Embracing the Challenge of Good Data Collection in Post-Conflict Liberia

—Reported from New York by Shannon Egan
18 July 2008

LOFA, Liberia — Dr. Geetor Saydee’s legs were tired, his brow drenched in sweat. He’d been walking for several hours through the dusty streets of Lofa, a county in Liberia’s northern region, to assess the status of the public healthcare system in the wake of the country’s 14-year civil war. But he trudged on, knowing how much was at stake.

Picture above: Survey team member Priya Marwah mapping out logistics with Dr. Geetor Saydee and Dr. Basia Tomczyk Photo: UNFPA

Lofa was a focal point during the war, a place where ritual murder, systematic rape and torture were commonplace. Though the war ended in 2003, clean water and sanitation are still scarce and nearly all basic services, including health facilities, were destroyed and remain in shambles.

The country’s Human Development Report recently concluded that as a result of the conflict, only 5 per cent of the country’s health facilities are still standing. In 2003, fewer than 20 government doctors (out of 400 who were trained before the war) remained in the country.

“It was important to evaluate the reproductive health situations of the women here. What we found was that they have a very low social and economic status, which makes them vulnerable to a variety of things,” said Dr. Saydee, a national consultant for UNFPA, the United Nations Population Fund. Early pregnancy, sexual violence and HIV transmission are among the issues he cited.

In fact, the data he and others collected suggested that “the single most important intervention needed is improved access to and availability of reproductive health services.”

A community effort
The survey was initiated in early 2007, when UNFPA collaborated with the government of Liberia, the US Centres for Disease Control and Prevention (CDC), John Snow, Inc. and USAID to assess post-war reproductive health and recommend improvements. One result was the Women’s Reproductive Health in Liberia; the Lofa County Reproductive Health Survey.

Local NGOs know the culture, which helps them address sensitive reproductive health issues. --Meriwether Beatty

At the beginning of the survey process, the 14-member survey team travelled across rutted roads and thick forests to reach the Lofa districts of Voinjama, Foya, Zorzor and Salayea to explain to village leaders the purpose and procedures of the survey, and to obtain their permission to conduct it. Making sure the communities knew what was going on and trusted the process was critical to the survey’s success.

“The local population was very helpful and cooperative throughout the entire process. They provided accommodation for the survey team and directions to the next selected towns and villages. The local population also assisted in the education and sensitization of the survey,” said Basia Tomczyk, a CDC epidemiologist.

Difficult conditions
However, even with the support from the communities, the team faced many obstacles while attempting to collect the data during January and February. Specific communities were identified to make sure that the data were statistically sound, but many of the vicinities proved too difficult to reach; the CDC had to recalculate sample frames in order to ensure data reliability.

“The biggest challenges were bad roads and inaccessible areas. We spent a lot of time walking. If the villages were too far to reach by foot, we’d have to turn around and find another option. After this survey was conducted, I realized that in order to gather good and genuine data, one has to surpass many challenges,” Priya Marwah of UNFPA’s Humanitarian Response Unit recalls.

Photo to the right: Driving on rugged roads into Lofa County. Photo: UNFPA

It had been nearly ten years since a population-based survey had been produced in Liberia. The lack of information meant that calculating sample frames was difficult since some of the villages and roads listed no longer existed. These obstacles are not uncommon when collecting important data in countries transitioning from the emergency phase of a conflict.

The participants of the survey included some 907 women of reproductive age living in 36 locales, which included both urban and rural areas. They were interviewed by women, many of them locally recruited, who had been trained by the CDC on the survey methodologies and who also spoke the local dialect. Survey team members filled out a questionnaire form for each participant, since many of them did not know how to write. Participants were asked about maternal health practices, knowledge and use of contraception, experiences with sexual violence during and after the recent conflict, and knowledge, attitudes and behaviours related to HIV.

Shocking results
The results of the survey were shocking: 96 per cent had lost shelter due to the war, 90.8 per cent had lost their livelihoods, and 72.8 per cent had lost a family member. More than half of all women in Lofa County were victims of at least one incident of sexual violence during the 1999-2003 conflict.

While 90 per cent of these women were physically abused at least once, almost half of the women reported more than four instances in which they were required to have sex for favours. The data also revealed that 61.5 per cent of women experienced violence at the hands of an intimate partner at some point in their lives.

The women fared slightly better in terms of getting obstetric care, mainly because some were able to obtain services from health facilities and doctors in neighbouring countries. But the survey showed huge gaps in care: more than 75 per cent women of women who had recently given birth had experienced complications during pregnancy, and approximately one fifth of them did not seek medical help. Almost half of all recent births (47.5 per cent) occurred at home, without the assistance of a skilled medical attendant. Other reproductive health indicators showed lack of contraceptive use and lack of skilled medical professionals to assist during delivery.

Forgotten and vulnerable
Ironically, access to reproductive health care often declines after a ceasefire because, once peace is forged, humanitarian agencies often stop providing emergency assistance. Yet in post-conflict settings, broken-down infrastructures and a lack of resources often mean that displaced populations are left to try to reconstruct their communities without the necessary supplies and equipment.

“The survey goal,” according the report, “is to highlight the critical need to continue funding and building programmes during a time when traditional humanitarian aid has ceased and development has not yet begun, leaving the population without essential public health services.”

Photo to the right: Members of the survey team from Liberia being trained on how to interview survey participants. Photo: UNFPA

Because this was the first population-based survey conducted in Liberia since 1999, its findings are critical to moving forward. “The data collected will provide adequate information that can be used in planning and implementing the unmet reproductive health needs, and in assisting the vulnerable population toward viability and sustainability,” Ms. Marwah explained.

This is very important in Lofa, where only 14.5 per cent of respondents showed comprehensive knowledge of prevention and transmission of HIV/AIDS. Safe patterns of sexual behaviour are even less common, according to the survey.

Sharing data to support NGOs
In many crisis-affected regions, local non-governmental organizations (NGOs) provide the only reproductive health services in a community. It is NGOs which are likely to remain long after international relief organizations have left. Therefore, building the capacity of local partners is a crucial step in ensuring sustainable and quality reproductive health services to vulnerable populations.

“Local NGOs are well-suited to provide reproductive health services because they are intimately aware of the needs and priorities of the communities. They also know the culture, which helps them address sensitive reproductive health issues in a way that more effectively engages community members.

Local organizations are often at a disadvantage in their ability to solicit funding. Yet it is these organizations which have the most promise of enduring sustainability,” said Meriwether Beatty of John Snow, Inc., a public health research and consulting firm.

The Lofa County initiative linked population-based data directly to JSI’s Reproductive Health Response in Conflict Capacity Building Programme, which supports and encourages national and local NGOs offering reproductive health services to — or planning to offer reproductive health interventions for — populations affected by conflict.

“For JSI's Capacity Building Program, this was a unique opportunity for our Liberian NGO partners to interact with the research team and to enhance the use of quality data to inform and guide their programmes. The research and implementation teams exchanged perspectives and shared information throughout each stage of the research,” said Molly Fitzgerald, JSI’s Capacity Building Advisor.

For example, even at the data collection stage, JSI met with interviewers to discuss reproductive health from a programmatic standpoint. The research team met later with NGO implementers to “translate” survey findings. Gaps identified through the survey were addressed by ensuring that small grants were available for implementation activities.

Good data can save lives
Three of the four NGOs to receive grants, MERCI, PARACOM and ChildrenSmile, are currently working to address the unmet family planning needs identified in the survey. About a third of married women expressed a need for services, although the contraceptive prevalence rate was reported as 6.8 per cent. The fourth NGO, PMU, is working with the community on obstetric care, so that fewer women die from childbirth-related causes.

“In addition to filling gaps in eproductive health services in a particular area, these NGOs often fill gaps in geographic coverage. For example, ChildrenSmile operates in a remote region of Liberia. It is one of the only reproductive health service providers in the area, and it works closely with county health officials, women's associations, teachers and hospital administrators. They have taken a leadership role in this community, and they have shared the information and resources we gave them,” Mr. Beatty explained.

Although these NGOs are providing desperately needed reproductive health services to communities in Liberia, there are still large populations of women throughout the world dealing with post-conflict issues and the consequences that result from unmet reproductive health needs. Good data is necessary in order to assess what is needed for planning, funding and implementing community-based programmes for humanitarian response and post-crisis settings.

Road building in Liberia: One UN, many new jobs

by Ch. Narendra Publication Date 18/7/2008 9:16:32 PM(IST)

On the new road from Mt. Barclay into Monrovia, Momo and others are digging a path to more jobs, better lives and hopefully, decent work. And along the way, the involvement of other UN agencies in the ILO-led project is showing how “working as one” can help marshal the efforts of a host of participants to speed the process of peaceful recovery.

“My job is to cut the bush on the road”, says Momo Diggs, one of the workers on the project. “With the money I am earning from my job on the road project, I want to support my children and put them in school. When the road opens, people will come from other villages to sell goods on the market. And the small market will become a bigger market.”

The expansion of the markets isn’t the only benefit of the new road. Since the ILO re-launched technical support activities in Liberia in 2006, it has developed numerous partnerships with other UN agencies, including joint studies with FAO, UNDP and UNHCR that focus on agriculture and on youth employment; joint projects with UNDP for the reintegration of ex-combatants and ILO support of the UNDP project for County Support Team to enhance the process of decentralization in Liberia; with UNV to provide volunteer services to support local economic development in Liberia; with UNIFEM to develop a common programme for “gender and employment generation”, contributing to lasting peace.

The new road, and the new approach of the U.N. agencies here, couldn’t come at a more crucial time for the country’s recovery. With almost no electricity, scant running water, an unemployment rate of more than 80 per cent and a life expectancy of 42 years, Liberia faces major challenges to recover.

But things are changing. Since President Ellen Sirleaf Johnson addressed the ILO’s International Labour Conference in June 2006 to call for decent jobs for all Liberians, an overall employment strategy for decent work in Liberia has been formulated by the Government with the assistance of the ILO and was launched in July 2006.

The road construction project is just one of the visible results of the new strategy. Not only does it provide work for local people, but it will serve as a lifeline to improvement of lives both during its construction and thereafter.

“For every job that is created on the road, five jobs are created off the road”, explains Peter Hall Armstrong, ILO project coordinator. What’s more, the labour-intensive road construction project does not only help to rebuild the country’s infrastructure, but also its values system.
“That’s what has been missing over the years because of the war. Just those values, and when people begin to feel good about the work they are doing and actually start taking a sense of pride in it”, says Natty Davis, a representative of the Liberian Government.

Towards a “One United Nations” approach

A full array of multilateral agencies has joined the ILO on the scene, helping in a variety of ways to meet this colossal development challenge. In addition to bringing the farm-to-market and employment objectives, the project has also attracted the skills and perspectives of other multilateral agencies, as well, like UNICEF.

“What’s important about the program that the ILO has encouraged us all to participate in is that it is going to be broad enough and all encompassing enough to allow even young people without basic skills and without basic literacy … to acquire the kind of life skills that will make them ready and able to get a job and to be able to stay in a job or to stay in a decent work opportunity”, says Rozanna Choritan from UNICEF.

In August 2007, the ILO, together with UNDP, assisted the National Commission on Disarmament, Demobilisation, Rehabilitation and Reintegration for ex-combatants to design the final stage of their demobilization and reintegration programme, which is linked to parallel programmes on employment creation.

Thus the road and the other projects bring global issues and perspectives into focus. They integrate policy coherence and program convergence in a very practical and coherent way into country-level agendas.

“It’s about bringing out the best in the multilateral system for those who depend on us for a better future and a better life. It’s about weaving together the many strands of our knowledge and expertise, we can deliver as “One United Nations”, concludes Alfredo Lazarte Hoyle, chief of the ILO Programme on Crisis Response and Reconstruction.

Hello from Liberia!

Mercy Watch

July 2008

Hello Family and Friends,

There are several appropriate greetings you may hear onboard, depending on the crewmember you are speaking with. One would be from our crewmembers who hail from Sierra Leone which would be “How da body?” to which the reply would be “Da body fine”. Another greeting from some of our Liberian crewmembers or friends could be “Are you well?” to which the reply would be “Yes, thank God” or just “Thank God.”

I find myself often asking new crew “Are you well?” and receiving puzzled looks. I suppose I should be asking “How are you?” and expect the reply of “Fine.” One lady actually was a little offended by my request, saying that so many people ask the question, but don’t really want to receive an answer. She wished people would only ask if they had the time and desire to receive the answer. I became more aware of how and when I asked this question and came to realize that at times it was actually used more as a rhetorical question or casual greeting by me.

Today I would really like to ask “How da body?” and pray that you can actually answer “Da body fine…thank God” and if you’d like to dialogue in greater detail, Denise and I are only a phone call or email away.

We had a picnic on the dock for the 4^th of July with our American crewmates…there were just over 100 crew onboard that were American out of about 350 crew members, including the kids. So we took a group picture!

We have been busy transferring and redesigning, uploading our website and this effort has taken up a great deal of our free time. Please visit www.mercywatch.com or http://mercywatch.blogspot.com to see our progress. Consequently we’ve not sent out our newsletters as we would have liked. So please let us take this opportunity to catch up a little.

In our April Newsletter we told you of the screening at SKD stadium. The screening was very successful and there have been many lives touched as a result of the surgeries performed aboard. We are sometimes asked to write about our experiences and this one was selected to be published…after it is edited. The non-edited story we’d like to share with you is of Philip…

We are able to become most involved in the patients onboard through the Adopt-A-Patient program on the ship. Usually this will involve, selecting a patient for adoption during their stay onboard, from a list provided by Hanneke, a mom onboard, who coordinates this effort for the crew. This particular time, we became involved through the local church we attend.

On Sunday, April 14^th, Denise wasn’t feeling well and elected to stay home that morning. This happens infrequently, so I was going to stay home as well. We provide transportation for any crew members who’d like to attend, so I went to check the sign-up sheet. Sure enough one crew member had signed-up to go, so staying home wasn‘t an option. Upon arrival at the church, Sunday school hadn’t finished yet (the adults are taught in the sanctuary) so I was waiting outside. A visiting Pastor arrived and we began a short introduction, she noticed from my name badge I was with Mercy Ships. She wasn‘t from Monrovia and had experienced some difficulty contacting Mercy Ships in regards to her son.

Background: Pastor Nelly Wright, a United Methodist Pastor, had adopted a young boy named Phillip who had a cleft lip and palette and his nose had been eaten away by a bacteria. Phillip had been abandoned by his father, after his mother died as he didn’t have time to raise a cursed child. Cyrus, another older child Pastor Nelly had adopted previously, found Phillip wandering around the streets of Monrovia. Cyrus brought him home asking if Pastor Nelly would adopt him as well and she did. In 2005-2006., Phillip had surgery aboard the Mercy Ship Anastasis to rebuild his nose and correct his cleft lip and palette.

Leading to Current Surgery: When Pastor Nelly arrived to preach at New Georgia and met Rob prior to the service, she saw this as a divine moment. She had been trying to contact Mercy Ships, but wasn’t sure how. They had lost the follow-up appointment card for Phillip. During the several years since Phillip’s surgery onboard the Anastasis, Phillip’s nose had begun to droop a little and looked a little like a pug nose. Pastor Nelly wanted to have a follow-up done on Phillip. We exchanged contact information and I agreed if she would call me at the ship on Monday I would try and be a liaison for her regarding Phillip. The photo to the left is Phillip's picture showing his drooping nose and scars from the previous surgery.

Today was a wonderful day for Phillip and his brother Cyrus and will soon be a wonderful day for their Mother. Cyrus and Phillip came to the ship today as directed by their mother. I met them at the gangway and was a little confused, as I was not expecting them. I was expecting a call, so we could work out further arrangements. I did not want to embarrass or inconvenience or be impolite to Cyrus and Phillip, but was a little lost for what to do at first.

I signed them in as my guest, and took them to Denise’s office and asked if she would sit with them in the Café area while I went to the patient coordinator’s office to try and coordinate this effort. She gladly agreed and I went to find the patient coordinator.

Initially, the patient coordinator was not available, but the crewmember I spoke with went to locate her. In short order, she was located and I explained to her the situation and apologized for the short notice. She understood and was glad and willing to assist. I went back to Cyrus, Phillip and Denise in the café and took them to the waiting area on deck three as instructed. The patient coordinator came and asked Cyrus and Phillip some questions concerning Phillip’s complete name, so she could locate the records of his previous cleft lip and palate surgery.

She was unable to locate the records, but asked Dr. Gary if he could come and speak with Cyrus and Phillip. He agreed, came out and saw Phillip and remembered him from surgery, he thought in 2005 – 2006 timeframe. He briefly examined Phillip and then went with the patient coordinator and checked the surgery schedule and Phillip is scheduled for surgery next week on Tuesday, April 22nd. He will have to come to the ship with Cyrus on Monday for admission and preparations for the surgery on Tuesday. The hospital stay should be five days.

So all in all, God be praised as all of the necessary people were seen, all of the schedules were in order. Obviously Cyrus, Phillip and Pastor Nelly were following the leading of the Lord and were at just the right place at just the right time and everything worked out. The photo to the right show's Phillip two days after this surgery. He is a very happy boy! As a follow up to this story…Phillip had his surgery and he is doing very well, he was able to leave the ship only 2 days after surgery! He is now back in school and doing well.

We are glad to have been used by the Lord, in this instance and see it as an answer to prayer. My younger brother is suffering with terminal cancer. Without the Lord performing a miracle and healing him, my brother will go home soon. We’ve struggled with the decisions as to, are we to go home, or stay. God has shown us very powerfully that He is using us right here, right now. So we are blessed to be used to bring a blessing.

We also like to update you on Rob’s brother, Ken, and his diagnosis of Pancreatic Cancer. Many of you have continued to keep Ken and Kaye constantly covered in prayer since you first heard of his diagnosis. Your prayers are effective and have greatly helped Ken and his wife, Kaye and our entire family during this time. Thank you so much!

Rob was able to fly to Texas June 7^th to spend a week with Ken and Kaye. They prayed together, cried together and laughed together. A heavy burden was lifted from Rob’s heart as he and Ken were able to spend many hours together early in the morning, talking and praying together. Rob came away with a new understanding of the love and dedication Kaye has for her husband and to a small degree the effort it takes each day to live with this illness. Ken and Kaye place their trust firmly in the Lord and are confident He is in control. Ken is doing remarkably well considering his diagnosis. We thank God for His hand working in many ways during this time! We continue to pray for complete healing for Ken. In the photo above is Rob, Connie and Ken (the three siblings) celebrating Ken's 53rd birthday!

The photo above is of twin Cotton Trees we passed on the way to Buchanan, Liberia! These trees were HUGE as you can see by focusing on the people and cars at the base of the trees! Incredible!

Thank you for your prayers and support, receiving your letters is a real blessing. One of the most recent ones from Stewart Hall, Jarrow, England was most uplifting for us. We met and became friends with Stewart while attending Park Methodist Church in Jarrow. We hope to possibly stop over to Jarrow and visit in January 2009 on our return from Christmas vacation in the USA. The plans are still being made so no promises yet, but just a little something we’d love to do. We were most fortunate to worship at Park Methodist Church during our 18 months in England and they made us feel a part of their family.

We thank each of you for touching our lives by sharing yours with us. May you be blessed today and share these blessings with someone else.

God bless you,

Rob and Denise

Denise, Malcolm and Rob

Denise, Malcolm and Rob
Originally uploaded by MercyWatch.

Malcolm Kelly (#12) is a rookie Wide Receiver for the Washington Redskins! He is visiting the M/V Africa Mercy for a few days before his NFL Training Camp begins.

Malcolm decided before he was drafted in the NFL that he wanted to give back and to a charity....so he picked Mercy Ships! He is a great guy and we were able to spend a bit of time with him and his Dad today. His Dad, Moses, came with Malcolm.

Malcolm also brought his trainer, Chip Smith, with him. They will continue to do Malcolm's workouts as he is here. And they will work out with the Liberian Olympic Team athletes. Chip wil also hold some training sessions for the Team's trainers! This is an incredible blessing to them as the trainers really desire to be trained to better prepare the athletes!

It is a joy to have these guys onboard. Thanks... Malcolm Kelly, Chip Smith and Moses Kelly! Watch for Malcolm making some BIG plays for the Redskins! Go SKINS!

Family in June 2008

Family in June 2008
Originally uploaded by MercyWatch

Here's some pics of the family - June 2008 Everyone was having fun as usual and I had asked Rob to take pictures of everyone...since I couldn't go. They did not fully cooperate.. Ha Ha! So here they are! We love them!

(Ryan, Chloie and Averi from Dec 2007) Rob was able to see all of them, but didn't get any pics in June.

Rob, Connie and Ken

Rob, Connie and Ken
Originally uploaded by MercyWatch.

The siblings....Rob, Connie and Ken as they celebrate Ken's 53rd birthday in Abilene, Texas! Rob has just returned this week from visiting with his brother, Ken, in Texas and seeing the family in Florida! He really enjoyed his time with Ken and Kaye and was so happy that he was able to go visit for a short time. Thank you so much for all your prayers for Ken and please continue them as he is receiving chemo on the clinical trials and must be fed through a feeding tube. He has good and bad days. Most days Ken's pain is controlled, however, it is really difficult for Kaye on those days that the pain is not controlled so well. She wants to do something to help, but just can't. She must call the hospice nurse for help.

Angie and Pink

Angie and Pink
Originally uploaded by MercyWatch.

Our good friends, Angie and Pink at their home just north of Dallas. Rob was able to have a short visit with them while back in the US. We appreciate them so much and miss them even more!

2009 - Benin Bound!

Mercy Ships CEO, Sam Smith recently announced that our next field service will be to the Republic of Benin for 10 months beginning in February 2009.

Both Sierra Leone and Benin had been expecting a Field Service, but we can only visit one location and still comply with the programmatic needs of our Team for a 10 month field service. After a thorough analysis, it was determined that Benin offers the best opportunity for maximum success for our Africa Mercy 2009 Field Service. Thankfully, Sierra Leone will continue to receive hope and healing through New Steps and the Mercy Ships West Africa Fistulae Centre in Aberdeen.

Guinea has been selected for our 2010 Africa Mercy field service and we are analyzing other nations for 2011. We are well on our way toward our goal of a three-year deployment plan.

We will continue here in Liberia until December 2008 as we complete our 10 month field service.

Our website is up! Please visit www.mercywatch.com

Mercy Watch

Hello Friends,

As promised, Denise has been working hard on getting the website www.mercywatch.com up and running again. Our initial progress can be seen on the Home Page and on the News Letter Page. The other Menu Links are still under construction. One of the features added to the Home Page is an RSS Feed to our blog. You can click on this link and subscribe by selecting the reader you would like to use. You will automatically receive any updates to our blog. We are blessed to have access to the internet and realize that although it seems slow at times it works and is faster than snail mail.

Thank you for your patience with us as we rebuild.

God's blessings,
Rob and Denise

MercyWatch Update

Mercy Watch

Subscribe Unsubscribe Change E-mail View Archive MercyWatch Update Rob and Denise Miller

Hello Friends,

You may have noticed by now, that when you go to our website www.mercywatch.com you see a page for Lunarpages Web Hosting versus the page you are used to seeing. Since August of 2007 we’ve experienced various challenges with our previous website provider and have made many attempts to resolve them. Unfortunately we were unable to resolve several of the issues. Accordingly, we have elected to move to another provider, which is Lunarpages. Denise is working tirelessly to reload our website, and we are also taking this opportunity to redesign some features. We’ll send out another notice soon, when the website is up and running. Please continue to visit us at http://mercywatch.blogspot.com . We look forward to hearing from you, and hope you’ll like the improvements.

May God bless you abundantly today as you serve Him with your labor.

God’s Blessings,
Rob and Denise

Christian rides the bike on the dock

Christian rides the bike on the dock
Originally uploaded by MercyWatch

Last year, after Christian's surgery in August 2007, he watched the ship's kids riding bicycles on the dock as he looked down from Deck 7 on the Africa Mercy! This year, Christian and his uncle came back to visit and Christian was able to ride one of the bicycles for himself. You may remember the picture of him as Daniel, one of the children on the ship, gave him a ride on the back of the bicycle just before Christian left the ship on his crutches to go home, about 4 weeks after his surgery on his foot.

Christian swinging for the 1st time

Christian swinging for the 1st time
Originally uploaded by MercyWatch

Christian and his uncle came to visit us on the Africa Mercy, here in Monrovia, Liberia. It was so good to see Christian again. His foot is healed up and he is walking, running and playing football (soccer) like a little boy should! We took him up to Deck 7, where we used to sit and look out as he was healing last August (2007) and the deck crew has installed some swings for the kids to play on. Christian was so surprised and wanted to try them out. He had never seen swings before! So, Rob was glad to give him a little push and et him swing!

Medical Screening in Liberia

Mercy Watch

Subscribe    Unsubscribe    Change E-mail    View Archive Medical Screening in Liberia Rob and Denise Miller Apr 14, 2008

Hello Friends and Family!

We will try to catch you up on what has been happening! Our last newsletter in February was just before screening here in Liberia. What a week it was! Screening went VERY well and we really enjoyed the day! Rob served in Security and left the ship at 4:30 am to drive the security team to SK Doe Stadium in Monrovia. Once on site they helped the people waiting in 3 lines to get into 2 lines to go through the entrance to the stadium. When they arrived on site there were already over 500 people waiting. The Liberian people are just incredible. No problems arose and everyone was calm as they learned that everyone would be seen for screening. Rob was stationed at the entrance gate into the stadium grounds and served there all day until about 5:30 pm. Here is a picture of Rob and the potential patients at the gate.

Denise served with the Children's Ministry Team and left the ship at 6:00 am.  We were inside the Stadium grounds by the chairs with the waiting potential patients once they were prescreened and allowed to enter the gate where Rob was.  We helped the patients with their children as they waited and also the patients that were children as their parent waited in line for them.  We colored with them, painted their faces, blew bubbles, made balloon animals, jump roped with them, sang and danced with them.  Basically, we just showed them love and care as they waited!  Basically..we played ALL day!   Oh...I was able to hold babies, too!   Here is a picture of me (Denise) holding Hope...he is a twin about 1 month old and his sister, Joy was held by one of the other children ministers. Their mom is a patient and a Pastor.  Two of her friends came to help with the babies.  The lady who was watching Hope shared him with me and we became friends as we talked and played with the children. 

 

It was such a blessing to be involved with the screening.  It was a very long and hot day, but we so enjoyed interacting with the Liberian people, showing them love and they were so lovely!  Many of them were disfigured with growths or broken bones, cleft palates or club feet.  They waited so patiently and when they were seen and given an appointment card...their faces just lit up so beautifully!    Rob told me afterward of a man named Hindrick.  This man needed help to get into the line and sit as he moved from the outside line to the line of chairs just outside the stadium.  The potential patients waited in these chairs prior to going inside and getting their screening tests and seeing the Doctors and Nurses.  We found out later that one of the photographers had taken a picture of Rob helping Hindrick to the chairs. 

He was weak and not doing very well, as he had been waiting in line for a very long time.  Rob was glad to help him and after his screening was done...he came over to where Rob was at the gate and let him know that he had received an appointment for early May.   Rob said he was beaming and was not needing assistance as his spirits had been revived!   Hope was definitely in the air on screening day!   It was very exciting to be a part of bringing hope to these precious people! 

We'd like to share a prayer need with you...

Rob's brother, Ken, has been diagnosed with Pancreatic Cancer on February 22.  Many of you have been praying for him already and others don't know about this yet.  Thank you for all the prayers and please continue praying for Ken's complete healing.  Ken was unable to have surgery due to the fact that the cancer has spread to his liver.  Tomorrow, Ken and Kaye will drive to Temple, Texas to Scott and White Hospital to see if Ken can enter a Clinical Trial for this cancer.   Kaye (Ken's wife) writes:

4-13-08
 
Crystal and Renee' have been working lots of overtime on many things for their Dad.  This A.M. while I was in Church Renee' called Ken to tell him that he has a Dr. appointment on Tues. at Scott & White in Temple, TX.  This is a miracle because you don't just get to get in to these things at the drop of a hat.  God is at work.
 
Please PRAY that this is from God.  Please everyone PRAY that this will help him.  Also PRAY that this is what God wants us to do now. 
 
I am sorry that I haven't had time to write until now.  I hope to write again as soon as we get back from there, but I don't know if it will be on Tues. night, or sometime Wed.  We may have to stay overnight if we get to tired.
 
Please continue to pray for Ken as we search for help for him.
 
Love and prayers Kaye

Please pray for Ken and Kaye!  We appreciate all your prayers! 

May God bless you abundantly as you trust in Him!  Thank you for your support and love shown to us which helps fill us up and allows us to overflow and show God's love to the precious people of Liberia! 

God's blessings,

Denise and Rob

A little Encouragement

Mercy Watch

Subscribe    Unsubscribe    Change E-mail    View Archive A little Encouragement Rob and Denise Miller Apr 10, 2008

Hello Friends,

We thought maybe you could use a little encouraqement today. This message was an encouragement to us.

The Concert

When the house lights dimmed and the concert was about to begin, the mother returned to her seat and discovered that the child was missing.

Suddenly, the curtains parted and spotlights focused on the impressive Steinway on stage. To her horror, the mother saw her little boy sitting at the keyboard, innocently picking out 'Twinkle, Twinkle Little Star.'

At that moment, the great piano master made his entrance, quickly moved to the piano, and whispered in the boy's ear, 'Don't quit . . . keep playing.'

Then, leaning over, Paderewski reached down with his left hand and began filling in a bass part. Soon his right arm reached around to the other side of the child, and he added a running obbligato.

Together, the old master and the young novice transformed what could have been a frightening situation into a wonderfully creative experience.

The audience was so mesmerized that they couldn't recall what else the great master played. Only the classic, ' Twinkle, Twinkle Little Star.'

Perhaps that's the way it is with God. What we can accomplish on our own is hardly noteworthy. We try our best, but the results aren't always graceful flowing music. However, with the hand of the Master, our life's work can truly be beautiful.

The next time you set out to accomplish great feats, listen carefully. You may hear the voice of the Master, whispering in your ear, 'Don't quit . . .
Keep playing.'

May you feel His arms around you and know that His hands are there, helping you turn your feeble attempts into true masterpieces. Remember, God doesn't seem to call the equipped, rather, He equips the 'called.'

Life is more accurately measured by the lives you touch than by the things you acquire.

May God bless you and be with you always! And remember,

listen for God's voice...

Rob and Denise

A Walk To Beautiful

The other night we were able to see this PBS movie, A Walk to Beautiful. This documentary follows several ladies with a VVF (Vesio-Vaginal Fistula)that was caused by an unsuccessful birth. This is a beautiful movie and very moving. We do this surgery here on the M/V Africa Mercy and also at our Aberdeen Hospital in Freetown, Sierra Leone. We were able to watch this movie, because Dr. Steve, one of our regular VVF surgeons and our VVF Coordinator is here and he brought the movie with him. He has served in Nigeria for several years and also at the hospital in the movie in Ethiopia for 3 years and many other African countries doing this surgery.

Broadcast Premiere

• NOVA on PBS
  May 13, 2008 - Check your local listings or go to pbs.org for details

Liberians are 45% undernourished according to World Food Programme

Click on the headline above to go to the United Nations World Food Program site and read about the critical need for food here in Liberia. Sierra Leone is also in critical need with 50% of the people undernourished.

You can help for free - just a few minutes of your time - visit http://www.freerice.com/ or click on the picture at the right. All you do is answer some vocabulary questions and improve your vocabulary! So play everyday!

Here is the way this works. (Taken from the website for Free Rice)

Who pays for the donated rice?

The rice is paid for by the advertisers whose names you see on the bottom of your vocabulary screen. This is regular advertising for these companies, but it is also something more. Through their advertising at FreeRice, these companies support both learning (free vocabulary for everyone) and reducing hunger (free rice for the hungry). We commend these companies for their participation at FreeRice

If FreeRice has the rice to give, why not give it all away right now?

FreeRice is not sitting on a pile of rice―you are earning it 20 grains at a time. Here is how it works. When you play the game, advertisements appear on the bottom of your screen. The money generated by these advertisements is then used to buy the rice. So by playing, you generate the money that pays for the rice donated to hungry people.

Does FreeRice make any money from this?

No, it does not. FreeRice runs the site at no profit.

President Bush visits Liberia!

President Bush and First Lady Laura Bush walk down from the Liberian Executive Mansion for the Luncheon with Liberian President Ellen Johnson Sirleaf (in a beautiful maroon dress and headdress). These pictures were taken by Solfrid Quist, Africa Mercy Executive Director. Our founders of Mercy Ships, Don and Deyon Stephens and Solfrid were invited by Madame President Ellen Johnson Sirleaf to attend the Luncheon with about 400 others! This was such an honor for Mercy Ships!

Rob at the Medical Screening

DSC_0933
Originally uploaded by MercyWatch.

Rob loved the children at the screening.

We are back in Monrovia, Liberia!

Mercy Watch

View Archive If this link doesn't work for you - please contact us at mercywatch@gmail.com We are back in Monrovia, Liberia! Rob and Denise Miller

Hello Friends,

Just a quick update to let you know what’s been happening! We arrived back in Monrovia, Liberia on Tuesday, 5 February 2008.

Since our departing Monrovia on 30 November 2007, we’ve been busy both on and off of the ship!

When we left Monrovia in November, we sailed for six days to Las Palmas, Gran Canaria prepared for dry-dock. The ship was floated into the dry-dock and the platform raised and in short order we were moving along on rail-road tracks.

It was quite an experience, we wondered if this grand ship which used to carry rail-cars aboard had ever been carried in this fashion before. The scheduled surveys and inspections were performed, the hull cleaned and repainted.

Just prior to the ship completing her dry-dock stay, we flew to St. Augustine, Florida to spend the Christmas and New Years holiday season with our family. This was the first Christmas we had spent in Florida with our family since 2001.

It was a joy to see our sons and their families and be able to spend time with all four grandchildren together! What a blessing!!

We enjoyed waking Christmas morning to the excitement of our youngest grand-daughter, Kendall. Sharing time with our son’s, Jason and Jeff, and their families was an extra special treat that continued through the middle of January.

This is Jeff and his wife, Valerie. It was good to be able to spend time with them! Jeff is working very hard as a new car salesman…so if you need a VW…let us know and we’ll get you connected! Valerie works for a credit card company in customer service. They are busy, busy, busy and still find quality time to spend with Ryan, Chloie and Averi!

This is Jason and his wife, Jill. They told us they enjoyed their time with us…even though we stayed longer than the usual few days! We enjoyed their hospitality and time with them! Jason works for a company that provides Human Resources to businesses and he is doing well. Jill works as a nurse in Labor and Delivery and gets to care for all the Moms and babies!

We had an opportunity to share with our home church, Lake Shore United Methodist Church in Jacksonville, Florida and at New Life Bible Church in Orange City, Florida.

We wore the clothes that our African home church, New Georgia United Methodist Church, blessed us with before we left Liberia. We were privileged to talk about our time serving in Liberia! We are so glad to back serving in Liberia, again!

We met for dinner and had a mini-reunion with some former Caribbean Mercy crew members; Katie, Jeremy and Missy! Tom is serving with us on the Africa Mercy and was also, in Jacksonville. Phil, Tom’s brother is also in the picture.

We flew up to Maryland for several days with Denise’s Dad and good family friend, Vivian, in Rockville, Maryland. It was good to be able to visit with them for a few days.

Dad is doing well and so is Vivian after her surgery early in February 2007.

It snowed twice while we were there…the first time just a dusting and the day we left for Tenerife it snowed about 3-4 inches!

This is a picture from our lunch at the Country Club with Dad, Vivian and Dawn just before leaving for the airport!

Denise’s sister, Dawn, came down from Delaware to see us and take us to the airport in Baltimore to fly back to Santa Cruz de Tenerife to rejoin the ship on 17 January 2008.

During our travels we were blessed to see many of you and yet, there are many friends, we wished we could have seen that we didn’t get to. We intentionally stayed close to home, (our oldest son’s home actually) in St. Augustine, Florida by request of our sons. Previously we’ve tried to travel and see as many people as possible during our month holidays and unfortunately, our sons got to see very little of their parents, even though we where in the United States for a month. So we hope you can appreciate the blessings we received just being Mom and Dad, Grammy and Pappy for a short while. We found it to be a very good and restful time for us personally.

It was great fun and Rob has caught up on his quota of pizza for awhile. Jason was very gracious in honoring his father’s never tiring desire for pizza and allowing Dad to drive the truck to his heart’s content! Jill, our daughter-in-law, couldn’t do enough to try and make our stay pleasant and enjoyable. She succeeded in all departments. We look forward to the time, we can host them (and you) onboard and extend all of the comforts and pleasures of serving and belonging to this wonderful community known as the Africa Mercy.

As we return to Monrovia, Liberia, there have been several crew sessions where we are discussing just that, “returning to Liberia” in an effort to prepare ourselves physically and spiritually. We’ve had a couple months in a culture where prosperity abounds and pleasures of many kinds are available to the crew.

We’ve lived in a nation, the United States and visited Tenerife (Spain) which are ranked as 12^th and 13^th on the 2007/2008 United Nations Human Development Index and are now again in a nation which must improve to even get on the Index! Liberia’s neighbor, Sierra Leone, is known to be the poorest nation at the bottom of the listing at 177^th. The Human Development Index (HDI) is the normalized measure of life expectancy, literacy, education, standard of living, and GDP per capita for countries worldwide.

Liberia has to improve to even be able to measure the statistics in order to be able to be recognized on the Index. And we do see improvement even in just the 2 short months that we were away. This is a picture of the cargo ship that was still mostly under water when we left…now the bow is a float! There will also be a census in March 2008 for the first time since before the war!

We prepare ourselves for the differences we will encounter immediately upon arrival; for some crew the very first time. We know and have seen that Liberia’s life expectancy is only about 40 years. So many die so young here! Many of very treatable illnesses.

The people of Liberia are very lovely and loving people. We look forward to seeing our friends at New Georgia United Methodist Church, and many of our friends that we have come to know and love within the community of Monrovia.

Two of our crew members, who went before us and prepared the way, Keith and Brenda, waived us into the dock. It is so good to see our friends here again! This picture is of Keith and Brenda greeting Oscar carrying the Liberian Flag off the ship (Oscar is our only Liberian Crew Member).

Please pray for these prayer points during this week:

• For our days of screening at SKD Stadium in Monrovia – Monday and Tuesday (February 18^th & 19th)

• During screening – Rob will be driving crew back and forth to the ship beginning at 4:30 AM and Denise will be a co-leader for the patient’s children’s ministry as the patients are seen by the doctors (some of these children may be patients themselves).
  

• For the patients that we are not able to help that God would touch them, heal them and give them comfort and peace, according to His will.
  

• For the patients that we may be able to help that they would come, be patient and calm as we do the appropriate tests, be encouraged and comforted and that they would be able to step out bravely to trust in what God can do through us. (Many of these people have never seen a doctor before)
  

• For all the crew of the Africa Mercy as we reach out to help these precious Liberian people in a tangible and loving way. Protection, perseverance, strength and wisdom.
  

• For the US President, George Bush and the Liberian people as he visits here in Liberia.
  

• For the Liberian President, Madame Ellen Sirleaf-Johnson as she visits the ship on Tuesday during the Civic and Media Reception.
  

• For the receptions this week for Civic and Media and on Wednesday the Pastors and Church Leaders.
  

While we were home, we were blessed in many ways, our strength renewed, our spirits restored and we look forward to this season that the Lord has prepared for us. We thank each of you for your part in God’s plan and enabling us to be your hands, feet and love for the precious people of Liberia. Thank you for sending us, and encouraging us with your prayers and emails. Thank you for sharing your lives with us, through your stories. We love to hear from you! May God bless you abundantly as you trust in Him!

God’s blessings,

Rob and Denise

Mercy Ships, M/V Africa Mercy

Rob, Denise and the Grandkids!

Rob, Denise and the Grandkids!
Originally uploaded by MercyWatch.

If you are wondering where we are.....we're on vacation and enjoying our Grandkids! We'll be back on the ship in just about a week!