This is the story of two modern day American heroes in a place far away from home. Neither of them would like that label. They don’t see themselves that way. Nor would they like being singled out. They will point to others. But let me tell you a bit about them and let you decide.
Andy Sechler was born 33 years ago in Union City, Mich., a town of 1,400. Andy’s father left when he was a toddler. His mother, who he calls “the shining star” in his life, did her best, but the young family was on and off public assistance in those early days.
Andy was a good student. Very good. The valedictorian of his high school class. But he was also good at something else: football. So good that as a freshman, he walked on to the University of Michigan football team. Over the next four years the team won a series of bowl games including the 1997 national championship. Already enough to inspire, but only the beginning of the story. Andy Sechler dreamed of becoming a doctor — a doctor dedicated to taking care of the most vulnerable, most desperate kids in the world, regardless the fact that there are over 40.000 students each and every year (according to medresidency.com) left without a residency, finding one takes a lot of energy and efforts.
I met Andy in New York City a month or so ago, on the eve of his second trip to Liberia, a struggling nation on the west coast of Africa. Liberia has deep historic ties to the United States, dating back to the 1820s when the American Colonization Society provided freed American slaves with passage to the West African coast.
Andy has worked in a variety of places in the developing world, but Liberia has a special pull. Now in the final months of his residency at Mount Sinai School of Medicine in New York, Andy is part of the hospital’s impressive Global Health program.
Andy is quiet and methodical as he packs to go. Trained in pediatrics and internal medicine, he tells us he is eager to go back to Liberia and that, in addition to the extra-strength mosquito repellent, he’s bringing a big box of pens for the nurses, as they are in short supply at the hospital. As we will soon see for ourselves, it’s not just pens that are hard to come by.
We arrive in Liberia on the eve of the presidential run-off on Nov. 8. I am traveling with “Nightline” producer Bartley Price, our colleague Katie Hinman joined us the following day. As we step off the plane, our Blackberrys spring to life: three people have just been killed in pre-election protests.
There is a strong U.N. presence everywhere, complete with road-blocks and vehicle searches. You can feel the tension. We share a van to the hotel with a man who tells us he is a helicopter pilot for the South African police, brought to Liberia in case of violence. On the way in from the airport, we see U.N. helicopters hugging the coastline.
American Doctors Volunteer in War-Torn Hospital With No Water or Electricity
We soon meet up with Andy, who greets us at the John F. Kennedy Hospital in Liberia’s capital city, Monrovia. Like the nation itself, the hospital is still traumatized by the war. Less than half of the hospital’s 400 beds are useable but that the place is open at all is a bit of a miracle.
The hospital was a gift back in the 1960s to the people of Liberia from the United States. Once considered the best medical facility in all of West Africa, a referral center complete with helicopter landing pad, the devastating 14-year civil war has left the place in ruins.
The hospital’s administrator, an extraordinary woman named Dr. Wvannie McDonald, tells me wistfully of a day when she was a young doctor here, a time when JFK had a paging system and central air conditioning, when fountains bubbled at the front door. That day is long gone.
At one point during the war, 20,000 people sought refuge on the hospital grounds. The operating room had a hole in the ceiling open to the sky. Machine guns poked out of the windows. The JFK hospital came to be known as the “Just For Killing” Hospital.
Along with many of those who could, Dr. McDonald left Liberia during the war. She thought she’d be able to return after a few years, but as the war raged on, it became clear that she could not go home. She made a life for herself and her family in Indiana. But that came to an end in 2006 when Ellen Johnson Sirleaf was elected president of Liberia. Dr. McDonald remembers a cold winter’s day when the phone rang and the president asked her to come home and bring JFK back to life. She said she felt she had no choice.
It was a daunting assignment. The hospital had no running water and no electricity. The medical equipment had all been looted, as had the beds and even the linens. The wounds of war were everywhere. And worst of all, there were virtually no doctors left. The World Health Organization estimated that there was one doctor for every 100,000 Liberians. In the U.S. the number is closer to one for every 200.
So that is where Andy and a team of American physicians have come in. Working with the truly astounding staff at JFK, and led by Dr. MacDonald, an impressive organization of America’s finest medical schools have banded together to provide doctors to JFK. Nearly two dozen medical schools including Yale, Harvard and the University of Chicago, send residents and faculty to JFK. Doctors like Andy.
The group is called HEARTT and it was founded by another remarkable man, Dr. James Sirleaf the son of the president. During the war, his mother brought him to the United States. Now an emergency room doctor in Bridgeport, Conn., Dr. Sirleaf started using his vacation each year to help out at JFK. But, he says, he soon realized so much more was needed and HEARTT was born. Now more than 70 American doctors a year take turns going to JFK with the HEARTT program.
Andy and his HEARTT colleagues are not only providing much needed care, their mission is broader: to teach the next generation of health care workers, not just new doctors — whose numbers graduating each year from the medical school are increasing — but also midwives, nurses and physician assistants.
The goal is to provide direct clinical instruction, but, more importantly, to serve as role models of excellence, both clinically and professionally. Due to the lack of resources and lapses in education for so long, in Liberia the expectations are often set low for what can be done for the patient. Although their Liberian collegues are extremely hard working, smart and dedicated, they were often discouraged from the years of being able to provide very little for their patients.
But as the overall health system improves and providers have more tools to fight disease, HEARTT volunteers work hard to help “raise the bar” of what can be done. Thus, both improving clinical care for patients, and the morale of the health care providers who then take on more ownership and fulfillment in their work.
Andy tells me the lessons he learned on the gridiron have served him well here. On rounds in the pediatric unit, his focus and determination are on full display. Watching him work you can feel his intensity, the coiled energy. Bringing his whole being to every tiny patient.
With HEARTT Foundation, Health Care in Liberia Has Seen Remarkable Progress
He confides that his trip to JFK last year was very painful. Eighteen of the kids he was taking care of died during his six-week stint. He felt helpless and frustrated. Kids just don’t die like that at home he tells me, and they wouldn’t have died in Liberia if there were more resources. If there was clean water for them to drink, and mosquito nets for them to sleep under.
Malaria is a virulent killer here. It can take a healthy child and push him to the brink of death in hours. Simple things kill in Liberia. Kids die from dehydration and malnutrition.
Until HEARTT got to JFK there was not one pediatrician in all of Liberia. Not one. Little wonder so many kids, especially kids under five, were dying. But slowly things are improving. Andy says in just a year he sees remarkable progress.
Dr. Torian Easterling, Andy’s friend and colleague from the Global Health Program at Mt. Sinai, agrees. Torian brings another kind of gift to the JFK hospital. Andy’s intensity is matched by Torian’s compassion. Torian, too, is also about to finish his training at Mt. Sinai. Whip smart like Andy, his style is different. A lanky, easy-going charmer, over the course of four visits, Torian has formed deep bonds with both the staff and the patients at JFK. He tells me there is a spiritual aspect to this for him; he feels called to this work.
He tells me the story of a mother who sobbed in his arms on his last visit when the baby he fought so hard to save, died. Of the connection he feels to the people here. Global medicine, he explains, means seeing people, not borders. People with hopes and dreams who need doctors.
Raised in Newark, Torian decided early on that he wanted to practice medicine where “the need was greatest.” I asked him about that… what about the gaping needs right at home? He paused. Ideally, he says, he’ll split his time between Newark and the developing world. He knows first-hand the depth of the need in America, he tells me, but continues to feel the pull toward children in circumstances he sees as even more dire.
As dedicated as Andy and Torian are to providing front line medical care, they are also dedicated to their role as teachers. We follow them to a classroom, littered with broken chairs, where they are teaching a group of midwives a simple technique for helping babies breathe in what’s called the “golden minute” after birth.
An estimated two million babies unable to breathe on their own, die right after birth, in what’s called the “golden minute.” In fact, nearly 2 out of 10 babies have trouble in that crucial minute, which isn’t a problem if the birth attendant knows what to do, but is deadly, if they don’t.
So Andy and Torian are teaching the simple technique developed by the American Academy of Pediatrics. It’s an important lesson. Midwives deliver nearly all of the babies in Liberia. So this teaching session will have profound effect as these young women go back to their communities. It is moving to watch the students gain confidence as Andy and Torian slowly go over the steps… using baby mannequins …again and again.
The hours are long at JFK, the heat intense, and the living circumstances are, as you might expect, rugged. Andy and Torian live in a dimly lit, simple concrete dorm on the hospital grounds. They say it is just fine with them. There are few escapes from grinding poverty and their sense of responsibility. How they are able to stay focused and upbeat is a bit of a mystery to me. But they do.
In truth I met several other doctors with the same dedication and passion on this trip: the extraordinary Mike Ward from the University of Chicago, the talented, Khoshal Latifzai from Yale, and an incredible young American nurse from Dr. Sirleaf’s hospital in Bridgeport, Colleen Grady.
Each has chosen to come here. To battle back against disease and poverty as best they can. To give all they have, while making peace with their own limits. They do not seek the spotlight. In fact, they are uncomfortable in it. They would tell you they are just doing their jobs. I would tell you they are doing so much more. Bringing hope with the medicine. I say they are the best of America’s exports. I say, let’s give thanks for them.