Professional Preparation

So how does a Physician Assistant and a Family Nurse Practitioner prepare professionally for caring for a rural population in a poor developing country. First some stats to give you a glimpse of what we will encounter. To give some perspective the numbers in purple are the US stats.

Human Development Index 180/187 countries (4/187 countries)


Average life expectancy 47 years (78 years)

Maternal mortality 970/100,000 live births (24/100,000 live births)

42% of births attended by skilled health personnel (99%)

Infant mortality rate 157/1000 live births (8/1000 live births)

Under 5 years old mortality rate 192/1000 live births with 58% of them due to malaria, pneumonia, and diarrhea (8/1000 live births with 43% attributed to prematurity and congenital abnormalities)

28% of children under the age of 5 can be categorized as being moderately to severely underweight (1%)

HIV prevalence 16/1000 adults age 15-49 (6/1000)

In Sierra Leone there are 0.2 physicians and 1.7 nurses or midwives for every 10,000 people (26.7 physicians and 98.2 nurses/midwives for every 10,000 people)

49% of the population uses clean water (99%)


This is the grim reality of life in Sierra Leone: there is great chance that you or someone you love will get very ill and great chance that they will not be able to see anybody who can help them and end up dying from a relatively simple disease process where prevention or early intervention could have made all the difference in the world.

There are a number of ways that we are preparing for this medical adventure.

Last fall we all moved to Slidell, Louisiana to enable Jeneson to attend Tulane University's Diploma program in Tropical Medicine. It was a lot of information crammed into one semester. He is also a class or two away from getting his MPH.

Last summer I attended a two week International Medicine and Public Health course held by INMED in Kansas City, MO. I was able to network with many others who are working in developing countries or preparing themselves for that task. Also, inspired by my recent observations in Sierra Leone, I am taking a two day crash course on Midwifery in Developing Countries down in Nashville. I am really looking forward to this class and hope to glean lots of information that will help improve the pregnancy and labor and delivery experiences of the women in Mokanji.

Additionally we feel like we are constantly preparing in many little ways. Next week we will travel to Louisville, KY for the Global Missions Health Conference where we will hear some excellent speakers and get some great teaching on medical and spiritual care in missions. Jeneson can often be seen walking around the house reading the  Handbook of Medicine in Developing Countries. We are frequently checking out websites that might offer us some information about health care in developing countries. I follow a few blogs of people I know who are caring for people overseas.

But, most of all, we pray. We know that there will be some tough times ahead;  that we cannot prepare for everything we might see or do and that there will be times when there is nothing we can offer the patient except prayer. We pray that God will sustain us during those times.