Checkups for the Kids

Wow we are already half way through our trip. This has gone by so fast!
Today we drove almost two hours out to Quita's orphanage located in the bush (for the second time). We caught a ride with the two missionary couples; Elder+Sister Kimball and Elder+Sister Kirkham. We love them to pieces!
When we arrived all the little orphans ran outside to greet us. Inside, Quita introduced all of us to the caretakers, advisors, security and cooks. They are all very gracious and love having company. My Mom and Dad sat in one of the rooms off to the side and had all the kids line up outside the door. My parents did small head to toe checkups on each child and gave each one worming medicine and any other special medicine they needed. Us kids read to the children waiting in line. They still had all the books we gave them last time; they absolutely love them! The missionaries who came with us donated a soccer ball to the orphanage; they were busy playing catch with the kids outside. My siblings and I stayed inside to help our parents.
Dad would look in the children's eyes, mouth, and ears, and listen to their heart and lungs, while mom would look for blemishes, fungus, and rashes on their skin and heads, GG would hand the kids their pills and a cup of water, Meg would stick a sticker on their hand and Lawrence would give them a peppermint candy for a job well done. If any of the smaller children started crying or were upset M.C. would hold them until they were calm. The kids loved her! For the most part the kids looked pretty good; a few had colds and a few others had ring worm. There were also a few distended tummies probably from malnutrition.
Word that a "doctor" was in the orphanage traveled like forest fire. All the village moms and their kids tried to push into line to get checked and medicated. But because of our time constraint, we were barely able to finish the orphans. So we gave the village kids stickers and candy to make sure their feelings weren't hurt. Quita is having a difficult time right now raising enough money to buy food for these kids. She makes coal from the rubber trees and sells that for money. Everyone uses coal to cook with over here in Liberia so there is a huge market for this type of fuel. Making coal is quite a process. You have to stack the wood from the tree in a certain way and then light a fire in the middle of the pile, then you cover this huge mound with just enough dirt that you don't put out the fire yet it is hot enough to smolder and create coal. This takes around three days to complete. It is more difficult right now though because of the heavy rains.
The orphanage children and staff members eat rice three times a day. Quita told us they go through a 50 pound bag of rice in 4-5 days; she said they also feed some village schoolchildren during the school day. We have recently helped them fund a bag of rice and some extra funds to get some protein into their diet. We enjoyed being with all the children and staff at Quita's orphanage - they are cheerful and fun despite their circumstances. Please think of them in your prayers!
~Golden Kids :)

Eternal Love Winning Africa (ELWA)

Today we went out to ELWA (a place about half an hour away) and visited an orphanage. Some of our friends here, who are medical students visiting from the States, told us about it and invited us to come with them. There were about 30 kids that came out to play with us once we arrived. We all got into a huge circle and played duck duck goose, sang some fun songs, and then played sharks and minnows. Then we separated into two groups. Us boys played soccer, and the girls played kick-ball. Oh yeah, and you have to watch where you stand because there are ant hills all over and they sting like crazy when they bite you!

Lawrence


The kickball game was fun! We had two teams and the girls were really good at it. After about an hour of playing this, the med-students said that it was story time. They usually read a scripture story to the kids and then have a prayer. This was neat to see.After that we taught the little kids how to play some hand games and they loved those. We blew some bubbles and the kids loved to pop them. We also gave out peppermint candies; once that happened almost every other minute the little kids constantly dug through our pockets for more. We got some pretty cute pictures.

*MC*


During our last hour at the orphanage the guys started having contests on who was stronger. Matt, our American friend, would do some crazy push ups and pull ups, and the Liberian boys would try to outdo him. It was quite humorous to watch. It was getting close to dinner time so we said our good-byes and left. We all walked back to the house that the med-students were staying in, near ELWA hospital, and changed into our bathing suits. All of us kids got to swim in the ocean for about an hour with Jared, Matt, and Elizabeth. We had fun passing the volleyball and football around, well, whenever we weren't being knocked over by the big waves. It was a blast! They all leave on Sunday to get back to school. We will definitely miss them and the friendship we have formed with them!

-G.G.


Our trip to the ELWA orphanage was a great experience. This facility first started out as a Sunday School, evolved into a school, and then from that the director and his wife saw the need to open an orphanage. Jefferson (the director) and his wife Hellena are both very dedicated to the running of this operation. They get very little government support, which is the case for all the other orphanages here in Liberia. I think the government's money is just spread way too thin with all that they are doing to rebuild after 14 years of war. The school is still in operation at this orphanage, with over 300 children in attendance. The small tuition that the students' families pay to go to school, helps fund salaries for the teacher's, care takers, and the cook's. It doesn't quite cover the cost for food, but Jefferson said that they have been blessed at different times by organizations such as Samaritan's Purse and missionaries from different churches offering food supplies or beds for the children. One really neat feature about this facility was a well that some missionaries put into place on the property. This well is operated by a merry-go-round that the children play on. The water gets pumped to a big holding tank that is located at the top of a tower. This provides the water pressure that is needed for the plumbing so that the children can take showers. I was quite impressed by this. Something else that was noteworthy about this orphanage and school was the big woodworking shop on the property. It was built by some missionaries from the USA who obviously had a fondness for Jefferson and Hellena's orphanage.
The workshop was in two portions - a large covered outbuilding that was open on 4 sides, and a large cargo container that housed the generator, power tools, a nice plywood saw and many hand tools. The vision was to provide a technical training opportunity to young men and interested girls, where they could learn furniture making, woodworking and production of doors. One of the older boys was placed in the position of manager of the shop, and another was in charge of marketing. Pretty cool concept and vision in that it provided job skills before leaving school and the orphanage.

Kim :)

Many Thanks!

A few days ago our accountant, Doug Collier, arrived here in Liberia. He came bearing a few gifts that some great friends of ours sent us from the States. We are very appreciative of all the people who sent us these supplies. We would also at this time like to thank all the people who have emailed us asking if they can help, or just wishing us luck in all of our doings! Of the things that were sent these have been our favorites:

CANDY- we have all been missing our favorites and can't find anything that comes close to replacing them. We have been trying to ration the candy and gum we received but whenever we eat some it reminds us of home!

Medical supplies- The nurses in the NICU were very grateful for the books that were sent. Dad told us that if it is a slow moving day he will see the nurses looking through them! They were most excited when they each received their very own stethoscope.

BATHING SUITS- Well, a while back, we visited a really nice beach. No garbage, no gross sand and no weird people hanging about. Us girls sat there longing to be in the water, while Luke was the only one able to swim in the basketball shorts he was wearing. Now that we have bathing suits, we can visit nice beaches and go swimming! The downside, the day after they arrived we were struck with bad weather so we're still waiting for a nice day to go swimming.

Once again we would like to extend our thanks to all of our friends and family who follow our blog and send us comments and words of encouragement. We have also appreciated your e-mails and facebook responses letting us know you care about us. We feel blessed to have so many great people in our lives. Thanks again for everything! We Appreciate and love you!


-GG

Story Time

Today Meg gave a talk in church. She did very well! Then in Young Women's class she was asked to give the lesson because her teacher wasn't prepared to give it. (This is the second time she has had to do this.)
After church we got home, ate, rested, and then our two Home teachers came over for a visit. Brother Franklin told us a story about himself during the war. He said that one night some soldiers came to his house and dragged him and several children out of bed, and threw them into a truck. The soldiers took them to a beach and had them stand next to a fallen palm tree. They came up to Brother Franklin first and said. "Take off your shirt." (Bro. Franklin says that this meant you were going to die) Franklin said that he asked if he could say a prayer first. The soldiers mocked him and told him, "That won't help you! There is nothing you can do that will save you. Lie down on the tree, now." Brother Franklin said he was persistent and asked until they consented. He knelt down to offer up a prayer, and he said as soon as he did so a voice came to him and told him, "Fight! Fight for your life!" He said this message was clear as day. Brother Franklin explained how he kicked down the two guards at his legs, got off the tree, and turned to run away. As he turned to run the third guard brought down his sword and cut his head open, right across the top. He did not stop running though. He said that he knew God was with him and was giving him strength, because he was not getting weaker from the loss of blood. He felt more energized and strong with each step. He outran the guards and felt impressed to run a certain way. He came to a compound with four walls, and realized that this was the ONLY wall that did not have barbed wire on the top of it.
Brother Franklin told us how there was a lone palm tree growing up one of the walls. He said he climbed up it, and it bent over perfectly to allow him to drop onto the ground on the inside. Franklin explained how it had been raining very hard all night. The rain water was pushing away the earth from under the roots of the trees inside the compound just enough to allow him to scramble and hide underneath. He scooped up the mud around him and packed it onto his head to try and slow the bleeding. Then he took off his shirt, and started rubbing mud all over him to try and camouflage himself. Not moments after he finished, Franklin said that the soldiers came up to the compound wall, shining their big lamps and flashlights all around the courtyard. He said they shined it right in his eyes, but did not see him. The soldiers gave up and went on their way. A while later Brother Franklin said he knew he had to get his 'flayed head' taken care of. So he pretended to be a soldier and went to a barrack to get his wound sutured up, since all the hospitals were closed. Franklin said that the nurse didn't even bother to clean it, and just sewed him right up. He told us how it started to get really big and built up. My Mom laughed and said, "That's called a hematoma. Blood welling up." Franklins eyes got all big and round and he said, pointing to his head, "Hematoma?! There was a MOUNTAIN on my head!" We all burst out laughing. Then he demonstrated how he would press the top of his head against a wall to get the swelling to go down. We all laughed again. He knows how to make a sad subject humorous.
He said the war was a bad time. And Liberia is much better now. The people don't want that happening again.
I am grateful for that. There are many things we hear about the war that would just break your heart. But each day the people are progressing, and striving to become better. We hope to share and help all we can to speed this process up.

Civil Compound-AGC

This morning we woke up early, ate breakfast, made sack lunches, and walked over to AGC. It was overcast and approximately 75 degrees, I think all of us kids have acclimated to the heat, because we felt cold and had to wear our jackets. Doug, the founder of AGC brought a team of eight people from the States with him. These people are here for various reasons. A couple are nurses, a few are teachers and one is a carpenter. They are mainly here to offer their services to the school. We divided up into three different cars to make a journey out to one of the outlying schools (Civil Compound-AGC) in the bush. My family got into a van with several other people. It was not the most comfortable car I've ever been in; GG and I could feel each metal bar and spring in the seat we were sitting on. We made a few stops along the road and picked up a few more people, somehow affiliated with AGC, who wanted to go visit the school. By the time we really got going, there were 17 people in our little van! (Talk about taking advantage of space!) The roads are in pretty bad shape from all the rain we've been getting. There were a few areas so covered by water I wasn't sure we would make it through. We had to cross over a river, on a make shift bridge made up of two fallen trees with planks of wood on top of them. The wheels of the car just barely fit on each tree. For our safety, we got out of the cars and walked across ourselves, with the cars following behind us. As we got closer to the school we passed through a small village where most of the students live. Once at AGC we got to watch the graduation of the Kindergarten class. It is a really big deal over here if you graduate from Kindergarten. We have had several Liberian friends talk about parties or celebrations and big dinners for their child, because they have graduated. We would say, "Oh that's so good! From High school or College?" They would laugh and answer, "No, from Kindergarten."
The ceremony was interesting and fun to watch. The students wore little caps and gowns and sang a song while doing a little march around the courtyard. They were each called up by name and awarded a certificate by Doug and his team. As the kids were called up, their moms would scream and clap and come to the front of the crowd and dance. Some of them whipped off their wrap that goes around their dress, and laid it on the ground for their child to walk on. The parents were very excited and had no qualms about showing it as they handed their graduate a gift or two and smiled big for a picture. The children though stayed very stoic. NONE of them smiled throughout any part of the ceremony. Not even when their picture was taken.
After a few hours we made our way home in the snug little van. We had to stop a few times because of car problems, but that gave us time to take pictures and take in the view around us. The fam stopped by JFK hospital so Dad could check on some of the babies, and then finally got home for dinner. It was a very long, interesting but exciting day.
~Meg

More Activities by the Family in Liberia

Last Saturday the 18th of June we were invited to see and share in the baptisms of four young men in our church. We travelled about 1.5 hours into the rural area outside of Monrovia, to Kakata where we met some new Liberian friends and enjoyed their great spirits. Then we all trekked over to the nearby River Du to see the baptisms occur in this river. Kim and the girls drove in the trucks with the two senior missionary couples to the riverside location where these men and boys would enter the water. Lawrence and I walked about 3/4 of a mile with our new friends over hill and dale to the same spot (I preferred the walk) and enjoyed the conversation and company with Nathan, who is a teacher and just completed his studies to be an elementary teacher.
When we arrived - some local villagers were doing their laundry at this riverside spot, but they cheerfully made room for our group to proceed. Eddy, who was the father of 3 of the boys, and friends with the 4th, then took each one and performed the baptism for each. This was a very cool, and very intimate experience - one I will not forget for a long time.
Later that day when we arrived home - we just kicked back and relaxed. This felt good, because we all had a busy week. I rounded each day at the NICU, JFK Hospital, often with Kim and the kids accompanying me back to the unit after lunch, to help in any way they could (starting new records, dismantling old records; helping mothers breast-feeding their babies, etc.).
My time in the NICU has been very busy for me, trying to model good care and good practices, I love joking with the nurses and all of the staff in the hospital: the housekeeping staff, the lab staff, the security folks, the midwifes and Labor staff, administrators, even visiting families. An interesting observation - I do not often see fathers, until they arrive to take Mom and baby home. Sometimes they arrive and demand to take the baby home. Then the nurses and I take turns talking them out of it, until a stern, seasoned Liberian nurse tells them to shape up! That usually takes care of it.
On the Friday of last week - arrived to find I had 24 to 25 weeks gestation twin brothers, both very small at 430 grams and 490 grams (less than a pound, right at one pound). We did what we could, which was a little oxygen, some warmth, some IV fluids but it was not enough and they could not survive being so immature. I found that I was at peace with this, since these tiny ones are tough to manage in the best North American or European neonatal units, but almost none of the needed resources were available here in Liberia. I see a composed acceptance of the serious limitations, and then we all move on to the next set of tough clinical battles, and there are many. I still enjoy going in to the hospital each day - glad to find that it is still a passion even in a new and strange land, a new medical culture.
~John

ELWA Hospital

Today we drove out to ELWA Hospital to teach NRP to the staff. Our friend Andy, a college student who job shadowed John last week, gave us a tour of the hospital. This hospital is smaller than JFK; it is a single story building, but has all the basic departments that a community would need. Like most facilities around here, ELWA is in need of equipment. Another problem over here in Liberia is that if a piece of equipment is donated to a hospital there isn't anyone around here who knows how to trouble shoot or fix the equipment if it breaks. That is the case with a ventilator in the NICU where John works. A ventilator isn't much good if it doesn't work. There are no IV pumps, so the nurses use the old fashioned method of counting drips/minute. Any of you nurses remember how to do that? Labor and delivery only has one birthing table with stirrups. It looks like it's from the 1950's. It is old, tattered, and rusty. There is one O.R. that does have an anesthesia machine that works well. The room was cool and clean. The staff at ELWA were friendly, but overworked. There are not enough doctors at any of the hospitals here in Liberia, so the nurses do almost everything including suturing.

Andy then took us to the hospital chapel where we would be teaching NRP. There were about 19 nurses, students, and a doctor all together, who attended the course. The nurses were very attentive and asked good questions. They were eager to learn and appreciated the hands on learning. We had 4 manikins for them to practice on. We had to emphasize that a baby only needs gentle stimulation if it is in distress after being born (ie- gently rubbing the babies back or flicking the soles of the feet).
The Liberian's believe that the African babies need more stimulation and therefore need to be hung upside down and smacked hard on their feet or back because they have a rough start being born in Africa. John and I trained MEG and GG on the basic steps of resuscitation the night before. The kids loved being there with us, learning alongside the staff.

After we finished our training we were invited to stay for dinner at Andy's living quarters. We had to walk through a jungle to get there. His house is about a hundred feet from the beach; must be rough! None of us brought our bathing suits to Liberia because we were told that the beaches were dirty, and they are in most areas. The beach that is a couple of blocks away from our house has trash and we have found some medical supplies like needles, IV tubing, and vials. Anyway, Andy's beach was very clean. Lawrence was so excited to be on the beach that he dove into the ocean with all his clothes on. The water is very warm! One of Andy's roommates swam with Lawrence and made sure that he was safe. The weather didn't stay nice for long. We made it inside the house just as the clouds began to dump their rain, and rain it did for the rest of the night. We had a nice dinner and then said our good-byes.

Michael, our friend came to pick us up in his friend's car. Of course he was an hour and a half late. The ride home was quite comical. It was raining so hard that we had to keep the windows rolled up. It didn't take long for seven people to fog up the windows and make it almost impossible to see anything outside. Not only were the windows fogged up, but the headlights were so dim that Michael had to use his hazard lights to see. You'll know how well this worked when to our amazement we found ourselves out in the middle of a field, and Michael asked us where the road went, Ha! Well, the fun didn't end here. After finding our way back to the road, Michael made a call to his friend asking him to trade out cars so that we would be in a safer one. We all got out of the car, in the pouring rain, grabbing all of our training materials and backpacks and scrambled into the other car. Once we were all settled, Michael looked over at us and said that the car wasn't working right, so out into the pouring rain once again and back into the original car. A guard was standing near by watching us crazy white people play musical cars. I'm sure he was quite entertained. Lucky for all of you reading this, we made it home safely so that I could blog about this fun day and share it with you.

Drenched~ Kim

Helping more at JFK

Today Mom, Dad, and I went to JFK after lunch to help out where we were needed in the NICU. Dad had to teach a class to some of the Doctors and Nurses as soon as we got there, so Mom and I went to his office and put together some binders that the NICU uses. It has all the information and notes about the patient and the mother inside of it. Before we brought in the binders and dividers, they had all the papers stapled together, or in a loose leaf open folder. This was really scrambled and things were often missing.
After finishing with the binders we went into the Nurses Station. There are three counters in this room, two are for the nurses, and one has all the loose pieces of paper that the unit uses. Such as Admittance forms, birth certificates, Doctors notes and orders etc. My mom and I brought in a big file folder accordion looking thing and placed all the papers inside here with individual labels. This left the whole rest of the counter open for use, and was a much more organized method of storage. The nurses were so thankful and loved it; we got lots of hugs from them.
Dad came in a little bit later and worked with a few of the babies. I got to help him dress a baby who had an omphalocele. It was very interesting and...different. But I learned a lot. He also taught me what he does when he examines the babies, and I got to try. I have learned a lot here, things that I would have definitely not been able to in the States. After we left the hospital we stopped at a street vendor shop and bought some scrubs for me (and GG). Now we can look official!
~Meg

Teaching Dental Care

Today we walked to AGC with the remainder of our dental supplies to teach the kids about dental care. We went to the little ABC class (Like Kindergarten) and pulled everything out of our bags. Meg and I started by asking why it is good to brush our teeth. They all stared blankly back. The teacher mumbled something to them and someone said, "So they can stay clean." We gave some more reasons as to why we brush our teeth and the benefits of it. Then we held up a tooth brush and asked them what it was. They all yelled, "Toofbruch" ....haha! Then we held up toothpaste and asked what that was. I don't think everyone knew so one kid replied once again, "Toofpaste". We demonstrated the motions of the best way to brush teeth, and how long to brush. After reviewing everything with them, and making sure they understood us, we handed out 34 toothbrushes and toothpastes. They were so excited and especially loved the different colors of the toothbrush. Class was let out right as we were done; and when we stepped outside apparently news had traveled fast that the white people gave out toothbrushes. Lots of kids came up to us and held out their hands expectantly waiting for something. Unfortunately we had given all the toothbrushes away and only had a few toothpastes left. We knew there wouldn't be enough to go around so we told them all that we ran out. Upon hearing that all the older kids started grabbing for the younger kids dental supplies. We had to take a few from the older kids and give them back to the younger kids. We said goodbye to our friend Louise who was in her office, and left. Directly left of the school ground we walk by a little daycare. The little boys that were playing outside were so excited to see us that they came running out the gate and wrapped their arms around our legs. We had only met them once before, and their cute little antics made us laugh. The lady supervising them gave us big smiles and invited us to come inside the daycare. We decided to give them the remaining toothpaste with them and apologized for not having anymore toothbrushes.
We got a couple pictures with them and the boys gave more hugs as we left. It was a very great service oriented, day and I was really happy!

-GG

Playing with the kids

Today we went with Dad to the hospital after lunch. We made egg salad. Yum!
Me, Meg and GG went to the Pediatric Ward where the little kids are. We play with them and try to keep them company so they aren't sad. We play with Play-Doh (Which is always Gray/Blue or Tan), color in the coloring books (always half colored in), read books, play on the little rocking horses or chase them around. We always end up having lots of fun. Today the play nurse, Rose, brought in Candy Land and asked us to teach her how to play. Each of us sat a kid on our laps and played four rounds. They loved it! Rose is so funny. She has a different hair-do every time we come. The ladies here have wigs, so they can change their style when they feel like it. She asked us to 'carry' her back to the States with us. When they say carry they mean drive or transport. She cracks me up!
*MC*

Crossing the road

Remember how we've told you that the drivers are crazy over here? I'm not sure that I've explained that we have to cross a busy 4 lane road several times a day to get to the school, hospital, grocery stores etc. , but that's what we do on a daily basis. There are no stop signs or traffic signals. Basically, you have to just walk out in front of the cars with your hands out asking them to stop or slow down and say a little prayer that they will obey. Anyway, today as the kids and I were getting ready to cross the street, one of John's many friends (he is friends with all the maimed, amputees, war vets, blind) ran up to us and asked if we were crossing and then he proceeded to make the sign of the cross, a couple of times, before jumping out in front of the cars and escorting us to the other side. This made me chuckle seeing that even a local was terrified for his safety in crossing the road, Ha!

Kim

That is right - my friend Abraham was looking after my family for me while I was at work! Thanks Abraham! One of several Abrahams I know. There are a few named Moses, Isaacs - I know a few of them, Emmanuel. Good biblical names, and yes many are crippled, amputees, wounded or shot in the prior wars and they ply the stores that cater to westerners here, hoping for handouts and freebies. I have been able to help a handful of them with medications - antibiotics for flesh or skin wounds, infestations; antimalarial medications for - yes, Malaria which is quite common. I have access to a stash of antibiotics left here by other American docs, and the malaria treatment is cheap at $2 US dollars for a treatment course. So I just stop in at one of the ubiquitous pharmacies and pick it up, no prescription needed. Like treating a cold!

The Abraham mentioned above is a street guy, of limited means and we have shared some of our food with him. I am finding that he is a bit of a humorous guy, but he did not start off well with my family the first week. In fact he scared them! I was lagging behind the family a bit at dusk, fending off another street guy, when Abraham approached Kim and the kids (inebriated)
and told them "share your food with me!!" Well this scared GG most who refused to go outdoors again for about a week!
Next day I found Abraham and told him that he had scared my family; that he must not do that again and must stay away from them but he could approach me and talk with me. Since that day, Abraham and I have been on good terms and we talk or wave whenever we see each other. We have talked about families, his situation, church, our lives etc. He calls me "Pastor" or "Brother John", in fact many call me brother John.

Today after church, Lawrence and I had to take a taxi to get home. A common taxi is a sedan meant for 4 people including driver; always there are 4 people in the back seat beside driver and front passenger. So Luke and I waited for about 10 minutes til we found one and shared it first with 2 large ladies, then a couple of gents, one carrying his chicken with him. Lawrence thought that was cool - clucking and feathers drifting around in the taxi. I nudged him to ask the chicken-man if his "chicken had extremely large talons?" (A line from Napolean Dynamite!).

This week in the NICU was busy and exciting on some days, with again a few sad, unnecessary deaths. But a few really exhilarating recoveries. Kim and Meg, as well as GG are lending more and more assistance in the Maternity hospital and the NICU; babies, Moms, charts, paperwork they help where they can. I appreciate the extra hands and support and I think the entire staff there does as well.
John

AGC Miles Away...

This morning we woke up early eager to help out at another AGC (All God's Children) school. There are three of these schools in Liberia funded by an organization called "Serve the Children." We gathered up some books that we brought to donate, ate breakfast, and waited for our ride. The school was about an hour and a half away. All six of us squished into a small cab that should have seated 4 passengers. Mom, MC, GG and I compressed ourselves into the back seat, with Dad in the passenger seat and Lawrence perched on his lap. We were quite a sight to see as we bounced down the road avoiding pot holes, and enormous puddles, feeling like a can of sardines.
Unfortunately we had to pass through a large market where many people travel to get great bargains on merchandise and food. It's called the Red Lightdistrict. I really hate going through this part of town due to the number of people, garbage and smells. The people act as if you are driving on their side walk. They weave in and out of the cars like nobody's business with their wheel barrows, buckets, and items balanced on their heads. The younger kids and teens run along side the cars trying to advertise the stuff they are selling. Sometimes its gum, a magazine or newspaper, a small fabric flag, candy etc. Cars drive both ways down a road that looks like one lane, trying to dodge the motorcycles, pedestrians, umbrella shops, garbage and ditches. No one abides by any traffic rules. The most aggressive driver usually wins.
Since there is no air conditioning in the car, the windows need to stay down. It is impossible not to smell all the smells of the rainbow! Gross! There is mud everywhere due to the heavy rains, and the place is just filthy with trash everywhere. The people are stoic, impatient with the cars, rude and determined to finish their job of buying or selling their goods before paying attention to anything else around them. The garbage is in heaps along the road, sometimes smoking because they're trying to burn it. It's a sad sight.
After an uncomfortable nap in the car we finally arrive at AGC followed by a second car with staff from the AGC school in Monrovia. The Principle, Ma Mary, greeted us and took us immediately to her office where we met the other staff members. Everyone was very warm and welcoming, even the kids. We were given a tour and met all the classes and their teachers. There is a class called K-2, 1st grade, 2nd grade and level 2 and 3. (The level two class is a 3rd-4th grade class and level three is a fifth and sixth grade class. Kids my age were in them.)
GG, MC, Lawrence and I read some of the books, we brought to donate, to all the classes. The kids loved it! Even though everyone speaks English here they don't understand American English very well. After I read a passage in one of the book's I asked, "So where did the birds fly to?". The class paused, then answered, "Yes" I couldn't help but laugh. My mom asked if the school had any soccer balls so we could start up a game with some of the kids. They gave us one that had been so worn down it had no outer rubber anymore and it was flat. We asked the older girls to come play soccer with us, and split them into two teams. They had so much fun! GG and I were each captains and found that we couldn't play like we are used to because the girls all swarmed to the ball and kicked it as hard as they could, so it was kind of a sketchy game, but fun nonetheless.
After school was out, we drove to some property where they are going to rebuild the school. The foundation has been completed, so now they can start building the walls. There will be 6 classrooms, some administrative offices, and an auditorium. The location was beautiful; It was up on a hill and had a beautiful view.
We stopped for soda on the way home at a little shop on the side of the road after eating some white bread rolls. It was so refreshing! But we had to stand there and drink them, because you have to return the glass bottles. We were looking forward to the dinner Martha was making at home for us! We got home, cleaned up and rested. But throughout the next hour, a very strange smell wafted through the house, and not a nice one at that. For dinner we had a Liberian dish called FuFu with pepper and fish soup. I will NEVER, ever in my WHOLE life, eat this again. The FuFu looked like rubber cement on a plate, while fish heads and tails floated around the soup. Martha rolled with laughter when she saw the looks on our faces as she set this on the table. She told us that you don't chew it. You put the broth over it, some fish on it and swallow it. No chewing! Lawrence gagged trying to swallow it, MC, GG and I tried some (spoon full) and didn't fancy it, so we took the left overs down to the guards watching our compound:) I'll learn how to make it so every one back home can have a taste! Not really, this will be the first and last time I will be around that stuff.

Hope everyone at home is enjoying their delicious meals! Please savor them and don't take it for granted!
~Meg

Our Weekend...

Friday: Tonight we are having company so I helped Martha make her spicy spaghetti because one of our guests is a vegetarian. I sat in the kitchen and wrote down the recipe while Martha made the food. We decided to also make some hotdogs on the side for those of us who wanted meat. We finished making dinner and I helped prepare everything to eat and cleaned up a bit. When our company arrived some introductions were made. I had already met Sister Kimball so I was introduced to Elder Kimball and the other missionary couple that just arrived a couple days ago that the Kimballs are training. After we visited for a while we sat down to eat. We had spaghetti, hotdogs, rolls, fruit, and vegetables. The food was really good! After dinner us kids did the dishes then visited for a while. Then... the Kimballs pulled out a desert they made. It was peanut butter and chocolate rice krispy treats! They were so good! Then the missionaries left and we cleaned up and went to bed. I had so much fun!

-GG

Saturday: Today it rained so much I thought we would wash away. Finally it stopped and was really sunny so we went on a family walk to the beach and played soccer where Dad and I went on a run along the beach. Afterwards I found a coconut in the sand. I'm always on the lookout for coconuts, even when I go to Hawaii and Mexico, and now here! My dad went for a swim in the ocean. The waves are really big! We all starting to get hungry and so we went home. Mom made some really yummy black bean burritos.

Sincerely, Lawrence

John and I got complimentary tickets from Cellcom for the Liberian National League soccer game. They were expensive tickets near VIP, but in retrospect I am happy that we were seated in this section as the fans were a little more controlled. stadium was packed past capacity with many ticket holders not being allowed to enter because the game had been oversold. This made for some very angry fans. While waiting in line to enter the stadium we had people cutting in front of us and pushing us to get through the door. The crowd was rowdy and people were being pushed and shoved; one man fell from one level to the next because of people pushing him. John and I saw a few fans being carried away on stretchers. The riot police were in attendance along with over 50 black belt karate students. It made me wonder how crazy the fans would get. Anyway, the game was exciting and Liberia won. John and I left a couple of minutes early not wanting to get caught in the crowd. But despite our early exodus, the driver of our car was last to arrive and then we entered the melee of people on foot, zillions of weaving motorcycles, countless honking cars jockeying for every inch of advantage on the road, all to the tune of total disregard for any prevailing laws of the road! It was major-crazy!

Warmly, Kim

5th Grade Graduation!

So today I was able to Skype my class back home to attend my fifth grade graduation. My tech teacher set up her lap top and called us via computer when they were all ready. My teacher and class mates were at the front of the room and all said hi when I logged on. He gave us a speech about middle school and all sorts of tips he thought would benefit us. It was really cool! Then we each got a picture with him handing us our diploma. I will just have to get mine, once I'm home.
I was really sad that I couldn't actually be there with them watching the photo slide show of the whole year. I told my Dad, "Why did you have to drag me here and make me miss graduation!? That is so not fair!" After a while he got me to realize that this is a really unique situation and not a lot of people will be able to say that they graduated elementary school in Africa!
I miss all my friends back home and am so excited to see them!

*MC*

Another Week In Liberia........

Another Week in Liberia - June 2d

A warm greeting to family and friends, from warm and rainy Liberia. Rainy season has arrived - it has gotten cooler which is welcome. After a good rain - lots of big, brown puddles to skirt on my walks to the hospital, JFK Memorial.
Did I mention - they gave me a "Visiting Doctor Office" here? It has an air conditioner that did not work for the first 3 weeks; now it works and it is awesome! I have a view of the Atlantic Ocean - just 3 blocks away. If i open the window I can hear the sound of the surf arriving on the beach. My view looks over some coconut palms, and over the corrugated metal roofs of the local dwellings in the neighborhood. Anyway - this may be the best office I ever have so I will enjoy it. Also has desk, chair, sink and water that runs most of the time, but spews occasional gobs of green algae-goo.

This Saturday we will have logged 5 weeks in Liberia. The young ones in this home tell me we have 76 days left in Africa. Hey - I'm not counting!

The Neonatal Intensive Care Unit (hereafter - the NICU) at JFK is housed in an acceptable building, recently renovated with a grant from the Japanese government - "Liberian Japanese Friendship Memorial Hospital." Slightly clumsy to say all of that - maybe I will just call it the Friendship Hospital?

I say acceptable because it has power most of the time, running water most of the time, but also contains nuisances. Such as a power cord that drapes across the lower doorway of the main entryway to the NICU (i have asked multiple times for it to be revised). No paper towels except one roll, on one occasion that lasted about 24 hrs. Have not seen another since. The alternative I "inspired" the Nursing/Admin leaders to provide is a cotton towel from Laundry Services that someone from NICU has to pick up, then trade for another when soiled or soaked. Guess I now need to go make friends with the laundry staff! To all my Tacoma NICU friends and associates who help themselves to 3,4,5,6, or more paper towels after a handwashing - I AM WATCHING YOU!

It appears that the way the supply chain works is this: a unit such as this NICU gets an allotment of alcohol swabs; once they are used - they are gone. Thus the lack of absolute basics; hoarding that happens, and no sharing. Disposable gloves - found a box in the closet that holds all the various donated supplies that visiting care providers donate with their trips. It's mine for now - but I mete them out to my cohorts in the NICU when really needed. Alcohol based hand gel for cleaning between patients: spotty supply from the hospital, but better supply if we just buy our own and share it. I have asked for supplies of hand-gel every day from the Nurse in charge - i have seen them arrive once.

Tape is referred to as "plaster". Medications are "served" as opposed to given or administered. Starting an IV = "open an IV". I opened my first peripheral IV in some time today - only one RN of the two assigned RNs made it to work, as the other was sick. So I pitched in a bit more than usual and opened the IV.

Yes - 2 RNs typically, though occasionally 3 will staff this unit which may have 8-12 babies in incubators, on warmers, or in cribs. Plus more on our service who may be rooming with Moms. Today I heard a knock on the side door of the NICU - opened it to find a clinic nurse with 2 parents and a 4 day old baby in tow wanting admission to the NICU. Here I should orient you to the way things are being done here: "newborns" up to even 2 weeks are being readmitted to the NICU if they have a fever, jaundice, are sick in any way. I am opposed to it and have voiced the usual concerns about infecting the babies already born at JFK, but various factors lead to the prior decision to still do this. The newborns come from home/home births (not like we think of home-births; no way to get to the hospital, no way to pay for the hospital, so just deliver at home); clinics where mothers lay-in and deliver; via the Peds Clinic and the Emergency room. Often there is no phone call - they just show up. So now in this instance, Husa was my only nurse. Knowing she was already swamped - I explained to this clinic nurse, the parents, the baby that I would have to divert them back over to the Pediatric Ward at JFK (right next door) as we could not admit him due to staffing limitations. And I explained it a 2d time, and then a 3rd time. I reassured the parents that the ward nurses would take good care of the baby, and called James, the Physician Assistant who sent the baby, to tell him of my rationale (he and I get along well - he is a caring provider, who does good work).

After hearing this, Husa said to me "Dr John - we want you to stay here forever." To which I said - " I will stay if I can have Liberia buy me a mansion on the beach with a pool so we can have NICU pool parties twice a year" She laughed heartily at this!!

Last Friday I performed a procedure that I have not done in several years: a double volume exchange transfusion for a newborn boy whose bilirubin was 39! For my non-medical friends, this is about twice the usual level (20) that strikes fear into the skulls of Pediatricians. So I am now twice as scared, and in a foreign land! But we rallied and came up with a good bag of blood (the father donated his O+ blood to his O+ son), the devices needed to do the infusion (it is done by taking small amounts of donated blood, giving to the baby and taking back now-mixed blood in small amounts, doing this over and over and over…….). I get good venous access, then I conscripted good wife Kim, a former NICU nurse to record for me and watch me in case I was about to commit any fouls! While I am sweating through this (literally and figuratively as the A/C is puttering along), Kim is recording - another baby unexpectedly starts to have seizures, and three more new admissions sneak into the NICU behind my back in the manner described above!
When i finally tucked in all of these characters, finished the exchange of blood, walked home at dusk - I was Pooped! Emotionally, and Physically!

And I have only scratched the surface! Really! I promise to tell more in another installment. Lastly, I must tell you all, as I have told Kim, my children as well as others of you already, death lurks around the families and newborns of Liberia much too much. I have seen many more newborn deaths in 4 weeks of practice here, than I would see in 8-10 months or possibly more back in our Tacoma practice. Some deaths were because of irreversible factors - too late, too ill, no critical care resources. Some deaths seemed like the efforts we put in should have worked, but did not. Birth asphyxia is common as is infection in these little ones. The Liberian people are stoic about the deaths of their newborns - some weep, but certainly not all. I encouraged a mother to hold her baby as life waned, she declined. The intern and nurse in this case tried to tell me that African people do not engage in a lot of drama or emotional energy when babies die or are dying. I am getting the sense infant deaths are common enough that many families are affected by it and inured to it. I have spoken with mothers who have lost 2 babies in their child-bearing years. The medical and nursing leadership I have met are keenly aware of the excess of neonatal deaths and want to reduce it. It will be a gargantuan effort from my point of focus. Kim and I hope to do a bit to improve it by rendering care when we can, teach good care at every opportunity, and promoting Newborn Resuscitation skills anywhere we can get in the door.

We miss you all and we think of so many of you often. Blessings to each of you from our home and family!

John