MEDICAL MISSION (LMM), 2020

LIBERIA MEDICAL MISSION 2020 Summary Report of Activities By: Joseph Sackor Executive Director/Chairman of the Liberia Medical Mission

Background

Liberia Medical Mission organizes and implements a lifesaving, medical mission trip to Liberia every two years, to provide free medical services to underserved and impoverished communities. The mission also includes training and workshop programs aimed at beefing up the current local healthcare capacity. The team comprises of three functional areas - Mobile Outpatient Clinics in collaboration with local physicians and nurses; Eye treatment (Cataract surgeries, assessment, and distribution of glasses); Mental Health (training of providers and general awareness).

The Liberia Medical Mission (LMM) extends its profound appreciation to all its partners, members, and donors for their generous contributions to the success of this year’s Medical Mission to Liberia. With your unwavering support and prayers, the team shipped to Liberia two, 40-ft containers with donated medications, medical supplies, medical

1 books, clothes, and shoes – worth over $3,000,000 (which included airlifting of more than $2.9 million dollars’ worth of medications from Direct Relief in California, Americares and Brother’s Brothers Foundation), The team provided FREE medical, educational, and psychosocial services to more than 5,233 Liberians. Thanks to our dedicated and ever committed providers, nurses, Psychologists, and volunteers who worked tirelessly to make this a reality.

The Medical Mission to Liberia took place from February 28 – March 15, 2020. This was the fifth mission implemented by our small but dedicated organization, comprised of a General Surgeon, Emergency Room physicians, a Pediatrician, 2 Nurse Practitioners of diverse specialties, Staff Nurses, Clinical Psychologists, a Bio-Medical Engineer, Information Technologists, and local volunteers. The medical mission team of 32 professionals, all volunteers, including the Executive Leadership of Liberia Medical Mission (LMM) covered their own travel expenses for the duration of the mission.

The primary focus of this year’s mission centered around general health assessment and treatment of diabetic and hypertensive cases, Mental Health awareness and training of mental health providers, Eyecare (screening, distribution of glasses, and free cataract surgeries) and repair of diagnostic equipment at no cost to the hospitals and clinics. Our focus on this patient population stemmed from the previous assessment and the availability of donated medications and supplies from our donors.

The medical mission accomplished the following:

Diagnosed, treated, and managed each patient appropriately. Educated patients on disease prevention and healthy lifestyles.

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Dispensed medications to underserved population that could not afford them. Distributed needed medical supplies and remnant medications to more than twenty hospitals and clinics. Established strong partnerships with United Nations Children’s Fund (UNICEF), United Nations International Organization for Migration (IOM), UN Refugees Agency (UNHCR), APM Terminal, the office of the First Lady of Liberia, Ministry of Health and Social Welfare, and other critical local institutions. Organized a day’s workshop for ex-combatants and young school teenage girls in Paynesville and Brewerville, respectively. Organized workshop on leadership and psychosocial issues, for 25 Paramedics and police officers, at Liberia National Police Headquarters at no cost to the Government. Paired ten local nurses with our visiting medical practitioners for knowledge transfer. In collaboration with UNICEF Liberia, our Youngest volunteer, Jamilah Sillah (12 years old) from Macon, GA, donated 200 pairs of new sneakers to two orphanage centers at .

From our assessment, illnesses observed to be on the rise among Liberian older adults (40-70 yrs old), include primarily hypertension, diabetes, ulcers, urinary tract infections, and ophthalmic infections. HIV/AIDS, and abdominal pain were high among the younger (16-35 years old) generation. The facilities and equipment available to us required inventiveness, and flexibility to function – in hard to work environments. Our goal was to assist everyone as much as we were able, under the resource constraints of the practice settings.

Most of the kids (0-12 yrs old) seen were malnourished and dehydrated. We ran into an 8-month old child who was severely malnourished. According to sources, the mother of the child had tried to starve him for days because she couldn’t afford to take care of him. We referred the case to UNICEF during our debriefing; they took the responsibility of follow up.

It is worth mentioning that some of our patients were hearing their medical diagnoses for the first time. Some patients with pre-existing medical problems were overwhelmed with the burden of not being able to pay for prescribed medications when they visited their private clinics/doctors. They have to choose between feeding their families and buying their medications. Feeding their families often wins out with their limited resources. Patients seen during the mission were very appreciative of the mission’s services. They thanked us, our donors, and partners infinitely after they received their treatments and medicines, free of charge.

Through the efforts of the LMM Medical Mission, in collaboration with its local and international donors, and local coordinating committees and volunteers, lives were changed, and many lives saved as a result. Everyone who contributed and participated in this year’s mission can be proud of the accomplishments and successes of which they were all an integral part. Without a doubt, the credits go to our donors and the team members, who worked tirelessly during the long days in less than ideal conditions, never 3 complained, and remained upbeat with positive attitudes in providing complete care and concern for every patient seen in our clinics.

Outpatient Clinics

The mission was a daunting challenge. With a goal to see and treat as many patients as time and resources could permit, our medical practitioners – aided by volunteers and local clinic staffs – treated and dispensed meds to patients at the following locations:

Johnsonville Community Health Center

Above: Patients waiting to be seen in LMM’s clinic at Johnsonville Health Center

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Below: Our Providers stabilize one of a critically ill patient at Battery Factory Clinic

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Group of 77 Disabled community – Newport Street, Monrovia, Monsterrado County

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Charlesville –

Photo provided at Parental Request

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Below: Patients line up for Registration at Banjor Clinic

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Below: LMM’s Nurse educates patients in their native language on disease management and healthy lifestyle

Mental Health Workshop

Dr. Williametta Simmons- Bakassa and Prof Wali organized Psycho social workshop for ex-combatants/Drug Addicts(Zogos). The seminar centered around Post Traumatic Stress Disorder (PTSD). During the workshop, the participants underscored some salient points about marginalization in the community and the difficulty of getting a good job due to their current circumstances. There were a total of 50 participants, and the workshop lasted for 4 hours

Dr. Simmons with Ex-Combatants/Drug Addicts(Zogos) during PTSD workshop

Below are the pictures of Ex-Combatants

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After the Ex-Combatants’ workshop, a 2-hour gender violence workshop was held with 75 students from a middle school in Brewerville, outside Monrovia, . The workshop was interactive, and it helped the organizers to comprehend some of the social vices and violence directed at young girls in the various communities. Drug consumption and prostitution were among the main issues that were also discussed during the workshop.

Our Mental Health team, in collaboration with the administrators at ES Grimes Mental Facility in Monrovia, conducted a 2-day training for the staff. Similar training on leadership and Post Traumatic Stress Disorder was held with 25 paramedics and police officers at the National Police Headquarters. The Inspector-General of the Police and the Director of the ES Grimes mental facility appreciated the training and asked that LMM continues to provide such a training remotely.

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Above: LMM’s Leadership and PTSD training at the Police Headquarters in Monrovia

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Dr Simmons at ES Grimes mental Facility

Eye Care / Cataract Surgery at JFK Hospital

Dr Baah in the Operating Theater

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Our host ophthalmologist, Dr Guizie and our surgeons, Drs Thomas Baah from Accra, Ghana, Dr Aisha Sheriff from Abuja, Nigeria did outreach and prescreened over 800 patients, 501 of whom were candidates for cataract surgery. Unfortunately, due to unforeseeable technical circumstances and some challenges at the local facility, our surgeons were only able to perform 34 cataract surgeries free of charge and dispensed medications and glasses to non-surgical candidates and those that needed reading glasses. The primary challenges we encountered were the availability of enough surgical rooms for our visiting surgeons and the local physicians. We were given limited time slots to operate during the afternoon hours while the local surgeons would perform their surgeries in the morning hours. Secondly, we did not get the final green light from our donor, SEE International to use the medication that we carried, which was procured under the medical license of Dr Kondrot. Due to COVID-19 and out of abundant precaution, Dr Kondrot could not come with the team to Liberia to perform cataract surgery as we had initially planned. We had to bring in an SEE International certified eye surgeon from Accra to do the cases. After consulting with SEE International, the remaining medications remained with our host Ophthalmologists for future eye missions.

Repair of Medical Equipment at Local Hospitals and Clinics

Liberia Medical Mission’s Biomedical Engineer, Ben Weefaa set up surgical equipment for John F Kennedy Medical Center in Monrovia, Liberia. The free professional service was our way of giving back to Liberia and saving the healthcare institution from incurring thousands of dollars of professional services costs. It was also an opportunity to train two young technicians how to service some equipment at JFK

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Distribution of Leftover Medication and Medical Supplies

The chart below shows the recipients of medications and/or medical supplies

Healthcare Location Medical Supplies Medications Facility SOS Clinic Old Road, Yes Yes Monrovia John F Kennedy Monrovia Yes Yes Memorial Hospital St. Joseph Catholic Congo Town, Yes Yes Hospital Monrovia Dr Swaray’s Clinic Jacob’s Town, Yes Yes Gardnerville Robert Moore Pipeline, Yes Yes Memorial Health Paynesville center Oniyama Teaching Brewerville, Yes Yes Hospital Monrovia Bensonville Bensonville, Yes Yes Hospital Montserrado NPHIL/IOM Yes NO El Hilal Community Jamaic Road, Yes Yes Clinic Monrovia Zorzor Lutheran Yes Yes Hospital

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Barkedou Health Lofa County Yes Yes center JohnsonVille Johnsonville, Yes Yes Community Health Monrovia center Virginia Thompson Monrovia Yes Yes Health Foundation Phoebe Hospital Suacoco, Bong No Yes Tubmanburg Bomi Yes Yes Hospital Agape Health Duport Road, Yes Yes Center Monrovia Saclepea Health Saclepea, Nimba No Yes Center Bahn refugee Bahn, Nimba Yes Yes Health Center County Methodist Ganta, Nimba Yes Yes Hospital County Banjor Health Virginia Yes Yes center Rivercess Health Rivercess Yes Yes Center Rivergee Health Rivergee Yes Yes center Zleh Town Health Zleh Town, Grand Yes Yes center Gedeh Martha Tubman , grand Yes Yes Memorial Hospital Gedeh Group of 77 Diable Monrovia Yes No Community

Distribution of Educational Toys and shoes to the orphanage centers

• Our Youngest volunteer, Jamilah Sillah (12 years old) from Macon, GA distributed 200 pairs of new sneakers to two orphanage centers at Monrovia. Majority of the recipients were Ebola orphans. She partnered with the Salvation Army in Georgia, USA, to donate these new sneakers to the children of Liberia.

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• More than 20 boxes of educational toys were distributed to needy children in Liberia

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Challenges

- Reliable transportation to take the missioners to various health facilities caused significant delays for the team. Thanks to the First Lady of Liberia for providing a 32-seater van, but it could not carry the team outside of Monrovia due to mechanical issues. UNICEF was generous to give a jeep to the team. - Accommodation and Feeding for the team were issues. Many of our providers could not rest well at night because the electricity/air conditioning at the hotel was not stable, and would go off in the middle of the night. - Lack of testing kits and anti-malarial medications to test patients who presented malaria symptoms. - Delays in processing temporary licenses for our visiting nurses and doctors to practice in Liberia

Recommendations

These are recommendations for the enhancement of future medical missions and the local operations of Liberia Medical Mission.

➢ Aggressive fundraising – The team needs to embark on significant fundraising efforts to support future medical missions. We have had volunteers that couldn’t go on the mission due to a lack of funding, and we couldn’t attract lots of local healthcare workers due to the voluntary nature of our mission. For LMM to be sustainable, we need to pursue grants in the USA and Liberia.

➢ Secure Warehouse Space in Liberia: The clearance of our medical containers on time has posed some significant challenges for the mission. LMM plans to collaborate with the International Organization for Migration (IOM) and UNICEF-Liberia to use their warehouse for the distribution of donated medical supplies in Liberia. The local coordinating committee, in partnership with UNICEF and IOM, will help clear the container and distribute materials in our absence to facilities already identified. In the future, it is highly recommended that we ship all our supplies two months ahead of the mission and store the needed supplies in the local warehouse

➢ Work schedule on the Ground- The medical team worked on average 12 hrs/day for the duration of the mission. To avoid fatigue and burn-out of team members, we recommend, the two-week schedule be divided amongst team members. (i.e., That is, some members work the first week and the rest the second week, avoid making team members work the entire two weeks if possible. Besides, the weekend must be work-free for the team members to relax and attend to family and other personal issues.

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➢ If the two weeks are equitably distributed between two teams, it is recommended that there be a handoff process between the first and second-team with the specifics of the teamwork, so that they can continue unhindered.

➢ The transfer of knowledge and expertise – All efforts must be made to co- mingle medical practitioners from the Diaspora with home-based health professionals to allow efficient exchange of knowledge, interaction, and working with the local doctors. LMM should hold a periodic online training session During our debriefing with IOM and UNICEF Liberia, LMM recommended suing UN Conference facility for the delivery of online training to healthcare workers. We are hopeful that our international partners will consider our recommendation in that regard.

➢ Medications/Drugs For future medical missions, the medications and drugs to be procured must be limited to the common sicknesses treated and observed during this mission. This process would allow future planners of the mission to request for a large quantity of these medications for the treatment of a more significant population. As such, before each trip, LMM will establish and communicate the focus/scope of each medical mission trip about 6- 8 months in advance. LMM must ship all medications and supplies about a month before the departure of the team for Liberia

➢ Preparation on the ground: The local LMM’s team should work with our partners in Liberia to identify potential healthcare facilities where our team will work and provide services. , and ensure team readiness before the arrival of the mission. This will include accommodation, team meals, transportation, and prospective sites. Efforts should be made to identify local partners that will be interested in implementing this worthy project with LMM.

➢ Issuance of Temporary Licenses to Visiting Doctors and Nurses- The Ministry of Health and Social Welfare, as part of our future collaboration, should waive all fees associated with the issuance of temporary licenses to our volunteer doctors and nurses. LMM will submit the credentials of all medical professionals traveling to Liberia about three months before the arrival of the team. MOH will verify all the credentials and do their due diligence and electronically issue temporary licenses.

➢ Repair of Broken Equipment- The Liberia Medical Mission should work with the local health facilities to identify any broken medical equipment that our biomedical engineer can repair while we are in Liberia. Additionally, our biomedical engineer will organize workshops for potential biomedical technicians that can help fix minor issues on the equipment in the absence of LMM

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Special Thanks to our Partners and Donors

1- Direct Relief 2- Americares 3- Brother’s Brother Foundation 4- Samaritan’s Purse 5- Sea Shipping Lines 6- Surgical Eye Expedition International ( SEE International) 7- Hospital of the University of Pennsylvania (HUP) 8- The Children’s Hospital of Philadelphia (CHOP) 9- Office of the First Lady of Liberia 10- Mr. Amara M. Konneh ( World Bank- Washington, DC) 11- Ministry of Health and Social Welfare, Republic of Liberia 12- Aminata and Sons, Inc (Liberia) 13- Minister Nathaniel McGill (Ministry of State for Presidential Affairs) 14- Professor Wilson K Tarpeh ( Minister of Commerce) 15- Liberia Embassy in Washington, DC 16- International Organization for Migration (IOM)- Liberia 17- United Nations Children’s Fund (UNICEF) Liberia 18- United Nations Refugee Agency (UNHCR)- Liberia 19- APM Terminal (Liberia) 20- Liberia Medical Mission Local Coordinating Committee and volunteers- Liberia 21- Liberia Medical and Dental Council (Liberia) 22- John F Kennedy Memorial Hospital (Liberia 23- National Port Authority of Monrovia (NPA) 24- Abraham Sesay’s Foundation 25- Kido International

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