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Into Liberia

Duquesne Physician Assistant Students Leave Supplies, Take Away Lessons

On July 1, 2010, five fifth-year Duquesne University physician assistant students, along with a faculty member, traveled to Liberia, in West Africa. The students, Laura Berkebile, Amanda Candelmo, Kayla Breindel, Olivia Hess and Michael Lynn, escorted by Mark Freeman, MBA, MEd, PA-C, assistant professor for the physician assistant studies program, arrived in Monrovia, capital of Liberia and made their way to the campus of ELWA Hospital (Eternal Love Winning Africa). ELWA Ministries Association is an interdenominational Christian organization founded in 1952 by the Sudan Interior Mission (SIM) with the mission of providing education, healthcare and community services to those in need.

The group traveled with a number of objectives, primarily to assess the general medical needs of the people, provide medical care and service, experience the culture of Liberia and assess the "fit" for future excursions for students and faculty from Duquesne University. Though fact-finding was a major objective, the trip provided the backdrop for a series of personal and professional life-altering adventures for everyone involved.

The residential accommodations at ELWA were very basic. The group shared a house with three undergraduate students from Wheaton College in Illinois. The house had no kitchen facilities; however, the staff of ELWA was able to locate a cooktop, small refrigerator, toaster oven and toaster for our use during the stay. This allowed us to prepare some basic meals.

After settling into our home, we later met with Kedrick White, the administrator for the ELWA campus. We were provided with an overview of ELWA and were introduced to James Gowen, the administrator for ELWA Hospital. After a tour of the facilities, the students began working in the various departments. The hospital provides basic medical and surgical care to thousands of Liberians as a part of its interdenominational Christian ministry. While working in the small hospital, students rotated through the obstetrics and post-delivery wards, as well as emergency department, surgical services and inpatient services for adults and children. Relying on only history and physical examination skills and some basic laboratory tests, students diagnosed and treated patients for a number of tropical diseases including malaria, filariasis and typhoid, as well as hepatitis, gastrointestinal worm infestations, sexually transmitted infections, HIV/AIDS and meningitis. In addition, they were actively involved in surgeries and labor and delivery.

While in Liberia, students also worked with Steven Trexler, an American-trained physician assistant and missionary. The students spent three days with Trexler and went to his clinic in Gbarnga (Bong County) and assisted in mobile clinics in the bush. While there, the students treated nearly 300 villagers, many of whom traveled for hours by foot to be evaluated and treated. The students experienced the cuisine and culture of the bush, dining on luxuries such as goat, barracuda fish and potato leaf. While with Trexler, the students stayed at DEN-L (Development Education Network - Liberia). DEN-L is a local nongovernmental, nonpartisan, secular and nonprofit organization charged with the mission to facilitate educational programs that promote quality human development, responsible and responsive leadership, and an empowered followership that appreciates its gender differences and is aware of its civic obligations and rights. While in Gbarnga, the students were given a tour of the new PA program that Trexler is developing. Trexler was the recipient of a laptop computer and various medical supplies that the students had collected prior to the trip. He expressed extreme appreciation and gratitude for the donations.

During this trip, the group was able to visit orphanages in Monrovia and Gbarnga, treating minor illnesses, while also playing and interacting with the children. Though all would agree that the conditions were subpar by American standards, the children appeared well cared for, happy and resilient. The group then also visited Mother Teresa's Sisters of Charity Hospice in Monrovia, where they learned of the outstanding work of the sisters as they care for men, women and children with HIV/AIDS and other debilitating illnesses. This rare look inside the mission was truly an honor for the group, as the sisters rarely open their doors to outside visitors. In addition, a tour of JFK Hospital in Monrovia (once the premier hospital in West Africa) sadly revealed evidence of the recent war as they try to rebuild the facility to its former glory.

Devastated by two civil wars in the last 20 years, Liberia is one of the most impoverished countries in the world. With the country's infrastructure still extremely battered and showing the evidence of war, the poorly maintained streets make even local travel by taxi a major obstacle. Electrical power is limited and unreliable throughout the country, and communication is maintained principally only by cellular networks at this time. Healthcare remains a significant need for the citizens of Liberia. Because of the cost of healthcare, which can sometimes cost as much as $5 to $10 per day for an inpatient stay, a year's wages for some Liberians, many citizens wait until the advanced stages of illnesses to seek the treatment they need. As a result, many patients die unnecessarily secondary to treatable illnesses.

Through charitable donations collected by the group, as well as medications provided by Brother's Brother Foundation, a 52-year-old Pittsburgh-based international charity, the group was able to deliver medical supplies, clothing, toys, computers and equipment to those in need. Special thanks to Hospitals of Hope, a Christian medical missions organization based in Wichita, Kan., and Daniel White, the organization's International Missions Coordinator, for facilitating many adventures during our time in Liberia.

The trip, funded by a local Pittsburgh benefactor, attorney Bob Peirce, as well as the students and the Duquesne University Department of Physician Assistant Studies, is expected to be the first of many trips to this region, continuing so that others may provide service and experience this "once in a lifetime" life-changing opportunity.

Mark Freeman, MBA, MEd, PA-C, is assistant professor for the physician assistant studies program at Duquesne University in Pittsburgh.


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