Effectual doer

A father's daughter

Below is a facebook consultation  or conversation I had from a father about a daughter’s health. on Facebook. Two days later with Imo app we had a video call follow-up with Barb  RN, with tropical health experience. Besides observation and knowing common tropical diseases there is also experience in play as well. 

But with a 14 year old daughter there can be other issues as well. Nothing beats a personal exam and appropriate lab, imaging scans, and tests to get more information for a useful diagnoses. The father who has to come up with a game plan has to find help with the medicine over in Liberia. Healthcare for the poor has many obstacles.

We will have another video chat this week in follow-up.

Facebook conversation

“We are fine, How are you?” Bill

“I'm doing good except my daughter.” Father

“Tell me more please?”

"My 14 year old daughter fell off at school, and was carried at the government hospital, (Buchanan, Grand Bassa) the doctor diagnosed nothing and she continued to be weak.” Father

“Did the doctor have any thoughts as to what might be reasons for weaknesses?” Bill

Nothing was said.... I'm thinking about malaria or low blood pressure... But she's fat and looks healthy only for the constant weakness…(what we think the father was referring to is Malaria and anemia caused by destroyed red blood cells from the disease. Fat means healthy and not a body racked with disease and lost of weight.)

This worried me a lot.” Father

“Yes, Barb is not home, but I would like for you and her to work through this”

OK , I will make a call on Sunday night by God's grace.” Bill

"Normally she is home by now," Bill

“OK  then, I'll make that call tomorrow same time,” Father. 

What would you make of the above info?

I gave our talk notes to Barb for her analysis. In Liberia, Elaine Laczny and Barb Reeves  would do the consultation and

Barb RN & my
beauty

possible diagnosis with treatment. I played no part in that process unless I was part of the communicating process which was very rare. They were the experts. They were good at it. Medical support beyond our clinic was rarely in our control. For the poor indigenous Liberian support was rare in those days. If you worked for a company, a foreigner with money, a descended from the Liberian Colonization families which populated the coastline and ran the country at that time. If you were Bassa or the other 15 native tribes to Liberia, medical care was hard indeed. 

Care today is given to more people but it is still uneven. In Monrovia is the better support than the other coastal towns like Buchanan.

In a phone conversation the father wants the doctor to prescribe the treatment and he doesn't want to self medicate. Imagine going to an office and nothing said or done with no care plan. Yet this is a reality for many in Liberia poor. 

The daughter continues to be sick. 

There are poor and sick and needy all over the place. A balanced Christian faith requires a beneficial expression of the faith in “word and deed” Col. 3:17. We can’t keep quite and we can’t stop being motivated in sharing God’s love in practical ways. The two go hand in hand. 

In James 1:25b-27 “an effectual doer, this man will be blessed in what he does. If anyone thinks himself to be religious, and yet does not bridle his tongue but deceives his own heart, this man's religion is worthless. Pure and undefiled religion in the sight of our God and Father is this: to visit (care) orphans and widows in their distress, and to keep oneself unstained by the world.” 

I want to become an effectual doer. Yep, I want to be an effective communicator who encourages people in the faith, but where the rubber meets the road I want to help those who need it. Having a loose tongue tears down people to build up oneself and being influenced to practice sin that destroys and hurts people and confuses our walk with God. We have to work on this stuff everyday. If you look at these verses it tells us we have a religion as well as a relationship with God. I know you will hear well-meaning people say that they don't have a religion but relationship with God, don't be too hard on them, (bridal your tongue) refers to a bit in the mouth of a horse to control the horse to the riders’s withes. Here we want our words to under the influence of the Spirit of God to communicate His love and our thoughts to be balanced and beneficial. But we do have a religion. 

James further helps with helping the needy in 2:15, 16 In verse 14 Faith and works are 

Faith	Works
Romans “God sees” vs. 4:2	James “you see” vs. 2:18, 22, 24
God trumps our view	We will eventually know God’s view
God knows his own sheep	We are fruit inspectors

discussed. In Romans it is faith that God always sees that saves. We have difficulty seeing inside another's thoughts, but God does not. What we see are the works and James picks up works from our point of view. Works validate what is going

Hospital in Buchanan, Grand Bassa

on in the heart. But even here we can be deceived. God is never deceived He knows. 

I few years ago, God wanted me to be specific in my care of the poor. He wanted me personally involved with real people.  note what James says,

2:15 “If a brother or sister is poorly clothed and lacking in daily food, 16 and one of you says to them, “Go in peace, be warmed and filled,” without giving them the things needed for the body, what good is that?”

I think sometimes we can’t walk away. That is what the fatman walking in Liberia is all about. Right now I feel very limited in what I can do. Pray, yes but follow up with some action. Clinics supported by the internet can really help. Doctors here are seeing old people on line from their homes. Diabetes, heart rates, blood pressures and a number of other basic observations can be done at home. A video check-up may lead to a follow up at the office or a call to the pharmacists. 

I think we can extend this overseas where a consultation from the United States, Canada, Europe can be followed up by clinics to deliver life-saving care with more accurate observations and expertise. Keep walking

By the way, I could use your prayers, ideas as well. Keep walking

Last Mile Health Organization using today's technology to provide healthcare

Coming up with healthcare solutions in Liberia one has to have an understanding of who is going to implement healthcare throughout the country. Liberia has a tremendous shortage of doctors. Liberian doctors because of the war relocated outside of Liberia. Many of the skilled health workers relocated in United States or Europe. There has always been those educated seeking to relocate outside of Liberia. I believe that impulse is still strong today. Even today there is travel advisories concerning travel to Liberia that limits travel because of safety.

Dr. Raj Panjabi

The Ministry of health in Liberia has teamed up with the Last Mile Health Organization run by Dr. Raj Panjabi of Boston, to train community health workers located in rural areas of Liberia to treat life-threatening diseases such as malaria, pneumonia, caring for expecting mothers. The community health workers will have ongoing training to reach higher professional standards. They will have their cell phones to connect to supervising nurses to help care for the patients who are more isolated in the villages and locations in the rain forest of Liberia. I became familiar with Dr. Raj Panjabi in a NYT article linked bellow. I also have linked below his web site. Check it out.

Barb crossing stream 77

In my brief time in the bush in Grand Bassa we ran a clinic with two RNs from United States. Elaine went to a  special six weeks course in Toronto in tropical nursing. Barb worked in emergency rooms and intensive care before coming to Liberia. Both of them attended a week seminar at the ELWA  hospital in identifying and treating common tropical diseases from the viewpoint of a doctor in primitive conditions without a lab or screenings. What does the train eye tell you? 

The medical care that the girls were able to give was real good. They had to train their interpreters for better communication in medical things. 

I can tell you that back in 1977 we were trying to figure out an ongoing training program for Liberians to have the skills described for community health workers in today's last mile health organization guidelines. Civil War prevented my return to begin working on training Liberians to expand the effectiveness of a medical clinic and create other centers in the bush. 

The technology of the cell phone brings real possibilities of support for people trained to help care for those who are out of reach of a clinic. Back in 1977 we were the only clinic in an area about the size of an Illinois County. As cell towers

CHW with back pack of medicine and training
Check out lastmilehealth.org

increase in Liberia, imagine not just voice but video calls that will help the supervising nurse to not only hear the description of the patient, but be able to see as well. This part of this service is not  there yet; I would definitely encourage the deployment for video calls as soon as it becomes available. Cell phones used in support is huge. I learned from the last mile health site 

Can you see the endless possibilities with online and medical support. There has to be a bridge between professional language and training people who are smart but I have a limited education. Under score that just because people have lacked educational opportunities does not mean that they are stupid. When I lived with the Liberians they taught me many things. The country or bush people were creative and sharp as they lived in the jungle. They were unfamiliar with modern life but they had an eagerness to learn. When you look at Dr. Raj Panjabi website I think you will pick that up with them in the many photos he has there. 

All of this is big-time motivation for me to lose weight to be able to go back to the tropics again and do my bit for the Lord and to serve the Liberian people to train and educate Liberians to sustain their education and medical needs. Keep walking

https://www.nytimes.com/2017/07/31/health/raj-panjabi-last-mile-health-liberia.html?rref=collection%2Fsectioncollection%2Fafrica&_r=0

http://lastmilehealth.org

What ever we do there has to be someone to do it.

There have been a couple of you who have sent gifts to encourage those I am ministering to in Liberia. Thank you. 

One of the new wings of ELWA Hospital

I am at present trying to work on my physical conditioning you improve my aerobics so that I can visit Liberia. I am also purchasing a bicycle scooter to help me with my mobility dealing with the heat. The bike can be taken apart and be able to move in villages and some trails. Because the bike as a single speed peddle there will be many times I can get some exercise. I guarantee you the little scooter will attract people for me to talk with. 

I am praying to raise support to travel to Liberia and visit there for about six months. I will have to find lodging in Buchanan where I'm likely to stay. I need to see for myself how the Internet works in Liberia. Using the cell phone or tablet how can I communicate back here in United States.

Is it possible to set up an Internet clinic or school? What are the real problems away from the big city concerning the Internet? From what I'm able to understand the Internet infrastructure may be limited to Monrovia, Buchanan and Harper? 

Would ELWA be willing to partner in this project? Would the hospitals and medical professionals in Liberia be willing to explore Internet clinics?

While I personally want to visit friends in Liberia and there are a few people that I want to find. I can only do this if I go to Liberia again myself. Also I need to go there to talk to people about Internet classrooms and clinics. 

Am I up for this trip? Liberia is a hard country travel to. It's doable but not without sacrifice. It is a country that you would never go to unless you have purpose. There are many more struggles today that we didn't have 40 years ago. So I'm praying about it.

The structures were all temporary

The large emergency ebola hospital that cost over 76 million dollars is now empty returning back to the jungle. More encouraging is the work that the Good Samaritan headed by Franklin Graham rebuilt ELWA hospital which has served Liberia for over 60 years. In the Civil War in the 80s and 90s the hospital was destroyed. Since then it has been rebuilt and played a large part in fighting ebola. The expansion and modernization we'll make the hospital the best in Liberia. 

Barbara and Elaine RNs who set up a clinic in Grand Bassa were in part trained at ELWA in identifying tropical diseases without a laboratory. Barb is my wife and Elaine Lazney were the real deal we went to relieve the Orta’s in 1977. I was just a beautiful blond guy who tag along. They were the only medical help for an area the size Will County, Il.

To be real, there is a lot of work I need to do now. Just what I needed in retirement. Keep walking

The passing of one of my former students, Augustus Potter.

I found out today one of my former students passed away. His name is Augustus Potter age 50 years old. He died from complications of diabetes. As a young student he was smart had a lively personality. He was part of a family with the father had 16 wives. The head wife was a Christian and insisted that all the wives children get an education including the girls. One of her sons became a doctor and another was a teacher. This was back in 1977. I was impressed that a country woman had such ambitions. Augustus was one of my older students and I thought he too would be successful. He remained a friendly guy and will be missed.

Diabetes is one of the three most deadly diseases we face. Liberia nutrition is based starches  on rice and cassava. Greens and herbs and spices are in the diet but little protein. Having war for over 20 years takes it toll on health. I am not sure if he had type 1 or 2 diabetes. Care in his life would have to had many difficulties. 

Can I get healthy and fit enough to visit Liberia? I would like to see how the internet could help with health and education improvements. Could people with skill be linked with people in need. It is on my bucket list. Keep walking

You are not alone with depression

You are not alone if you battle depression. Over 300 million people worldwide suffer from depression. Depression can affect anybody rich or pour. Whether you live in Europe, North America, Africa or the South Pole you can suffer from depression. Liberia has been through Civil War and political wars that lasted a long time.
War can bring on a special problem called posttraumatic stress, PST. We will explore this topic later; but it has a connection to depression.
Depression wants to tell you that only you have a problem. But the truth is many people have depression and you're not alone. People sharing together there're stories can be very helpful in overcoming depression. You can learn from each other.
Job, David, Elijah, Jeremiah all suffered depression in the Bible. Great people in history suffered from depression like Abraham Lincoln and Winston Churchill.
Famous people from every country have suffered depression. You may know well known people in Liberia who have suffered depression.
Depression is a major health problem that can be very dangerous. We have to take it serious because many people kill themselves. Let me be clear, depression can be overcome and you can feel good again about yourself.
After two years with insomnia I suffered from depression and Anxiety. With therapy, medicine and strong family support I am overcome depression, anxiety and posttraumatic stress. I also sleep very well every night now. I began to feel better rather quickly by practicing some of the things I've learned in therapy. We will talk about these things. I saw an improvement weeks before the medicine was supposed to have an effect.
I knew that God was with me and wanted to help me overcome depression. He brought good people into my life that new how to treat depression. I was his child and he loved me.
Have hope, keep walking

Negative thinking is like driver ants

Dr. Daniel Amen an American psychiatrist shares another way you can fight depression is to identify and kill the ants, the Automatic Negative Thoughts that keep you feeling down. This List is from an article, Two of the Most Important Ways to Beat Depression Dec. 8, 2016

#1 All or nothing thinking – also known as black and white thinking

#2 “Always” thinking – using words like, always, never, no one, everyone, every time and everything

#3 Focusing on the negative – selectively seeing only the bad in a situation and disregarding the good things that occur

#4 Fortune telling – predicting the worst possible outcome to situations

#5 Mind reading – believing that you know what another person is thinking even though he or she hasn’t told you

#6 Thinking with your feelings – happens when you believe your feelings and don’t question them– even when there is no evidence to support how you feel

#7 Guilt beatings – thinking with words like should, must, ought and have to

#8 Labeling – calling yourself or someone else a derogatory name diminishes your ability to see situations clearly

#9 Blaming – when you don’t take responsibility for your actions, you lose your power to make changes

Try to come up within an example of each of the nine negative thoughts.

I'm going to take a look at #3 focusing on the negative. When we are depressed we actually see everything from that point of view. When it comes to ourselves always see is bad things. When you look at your day all you can recall is the bad things that happen. Those bad things are all you're thinking about.

You can help your depression by challenging each negative thought. What is not true about that negative thought? Think of three things you are thankful for. Think up two things that were good for you today. You had a meal today. Before you went to bed it started to cool off. You saw a child smile today. You saw a snake in the bush and were able to walk away from the snake. Now think of three things in your experience today that was good.

Overcoming depression isn't it easy. It is harder when you don't have today's medications. But I can tell you even if you had the best of medicine you still have to do the work at it like identifying the ants, negative thinking that we all look at. Keep walking

http://danielamenmd.amenclinics.com/1-2-punch-to-beat-depression/

I am not a doctor. But I do want you to know things that may help you with depression.

Exercise can help you with depression

Exercise can help you with depression

Good day to you my Liberian friends. When it comes to walking most Liberians are walkers. But did you know a 20, 30 minute walk done at a fast pace your brain releases many feel good chemicals that's give you a feeling of eveerything is OK according to Dr. Daniel Amen. Dr. Kenneth Cooper observe this years ago with people who are training to be long distance runners. It was called a “runners high”. 

Liberia being in a rain forest is very hot. I would encourage this walk that is fast-paced early in the morning before the sun rises above the palm trees. Make sure you drink plenty of safe water. Walking this way helps the heart, can help diabetes, and it helps your body fight illnesses. You have and immune system in your body that fights against germs, bacteria, and viruses that you cannot see but can make you very sick.

Exercise is one of the things that we do and take care of our selves. For most of us walking is easy. For Liberians, we have to find a way to walk faster for a 20-30 minute walk. Not all of our walking has to be fast-paced. It is too hot in Liberia to walk that way throughout the day. A short time in the morning or evening can't helpless to enjoy this healthy walk. Keep walking.