Dr. Glick's Final Trip Reflection

Tonight is our final evening in this beautiful and challenging country.

Phebian and Pastor Joshua are two of the most committed and faithful

people I have ever known and I am confident that they will represent

Jericho Road and Jesus with excellence and sacrifice and passion and

integrity here in Sierra Leone. Please keep them in your prayers.

The logistical challenges of launching this work will be daunting. But

God is faithful. And these 10 days in Sierra Leone have been

productive in so many ways. We have actually started doing medical

care. Phebian is now connected in real and tangible ways to people,

NGOs, hospitals, doctors and government officials here in Sierra Leone

who will be able to help and support her and Pastor Joshua in carrying

out this mission. Even today we had an amazing meeting with the wife

of the Vice President of Sierra Leone who seems excited to work with

Phebian and who also opened the door for us to meet the Vice President

and Minister of Health tomorrow. Partly because both the President and

Vice President are originally from Kono District we think they could

be especially helpful to Phebian.

Paul and I have had a great time together. Our friendship has been

strengthened ( except when discussing American politics). He is an

excellent travel companion and has great experience doing these

mission trips. Paul's passion for medical missions and especially for

this work in Sierra Leone are incredibly important to our long term

success here.

Phebian has been a tremendous host. What a wonderful person she is!

Tonight I am excited to come home. To see my extended family at

Jericho Road and especially to see Joyce and Peter and Tommy again! I

commit to doing my very best to help lead Jericho Road both in Buffalo

and in Sierra Leone.

Thanks to each of you have read these emails, passed them on and who

have prayed for us. May God give us all the passion and determination

to carry out this mission.

God Bless. Myron

Spring 2013 Update #8

Tonight I am sitting out on a balcony overlooking the ocean in

Freetown. It is 8 pm and we just arrived back in Freetown after an

encouraging and productive visit to the Kamakwie Wesleyan Mission

Hospital and then a long and dusty 8 hr trip back to Freetown.

First Freetown. What a city! Home to over one million people squeezed

in between the ocean to the west and mountains to the east. There are

people everywhere and one is bombarded by a cacophony of sights,

sounds and smells that I am sure are unique to this city. Horns

beeping constantly, people crowding the narrow streets, motorcycles

everywhere, the smell of open sewage and burning trash and the ocean

all mixing together.

There are no traffic lights, stop signs or markings for pedestrian

crossings. It looks to me like a free for all. Tomorrow we will

navigate this city with Phebian and Pastor Joshua hoping to tour the

government hospital, visit the vice president, connect with our bank

and meet with the Christian Health Association of Sierra Leone. It

should be a fun day.

Last night and then this morning we stayed at the Wesleyan Mission

Hospital in northern Sierra Leone in a village called Kamakwie. We had

a worthwhile and productive visit. This mission hospital was founded

54 years ago by Wesleyan missionaries from the USA. In fact we saw a

plaque today of the opening dedication of the hospital and Dr. Warren

Woolsey ( well known and beloved Houghton College emeritus professor)

was one of the speakers 54 yrs ago! This hospital was primarily funded

and staffed by American missionaries for the first 30 years but over

the past 20 years and especially since the war it has transitioned to

now being owned by the Sierra Leonian Wesleyan church and today is

100% self sustaining. There is only one American missionary remaining

and she is a nurse practitioner and midwife. But the faithfulness of

those early medical missionaries lives on today through this hospital

We were much encouraged by this hospital. Compared to the district

government hospital in Koidu this hospital seems functional. They have

X-ray machine, sonogram, 24/7 electricity, two OR theaters that are

air conditioned and a dental suite and someone who can do eyeglasses.

They have some creative community based programs including a feeding

clinic for malnourished children, a microenterprise loan program for

women and a fulltime Chaplain. Like all the hospitals here their

biggest ward is for kids. Kids die to often in Sierra Leone.

In this hospital they do not presently have any doctors but instead

they have 4 RN nurses who act as the surgeons doing c-sections, hernia

repairs and emergency abdominal laparotomies. And they seem excellent

and well trained. This region has the lowest maternal mortality rates

in the country and the HIV rates here are 2% compared to Kono where is

20-30%. They also see very few cases of measles. The main killer still

is malaria

Phebian made some good connections. She will come back to this

hospital later this year for an extended period to get further

training.

Finally a word about sustainability. Obviously we will need to raise

money in USA to build the clinic, support Phebian and for initial

operating costs. This is our primary task now. But being here, seeing

Phebian work, visiting the mission hospital give me great hope that

within 5-10 years our medical work will be self sustaining. This is

our goal. Here is how I think it can happen...

1. Like the mission hospital ( and like JRFP in Buffalo) Phebian will

charge people for the care she provides. In fact this week she charged

most of the pts we saw a small fee to be seen. We collected $295 US

dollars for seeing over 300 people. In Buffalo this does not seem like

much money but here it is something. Now Phebian will buy more

medicines to replenish her stock and thus already there is a self

sustaining component to our work. Charging the patient is the primary

way the mission hospital at Kamakwie sustains itself.

2. Build a working relationship with the government medical system. At

the government hospital malaria meds are free to kids. We are hoping

they will include our work as an approved site and give us free

malaria meds.

3. Build working relationships with NGOs working in Sierra Leone

already. World Vision has a base in Koidu. They may be able to help us

with certain meds and also help us with health education, training and

other community development programs. Samaritans Purse sometimes sends

a free container of medical supplies to the Wesleyan Mission Hospital.

We will contact them. We also are connecting with the Christian Health

Association of Sierra Leone to see how they can support Phebian

4. Invest in infrastructure that lowers operating costs. Last summer

the mission hospital installed a solar panel electrical system( the

sun is one of this countries most consistent resources) and as a

result they have decreased their use of diesel fuel from 160 gallons

per month to 60 gallons and now have 24/7 electricity for their

hospital. This is good for the environment and good for budget.

5. Finally the mission hospital is building a solar powered water

purification system that will allow them to generate clean water for

themselves and also to sell water and ice to the community. This would

be a great project to invest in at our clinic providing clean water

and jobs and an income for our medical work.

One more point that I failed to mention earlier and

will be most appreciated by the JRFP folks who are

reading these emails. In my opinion if nurses in Sierra Leone are

doing c-sections with excellence then surely our well trained and

exceptional medical assistants in Buffalo (Nigesse, Aester, Han Moe,

Melissa and Aung) should be able to give kids shots. I am worried that

when I return to Buffalo I will be a terrible medical director who

will no longer care passionately (as you all know I did) about

meaningful use measures, HIPAA regulations, medical liability issues

or FQHC policies. Maybe you guys should just fire me now to be safe.

But I do promise to continue to lead Jericho Road towards caring for

the "least of these" in Buffalo and now in Sierra Leone and hopefully

someday in countries like Congo and Sudan. To demonstrate the love of

Jesus through word and deed to those Jesus loves the most.

Our team is well. It will be great to come home. Pray for Phebian who

misses her family terribly but is so committed to this mission

God Bless. Myron

Spring 2013 Update #7

"What manner of man is Jesus? Alleluia. He made the blind to see. Alleluia."

This morning we started our day at the land that Jericho Road was
given in Koidu and upon which the clinic will be built. It is a
beautiful site on a hill overlooking a lush valley, various houses, a
soccer field and in the distance the mountains. It is plenty big for
the clinic. Today we had a groundbreaking ceremony and Phebian , Paul,
myself and the Chief each laid a ceremonial block and Paul and I each
planted a fruit tree. The most moving part of the ceremony for me was
having about 30 kids from the nearby School for the Blind sing a song
about Jesus healing the blind. The faith of these people of Kono
district who have suffered so much is incredibly inspiring to me.

Today we completed our final of 6 clinics. This clinic was right here

in Koidu where Phebian lives and we set up in the Blind School. We saw

60 people.

So many of the children I saw today were suffering from malnutrition.

Orange tinted hair and pot bellies are classic medical signs of
Kwashiorkor malnutrition. The children mostly are eating rice and very
little meat or other sources of protein. We saw less of this in the 4
outlying villages because in those villages the people are farmers and
so can raise peanuts and beans and catch fish and other sources of
protein but here in Koidu the kids are mostly eating rice. It is
painful to see. The last time I saw this type of malnourished little
children was in 2004 in Buffalo when the Somali Bantu refugees started
to arrive from the refugee camps. Improving the nutrition status of
these children will need to be a big priority for us. I know never to
take the WIC program for granted again.

Today an elderly woman was carried in to see me by her two sons. She
had a stroke paralyzing her right side and rendering her unable to
speak one month ago but the family did not take her to the hospital.
Instead they tried various treatments on their own. Today was the
first she had seen a medical person. Her BP was 300/130! What do you
do about that?? We started her on BP medication and thankfully Phebian
will be here when we leave and will be able to follow up.

So we have seen over 300 people this week in 4 villages and in Koidu.
Our medications have been more than sufficient. We have seen and
learned so much. We have kept good records by keeping a list of each
person seen with their diagnosis and age (no addresses here, no HIPAA
forms to sign, no medicaid insurance cards to copy) and also writing a
brief medical note on each person. Now Phebian can f/u up with folks
who need it in each village and this will give her a wonderful
opportunity to build relationships.

Tomorrow we leave Koidu. (if Joyce and kids were here I would be
tempted to stay. Jericho Road in Buffalo has 11 other providers. This
whole entire part of country has 2 doctors. There is so much more to
do). We will travel about 8 hrs (132 miles ) tomorrow to visit the
Wesleyan Mission Hospital in northern part of country. We intend to
see if this hospital can help Phebian in any way and just continue to
ask alot of questions about medical care and resources in this
country. Then on Monday we will have another 8 hr trip back to
Freetown. In Freetown we hope to meet with the President of Sierra
Leone and visit the government hospital in Freetown. Then on Wednesday
we leave for home in Buffalo.

Our team is doing well. Keep us in your prayers. I trust all of you
are well. I am praying for our Jericho Road team in Buffalo. Thanks to
all of you for letting Paul and I have this chance to come and for
covering in our absence. Your support of Phebian and this mission has
made a huge difference. Because of all of our faithfulness and Gods
faithfulness Jericho Road has now been planted in the Kono District of
Sierra Leone. That is pretty amazing.

God Bless. Myron

Spring 2013 Update #6

Our team had a busy and tiring clinic today in the village of Tombodo.

We saw 70 people. Finished in the dark using flashlights again. The

highlight for us was one elder of the village saying that "before you

came with only words but today you come with medicines and I am so

happy. I know you will come back now"

When we started this week I was not sure how long our medication

supply would last but we prayed at the beginning that it would be like

the story in the Bible of the poor widow who had only one jar of oil

but God blessed her and she kept pouring oil out of that jar until she

and her family survived the famine. We have experienced something like

this. Our medication supply is still robust and plentiful despite 5

village clinics. We are thankful.

Tomorrow at 10 am we are having a groundbreaking ceremony for the

medical clinic on our land here in Koidu( though we will not proceed

with actual construction until we have raised enough money to assure

completion of project) Then at 11 am we will do an all day clinic

right here in Koidu, Phebian’s home town, and I am sure we will be busy

and a long day.

One of the most disconcerting things we have seen this week has been

men with very large inguinal hernias who somehow keep living and

working with the hernia because they cannot afford to pay for the

surgery. These are mine workers and bush farmers who have done heavy

lifting their entire lives. The hernias are painful us to witness let

alone the person who has to suffer for years with it. We have kept

meticulous records of each pt we have seen this week, including all

the hernia pts. Phebian has a list of 15 men with large hernias and

today we discussed the situation with the two doctors at the district

hospital and they have agreed to work with Phebian to get each of

these hernias repaired. Each hernia operation costs about $50. Phebian

will bring the men in to hospital for consultation and then work with

each one to see what they can afford and then help as needed and make

sure the hospital keeps its word. This will be a great way to build

real relationship between Phebian and the hospital and to show the

villages that we care.

Our team is doing well. Paul and Phebian are excellent to work with.

It is a real blessing to see this vision finally begin to be realized.

Please continue to pray for us.

God Bless. Myron

Spring 2013 Update #5

This evening for about 10 minutes Paul and I got a glimpse of what it

is like to live in Koidu. Our clinic finished much earlier today and

so we decided to play soccer with the village team again( Paul was

goalie!). Before the game I put both our eyeglasses in the jeep. After

the game on our way back to Phebian's house I suddenly realized we did

not have our glasses and we could not find them anywhere. The prospect

of spending the next week without glasses was pretty scary. We drove

back to the field and luckily they were both lying along side the

dusty road still intact and we could see again.

But all week I have not seen one patient who wears glasses and plenty

have c/o of poor vision and on exam had cataracts or simply needed a

pair of glasses. But for the people of Koidu they would need to travel

6-7 hrs to see eye doctor and it would be cost prohibitive for most.

So they gradually become blind.

This morning on our way to Woama village for our clinic we drove right

alongside the infamous Koidu diamond mine. It is several hundred acres

enclosed by a tall stone fence with electric wires on top and armed

guards patrolling all entrances. During the war rebels from Liberia

took over the mine and sold "conflict diamonds" to finance their

terror. Eventually the rebels were defeated and the mine is now back

under operation by a South African owned company. Even though some

people from Koidu get jobs at the mine and the government of Sierra

Leone gets a share of the profit it is quite clear that little of the

diamond money is benefiting this community. So in a town where we

could not even find a single thermometer to buy  (ours are on the crate

which we last heard is still weeks away ) diamonds are being produced

to sell all over the world. I for one get nauseated at the idea of

ever buying a diamond again.

At our clinic today we received word that a man in another village

close by had fell out of a coconut tree and was hurting bad and could

we help? So since there is only one "ambulance" in all of Kono

district we sent one of our team to get him and bring him in. On exam

it was clear he had a broken wrist( although the nearest X-ray is a

days journey away) and we did not bring splints or casting material.

But we ended up creating a quite beautiful splint using what material

we did have and I think he will heal fine.

I also saw two people with seizures today. One woman told us she has

had the seizures from a child and had always been told it was from an

evil spirit. The other was a 7 yr old boy whose mom brought him in

saying he is always wetting himself and shaking. Luckily when I put

him on the exam table he had a seizure and urinated on himself while

Phebian and I were in the room watching so we know the diagnosis.

Unfortunately we did not bring seizure meds but we will find some and

these two pts will be someone Phebian will be visiting regularly in

the future.

It is great to know that Phebian will be continuing to visit these

villages. We have a whole list of pts she will follow. She is doing

great clinically. Her and I are working together and I am trying to

teach her everything I know. Yesterday someone walked in with a BP of

180/130 and rapid heart rate and just by observing and examining the

pt she identified hyperthyroidism ( bulging eyes and neck mass) and

congestive heart failure( edema and crackles) and chose the right

medication!

Our team is doing great. The Sierra Leonian members of our team are

amazing people. In spite of their lack of money and things we take for

granted they are so giving, faithful to God, fun to be with and hard

workers. It is humbling to be in their presence. Phebian is taking

great care of us. Tomorrow her sister is washing my clothes the old

fashioned way by hand. No washing machines here.

Because of Phebian’s faithfulness Jericho Road is now demonstrating the

love of Jesus through word and deed to the people of Kono District.

This project will make an incredible difference.

Thanks for your prayers and thank you for supporting this new mission

of Jericho Road.

God Bless. Myron