Category Archives: Liberia


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!

Doing, Teaching, Learning – Liberia 2019

The day starts early at the Firestone Liberia guest house. If I listen closely from my room above the dining hall I can hear the staff at work on our breakfast by 4 a.m. There are eggs to crack, bacon to fry, pancakes to grill, and fruit that won’t cut itself. The food here is delicious, and I eat too much.

We are on the bus by 6:30 a.m. Some days I can see Venus in the west as we leave the guest house. We lose the sky to fog as we drive inland, winding our way through the rubber plantation to the hospital. By the time we reach the hospital, daylight is full and the air is warming.

My day starts off with a bustle as I gather supplies for the cases I’m assigned. I check the oxygen supply (twice), make sure there is anesthetic in the vaporizer and more at hand if needed, and prepare the drugs for the nerve blocks that I’ll perform once each patient is asleep. We have 25 surgeries scheduled for the day. General surgeon Dr. David Andrews spends time in the OR helping a Liberian colleague polish his surgical technique. Midday, CSI nurse educator Dody Barr takes a break from her work in the pre-op area to present a lecture on newborn resuscitation.

After work, it’s back to the guest house for dinner and relaxation. Dinner is on the table at 7:15 and we are finished eating by 8. The staff cleans up and does what prep they can as we will all be back at it again in tomorrow.

Doing, teaching and learning. That’s our day, and we are grateful for it!

~ Kevin Healy, MD – CSI anesthesia volunteer

Click here to see more photos from Liberia, 2019.

Stories from the Operating Room – Liberia 2019

When our logistics coordinator asked for volunteers to write a blog post, my hand shot up. Not surprising to those of you who know me – I’ve always got a lot to say. I want to start this blog by saying that today was the first day I actually saw a couple of puppies walking around the hospital! I suppressed the urge to pet them, or even take one home in my carry-on bag.

Reflecting on my busy day in the OR, many amazing thoughts and memories put a smile on my face. Watching CSI’s two newest OR nurses spread their wings and fly solo with minimal assistance astounded me. I look at Emily Butcher and Monica Hooley and marvel at their enthusiasm and motivation. I know they will be hooked on CSI  for life, just like I knew I was on my very first trip. I am amazed at how universal OR nursing can be. The Liberian nurses are phenomenal at helping with our room turnovers – or should I say – table turnovers, as there are two tables in each of our ORs.

I want to tell you about Jackson. The details of his story are not completely clear to me or his pediatric urology surgeon, Dr. Janelle Fox. What we do know is that 16-year-old Jackson suffered a serious pelvic injury in an accident. As a result, he has lived with a suprapubic catheter for almost an entire year. Jackson has been living away from his family, staying with family friends who have more medical knowledge. Yesterday he underwent a life-changing surgery that will allow him to urinate in a way most men take for granted.

What is truly incredible about Jackson’s situation is his bravery and determination. As he came into surgery I noticed the OR staff remove his shoes and take them from the room. Normally we would hand them to waiting family members, but Jackson had no family accompanying him. The shoes would wait for him outside the door. I was really touched. Here was a young, stoic man who was going into surgery without any loved one near to offer him encouragement or support, yet he made sure he was properly prepared for surgery and signed his own surgical consent form. How completely remarkable and mature.  I am proud to have been able to serve Jackson, and all of our incredible patients here in Liberia.

~ Jessica Driscoll, RN, surgery

View lots more photos here!

Reflections from Dr. Dave Vandersteen – Liberia 2019

Full disclosure: Today’s blog is written by a urologic surgeon. Feel free to gloss over as much as necessary to remain in your comfort zone.

As the sun still struggled to meet the horizon, a team of motivated CSI members arose around 5 a.m., strapped on headlights and left the Firestone Guesthouse where we reside. Why? To run in the 80 degree, 100% humidity environment and to enjoy one another’s company. (Writer of this blog was soundly sleeping, BTW.) These CSI team members reflect the spirit of our mission: teamwork, sacrifice and hard work. They support and encourage one another along the way as they climb the Liberian hills in the dark. They are rewarded by a magnificent sunrise and the ensuing endorphin rush.

It is a blessing to return to Liberia for the seventh time. As “frequent flyers” we have built strong bonds with our local colleagues. Within minutes of arrival at the hospital and the Firestone facility, we were able to reconnect and plan our work to help the children of Liberia as if we had never left.

The support we receive from Firestone and the local community is invaluable. The Liberian and Firestone communities provide us with the food, shelter, transportation and facilities to do this work. They prescreen patients, house patients awaiting surgery and provide dressings and other supplies necessary for us to be successful. Thank you, Firestone!

Reconstructive pediatric urologic surgeons perform staged surgeries that are completed over a number of years. So each year we return, we see the results of our prior trips and diligently work to restore these children to their full potential. Today, we had a return visitor whom we first met in 2012 following a traumatic injury to his bladder. At that time he was not able to urinate at all and had  been living with a constant indwelling tube extending from his abdomen that drained his bladder. We performed a Mitrofanoff procedure (presumably the first ever in Liberia), allowing him to live a normal tube-free life. He returned today, as a healthy, productive 27-year-old man!

We started the day with rounds to evaluate yesterday’s surgical patients, and all were doing well. Dr. Janelle Fox performed a urethral reconstruction in a young man who could not urinate because of a traumatic injury. Dr. Dave Andrews continued to save the world “one hernia at a time,” and Dr. Eric Moore was able to remove a disfiguring tumor from the head of a beautiful young girl.

The day was capped off by the families of our patients singing and dancing in gratitude. It was impossible to leave with a dry eye. It is impossible not to love this place and these wonderful people. xxxoooo, Liberia! 

~ Dave Vandersteen, MD

View more photos in our Liberia Flickr album.