Liberia's hospital system collapsed during the Ebola epidemic
Dr. Rick Sacra says faith and teamwork make a medical team successful
Editor’s Note: Dr. Rick Sacra is an American Ebola survivor and doctor who works with SIM, a Christian missionary nonprofit that has been bringing medical help to the people of Africa. His home base is the ELWA Hospital in Liberia. He agreed to keep a journal and share it exclusively with CNN to provide a glimpse into life in the heart of what has been the Ebola zone.
Monday morning, February 9, was my last morning at the hospital; in just a few hours I would be headed for the airport.
We held an appreciation program with breakfast for all the ELWA Hospital staff after our morning chapel gathering, to recognize those who had served so courageously during the worst of the Ebola crisis.
Along with Dr. (Jerry) Brown, our medical director, I was asked to say a few words.
As I spoke, thanking our nurses, midwives, aides and cleaners for coming to work during the toughest times in August, September and October, my mind went back to a meeting with health care planners from an international nongovernmental organization.
They wanted to know: “What allowed ELWA to remain open when other hospitals closed?”
The health system collapse was one of the greatest unanticipated consequences of the Ebola epidemic.
It led to many deaths due to malaria or obstructed labor or pneumonia: illnesses that have nothing to do with Ebola, but which went untreated because hospitals and clinics were closed.
ELWA Hospital was one of the bright spots, remaining open and caring for the sick through the most difficult months of the crisis.
Also on Monday morning, we discharged little Noah (not his real name) from the hospital.
Noah, a 5-week-old, had come in about 12 days earlier with severe vomiting. He couldn’t keep anything down.
He was hungry and was breastfeeding vigorously, but after every feeding he would vomit all of it up.
He wasn’t making dirty diapers any more. He had lost weight and become dehydrated.
One of our doctors suggested he might have pyloric stenosis, a thickening of the muscle around the outlet of the stomach into the small intestine, which leads to blockage of the flow of nutrition.
The best test for pyloric stenosis is an ultrasound exam, and I’ve developed reasonable ultrasound skills over many years of scanning and learning on the job. I went to the office and found our big two-volume ultrasound text, and read about pyloric stenosis.
With the ultrasound machine, you can measure the thickness of the muscle in the pyloric canal (the outlet of the stomach) to confirm the diagnosis. As I scanned little Noah, one of my colleagues joked with me about doing the scan with the ultrasound in one hand and my textbook in the other.
I told him this was not the first time I would be doing this, nor would it be the last.
We got some clear images showing that little Noah did indeed have pyloric stenosis and would require surgery.
God has blessed ELWA with some truly gifted staff.
Brown, our medical director, is one of the few residency trained surgeons in the country.
We also have some highly qualified anesthetists, one of whom is especially skilled handling infants. So after coordinating the schedules of all the staff who were needed, the child had a successful operation about four days after admission.
As we monitored Noah through his recovery, I realized we were one of only a few institutions in Liberia that could pull together the resources to successfully diagnose and operate on this little baby.
After the surgery, little Noah improved quickly.
He nursed voraciously and started gaining weight. His mom and dad were so relieved.
Finally, on my last day in the country, he would be going home!
This takes me back to the question that was asked by the visiting international health care coordinators.
After the reopening of the hospital on August 6, how did ELWA manage to stay open when other facilities were having repeated closures?
As I see it, there are two reasons: the first is that our staff are mission driven.
They are motivated by the example of Jesus Christ and his call to care for their neighbors who are in need; their belief in God is no mere intellectual assent or religious ritual, but real, where-the-rubber-meets-the-road faith that strengthened them to do this difficult and fearful work and leave the results to God.
The second answer has to do with little Noah.
When you put all the pieces of the puzzle together, you can accomplish so much more than any one of you could accomplish on your own.
That synergy, the teamwork that results in the ability to give a couple back their baby, who surely would have died otherwise, makes the work so satisfying.
This, too, can motivate people to come to work, when they know they are a critical piece of the puzzle that saves lives.