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

Moses home making a little progress

Progress on Moses Tarr' home, He was able to put a metal roof on his house. Considering the amount of rain is 118 inches a year and being on the coast Buchanan has rain during the dry season that you would not experience inland.
Moses has informed me further improvement have been made.

Rain also wreaks havac on the roads. Moses is traveling into the bush where I used to live to work on the mission. Imagine trying to travel on these roads.

I can remember traveling when the roads were like this. A 40 mile trip may take hours to complete. By the time you got your designation you would need to change your clothes and get a shower. Back in the 70's, when I was there, people would asked me, if I was from the Peace Corps. That wasn't a compliment because the peace core workers we're often unkempt and dirty. The kids were often dropped off in locations with very little support. They had to make due.
There was a book then I read, Red Dust on Green Leaves which describes what the iron ore roads did to the green vegetation.

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

I can see the difference it makes

Moses is making progress on his home

Most people in world are poor. Also the majority of Christians are poor. We live the fallen world and as a result we will always have poor people. This is such a big problem no government or person can remove poverty from the planet. Today there is a common outcry about our founding fathers either compromising or benefiting from slavery. But did you know that slavery is a big problem today. Slavery was always wrong. In the first century church 60% of the population were slaves. A large number in the church were slaves. We can learn from history but we need to be aware of real problems today. There are millions of slaves today.

One of the consistent sarcasm's against the church today is that the church is filled with so many dysfunctional, uneducated, lower class people. The church is often a haven for the mentally ill. If we look pass some of these modern labels the common thread is that the church is made up of a lot of poor people. People in poverty and they are always easy targets.

I have many happy memories of sitting in poor villages talking to very poor people. Many of these people only had the

He is building his home
during the raining season

clothes on their back. We shared stories back-and-forth. A poor village wouldn't give me the honor of a bottle of coca-Cola. The cost of that drink would be a day’s wage. I learned so much about the Liberian culture. 

Things are improving in Liberia. Most people in Liberia make $150 in a month or less. The best way to live in Liberia would be to have a job and the ability to continue some level of traditional farming. The poorest people in Liberia are unable to continue some level of traditional life, packed into the city's ghettos there are a lot of desperate people. 

There is no amount of human resource they can meet the need around the world, or even in the United States. We will always have a problem of human poverty. 

This is my opinion that this should humble us. If we look at it closer it can even overwhelm us. Our level of ability to inflict pain and oppression on one another goes above my comprehension. 

Bible conferences are reaching many w the Good News

As a Christian I can't ignore the poor. Helping the orphan and the poor is basic to a biblical religion. All humans suffer from spiritual poverty which is why I share the gospel. There are strong appeals from God to care for the poor in the Old and New Testament. Our response should be personal and addressing some need that we are aware of. It is not first a call out to others, first personal response. 

That response certainly made involve cooperation with other people doing a specific situation. In my case, it is being aware of people in my life who are in poverty. I am blessed to help those I know in Liberia. I certainly have my limitations, but it's good to know I can make a difference. Seeing these few take advantage to improve their education, to improve their shelter and home. To improve their care and education of their loved ones. To see them share the gospel and encourage others in their church. What ever I can encourage for the people of Liberia in regard to online education or clinics I know there's a few poor people who God connected me with to bless them. 

Great article from WSJ. Education in South Africa struggling like our own urban schools. Can online support help Sibonelo?

The Wall Street Journal published the story today on report of South Africa schools. Apparently teachers are not accountable and many students are on school grounds missing classes and participating in gambling and drugs. In the classes there are too many unmotivated students. Schools such as Orlando West High School that was a beacon of light for students has now deteriorated. 

According to the article more money is spent on education, 20% of the South African budget which is a higher percentage than either Switzerland or Japan. In fairness I think it's safe to say that Switzerland and Japan make more money and have a more stable economy. More money is spent on education then healthcare or military in South Africa. 

Many classes are canceled because the teachers to stay home. Drugs like marijuana and

Sibonelo 18 wants to study botany

home made opiates are widely used. Motivation is certainly being affected. 

Sounds just like in the US  there are not enough jobs in the marketplace to give people an opportunity for success. Educators and economists spin the same dogma that the only way to advance is through education. The jobs that education require are very competitive. Many people are not made to succeed in education. There's nothing wrong with them, but they need other kind of work. 

People who make their living through capitalism have not developed opportunities for people who are not text savvy or book smart. Government has not developed anything to expand opportunity to those whose skill sets not include books. In the urban culture particularly there is a sense of hopelessness and non-inclusion. Our political parties have failed and so has Wall Street. We have seen the same failure in communist countries as well as socialism. 

I think partnership of capitalism and government pulls together resourceful people but they have to be challenged to new ideas, good old ideas to increase opportunities for others. 

In the article I was thinking about the students who were trying to get an education that could compete in the South African universities and workforce. They are smart enough to know that they are not getting what they need. The article talked about tutoring which is a great support. 

There was no mention of students getting support through our online education. I believe that this is a real possibility for the Third World. South Africa is one of the most educated countries in Africa. Educators, government resources need to become more aware of online support. 

motivation & judgement impaired

Sibonelo an 18-year-old featured In the article wants to be the first black botanist in South Africa. He is afraid he is not given the tools to compete. There are courses online that specifically study Botany. In his school there is a lot of time lost because of lack of teacher management in allowing many inappropriate behaviors to dominate the classroom. Sounds like classrooms from Chicago or Philadelphia. Rather than lose the potential of a student like Sibonelo wouldn't online education give him the support he needs. 

Not only do I think online medicine and education can help Liberia, but I think the machines could help the US and South Africa.

Whether or not you agree with my analysis read this informative article.Share with others and help me get the word out.

http://www.wsj.com/articles/south-africas-schools-like-the-nation-are-falling-short-1470148770