A gift of care in Liberia
For nearly two years, alumni Jen and Steve Butwill have focused on the medical needs of a small Liberian village. Now, the Ebola epidemic is creating new challenges.
Singing and dancing villagers greeted Jen and Steve Butwill when they returned to Liberia in early November. Many residents of the isolated Yarnee District didn’t expect the couple to come back so quickly to the West African country devastated by the recent Ebola outbreak.
“It feels right to be back in Liberia,” Steve writes in an email shortly after their return.
The Ohio State graduates founded and run the Po River Medical Clinic in Liberia’s Yarnee District. In July 2014, they returned to the States to raise money for the clinic and visit loved ones. While they were gone, the largest Ebola epidemic in history swept through West Africa, hitting Liberia particularly hard. According to a mid-November report from the World Health Organization, Liberia has had the most cases (7,168) and the most deaths (3,016) of any country since the outbreak began.
In October, Jen, a nurse practitioner, underwent Ebola training with the Centers for Disease Control and Prevention. She worked in a mock Ebola treatment unit and learned about triaging suspected Ebola patients, providing basic care and tracing contacts. Her clinic in Liberia isn’t equipped to treat Ebola — an infectious disease with a fatality rate of about 50 percent — but she must be ready to deal with it.
It’s a scary prospect, but the Butwills seem unruffled. When asked in late October — about a week before they were to fly back — about the challenge of returning to Liberia, Ebola isn’t what they mention first. “We need, at some point, to start packing,” Jen says with a laugh.
Despite the epidemic, they never considered staying in the U.S.
“When we came back in July, we were pretty whipped from being over there for a year and a half without a break,” says Steve, who handles clinic operations while his wife manages patient care. “Now I think we’re fully ready to go back in there. Our buckets are full, and we’re ready to pour them back out again.”
A tremendous need
Dr. Daniel Sedmak, who directs the Ohio State College of Medicine’s Office of Global Health, says there’s a tremendous need for this type of work, especially in Sub-Saharan Africa, which has some of the worst newborn and maternal mortality rates in the world. Every year, the office sends 60 to 70 medical students on overseas missions to low-income countries such as Malawi, Ghana, Uganda, Peru, Ecuador and Nicaragua.
“Poor countries are very similar in several ways, and what they have in common generally are very poor health care systems,” Sedmak says.
Already a very poor country, Liberia was devastated by a 14-year civil war that killed 250,000 people and destroyed nearly 95 percent of the country’s medical facilities. The war ended in 2003, but the country is still rebuilding. Before the Ebola outbreak, there were just 50 doctors in all of Liberia, a country of some 4 million people.
The Butwills became interested in mission work through Zarephath Christian Church in New Jersey, where they lived for 11 years before moving to Liberia. They met at Ohio State during a sorority-fraternity mixer. Steve, who grew up in North Canton, took a job in New Jersey after he and Jen, a Cincinnati native, graduated in 2001. (Steve has a bachelor’s degree in industrial and systems engineering, while Jen, whose maiden name is Schnauber, majored in speech and hearing science and also holds nursing degrees from the University of Cincinnati and Rutgers University.) Jen joined Steve in New Jersey after they married in 2003.
Before starting the Po River Clinic, they both made short-term mission trips overseas through their church, Steve to India in 2008 and Jen to Liberia in 2010 and 2011. During Jen’s second trip — a medical mission to the Yarnee District, an area with about 9,000 residents and no medical facilities — she saw close to 250 patients in one day.
In 2012, Zarephath Church began to raise money for a permanent clinic on a mission site in the Yarnee District and appointed the Butwills to a team that led the campaign. “At that point, I said, ‘It’s a great idea, but you have no one to run it,’” Jen recalls. After some soul-searching and prayer, the couple volunteered to lead the clinic and moved to Liberia in January 2013.
Serving the community
When a government hospital in the same county as the Po River Clinic closed after two people died from Ebola there, the Butwills were forced to close their clinic in August. The clinic reopened in October after its 12-member staff received protective clothing and training to recognize Ebola patients, whom they would refer to a nearby Ebola treatment unit. “The staff did a perfect job running the place and kept good records while we were away,” writes Steve, who like his wife plans to aid in the Ebola epidemic however he can if they are forced to close the clinic again.
Meanwhile, the need for the clinic is as great as ever: Not only are people in Liberia dying from Ebola, but more routine maladies — such as malaria, diabetes and heart disease — are claiming lives because of the limited access to care. As a precaution, clinic staff members take the temperature of every patient and ask 20 questions to identify those who may have Ebola. CDC officials in Liberia told the Butwills in early December that the outbreak seems to be contained.
“I think everyone here knows someone who has died during the past six months,” Steve writes. “But no one on the mission, no one in the surrounding villages, no one living within our district has caught the virus. It’s absolutely a wonderful blessing.”