treated for malaria and dewormed. Some mothers told us how many pregnancies/babies they have had but don’t know how long ago. Age isn’t that important.

 

Girls marry around 13 or 14 years old. They have problems with CPD so I will be teaching the Partograph to identify when labor is lasting too long, without progression. VVF is a big problem.  Early identification of problems will prevent these.
 

I will be teaching the nurses prenatal care and the importance of early identification of preeclampsia- hopefully preventing eclampsia.   If the urine dipstick is + for glucose, a random glucose or fasting is used as the screening tool for GDM.  This isn’t too common of a problem here.

 

I was given a tour of the staff quarters where I will be staying from Monday- Thursday every week.  Nice sleeping area, small kitchen and a squatty potty!  There is running water and a shower.  My room has a lot of bees right on the window screen. I have been told they will spray.  No internet and very limited electricity so I doubt I will be e-mailing throughout the week.

 

After finishing clinic we went to the other clinic – MV2.  They had a delivery about an hour before we arrived.  The placenta hadn’t separated yet.  We had the baby nurse and promised to return after going to a community health survey of a village outside Pampaidas Millennium Village.  Ht/wt, Hgb, blood smear and urine and stool cultures are being done.  These people are the control group to see if the MV has shown improvement over the outlying communities.  They will gather the data and do teaching with these people.

 

When we returned to MV2, the placenta was out and intact! We rode back to the Zaria office.  Barbara, the secretary , is spending the night here with me.  Dr. Woje stopped at a restaurant so I could get a meal.  I got greens (spicy), pounded yams (bland), beef and liver.  I also  got two  bottles of water and some fruit juice. Going all day in the heat without water is tough. I downed them in no time.  I shared my meal with Barbara. Then she suggested we walk down to the Chinese restaurant to get bread for the morning.  I bought a loaf of bread and 2 more bottles of water.  It was good to go for a walk, but I won’t venture out on my own.

 

The electricity just went out so I will bathe by penlight.  This consists of splashing water, soaping up and rinsing off with a small bowl dipped into a bucket of water.  It will get rid of the dirt and sweat and cool me off.  I feel privileged to have these amenities.  My computer is  on battery and getting low so I will close for tonight. 

 

Great Day!

 

Day 4 - 

 

Today I was in Pampaida village to meet with the village chief.  He welcomed me as his guest and assured me of my safety. He asked what Nigerian food I will eat. Food is spicy here, so I am preparing for that. I told him I am willing to try anything. I met with the nurses (females) and the CHEWS (Community Health Extension Workers) (males) that I will be teaching. It looks like teaching days will be Mon and Thur, Prenatal clinic days are Tues, Wed and births will be OJT.  I will actually stay in the village Mon-Thur, then back to the guest house at the office in Zaria (1  hr drive) Fri-Sun.  There I will have electricity and Internet access (though sporadic).  So after this Sunday, Communication will only happen on the weekends.  Dr. Woje has invited me to worship at his church this Sunday.

 

From my work e-mail, I can attach pictures.Yeah!  Here are just a few.

 

Thanks!

Many thanks to Robin for taking the time to send such great field reports from our volunteer medical missions! If you would like to make a donation to help mothers in poverty and support our medical missions in Africa, please visit our web site at www.physiciansforpeace.org.

Robin Jones, a Registered Nurse and Women's Health Care Nurse Practioner, is currently on a mission to Zaria, Nigeria, to assist with work being done there as part of the United Nations Millennium Village Project. The core mission of the project is to help underserved regions of sub-Saharan Africa reach the Millennium Development Goals for ending poverty and improving maternal and child health by 2015. 

Robin will be working with local clinics to provide education so that those who are assisting during labor will have the knowledge they need to help prevent trauma to the mother and protect the health of the baby. She will also lay the groundwork for future missions in midwifery training to increase the number of qualified midwives available to expectant mothers. 

Robin sends us her first impressions of Pampaidas and the progress being made there: 

Day 1 -

Hi!

  I finally arrived in Nigeria yesterday at 11 am. We had a 3 1/2 hr drive to Zaria, where the Pampaidas Millenium Project offices are located. I checked into a hotel for 2 nights.  The accomodations are meager but sufficient. Water was off until this morning and electricity is sporadic. The 24 hr internet cafe was locked up. But the office has wireless, so I will be able to keep in touch with those in the States!

I was given an overview of the Millenium Village project this morning, watched a documentary of the project and met with the various directors.

 

There are roughly 5,000 people in Pampaidas village. Seventy percent of the village are below the poverty level (live on < $1 US/day) The areas being addressed over this 5 year project are
 

    1. Education- the children are educated from grades 1-6. They are working at ensuring the girls, as well as boys, attend school. Each child is given a backpack with books, paper and pencils. School furniture was obtained and they are completing the building of a school kitchen. Each child is guaranteed one meal a day at school.

      Goal: to sensitize parents on the need of school enrollments

 

    2.  Health- they now have 2 operating clinics.  Last week the clinics saw 221/158 patients.  Total antenatal care was 15/24 with 4/8 new OB patients.   .

       a. Outpatient consultations- provide basic PHC (Public Health Care ) services to all villagers; treatment of common diseases; provide short-term in-patient care.

       b.  Antenatal care - to provide routine prenatal monitoring including interventions such as deworming, IPT  Iron/folate and vitamin A supplementations.

        c.  Child welfare clinic where basic immunizations, growth monitoring, Vit. A supplements are provided. Deworming and treatment of  common nutrition/infection related illnesses are treated. 

       d.  Outreach activities- provision of proximity interventions that target families in their homes, build trust and ownership throughout the communities, and address cultural beliefs and socio-economic and behavioral barriers to care.

     I will tour the village and clinics tomorrow and meet with the clinic staff to formulate the needs/teaching plan.  I am excited to get started.

 

    3..  Gender and Community Mobilization- to mobilize the community (men and women) for farmer field day and to mobilize community clusters for training in agriculture and business development.

 

    4.  Water and Sanitation- 23 wells have been dug and capped to provide clean water with easy access, Latrines are being built.

   

    5.  Agricultural Business development and environment- on-going improvement and training on agriculture and business; develop receipts for repayments of loans; Improve on grains banking; increase fish farming activity and business; encourage home gardening to improve nutrition; start stocking agro input supply centerwithin cluster.

 

    6.  Infrastructure- receive materials for completion of work on poultry houses and agro processing centers.

 

   As you can see, a lot is happening here in the Millenium Village Project. I am excited to be a part of helping this village to become healthier, more educated and sustainable. I will try to send frequent updates

 

 

Peace on Earth Begins with Birth!

Blessings!

Robin

Day 2 - 
 

My body is still on US time so sleep is quite elusive.  When the electricity is up, I read. Currently I am reading Three Cups of Tea by Greg Mortenson.  It is about an American who decided to build a school in the mountains of Pakistan.  It is amazing what people can do when they put others before their own comfort. When the electricity is down, I have been listening to my IPod- music or audiobooks.

 

Last night I had my first full “splash bath”. You fill a bucket with water (cold), use a bowl to splash water on yourself, soap up, and then splash to rinse. It felt good to cool off. Much better than the Baby wipe bath the day before!  When finished, you mop the bathroom floor of all the water you splashed!

 

For breakfast, I had bread with peanut butter. I remembered to take my weekly Malaria Prophylaxis today. Several mosquitoes have already dined on me, so I don’t want to take any chances!

 

Last night I plugged my phone in at the office to recharge. When I walked in this morning, they turned the generator on. I heard a POP! And saw flames shooting out of my adapter/converter. That is now fried. The phone is OK but didn’t charge. I brought 2 adapters so I was able to get the phone charged. Glad I brought two.  I may have to get another locally!

 

Today we were at MV2 doing prenatal care. I worked with Hadassah, the midwife. Unfortunately, she said the BP cuff didn’t work. Dr. Oje had the Doppler at the other clinic, so while we waited for him, I did the weights, tummy checks, and improved my skills with the fetoscope.  Dating is difficult as women do not use calendars as we know them and most today had no idea how far along they were. Babies come when they come.  So the pregnancy wheels I made will be of little use.  We just measure the belly and see if there are appropriate changes in size and weight between visits.

 

I taught Dr. Oje how to use the Doppler. It is just an $80 model off E-Bay but it works well.  He was amazed when we found heart tones on a 14 week fetus.. Yesterday he wore and changed gloves between each woman. I have just used hand sanitizer between patients as we only do external exams.  I will bring extra for the clinics next time. Gloves seem to be a bit much just for measurements!

 

We had one girl, about 15 or 16 years old here with her first pregnancy.  They explained that she is of Low IQ, as is her husband.  She was very anxious, but we were able to get her calmed down and check the baby.

 

There is a lot of anemia due to the poor nutritious quality of the diets.  The primary stable is maize (corn) They grind it up and make a cereal or paste.  All the women are given iron supplements and also folate (B vitamin).  I saw several women with Vit B deficiency.  They develop cracks in the corners of their lips.
 

They admitted a young child to the ward who was having a seizure.  They gave her IV medications to stop the seizure.  The doctor felt it was a febrile seizure as a result of malaria. I said a short prayer for her.  

 

The staff are teaching me short phrases “senu de zwa” means Welcome; “Na Gode” is Thank you,” "Ina quana” is good morning and “Sa hanjuma” means See you later.  I hope to add a phrase or two each day. At my age, I can only retain small amounts with lots of repetition.  I am learning so much from them. I hope when we formally start classes, they will learn from me.

 

We will have a meeting with the health workers tomorrow to set up a class schedule that won’t interfere with the clinic work. Today, the doctor, midwife and I were a very efficient team. Between 11 and 1:30, we saw around 30 women. The midwife documented while the doctor and I did the exam.  Team work is great.  I will also poll them to see how they want to proceed with the classes. I think we will start with prenatal and move on from there. If a delivery comes in, we will immediately do “on-the-job training.”

 

Time to go to my room and relax a bit. I hope all is well back in the States.

 

From Nigeria,

Robin

We look forward to hearing more from Robin as we receive her reports from the field! If you would like to make a donation to help mothers in poverty and support our medical missions in Africa, visit our web site at www.physiciansforpeace.org.

 

Physicians for Peace is proud to announce the recipient of the third annual Charles E. Horton Humanitarian Award for Global Health: ONE. 

ONE is a grassroots campaign and advocacy organization backed by more than 2 million people who are committed to the fight against extreme poverty and preventable disease, particularly in Africa. Co-founded by Bono and other campaigners, ONE works closely with African policy makers and anti-poverty activists to raise awareness and mobilize public opinion in support of tested and proven methods of tackling poverty and disease. Among many of its accomplishments, ONE was responsible for getting the G8 to direct an additional $25 billion in effective assistance to Africa by 2010. 
 

“ONE is deeply honored to receive the Charles E. Horton Humanitarian Award for Global Health, an award whose namesake continues to inspire action and hope in the fight against global poverty and disease,” said Sheila Nix, ONE’s U.S. Executive Director.  “Today, effective advocacy is more important than ever in supporting results-driven efforts that fight poverty, combat preventable disease, put children in school, and create economic opportunity for the world’s poor.  As exemplified by organizations like Physicians for Peace, huge advances against disease and poverty are being made every day, thanks to smart programs and strong local leadership in developing countries.  We are humbled to join the ranks of former award recipients Senator Bill Frist and Professor Jeffrey Sachs, and we thank Physicians for Peace for this honor.” 

The Charles E. Horton Humanitarian Award for Global Health is bestowed in honor of the late Physicians for Peace founder, Charles E. Horton, M.D. Horton, an internationally recognized humanitarian, founded Physicians for Peace in 1989. Through Dr. Horton’s leadership, our organization has touched the lives of thousands of patients and doctors in more than 50 countries around the world. 

  

“Dr. Horton was an articulate advocate for the vulnerable populations of the world,” noted Physicians for Peace President and CEO, Ron Sconyers, Brigadier General (USAF Ret.). “He used his voice to rally the medical community to take their healing and teaching skills where they were needed the most. ONE has been able to use its voice to help bring balance and stability to a world that has neither. We are extremely honored to recognize ONE for its many accomplishments in offering hope to those who need it most – the poor and the vulnerable."

ONE will receive the award during the Physicians for Peace "Celebrate the Nations" Gala Reception on October 3rd in Virginia Beach, Va. For more information about the Gala event, go to www.physiciansforpeace.org/events.html

To learn more about Physicians for Peace medical volunteer work and international health programs, visit our web site at www.physiciansforpeace.org

For more information about ONE, visit www.one.org

Read the ONE blog...

The country of Eritrea, in the horn of Africa, suffers from a severe shortage of doctors, especially pediatricians and surgeons. With close to half of the population under 14 years of age, and only a handful of pediatricians to serve them, many children remain without access to proper medical care. Yet great strides have been taken to remedy this problem, thanks to the dedication of the Eritrean people and the help of The George Washington University Medical Center, Physicians for Peace, and the Eritrean Ministry of Health. 

As part of our 20th Anniversary series honoring the exceptional work of our medical volunteers, we would like to put the spotlight on five women who have been devoted to establishing post-graduate medical education in Eritrea, and who have worked to make the The Partnership for Eritrea an example that others can follow...



Dr. Jennifer Egelseer (above), the first pediatrician of the group to visit Eritrea, had very little experience in medical mission work, but was quickly won over by the people of Eritrea and recognized the needs in the country.




Dr. Margot Anderson (above) became involved in the project following years of work in health care in the developing world, particularly in Laos.



Dr. Fatima Khambaty (above), a surgeon with mission experience in Ghana and Liberia, also decided to help with the project.

These three women developed post-graduate medical education programs in surgery and pediatrics to be conducted at the Orotta School of Medicine in Eritrea’s capital of Asmara.  In a country where the health care system has been wracked by a war of independence and no medical school existed until 2004, they became the first post-graduate faculty as part of the Partnership for Eritrea, a collaboration between The George Washington University Medical Center, the Eritrean Ministry of Health, and Physicians for Peace. In conjunction with these new partners, they built new residency programs from the ground up to address the urgent need for doctors. 

In the United States, two other heroes are the glue that makes this Partnership work - 

Dr. Ellie Hamburger (above), in the Department of Pediatrics at George Washington University and an attending physician in the Pediatric Residency Program at Children's National Medical Center in Washington, D.C., has gone above and beyond the call, totally committing to making the pediatrics residency program in Eritrea the benchmark for Africa.  




Dr. Huda Ayas (above), Executive Director of The George Washington University Medical Center’s International Medicine Programs, whose passion for this project has helped it become what it is today - a program which provides care for thousands as it serves as a model of workforce development and international health education. 

 

The Partnership has seen great success and plans to graduate the first class of pediatricians in December, 2009, and surgeons in 2010. They have also expanded to new medical specialties, adding an Obstetrics and Gynecology program this year with the help of Columbia University. There are plans with Yale University to launch an Internal Medicine program in 2010. We congratulate the women who have worked so hard over the last several years to make this dream a reality for both the medical students and the people of Eritrea who need their care. Find out more at www.partnershipforeritea.org

You can be a part of this exciting opportunity to build the future of medical care in Erirea - Your gift to the Partnership Program helps an Eritrean medical student receive training in his own country and gives the people of Eritrea a chance to get the medical care they need...

Please support the Partnership today! 

For more information about Physicians for Peace medical volunteer work and international health programs visit our web site at www.physiciansforpeace.org

Natalie Lee, a Masters of Public Health student at Eastern Virginia Medical School, recently traveled with Physicians for Peace on a surgery mission to Jos, Nigeria, where she wrote about her experience: 

When I stepped on the plane to embark on my first surgical mission trip with Physicians for Peace, I had no idea what to expect. I was anxious, nervous, slightly scared out of my mind, and excited all into one. Leading up to the trip, I had little time to mentally prepare for the challenge I was about to take on, so when I boarded the flight, every emotion in the book started to rush over me. Once I saw the team members, which would eventually become my family for the next ten days, all the anxiety and nerves began to melt away. It was strange to me that you could board a plane, sit there for 11 hours, and end up in, what felt like, another planet. The terrain, the language, the mannerisms, the clothing, the driving etiquette, the list of differences goes on and on. After about 15 hours of traveling, the team and I made it to our final destination of Jos, Nigeria.

 

We almost immediately got to work and went to The Plateau State Specialist Hospital, where the subsequent days of surgery would take place. It was nighttime on our first visit to the hospital, there was no electricity at the time and it seemed like patients were coming out of every corner. This first encounter was a bit overwhelming, I immediately noticed the poverty, and malnourished children, but the most striking and exciting observation was the hope in the eyes of all the patients, as if they knew their lives were about to be changed for the better.

 

We were able to change the lives of 43 beautiful patients and the gratitude that they showed us could fill the entire atmosphere. It was amazing to see a deformed baby go into surgery and in about an hour, come out even more beautiful than before. You could almost see how the path of their lives had been changed right before your eyes, as often children with such deformities live a life of ridicule and judgment. Cleft repair surgeries are very expensive for the citizens of Nigeria, and the quality is not always as high as one would like, so to be a part of an organization that was able to provide this procedure at top quality and at no expense to the patients is an experience that I will carry with me forever and the memories will never fail to bring a smile to my face.

 

Being thrown into a culture that is so different than the one you are accustomed to, is something that everyone should experience. For me, I grew to respect the culture, love the people, and become more appreciative of everything that I have been blessed with. I sincerely hope that many more PFP teams will be able to reach the forgotten cities with more medical mission trips to Africa, and many more patients will be transformed in the future. Medical volunteer work is one of those rare win/win situations, where the team, the patients, and every citizen of the world benefits.

You can support our international health programs - Make a donation today!
 

Eritrea, which borders Ethiopia in the horn of Africa, is a country suffering from a severe shortage of physicians. Until recently, the country of 4.9 million people was served by only 5 pediatricians. Physicians for Peace has been working with the local government and hospitals in the capital, Asmara, to help train doctors and treat patients in this country recovering from years of war and instability. During the latest medical mission to Halibet Hospital in Asmara, a team of specialized surgeons from Chicago and Arizona spent two weeks performing limb reconstructive operations to help those suffering from deformities as they also trained Eritrean orthopedists in new techniques. 

Team leader Dr. Keith Goss reported that many of the patients suffered from manifestations of polio, clubfoot, cerebral palsy, and cerebral injuries. Others had post-traumatic limb deformities from chronic infection, land mine injuries, gunshot wounds, and motor vehicle accidents. The team was able to help both children and adults with the goal of creating a functional, pain-free, end-bearing limb that could maximize the patient's ability to work and participate in the activities of daily life. 

The team worked diligently 10 hours daily for 9 days, ultimately performing 59 major reconstructive surgeries on 34 adult and 25 pediatric patients. Eritrean orthopedists also received training and gained full competency in state-of-the-art techniques for deformity correction and fracture repair. 

Thank you to all the volunteers for their hard work in making this a successful medical mission trip. There is still much more to be done, as we continue to work with the Eritrean people to enhance their capacity to provide medical care to their population.

You can help third world countries by contributing to our international health programs. Make a donation here. 

Our volunteers returned safely this weekend from Segou, after a successful surgery mission to help dozens of women in Mali heal from severe complications of childbirth.  Jaya Tiwari, Director of Global Health Programs for Physicians for Peace, who traveled with the mission team, sends out her heart-felt appreciation for all the hard work and dedication of everyone involved:

 

Hello Ladies,

Just wanted to drop a little note to say a big thank you to all of you for your time, energy, skills, and resources in making this mission a success!!! I have traveled with many other PFP teams before and can tell you that without a doubt this was my best experience of a PFP team working so well together on their first mission. Even with all the bureaucratic and language barrier issues, the whole mission ran so smoothly!!

Laura, I couldn't thank you enough for agreeing to not only join the team at a short notice but staying the extra 11 days to help us do the post-op follow up and information gathering. I am humbled by your compassion, commitment, and willingness to invest your time, skills, and resources to help women suffering with VVF!! You know that I will always have a soft spot in my heart for my “PSR Docs” but seeing you jump in and make the kind of personal and financial commitment and sacrifice you did in your first PFP mission left me speechless!!!  Even before this mission, I knew you were a fantastic surgeon but seeing you blend so easily and work so efficiently with the Malian team and your amazing ability to put people at ease, whomever you interacted with and wherever you went, made me realize what a wonderful and special human being you are!!!

I am really excited about you working with Dr. Samaki in Segou on additional cases this week and especially getting the opportunity to work with Professor Oauttara at Hospital Point G for 4 extra days before you leave for U.S. With this and your previous VVF mission experience, you are unquestionably the most experienced VVF surgeon of the U.S. team that PFP has worked with so far, and I truly hope that you will become one of the core members/U.S. team leaders for our future VVF missions. After this surgery mission, I am more and more convinced that regardless for where in Africa we do VVF missions, we must find an in-country team leader like Professor Ouattara for Mali or Dr. Saad for Nigeria to take the overall lead of the mission, at least for the first three or four missions, in every country we go into, so I will need to work with my bosses at PFP to see if we can adopt this as an organizational policy. However, even with a strong African team leader, we need an equally strong, experienced, and skilled (but also humble and culturally and politically sensitive) U.S. team leader and I see you taking on this role in future PFP missions in Mali and other countries in West Africa!! As you heard, Mavis and Dr. Coulibaly were requesting additional PPF VVF missions not only in Segou, but in Markala and Timbuktu, so we are really going to need to expand the team and have you and Ellie start to take on the lead in helping recruit and train more surgeons and OBGYNS to join the U.S. team!! 

Ellie, I know this was your first VVF mission and at times you were unsure and nervous but I want you to know that I have seen veteran U.S. OBGYN (people twice your age and twice the years of service in U.S.) on their third or fourth VVF mission be completely at a loss about what to do (and that is in a English speaking country!!). As I mentioned to you in Segou, most U.S. OBGYN are so intimidated by their lack of exposure to VVF as a condition that they cannot even muster up the courage to join a mission let alone travel to Africa and do half as well as you did in Segou on your first day in the OR. The fact that Professor Ouattara asked you to take the lead on a number of cases on your very first mission should tell you the level of trust and confidence in your skills and ability by one of the most prominent Malian surgeons. Also, the fact that you were so prepared and came so loaded with meds and supplies for your very first PFP mission warmed my heart and left me forever grateful to you!!  Your energy, drive and motivation, attention to details and the willingness to jump into a completely unfamiliar situation and master it all so quickly is exemplary!!! I know you run your own very busy practice and have two young kids of your own so taking 10 days off to be on a PFP mission is a HUGE financial and personal sacrifice, but I hope that the joy of being able to help some of the most vulnerable women in Africa and the opportunity to step out of your comfort zone and expand your surgical, professional and cultural experience in life made up for some of it. The fact that I have repeatedly asked you to plan on joining the next mission in Segou and remain a core team member of the Mali VVF team, and even think about taking the lead of the U.S. team of one of the future VVF missions in Mali or other countries in West Africa should tell you of my trust and confidence in you. As I said earlier, this was our first surgical mission (and of course first VVF mission) to Mali so it was a learning experience for all of us (including our hosts at MV/MCI project and at the hospital) and I assure you that things will continually get easier and more efficient as we work together. I hope that you and Laura will continue to be our lead doctors of VVF team in Mali and help us figure out how to expand our volunteer medical missions to cover even more people and places!!

Pam and Lisa, thanks a million for bringing so much more than your superior medical skills to this team. Your patience, warmth, charm, and sense of humor kept all of us grounded and sane whenever things started to get crazy and stressful. Pam, as we discussed earlier, as we expand the scope of the mission and start to work in other hospitals and cover additional surgical specialty areas in Mali, we will be able to utilize more and more of your fine trauma and triage skills but I am indebted to you for your flexibility and willingness to roll with the punches and adopt to the new and ever changing roles and responsibilities we threw your way everyday to keep the mission running smoothly. I am so glad I called on you to be a part of the Mali VVF mission, you really completed the team. And you lucky bum, I am so envious (happy for you but still envious) of you that you got to spend a few hours in my favorite city in the whole world, Paris, while Frances and I were moping around at the CDG airport!!)

Lisa, in addition to being an excellent medical assistant, you are a sweetheart!! I can see now why Ellie is so fond of you and insisted on bringing you as part of the team. I have to tell you that I am always hesitant to let someone with no previous overseas travel experience join a PFP mission to Africa (because of the obvious physical, professional and emotional challenges we have to face on these trips), and had my reservations about how you were going to handle the trip. You, my friend, exceeded my expectations! The fact that even after Ellie making you walk all over town in 106-108 degree temperature you could still jump in and do a full day of OR assisting left me speechless.  You have such a big heart, and so much empathy for those less fortunate than you, that I wasn’t surprised a bit when you broke down at the sight of the boy with leg injuries. I was humbled by your willingness to take on the responsibility of paying for his care!! You single handedly saved that kid from so much pain and suffering in life, and you know that even without knowing your name and knowing a whole lot about you, that boy and his family will always remember you as someone who reached out and helped in time of their need!! Don’t forget to show your kids (and their young friends) pictures of this boy and his family and remind them just how lucky they are compared to the majority of kids their age in other parts of the world.   

Frances, my traveling companion in Nigeria, travel buddy and roommate in Mali, and surgical tech extraordinaire, you don’t need me to tell you how lucky PFP is to have you as a volunteer. You were the glue that held the PFP’s Nigeria VVF team together, and you are now the core part of the Mali VVF team. Your ability to anticipate what’s needed in the OR room and step up the supply room and make things run smoothly under the most stressful situations, and relate to our host hospital staff so beautifully despite the language barrier is an amazing gift and something PFP will continue to depend on for future VVF surgery missions in many years to come. My hats off to you our “Africa Princess” (we do have to switch you to a different anti-malarial pill for the future missions though!)

With every obstacle that came our way in planning and implementation of this very first surgical/VVF mission to Mali, I couldn’t have asked for a better team!!  I will always treasure the time spent in Mali with my “sisterhood of traveling medical mission team”. It was my personal honor and privilege to accompany this team, and PFP is indebted to each one of you for your contribution. We look forward to working with you for many years to come!

With lots of love and hugs to you all,

Jaya

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The first report is in from Jaya Tiwari, Director of Global Health Programs, who is traveling to Bamako and Segou with our team of volunteer surgeons who are on this very important medical mission trip to treat women suffering from VVF: 

After a long journey, a few flight connections and airport delays, the Physicians for Peace team safely arrived at Bamako International Airport on Sat, May 9th night. The team consisted of Dr. Laura Hart, an urologist from Seattle, Washington, Dr. Ellie Hogenson, an OBGYN from Fairbanks, Alaska, Mrs. Pamela Allen, a Physician’s Assistant from Boston, MA, Mrs. Lisa Byman, a Surgical Assistant from Fairbanks, Alaska, Mrs. France Dargan, Surgical Assistant from Norfolk, VA.

Going thought immigration in Mali seemed surprisingly and pleasantly  unbureaucratic and fast so we happily proceeded to the baggage claim area. Well, we more than made up for our fast clearance through the immigration process in the baggage claims area, where a small conveyer belt SLOWLY and with frequent stops proceeded to spit out the checked bags from our flight. Given that we had checked in 8 huge suitcases of medicine, medical donations, and
instruments essential for this mission, we all stood around nervously awaiting the appearance of each bags of supplies, all of which finally arrived at safe and sound. We proceeded to the customs area in one big and semi-confused mass of people where another slow baggage screening machine was used to screen every single bag and passenger item with many passenger bags being pulled off the screening belt for hand searches and inspection. Unfortunately, two of our huge bags of medical supplies were also pulled aside for additional inspection, and after some more delays, explaining and negotiations, we finally got all our bags with all items intact and could leave the airport more than three hours after our flight landed!! 

We were met at the airport with Mavis Ama Frimpong, Sub-Regional Sexual and Reproductive Health Advisor of the Millennium Development Goals (MDG) Center, West and Central Africa. After an overnight stay in Bamako, the capital of Mali (West Africa), we started another three hour jeep ride to Segou, the site of this Vesicovaginal fistula (VVF) repair mission, accompanied by Mavis and our esteemed team leader, Professor Kalilou Ouattara. Professor Ouattara is one of Mali’s most renowned surgeons and VVF repair experts and is also the Head of the National Fistula Policy. This is Physicians for Peace’s first VVF mission in Mali, conducted in partnership with the MDG Center, West and Central Africa, and the Ministry of Health to assist the women suffering with VVF in the Millennium City of Segou.

The ride between Bamako and Segou was pleasant as we passed the roads lined with mango groves and small street side market areas. Both Bamako and Segou are famous cities rich in history and architecture, which given our busy schedule, we have not had the chance to explore but hope to do so by the end of the mission. Monday and Tuesday were full, long days for the volunteer mediteam in visiting the hospital: meeting various stakeholders and health officials key to VVF repair and prevention campaign in Mali, getting to know the local doctors and health professionals that will work alongside the U.S. team for the duration of the week, familiarizing themselves with the VVF work in the OR at the Segou Hospital, setting up supplies, screening patients, and starting to perform operations. Stay tuned for more...

Find out more about the problem of VVF on our web site: www.physiciansforpeace.org/vvf.html

Help mothers in poverty suffering from VVF by supporting our international medical missions to improve maternal and child health - Make a Donation




 

On April 18th, I gave birth to my first baby.  I had a few issues along the way - but I also had access to excellent prenatal care, whenever I needed it.  My baby is healthy and so am I.  I can’t wait to celebrate our first Mother’s Day together! 

But as a staff member at Physicians for Peace, I am all too aware of the dire situation facing millions of soon-to-be young mothers around the world. A difficult pregnancy – a stillborn baby – a young mother, looking forward to a new life, who then dies in childbirth. Tragedies like this are exceptionally rare in the United States. Modern health care in developed nations ensures that only 9 pregnancies out of 100,000 end in the death of the mother. In third world countries, the rates are shockingly high. According to the United Nations Population Fund, there are 450 maternal deaths out of 100,000 in the developing world overall, and as many as 2000 deaths per 100,000 in some countries in Sub-Saharan Africa. 

Every minute of every day of the year, a woman in the developing world dies in childbirth.  

That’s where Physicians for Peace makes a difference. We send our volunteer doctors and nurses to some of the most under-served regions of the world, to train their peers in the latest medical techniques. Our volunteer doctors and nurses make a difference in the lives they touch. For example: 

In Nigeria, when Physicians for Peace volunteers travelled to teach pediatric advanced life-saving techniques, scores of pediatricians, nurses and midwives came from all over the region to get training. After participating in the two-day seminar, one of the Nigerian pediatricians tearfully told the volunteers “a year ago, I lost my own baby. If I had this training then, my own baby would be alive today.” 

Also in Nigeria, we teach and perform obstetric fistula operations, for a wide range of women, some as young as 12 or 13, some much older. One woman we treated, in her 40’s, had given birth to 7 children, all stillborn. The difficult deliveries of these 7 dead children had caused her extensive pelvic damage. After years of suffering the horrible consequences of fistula, including non-stop incontinence, she thanked God that Physicians for Peace could help her get her life back.  

You can change things for the better in the developing world. You have the power to help.

This Mother’s Day, when you think of your own loved ones, safe and sound, take a moment to think of young women in places like Nigeria and Haiti – facing the loss of a child, facing the threat of disease for them or their children, facing death during delivery when they should be looking forward to the delivery of new life. 

Physicians for Peace has many international health programs that work in support of the United Nations Millennium Development Goals to improve Maternal and Child Health. Our medical mission volunteers train midwives, provide mentors for mothers in poverty, train nurses in prenatal lifesaving, and perform surgeries for women whose lives have been shattered by severe childbirth complications.  

This year marks the 20th Anniversary for Physicians for Peace and our goal is to offer hope and healing to even more lives. Our goal is to send 100 doctors, to train 1,000 of their peers, who will then be enabled to heal up to 1,000,000 lives.

We have upcoming medical missions to Africa, the Caribbean and Central America and Asia, all of which will help confront the dire conditions facing women and their young children in the developing world. The small group of medical professionals we send will ultimately impact countless lives. 

As if often the case, these missions are not fully funded. Our volunteers need your help to reach those in need. With your help, the young women we treat can regain their health, and their dignity. They can have a safe pregnancy, emergency care if necessary, and ultimately a healthy and happy baby. With your help, these young women can start a new life.

We need your support now more than ever, to keep our programs alive, and to ensure that the young women we care for have their own miraculous Mother’s Day.   

Remember, whatever you can do will make a huge difference. So, this Mother’s Day, when you think about your own children, please lend your support to women less fortunate, and truly help us create “a world of hope.”

Sincerely,

 

Shannon Kane

Senior Director of Development and Communications – and First-Time Mother

Dr. Paul Farmer, an infectious disease physician,
anthropologist, and health expert is
founding director of Partners in Health, an organization that works with poor communities worldwide to fight disease and poverty. His work is the subject of Tracy Kidder's best-selling 2003 book, Mountains Beyond Mountains:
The Quest of Dr. Paul Farmer, a Man Who Would Cure the World.

The Forum will examine the challenges and opportunities for health care organizations to collaborate and create sustainable, replicable, and effective health care. It will discuss delivery models for supporting and expanding existing public health infrastructure to more effectively serve the most impoverished populations worldwide. Panelists will include representatives from a range of hospitals and medical schools, as well as prominent global health care experts from Haiti and Africa.

Don't miss his unique opportunity to hear Dr. Farmer speak about international health programs and medical charity:

Afternoon Program:
1:00pm - 5:15pm (Registration opens at noon)
Keynote Address, Part One, with Dr. Paul Farmer Followed by Panel Discussions

Evening Program: 7:00pm - 9:30pm (Registration opens at 6:00pm)
Keynote Address, Part Two, with Dr. Paul Farmer Followed by Book Signing

Advanced Registration is required:

For information and registration, 
visit www.physiciansforpeace.org/ghf.html

Sponsored by:
Old Dominion University, Operation Blessing International, McDonald's, and Sentara Health System

Special thanks to Partners In Health and the other organizations who have helped make this event possible:

Eastern Virginia Medical School
Norfolk State University
Old Dominion University 
Operation Blessing International
Operation Smile
McDonald's
Sentara Health System 
Tidewater Community College
University of Virginia 
Virginia Wesleyan College 
World Affairs Council of Greater Hampton Road