Posted by: Alicia Phillips | April 10, 2013

She Works With Heart

So it has been a while since I last did a spotlight on a fellow volunteer, you may remember me talking about Samantha, an environment volunteer living in a rural Fijian village. This time I am doing it on a city volunteer, my roommate in fact, Ms. Carol Fox.

Now let me tell you something about Carol, she rocks. She is one of the hardest working volunteers in the country and her presence here has literally changed people’s lives, although she would never admit that to you herself. Let me tell you a bit about her project…

Carol is an echo cardiographer. For those of you who aren’t familiar, an echo cardiogram is a 3 dimensional picture of the heart and it uses a Doppler ultrasound to create images of the activity of the heart.

So, this is Carol.

Carol is from Wisconsin where she has been an echo cardiographer for more than 20 years.

You can break up her Peace Corps service into two parts: the village & the city.

Carol’s original assignment was as a rural health promotion volunteer in a beautiful little coastal village on the northern island.  She was the 3rd Peace Corps volunteer this village has had, and sometimes found it hard to come up with new projects to do that hadn’t already been done. She volunteered in the local school and did some work for the library. She also worked with the women’s group and found 15 broken, rusted sewing machines and taught the women how to fix them and clean them up.

One day while she was in town she took a tour of the local hospital. She started talking with a doctor, telling him a little bit about her background in echo and turns out……they had an echo machine that was donated to them 2 years ago that NO ONE knew how to use! It has just been sitting in a room for years while one of the doctors was trying to teach herself how to use it. YEAH! PROJECT!!!

So then she started coming in from the village every other week for a few days to help train a few people on how to perform echo’s. After about 3 months of this, the Ministry of Health saw her potential and went to Peace Corps to ask if Carol could be transferred to the capitol to work with echo at the hospital. Peace Corps eventually agreed and she was moved in with me in Suva and immediately got to work developing an echo training program at Colonial War Memorial Hospital, the first of its kind. In addition to the training program she was charged with the task of creating an echo department within the hospital. She was faced with all of the policy making and procedures that go along with developing a new unit.

She started an intense 6 month fast track training program with 5 graduates of the Fiji School of Medicine radiology technology department. She was determined to conduct the training according to U.S. and international standards that included: echo theory, knowledge of machine operation and controls, basic understanding on sonographic waveforms, and identification of diseases.

If you have read any of my other blogs you might remember me telling you about how non-communicable diseases such as diabetes and heart disease are at a crisis level in the South Pacific. What many people also don’t realize is how prevalent Rheumatic Heart Disease is.

RHD is a type of heart disease; it is an auto-immune disease that is caused by the strep virus.  If you catch it early you can take medicine for the rest of your life to manage it, but if you catch it late, the prognosis is very poor if you aren’t able to get a valve replacement. Only visiting teams from overseas are capable of doing the valve replacement surgeries and they usually only come a few times a year and see limited cases of people.

Working with echo in America, Carol had seen less than 10 cases of RHD in the past 20+ years. In the last year alone, Carol has witnessed hundreds of cases. She sees the extreme cases here that are never seen in the US because it never gets that far.

Why is it more prevalent here than it is in America? No one knows, could be genetic, could be hygiene, and could be living conditions. But it is know that by detecting it early you can get treatment earlier and have a chance of living a higher quality of life.

And guess what? Echo is the only non-invasive test that can detect rheumatic heart disease.

Working in a hospital in a developing country presents challenges that we’re not used to in America.  She said at first she was shocked by the conditions of the facilities, and the utter lack of privacy given in the wards. As a westerner we think not having any privacy is a bad thing; but with the culture here people would see it as a bad thing if they were all alone in personal rooms. It’s all in the way you look at it.

Another big challenge is not having resources needed to get the job done such as books, printers, internet access, or something as simple as a desk with a chair.

Just recently the Fiji government said they want to start a new initiative that would include doing an echo on all the school children across Fiji to test for RHD by the year 2015; something that never would have been considered if she hadn’t started this training program. Because of her there are at least 5 trained echo techs that can perform the scans or train others to.  These 5 echo techs now have a skill that no one else in the country has, a skill that will be in huge demand in a few years…months even. They will be able to find a job that pays well, they now have options that were not available to them before.

Living with Carol I have learned more about echo that I ever thought I would. Learning about RHD has really made me aware of how behind Fiji and other developing countries are when it comes to diagnosis and preventative care.  I could tell you a dozen more cool aspects to Carols work here as a volunteer but I think her project speaks for itself. She was able to accomplish more in just one year as a volunteer than most people care to accomplish in 10. When most people hear ” Peace Corps Volunteer” they think grassroots community based bottom up small projects. However, Carol is proof enough that if you have a skill and the passion to teach it to others then you can work in any level and reach as many people as you want to really make a difference in their lives.

I have to constantly remind Carol that she is just a volunteer, not an employee. She doesn’t have to work 10-12 hour days or work on the weekends.  We should probably just go hang out on the beach instead. You can see how having a project like hers would make it difficult for her to get away and enjoy living in Fiji, which is where I come in and force her to go spend the weekend at the beach with me instead!

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