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

Chain, chain, chain The dark side in West Africa, Mental Illness

chained in a room at a prayer camp near Lomé, Togo,
in April. Chaining is a last resort for families in
.chained in a room at a prayer camp near Lomé, Togo
175 are chained there.

When I lived in Liberia, West Africa I came across a man who was wearing no clothes and had a car bumper chained to his body.  He was carrying it Down the street of Buchanan, then the second largest city in Liberia. Traveling in the backcountry I would often see women topless, But I never seen a man naked. Louis Orta a veteran missionary explain to me that the man was mentally ill and this was the way people knew to stay clear. His family would have to feed him and providing any shelter. I inquired about the man and it sounded like he was suffering from schizophrenia.

When I read the New York Times, the series of articles by Benedict Carey reporting on the Chains of Mental Illness from West Africa, my 40 year old memories came back to me. It was in the rainy season and this man would've been naked day and night.

The West Africans have a strong belief and fear of demons. It is embedded in their culture long before Christianity came to Africa. Mr. Carey I think is absolutely right in reporting what are families to do with the severely mentally ill. In Liberia there is one psychiatrist and very few are in the other countries of West Africa? If the mentally ill have a family who will care for them, it is my guess until I'm proven wrong, that they would be fed once a day. I would have to have that theory checked out but, I think it's very possible. Most people in Liberia eat one meal a day when I was there. 

When I was in Liberia, if you were convicted of a crime or waiting for trial if your family did not feed you, you did not live to be tried. I interviewed a man name Matthew Sasaw who had ate 9 people near Harper, Liberia. Cannibalism was still practicing the month of December back in the 1970s. I interviewed several tribal people who told me before Pres. Tugman the practice was more widespread in the 50s. Matthew did not live up to the trial because his family did not feed him.

Once again here is an opportunity for the Internet to play an important role in helping to advanced care for Liberia and West Africa. There is little chance for medical people to give up all lucrative practice to go help the unfortunate who cannot pay. But what if psychiatrists could donate an afternoon for an online clinic where they can help diagnose precribe medicines that could be adapted with follow-up online appointments. Online classes and workshops could be presented to the people who care for these unfortunate. With better information and support families and caregivers could provide more humane care.

The lessons that we learn in our own world of the mentally ill who are homeless and inadequately medicated and uneducated can be applied to the third world. Or the other way around, if we put into place strategies to improve care for the mentally ill in West Africa, what we've learned could be applied at home. 

Carrying for the mentally ill is filled with challenges, both at home and abroad that isn't nice to care for something beyond ourselves. Keep walking

Share my blog with others.

Follow up and read

http://www.nytimes.com/2015/10/13/health/mental-health-care-in-west-africa-is-often-a-product-of-luck.html
http://www.nytimes.com/2015/10/12/health/the-chains-of-mental-illness-in-west-africa.html

Help me with the vision of online care for Liberia

No matter where we live our lives can change rather quickly. We can be healthy and get the flu bug which can lead to complications. All of a sudden it is serious.
If you live in the tropics and specifically in the rain forest you will be facing a lifetime battle with malaria. Not all water sources are safe and typhoid is a real issue. If you get both of these things at the same time you are in serious trouble.
Moses became very sick and fortunately he was able to get help at a local hospital. He is pictured here with an IV running with fluids and medicine helping him to recover.
Liberia needs good water sources and water treatment. Library is also in need of better mosquito control and treatment for malaria.
I got malaria when I was about 23. My temperature spiked to  to 105 degrees. I actually hallucinated colors on the wall like a modern artwork of sparkly color. My head really hurt and I and severe flu like symptoms. I was treated and immediately I started feel better. It would be easier for me to get it again if I was in a tropical location.
I saw an ad on the TV where a sick person had a video conference with the doctor. The doctor could interview the patient and view him and was able to start treatment. Such a tool could help a lot of older people get an initial treatment without travel. Lab work and physical examination are lacking, but video conferencing can be a lifesaver for many.
The same could be true for people who need psychological help. People could see a therapist or psychiatrist via the Internet as part of their care. Group counseling could be conducted via video conference.
I am convinced that computer technology can revolutionize medical care to the third world. We could help many poor people who have no access to medical expertise. This could be done from local clinics or even directly into the home or village. My friend who became deathly sick could see a doctor via the Internet and the right modern medicine or treatment could then be conducted.
Clinics in the US could be plugged into medical expertise where is the professional at the clinic could be the eyes and hands of the doctor overseeing it. What we learn both here and abroad could be used to bring medical care to millions of people.
Help me get this idea out to interested people. Needed are the infrastructure of cell towers. The business to supported is already in place. People in Liberia really love their cell phones. Needed are the clinics and pharmacies which can develop the network for security and source to distribute the medicine without corruption. Computer people who would be willing to invest in Computer connections for video conferencing from clinics, villages, smart phones. There are are particularly a lot of young people in America who are tech savvy. This whole project could be very helpful in helping people have a purpose worth getting involved with.
"The generous man will be prosperous, And he who waters will himself be watered." Pro. 11:25 

Letter I am sending as an advocate for Liberia.

Recently America responded to the health crisis in West Africa concerning Ebola. While the threat of Ebola remains the wave of the deadly virus was brought under control. 

I followed the story and along the way made contact with students now adults when I served in Liberia as a missionary back in the late 70’s. 

To be a missionary back then you had to be involved in education or medical care along with spiritual care. We were in the bush with a clinic and elementry school. 

War over the next 25 years kept my wife, Barb and I from returning.

From Facebook one of my students contacted me and from there I have decided to become an advacate. 

While my personal commitment develops, brainstorming I believe there are good ideas we could help countries like Liberia and develop improved goodwill of America throughout the world.

Most of Liberians have no access to education or healthcare. Education I believe can give the Liberian people the human resourses they need to grow independent and strong. Right now they are dependent on others to develop their natural resourses and commerse. This will lead to outside control and influence that may not be in the Liberian interest. 

My idea though simple is bigger than myself.

What if clinics could be developed where people could be seen through internet technology where medical personel trained in tropical health care could see and hear people, care for them from health centers in Liberia or in the US. Local clinics could distribute medicine or do lab work. 

There are many complications but care for malaria and other tropical conditions could be cared for. Medical care would improve when doctors and other professionals work with it.

Young professionals and grad students working towards their certifications could be hired to support and develop the service.

In Liberia there are many places where there are no schools. What if we took the internet tools and developed online schools.

Education centers could be developed in Liberia where teachers are trained to teach to areas without education. Where there is education, online work could be developed to upgrade what would be taught. For example a teacher could get support for the class in areas that there might be a weakness. 

Teachers in the US could teach a class from their location and have direct contact with students  in the interior of Liberia.

Liberian villages are pro education, they could provide supervision. Liberians working towards there own education goals could be trained as educational technicians and in conjuntion be working towards there own certification.

Young people graduate from college in this country looking for work in the teaching field could be hired to work with online classes, evaluating work, working out the many problems that may occur. Others may want a more hands on experience and be part of the work that has to be done in the host country.

What we learn and experience may also be used to improve our own education efforts here at home.

Problems yes, but look at the possible benefits:

• More people educated
• More Americans involved in helping others
• People suffer less because of tropical diseases
• Improvement in online medicine that could be applied for our senior citizens, those who need to see a doctor,
• An opportunity for our young people to serve their country with the training that they have achieved in colleges. Valuable experiences to build their own careers on. Service could be done right here in the US or for those wishing foreign service on sight work.
• What ever percentage this improves education in Liberia in other places speaks loudly that we've done something to help.
• One more way to improve America image as a people who care.

In your service, 

William Reeves Jr. 

bbbbsa@sbcglobal.net

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