ELWA Hospital

Mission: ELWA Ministries and Trinity Dental Clinic, a subsidiary of Serving in Mission

Vision Statement: ELWA Hospital seeks to provide affordable, high quality services to all who seek our care, focusing on community needs and portraying Christian ethics, Christ-like compassion, and integrity.

Profile:  ELWA Hospital is located 12 miles outside of Monrovia, the capital and primary city in Liberia, West Africa.  It is a newly constructed 81 bed facility: (20) male medical/surgical, (20) female medical/surgical, (18) pediatrics, (16) post-partum, (7) Labor & Delivery beds.  The medical staff is led by a PAACS trained surgeon. Other medical staff include (6) Liberian and other African physicians, (1) full-time and (2) part-time expatriate physicians and (1) full-time and (1) part-time nurse practitioners. The nursing, laboratory, midwife, and surgery staff are Liberian.

Travel/Orientation:  Fly by commercial air to Monrovia (Airport Code: ROB).  SIM-Liberia personnel will oversee orientation.

Climate:  Temperatures range from 70-95 degrees Fahrenheit, averaging in the mid-80s. Humidity is usually around 90%.  Rainy season is April through October, with the peak rains from July through September. The dry season is November through April. The ELWA compound and the city of Monrovia are on the Atlantic Ocean.

Language:  Liberian English is the primary language spoken at the hospital.  There are numerous local Liberian languages that may be spoken by some patients exclusively.  Hospital staff or family members usually provide translation.

Charting: English

Outpatient services: Outpatients are seen in a public (OPD) clinic or in the private-style doctor’s office. About 150 patients are seen daily in the OPD clinic by midwives, physician assistants, and other mid-level providers, with back up by physicians. The doctor’s office cares for 10-15 private patients each day.

Emergency room:  The very busy emergency room is open 24 hours a day, staffed by a physician’s assistant with a physician on call. It is the main gateway to acute medical care by a physician or admission to the hospital. It contains 12 regular beds, 2 trauma beds, a 1-bed isolation room and 6 infusion chairs.

 Pharmacy: A pharmacy is located on the hospital grounds where outpatients can purchase their prescription medicines at low cost.  A formulary of drugs carried in the pharmacy for outpatients and hospitalized patients will be provided to volunteers. Supplies can vary.

 Surgery: There are 3 large, well-equipped operating rooms. The hospital performs about 75 major operations and 25 minor operations per month. There are colonoscopes, a gastroscope, and a bronchoscope. There is no portable x-ray in the operating rooms. Surgeries are performed daily, and Liberian nurse anesthetists do the anesthesia. The surgery services cover a range of surgical diseases, c-sections, ectopic pregnancy, appendicitis, typhoid perforation, bowel obstruction, prostatic hypertrophy with urethral obstruction, as well as some orthopedic fractures. The PAACS-trained surgeon also performs SIGN (intramedullary) nail surgery.

Anesthesia: Dräger equipment is used for general anesthesia. Types of anesthesia include spinal and general with LMA or intubation/paralysis as needed. Isoflurane is the only inhalation agent. Ketamine is also available.

 Pathology:  There are no pathology services available in Monrovia, however tissue can be processed and sent for review. Results are often available within 3-4 weeks.

Obstetrics:  The hospital has about 75 deliveries each month.  The C-section rate is about 25%. This rate reflects the fact that many of the deliveries are high-risk as many women with uncomplicated pregnancies deliver at home. A fetal monitor is available.

Pediatrics:  The 18-bed pediatrics ward serves children of all ages with a range of diagnoses from severe malaria to burns, respiratory infections, and diarrhea with dehydration.

Radiology:  Radiology services are available routinely during the day, and via on call technicians for emergencies at night. A portable ultrasound machine is available for obstetric as well as routine ultrasound. There is a fixed, digital x-ray machine and ultrasound machine. There is no long-term radiologist on staff.

DentalTrinity Dental Clinic is on site at ELWA Hospital, staffed by one full-time dentist and Liberian dental therapists (these are mid-level dental providers, analogous to physician assistants).

 Lab tests: Basic laboratory tests are available, with a technician on site 24 hours/day.  Hemoglobin, malaria smear, urinalysis, stool analysis for ova and parasites, HIV, hepatitis B, syphilis (RPR), and typhoid (Widal) tests are routinely available. Blood Chemistries, Sedimentation Rate, PSA, and TSH are available weekdays. Electrocardiography is available. No cultures are done. Blood typing, Blood donor screening, unit collection and transfusion are all routinely available.

Common diseases/trauma: The most common diseases treated at the hospital are malaria, respiratory tract infection, diarrhea, hypertension, and urinary tract infection. The leading causes of death are malaria, AIDS, road/traffic accidents, diabetes, hypertension, pneumonia, TB, and congestive heart failure. HIV prevalence is relatively stable. About 4% of prenatal patients in Monrovia are positive for HIV. Measles, yellow fever and leprosy are quite uncommon. Traumatic fractures and soft tissue injuries present regularly.

Teaching: ELWA currently hosts 3 surgical residents in the 2nd year of their training. ELWA also hosts Liberia “post-internship” doctors for 3 month rotations during their Emergency Management of Obstetric Emergencies (EMOC) training. In July, ELWA will be home to the country’s first family medicine residency program. We are currently seeking teachers of family medicine, pediatrics, surgery, ob/gyn, and internal medicine to join us as faculty members.

For More Information: Contact Becky Richmond via e-mail or by phone at (828) 278-1203.