Nurses of the Nations

By Mary McMahon, RN, M.B.A., MS BSN, Co – Authors: Vicki Agyekum RN MSN, Rhonda Brown RN, Justin Taylor, Nursing Student, UAP

Nurses for the Nations (N4N) just recently returned from Liberia’s six African town-villages: Loon, Kama, Garpeh, Duo, Biogar and Gblenyouway to complete Phase II of the project to establish malaria-free zones with the villagers and village-towns located in the rural areas of Monserrado County, outside the capital city of Monrovia. The project was made possible through donations which were funded and used for 100% of the project.

Entering Village at commencement of the project is N4N RN team members, Rhonda Brown RN, Vicki Agyekum RN, MSN and Liberian RN, Deddeh Darwolor (kneeling)

 

 

 

  

Nurses for the Nations supports the United Nations Millennium Development Goals to combat HIV/AIDS, malaria and other diseases, improve maternal health, empower women, reduce child mortality, teach, educate and eradicate extreme hunger and poverty. Specifically, N4N acknowledges the need to focus on issues with the sick and globally underserved at the participatory level in local villages where health concerns occur from lack of information and sound health practices, obsolete care or lack of available resources to produce sustainable outcomes. Nurses for the Nations utilizes evidenced-based nursing practices, delivering compassionate care and treatment of the whole person: the physical, mental, emotional, and spiritual sum of the parts equaling the whole.

N4N left for Liberia January 26^th, 2010 and returned to the United States on February 6^th.  The team worked in partnership with the Florence Nightingale Institute of Health Sciences: by providing teaching, training, testing for malaria and emphasizing concrete steps through education, to prevent future malaria outbreaks. The project was the springboard to establish malaria-free zones in the six village regions and beyond for the local villagers. It also was the stepping-stone to provide a sustainable malaria-free prevention  health-model for future surrounding villages.

Mary McMahon RN, M.B.A, MS, N4N team leader organizing assessment table for commencement of project

 

 

 

 

 

The team consisted of eight members and six village leaders: N4N’s medical team (Vicki Agyekum RN, Rhonda Brown RN, Mary McMahon RN, and Justin Taylor, Nursing Student-unlicensed ancillary personnel (UAP), and Liberian’s Medical and UAP Team, (Administrator Hope K. Agbeko, Pastor/Counselor, Deddeh Darwolor RN, Samuel S. Gbor Jr., UAP from the Florence Nightingale Institute of Health Science (FNIHS) and Quasi-Nurse Program FNIHS representative and Administrator, Nora Mangou.

Pictured here, three of the N4N Team members. Vicki Agyekum RN, MSN, Rhonda Brown RN and Justin Taylor, Nursing student, Unlicensed Assistive Personnel, (UAP)

 

 

 

 

In addition, six village leaders (Mensa Thompson, Emmanuel Williams, Tay.Her.Sins, Siatta Gibbah, Munnie Pitman and Jessie Harris) and their representatives were involved in the project. The village leaders were instrumental in organizing village participation and assisted in streamlining the villagers for testing and health assessments. They also helped distribute N4N patient numbered armbands at the beginning of the project with each of the villagers for identification purposes with testing, assessment, distribution of health improvement packages and mosquito-nets. N4N offered teaching, testing, training, education and distribution of insecticide-treated nets (ITN’s), over the counter medications (OTC’s) to help with colds, coughs, relief from worm and parasite infestation and health-improvement packages (HIP), consisting of wash cloths, brushes, toothpaste, toothbrushes, plastic utensils, cups, soap and other hygienic articles including children’s clothing to the villagers. N4N also gave out donated toys to the children who required malaria testing.

Villagers, waiting to be tested for malaria

 

 

 

 

 

 

Six village leaders who participated in the N4N project. In this picture, they are getting ready to recieve the garden tools from N4N. Right hand corner, is Village Chieftan and Elder

 

 

 

 

The Florence Nightingale Team and village leaders worked in conjunction with N4N to support village organization, malaria testing (Liberian RN), HIP package distribution, N4N’s net distribution (ITN’s) and counseling (emotional and spiritual support) for the villagers during the team project. The project was the first ‘combined’ hands-on N4N international effort at the indigenous level where both United States and Liberian health team members coordinated and co-partnered with the planning and execution effort to eradicate malaria and establish a village-model as the ground-work for the six villages to remain malaria-free.

 

Deddeh Darwolor RN, Samuel S. Gbor Jr., UAP from the Florence Nightingale Institute of Health Science (FNIHS) partnering with the N4N team

 

 

 

The N4N team presented the six village leaders with tools for planting vegetable gardens and directions to begin construction of latrines. The village leaders named their future gardens for each of the six villages: Garden of Hope, Garden of Unity, Garden of Love, Garden of God Be with Us, Garden of God Is Able, and the Garden of God Will Make It. Water of Life is continuing to work with three of the villages for installation of fresh water pumps and wells.

Tools for planting vegetable gardens and construction of latrines for digging

 

 

 

 

 

Mensa Thompson, African team leader of Gblenyouway village-town, will be working with the villagers to establish the first latrine. Continued donations and financial support to N4N will help complete this project portion for the final construction. The overall objectives of the project were deemed a success by the FNIHS, village leaders and N4N. N4N’s objectives for Phase II were satisfied by all team members and village leaders.

Teaching and Training of the Villagers

Picture illustrations were utilized for majority of teaching sessions to emphasize the causes, treatment and prevention of malaria. Open discussion and question and answer periods helped villagers clearly understand the N4N lesson material. The N4N nursing team requested the villagers to give a verbal return demonstration of the information and instruction about malaria which reinforced their understanding of the disease and its causes. In addition, the N4N nurses and Liberian team demonstrated how to hang a mosquito net and reinforced its proper usage.

Teaching and Training Analysis:               

-There appeared to be no correlation at the ‘village level’ between the use of mosquito-nets for protection and the mosquito as the cause of malaria

-When asked about the cause of malaria, the villagers were unable to answer the question

-The N4N team discovered one old mosquito net in the village premises during the project; however, it appeared to be used for alternative purposes

 -The villagers were surprised that the ‘mosquito’ and its bite caused malaria

-Most of the villagers in the project stated that they and their children had contracted malaria in the past (based on self-diagnosis-see statistics).

-The villagers correlated only signs and symptoms of chills and feeling ‘hot’ to the touch as indications with having the disease

 

-Villagers admitted to cutting up prior nets and using them to wash and clean with, fish and perform other purposes with them. They also reported in the past of being afraid to sleep under them

-The N4N Team discussed environmental factors and instructed the villagers to begin filling in water holes, clean up garbage areas and avoid urinating/defecating in areas near the main village, using common ‘relief’ areas in designated locations until they could begin construction of the latrines

-Six tools for garden and latrine building were distributed to each of the six village leaders for the villagers to prepare their community gardens and help them with latrine digging and construction. Additional picture instructions on latrine building in addition to discussions and advice about vegetable planting were given to the six leaders.

-All villagers receiving numbered armbands were tested. Additional ‘late arrivals’ were also tested until all test kits were exhausted.

-Malaria infestation was noted in the village population during the assessment and testing phase (see statistics). Positive test results correlated with signs and symptoms of headache, jaundiced sclera, profuse sweating, irritability, aches and pains, weakness and fever. Pregnant women who tested positive (1) had to be referred to a local free-clinic for advice regarding treatment. She was in the first trimester of pregnancy. Her young child also tested positive.

Mary McMahon, RN Team Leader assessing young mother before malaria testing

 

 

 

 

 

Testing stations for Malaria

 

 

 

 

 

          

 

Forming lines at the Malaria stations

 

 

 

 

 

 

 

Common complaints and observations reported and assessed during malaria health assessment: 

-Stomach pains

-Generalized body aches and pains

-Worms in bowel movements

-Skin disorders

-Sore throats, runny noses, cough

-Vomiting and feelings of being too hot or very cold

-Sweating (profuse to mild)

-Large percentage of umbilical hernia’s with children and one large umbilical hernia with one male adult

-Undescended testes-per mother’s request-the nurse examined her young ten year old male child she was concerned about (the mother stated to the nursing assessment team he would not be able to have children in his later years). The Liberian male UAP was present during the exam and assisted the nurse with the child. The male child needed surgery and mother was advised to initiate contact with a local free clinic for further follow-up to a hospital for corrective surgery

-Abscesses (major pus infections) in the inner ears (two-male children)

-Urinary incontinence

-Body rashes

-Blood in the stool

-Diarrhea

-Enlarged liver’s with many of the male adult villagers

-Admission of ‘drinking’ alcohol in excess

-Jaundiced sclera (prevalent with over 80% of the villagers)

-One large leg ulceration

 Severe leg ulcer which was covered in dirt and filth before cleansing and treatment

 

 

 

 

 

 

Final Statistics:

-419 villagers or 95% of the total number of villagers in real time (440) were present for N4N teaching, training, education and testing portion during the project. Village leaders were also tested but excluded from the above numbers-categorized as leaders and facilitators

-83% of the total number of participants stated they had malaria in the past (self-diagnosis)

-Twenty-seven villagers tested positive for malaria or 7% (seven-percent) of the participants (30% were under the age of 5 while 70% were over five and under 52 years of age)

-A total of 258 ITN’s were distributed to village families. Villagers were instructed about net usage and were instructed by the Liberian team that follow-up would be performed after the N4N Team left Liberia to ensure nets were not sold or misused

-Village homes were inspected by the N4N Team on day seven of the project, to ensure nets were up and being utilized (see pictures)

-Village leaders were trained in basic health relief with accurate return verbal demonstration and understanding of instruction to support villagers with relief of common colds, aches and pains

-Villagers visited the counseling and spiritual support station for advice, coaching and assistance with emotional, family and spiritual issues

-Three major free-clinics were visited and given antibiotics, malaria medications, cough and fever medications and skin creams before the N4N team left Liberia

-Additional malaria test-kits needed to be purchased from a Liberian pharmacy for completion of village testing

Nurses for the Nations would like to publicly thank our benefactors and private donators for their financial generosity, our N4N project team members, Nora Mangou, Administrator for the FNIHS, Hope Abegko, Pastor and Counselor, the Liberian nursing and UAP team, MAP International for our supplies, insecticide treated nets (ITN’s) and medications, Water of Life for their continued work with well and fresh water installation, the N4N Phase II nursing planning team and all of the members of the Nurses for the Nations Board of Directors and Advisors, family, colleagues and dear friends. Your help and support has not only made this project a success but your commitment in time, service and money is allowing us to bring physical, emotional, mental, spiritual and environmental care to the under-served in Africa.

This was how your monetary and goodwill donations were used for Phase II of N4N’s project. We were able to:

-Provide four N4N team members for the hands-on project

-Provide malaria testing

 

 

 

 

 

 

 

 

-Provide health assessments and nursing treatments

 

 

 

 

 

 

 

 

-Provide teaching and training about malaria to the villagers

 

  

 

 

 

 

 

 

 -Provide education to the village leaders

 

 

 

 

 

 

 

 

-Provide counseling and spiritual support individually at the specific N4N station and collectively for the village group

 

 

 

 

 

 

 

 

 

-Provide insecticide-treated nets

 

 

 

 

 

 

 

 

-Provide health-improvement packages for the village families (wash-cloths, brushes, toothpaste, cups, soap, sanitary items for women, deodorant, plastic utensils, etc.)

 

 

 

 

 

 

 

 

-Provide donated toys for the children

 

 

 

 

 

 

 

 

 -Provide OTC’s for common ailments (colds, runny noses, minor aches and pains, flu-like symptoms)

 

 

 

 

 

 

 

 

-Provide relief from worm and parasite infestation

 

 

 

 

 

 

 

 

-Provide six tools for garden and latrine construction for each of the village leaders for their villagers

 

 

 

 

 

 

 

 

 

-Provide latrine instruction

 

 

 

 

 

 

 

 

 

 

-Provide three free-clinics in Monserrado county with malaria medications (ACT-combination Artesunate 50mg and Amodiaquine 153 mg both adult and children blister pack doses), antibiotics, worm and parasite medication and over-the-counter preparations before the N4N team left the country

 

-Cement health partnerships, promoting physical, spiritual and environmental models of care through teaching, education, training and treatment of the disease malaria

 

 

 

 

 

 

 

 

Nurses for the Nations has commenced with Phase III of its Project to erect a ‘Life Treatment Center’ to assist and treat more remote villagers and villages by providing  treatment, teaching, training and holistic support with Malaria and other diseases outside the Paynesville City area in Liberia. News about the Project, called ‘Partnership’s for Health’ will be forthcoming soon!

 The result of your generosity and support:

 

 

 

 Nets in the village homes are up

 

 

     

 

 

 ITN’s are being used

  

This entry was posted on Friday, February 19th, 2010 at 2:42 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.