Mission of ‘Mercy’: Professor takes sonography expertise, spirit of service into African Congo

Jul 23, 2014 by

When sonography department chair Pamela Brower traveled to the African Congo with Mercy Ships last year, 15 Congolese physicians were invited to attend her lectures and demonstrations during her weeklong stay.

On the first day, 35 doctors showed up.

“They couldn’t get enough,” Brower said. “We had to walk away. They just absorbed everything that we had to give. It was so rewarding.”

Lindale-based Mercy Ships runs the largest non-profit hospital ship in the world. Their mission is to bring “hope and healing” to poverty-stricken areas in western Africa.

Those missions of hope and healing often happen on the ship, Africa Mercy, where surgeons work in five operating rooms, and patients recover in 82 beds.

Brower’s mission, though, was one of education. She was accompanied by Dr. Robert Harris, a radiologist from Dartmouth College, to teach diagnostic medicine in the field. Between them, Brower and “Dr. Bob” taught lectures in the morning and scanned patients with ultrasound machines in the afternoon.

Pamela Brower, TJC diagnostic medical sonography chair and professor, spent a week in Africa, to help train Congolese physicians and medical personnel on sonography techniques. Brower (left) is pictured with Dr. Françoise Ngindga Andely Loandjili, director of General Hospital in Pointe-Noire.

Pamela Brower, TJC diagnostic medical sonography chair and professor, spent a week in Africa, to help train Congolese physicians and medical personnel on sonography techniques. Brower (left) is pictured with Dr. Françoise Ngindga Andely Loandjili, director of General Hospital in Pointe-Noire.

“Part of my mission was to go and assess the equipment,” Brower said, referring to their ultrasound machines. “Their equipment is OK. They need better equipment, but they also need funding.”

Brower said she helped them adjust the way they scan, and what she calls “knobology” – what knobs to turn and what not to turn.

“It’s unfortunate they don’t have anything better.”

As far as equipment is concerned, ultrasound machines are an appropriate technology for diagnosing in Africa and low-resource settings because some of the other equipment is harder to maintain. Sonography equipment is getting lighter and more portable for field use, and its ability to scan any body part – not just pregnancies – makes it versatile.

Michelle Bullington, the programs design director for Mercy Ships, said the goal is not to give them equipment but to give doctors in poorer countries the ability to more effectively treat patients.

“We ask ourselves, ‘How can we improve the system that’s there?’ The main component of that is education and providing that training,” Bullington said. “We are looking at how we can couple supplies and equipment in a way that doesn’t create a dependency.”

That’s where the importance of education comes in – teaching a man to fish rather than giving him a fish. Many of the doctors in the Congo are self-taught, and many know multiple disciplines but were eager to learn more.

“The difference is that they don’t have sonographers there,” Brower said. “The physicians are doing it themselves. We have the luxury of having technicians here to specialize in ultrasound. It’s almost sad because they’re doing everything, even drawing patients’ blood themselves.”

To make matters even more difficult, many of the doctors from that region of Africa don’t practice medicine in Africa but rather in more developed countries. At least 42 percent of African-born physicians work in the United States or Europe – most citing educational reasons for leaving their home country.

Pam Brower performs an ultrasound scan of a patient’s carotid artery as physicans and medical students observe.

Pam Brower performs an ultrasound scan of a patient’s carotid artery as physicans and medical students observe.

To address this problem, Mercy Ships develops educational programs that are built on reinforcing, and in some cases retraining, local doctors on proper methods, which is where Brower’s ultrasound expertise fits in.

But this isn’t Brower’s first time in the field. She’s been to Haiti twice since the earthquake in 2010, when Mercy Ships was involved in the reconstruction process.

She says the medical needs of impoverished nations rest heavily on environmental factors.

“Here in America we die of cancer, heart disease, stroke. There, they die of malnourishment, diarrhea – mostly environmental diseases. They have elements that they can’t control,” Brower said.

“I’ve been doing education for 17 years,” Brower said. “I felt like it was time I could give back. To me it was all about timing and the opportunity to give unconditionally.”

When Mercy Ships pulled out of Haiti, Brower wrote a letter to anyone she could in the organization asking why they were leaving.

“We told her ‘we might have something else for you to do’,” Bullington said.

“Mark (Thompson, vice president of Mercy Ships) said there was a possibility they would implement ultrasound education at Mercy Ships in Africa,” Brower said. “Not being a nurse, it’s hard to donate time for what I do because it’s such a specialized skill, but I would have done anything.

“To me it was just kind of a God thing that it all worked out.”

Patient care

Brower and Dr. Harris dealt with a number of illnesses and treated a variety of diseases while the students watched closely.

“We were scanning patients and this gentleman came up. He had a huge, swollen knee and wanted us to scan,” she said. “The students wanted us to drain the fluid and demonstrate the technique. We went to the hospital and set him up, and with ultrasound we guided the needle.”

Brower said the man had been hit by a car the week prior, and he most likely would not have ever had the knee treated unless Mercy Ships surgeons were there.

“Immediately he felt better, and it was great to apply what we had been teaching and show it in ultrasound,” Brower said. “The doctors that were there just hovered over you. It’s a small room and they’re very excited.

“It was neat to have that closed loop and apply what they’ve learned.”

The one thing Brower emphasizes the most is patient care and bedside manner.

“I talk more about patient care and to love and touch your patients,” she said.

“What I tried to tell the doctors who were with us, is that it wasn’t a patient, it was a person. I would make sure they were comfortable. It’s so important to me that they see passion in patient care.”

“Patient Passion,” as Brower calls it, can be difficult in the Congo. The training and patient service levels are simply not as well established as they are in the West.

The Mercy Ships volunteers pose for a last-day photo with African physicians and medical students. Pam Brower (standing, third from left) shared lecture and training duties with radiologist Dr. Bob Harris (standing, in blue scrubs). Harris is professor of radiology and director of ultrasound education and research in the Geisel School of Medicine at Dartmouth College in Hanover, New Hampshire.

The Mercy Ships volunteers pose for a last-day photo with African physicians and medical students. Pam Brower (standing, third from left) shared lecture and training duties with radiologist Dr. Bob Harris (standing, in blue scrubs). Harris is professor of radiology and director of ultrasound education and research in the Geisel School of Medicine at Dartmouth College in Hanover, New Hampshire.

“One of our interpreters had a small fatty part on his arm that needed to be removed. They didn’t do any numbing,” she said. “The way they’re taught is just different.”

“We’re hoping we can be the demonstration of what a good hospital could be like,” Bullington said.

Bullington noted that education is a big factor, but so is funding. While the Congolese government has it better than most in the region, they still struggle to maintain an appropriate medical infrastructure.

“You can dump money into it and not do anything,” she said. “It’s really important that it’s gone through the right channel, that people understand the value of a good healthcare system and what it looks like.”

“Our hope at Mercy Ships is that’s what we can demonstrate.”

Brower’s 10-day trip wasn’t nearly as long as she wanted, and she’s eager to go back. She took no vacation time, no paid leave or sick leave, and doesn’t want anyone to think this is about her own ego.

What she brings back to her students in the TJC Diagnostic Medical Sonography program is gratitude.

“Anytime my students start to gripe, I tell them there’s no right to gripe,” Brower said. “We have air conditioning and sterile equipment.”

She plans to volunteer again late next summer, but teaching courses at Tyler Junior College is still her number one goal; and she can’t take off as much time to work with Mercy Ships as she wants.

“I hope when I retire one day that I can do it more.”

Allen Arrick is TJC multimedia content producer.

 


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Features, Spring/Summer 2014

About the author

Allen Arrick is Tyler Junior College's Online Multimedia Content Producer. He can be reached at 903-510-2526 or at aarr@tjc.edu