Category Archives: Liberia


A surprise visitor in Liberia

Our team in Liberia had a surprise visitor last week. Othello, 22, says his life was changed forever when CSI volunteer Dr. Eric Moore removed a large tumor on the side of his face and neck during our fall 2013 trip. Othello traveled two days to Firestone Duside Hospital last week to say thank you and to share his plans of attending nursing school. Thank you, Othello, for letting CSI be a part of your magical story.

Watch Othello tell his story during our 2013 Liberia mission:

Reflection from Dr. Janelle Fox

Dr. Janelle Fox

As I journey home, I reflect on my seventh CSI Liberia trip with several of the same colleagues, but also many new friends. This trip successfully deployed many lessons learned over the past 10 missions, including a recruitment flyer using local wording, a comprehensive patient database from seven prior missions and even the debut of music therapy, courtesy of Elyse Vandersteen, mission partner. 

During our trip, 177 children were screened, 110 received surgery, and 5,000 more were dewormed. We learned to appreciate the resources we take for granted, like basic emergency transport, serum electrolytes, CT scanners, IV pumps, the ability to vent sevoflurane out of the OR, and the luxuries of outpatient surgery and clean water.  We were spoiled over the past week by the hospitality at the Firestone Guesthouse and now find ourselves unwilling to return to the world of doing our own laundry and cooking. Today, we leave our Firestone friends and Duside Hospital patients tired, rewarded and excited to be invited to return again next year.  

View more photos on CSI’s Flickr site.

A day in Liberia for nurse anesthetist John Erlandson

CSI volunteer John Erlandson, CRNA shares what his days have been like on the Liberia mission:

It’s 0530 and the alarm goes off – it feels much earlier than it is. My body fights with my brain: My body wants to stay in bed, but the brain knows we have good work ahead today.  

I stumble to the dining hall and hazily greet my new friends on this journey of care. Some I’ve known from other CSI trips; others I met a few days ago. Coffee, a big breakfast, more coffee.  Wakey, wakey, eggs and bakey.

I jump into the van, smooshed in with the 20 other volunteers and gradually wake as the sun kisses the sky and the plantation around us comes to life. By the time we reach Firestone Duside Hospital, I can feel the caffeine kicking in. We wash our hands in chlorine water before entering the hospital, and I head upstairs to the storage room and change into scrubs and then head into the OR to get set up for the day.  

After a thumbs up from my circulator nurse, Samantha Chaplin, I go get the first child. In pre-op I am greeted by many sets of eyes – those of the nervous/happy parents and those of the scared/unsure kids. I triple-check to make sure I am getting the correct child (such wonderful names like Blessing, Godgift, Favor, Miracle, Success), scoop the child up and head back to the OR. I sing “Itsy Bitsy Spider” as we walk, and I get through two verses as we grab a brand-new, warm fleece blanket and settle onto the cold OR bed. Off to sleep you go, little tyke.

 

The surgeons (Drs. Janelle Fox, Nathan Kreykes, Trish Valusek and David Vandersteen) work their magic as I patiently monitor the little one and give medications that make them comfortable during and after the surgery. Once the procedure is done, I disconnect all of the monitors, scoop the child up in my arms and carry him/her to the recovery room – all swaddled up in the new, warm blanket, with my ear tilted down to listen for their breathing. Bursting into the recovery room, I exclaim, “Pannekoeken,” to let the nurses know we have a fresh arrival. After a quick check that they are still breathing well, I grab vital signs and depart.

Back in the OR, I quickly turn over breathing equipment and get medications ready for the next patient. I get a quick thumbs up from Samantha again and head back to pre-op for the next patient. 

WASH. RINSE. REPEAT.

The day becomes a little bit of a blur, but soon we are loading back into the van to trek back “home” to the Firestone guesthouse where a large dinner is waiting (along with a cold beer).

The warm evening passes quickly, chatting and playing games with my newfound friends. Then it’s off to bed. I keep thinking I’ll get to bed earlier each night, but it’s hard to pass up time with these friends. My brain is asleep before my head hits the pillow, and the next thing I know, it’s 0530 and the alarm goes off…

 

View more photos on CSI’s Flickr site.

Highlights from Liberia

Our CSI Liberia team is hard at work at Firestone Duside Hospital this week.  They are on pace to complete 110 surgeries during this mission. Our volunteers are also dedicated to building self-sufficiency through education for our medical partners in Liberia— bringing hope to children, families and communities around the world, one child at a time.

Here are some trip highlights from our team members:

Jerrlyne, 5 years, arrived for screening day after a three-hour motorcycle taxi ride with her mother, who heard on the radio about CSI’s visit to Firestone Duside Hospital. Yesterday, Jerrlyne went home after having her umbilical and inguinal hernias repaired. Her mother was so grateful.


Walking patients, or carrying them if they’re a baby, back to the OR is by far my favorite part of this mission. We do two surgeries in one OR and my partner CRNA John Erlandson was able to get some action shots. We each did 11 general surgeries – exhausting but all so worth it.

– CSI volunteer Patrick Faunillan, CRNA

CSI not only provides free surgical services to children in need – we teach others to do the same. CSI volunteer, Patty Akers, is pictured here sharing knowledge with her Liberian colleague Alice Sayndee, RN.


Tuesday morning we were greeted by the mothers in our 25-bed ward singing an amazingly lovely song for our benefit, complete with harmony, clapping and a parade around the post-surgical ward. It moved me to tears. If anyone’s counting, 37 patients, each with a parent, several siblings of the patients and seven nurses, made for over 87 beautiful people in one room. 

– CSI volunteer Cindy Markham, RN

Patience met the CSI Liberia team in 2010 after her mosquito netting caught fire, leaving her with severe burns. During the healing process, she was left with scars that hardened and shortened the area between her neck and shoulder. CSI performed surgery to repair this contracture, and now, 10 years later, she is able to move her head freely. “CSI was a beautiful gift,” Patience says.

– CSI volunteer Louann Randall, RN

Dr. Kevin Healy prepares for the week

Dr. Kevin Healy

We arrived at the Firestone guesthouse Friday night and were treated to a scrumptious dinner before turning in after our 24-hour trip from the United States. Saturday morning I had to be roused from my bed to go shopping. I bought two bolts of fabric that a local seamstress will turn into dresses for a granddaughter and some great-nieces. 

Sunday morning I woke up much better rested. We were out the door promptly at 7 a.m. and on our way to Firestone Duside Hospital, where many children and adults were waiting for us to be screened for surgery. I’m an anesthesiologist, so I spent the first part of the day looking for, unpacking and storing supplies. Mr. Peye, one of the Duside nurse anesthetists, briefed me on how to distinguish between a 110 and 220 volt outlet. I stocked my cart and set up my anesthesia machine and monitors. My big coup of the morning was guessing the password to set the clock on the monitor. It’s “biomed.” (Please keep that to yourself!)

After eating lunch with some of our hosts, I went to the screening clinic where I saw half a dozen patients for pre-op clearance. There I met a 10-year-old girl who was scheduled for an inguinal hernia repair. I talked  to her mother with the aid of one of the Liberian nurses and learned that the girl had bloody urine once a month. I talked her case over with Dr. Janelle Fox, one of our urologists, who was interested and got the girl’s surgery put on her schedule in case she needs a cystoscopy. 

 

It was a satisfying day, although I prefer the days that we do surgery. Tonight we’ll have another meal together, and I plan to turn in early as we leave for the hospital at 6:30 a.m. Monday morning for our first surgical day.

–Dr. Kevin Healy, CSI volunteer anesthesiologist

View more photos on CSI’s Flickr site.

CSI team experiences Liberia

Today was a perfect day in beautiful Harbel, Liberia with the CSI team and our Firestone hosts. Over a delicious lunch, we were visited by the U.S. ambassador to Liberia, Christine Elder, and her leadership team.  

Afternoon activities included visiting an orphanage, where we gave the children beanie babies, donated by Irene Davidson and Rachel Leaf, and new backpacks provided by the Blaine National Sports Center.  We spent time playing and dancing with the precious children. And, of course, we also gave them deworming tablets followed by a sweet lollipop.  

 

Another unique opportunity was a tour of the Firestone Farm which included demonstrations of latex tapping and the grafting of rubber trees for optimal production at the Firestone nursery.

Late in the afternoon the CSI team was honored with the opportunity to visit Liberia Chimpanzee Rescue & Protection (LCRP), a sanctuary for orphaned chimps.  There are 54 chimps at this sanctuary, all of which were full of life and very active. LCRP co-founder Jimmy Desmond gave us a great tour of the facilities and a history of the site and organization.

 

In the evening, the Firestone guesthouse staff served us a delicious BBQ dinner while we had a very informative presentation by Don Darden, General Manager of Firestone Liberia, Inc.  We learned about the history of the Firestone Farm and its contribution to Liberia and their people. 

It was indeed a great day!

–Cindy Markham, CSI volunteer RN

 

The CSI Liberia team is nearly complete. We anxiously await the arrival of volunteer RN Samantha Chaplin who is on her way after air travel delays—safe travels, Samantha!

View more photos on CSI’s Flickr site.

A sweet first day

After arriving late Wednesday evening, the advanced team of 11 people spent the day working on a community health initiative. We handed out 2,000+ pills to treat children for intestinal parasites that interfere with their nutrition, growth and development. DumDum suckers sweeten the medicine as it goes down. 

The locals were excited to see the arrival of the team, greeting us with song and dance.  Lora Koppel, mission lead, and Elyse Vandersteen, mission partner, were presented with flowers and a letter at Beautiful Blessings school as a show of appreciation for our work.  Tomorrow we will continue our service project, visiting additional schools and community centers outside the Fireside farm. 

–Katie Johnson, CSI medical records volunteer

Visit CSI’s Flickr page for more photos.

 

Spreading hope in Liberia

As a CSI team of 24 medical and support volunteers prepare to journey to Liberia next week, our partners at Firestone Hospital Duside are already hard at work recruiting patients for surgery. Word traveled throughout Western Africa this fall in the form of posters placed in common areas and radio announcements broadcasting an invitation for families to bring their children for pre-screening last month. When the CSI team arrives for screening day on January 18, CSI volunteer surgeons Janelle Fox, Nathan Kreykes, Trish Valusek and David Vandersteen will determine which cases can be completed during this mission.  

This streamlined process is thanks to a strong partnership with Firestone Natural Rubber. The corporation hosts CSI at Firestone Hospital Duside — a hospital on the Firestone Natural Rubber Plantation in Harbel, Liberia — and provides room and board for volunteers. In addition to a goal of completing 80 surgeries during this mission, CSI is committed to providing training and education for local personnel so they can continue this important work. 

 

Lora Koppel, RN and CSI board member, is the clinical lead for this trip. She was part of the team that first established CSI’s Liberia partnership in 2008 and has traveled on each mission since. Lora says she is continually impressed by the talent and determination of the staff at Duside and credits the mutual respect as being paramount to CSI’s success in Liberia.  “Everyone wants to be part of the team when we arrive.”

Duside RN Tetee Urey-Morris was so inspired by the mentorship of CSI nurses that she eventually joined CSI as a volunteer nurse, traveling to Ethiopia on the spring and fall 2019 missions. Lora sees Tetee’s evolution from in-country staff to CSI volunteer as proof of the lasting impact of CSI’s dedication to education.

 

Next week, Lora will be at Duside during screening day when dozens of children will be given a chance at life-changing surgery. It’s a happy day for many families, yet others will unfortunately not receive surgery. Lora is focused on helping them, too. The mother of a child who swallowed permanent hair solution, resulting in a  burned esophagus, reached out to CSI for help in advance of the upcoming trip. While surgery is not an option for this boy, Lora is working on collecting protein powder and a blender to provide this family with resources to give him better nutrition. Similarly, Lora shares, “Families have brought babies that may be too young for a cleft palate repair. We can’t add them to our schedule, but we can provide specialized bottles that will help with feeding.” 

Lora is proud of CSI’s commitment to providing some of the world’s neediest children with a chance for a better life, whether that be a surgical intervention, new resources or education for their in-country providers. Her hopes for this trip? “To continue being able to reach kids in remote areas that would otherwise not have access to healthcare. I want families to know that if they come forward we will try to help.”

And that’s a wrap – Liberia 2019

“An individual has not started living until he can rise above the narrow confines of his individualistic concerns to the broader concerns of all humanity.”  — Martin Luther King, Jr.

Our team has completed their work in Liberia and is heading home. CSI anesthesia volunteer Joanne Hill reminds us that on the eve of our U.S. national holiday honoring Dr. King,  this incredible team, our amazing partners and all who support CSI have, indeed, risen above to focus on that which is bigger than ourselves — to make a lasting impact in the world.

This week we screened nearly 130 patients, performed 97 surgeries and provided clinical training and lectures daily. We have more than 20 patients pending for next year as Firestone has graciously invited us to return in January 2020. Until next time, with deep appreciation and gratitude, we thank our partners and this CSI Liberia team:

Dr. Dave Andrews
Rose Andrews, RN
Dody Barr, RN
Emily Butcher, RN
Maggie Cavanaugh, RN
Cathy Cook, CRNA
Ashley Dingmann, RN
Jessica Driscoll, RN
Dr. Janelle Fox
Dr. Kevin Healy
Dr. Jesse Hennum
JoAnne Hill, CRNA
Monica Hooley, RN
Mary Johnson, RN
Dr. Micki Klearman
Anna Koppel, RN
Jim Koppel
Lora Koppel, RN
Sally Lannin
Dr. Eric Moore
Ethan Moore
Lloyd Nagbe, CRNA
Lynn Randall, CRNA
Dr. Dave Tetzlaff
Dr. David Vandersteen

Click here to see more photos from Liberia.

We made a difference for that one… Liberia 2019

Today we met our first pangolin, brought to the hospital campus to be sold, most likely for stew meat. The pangolin is a small, scaled mammal that looks a bit like an armadillo. They are one of the most trafficked mammals in the world and are protected under national and international laws. Not unlike some of the human visitors to Duside, this pangolin, accompanied by a confident adult, seemed very unsure of what the day might hold.  

Fortunately for the children at Duside, what lay in store was a small amount of discomfort in exchange for a significant step toward a better life. The sting of an IV was followed by the elimination of a hernia or the restoration of the body’s normal anatomy. The pangolin was not facing such a fair transaction. This spurred a debate amongst several team members and visiting embassy members. A proposal arose: What if we pay the $10 (the going rate for 3 pounds of fresh pangolin), drive it a few kilometers past the gate, and return it to its bush home in a tree? “No, that’s not the official stance on endangered edible animal management in Africa,” one of the embassy members pointed out. That practice risks encouraging more pangolin trafficking.  

The philosophical conundrum got me thinking about the parallels in our week’s endeavors.  Sure, springing the pangolin may not stymie the hunting of her species or even affect her type’s declining numbers. But spending the liberating $10 would be a life-altering action for her. The same philosophy applies to our work here.  

Our seemingly small CSI presence may not change the existence of viruses like Ebola that can make an orphan of a 12-year-old within 72 hours. Nor can it change the fact that thousands of children are born with maladies that go untreated because they can’t access care. But for the 12-year-old orphan (who not only lost both parents to Ebola two years ago but also had lived his whole life with a giant hernia) and the other 90 children who had surgery this week, our presence ensured that tomorrow would be better than yesterday. And maybe, with the new skills and knowledge of our Liberian colleagues, we helped improve access to care for years to come.

At the celebration today, as 250 Liberians and Americans gathered to express mutual thanks, I think everybody was arriving at the same conclusion: You may not change the world, but you can make somebody smile, help somebody feel better, make somebody feel safe — and that makes for a good day.  

~ Eric Moore, MD, CSI surgeon

Check out more photos from Liberia here!