In her 28 years of nursing, Mary (Lagasse) Macklin has seen her fair share of medical situations and has worked with some of the most cutting-edge equipment around.
But last month, she got an entirely new education, with nothing but a stethoscope.
The 53-year-old Bradford native spent most of December on a medical mission in Sierra Leone, a country in West Africa.
Macklin and her son Grady, 20, spent Dec. 7 to Dec. 20 in a village called Yele. Macklin, who lives in Henniker, N.H., worked at a free clinic while her son spent his days teaching physical education to school children.
With no CT Scans, MRIs, heart monitors or any of the other modern equipment that Macklin was accustomed to using, she had to rely solely on her eyes, hands, ears and stethoscope to make diagnoses.
"It was overwhelming the first day," she remembered.
Macklin connected with the clinic through Women for Women of Sierra Leone. She had always wanted to go on a medical mission, and was on an informational e-mail list. When the organization was looking for a nurse practitioner, they decided someone from a rural community would work best in the African village. Macklin, who has worked for Concord (N.H.) Hospital for the last 28 years, turned out to be the perfect fit.
Macklin has been a nurse since 1980. She was working as a secretary in a radiology department when she realized she wanted to do more in the medical field. She plugged away for years, earning her bachelor's degree and finally her master's. In 2000, she became a nurse practitioner.
"I went the long route," Macklin joked.
Right away, Macklin realized how lacking in care the villagers in Yele had been, mostly because they don't have enough money to pay for services. The medical system in Sierra Leone is set up so patients have to pay every step of the way, unlike in the United States, where we get a bill after our care is complete. If patients in Sierra Leone can't come up with the money up front, they don't receive care.
Because of this system, the patients Macklin encountered were completely unaware of how their bodies worked. She met with women, for example, who described hot flashes and ceased menstruation but didn't know that was normal at their age. She also met with people who didn't understand why they had chronic pain.
"They work so hard, their bodies are worn out," Macklin said. "They've been working on their knees for the past 10 years."
She also realized quickly that everyone who came into the clinic said they were either 50, 60, or another round number.
"No one knows how old they are," she said.
Sierra Leone is on the Atlantic Ocean, with Guinea to the north and Liberia to the southeast. The country has a tropical climate and takes up 27,699 square miles, roughly 3,000 square miles larger than West Virginia. The population is 6,296,803, about 2 million fewer people than Massachusetts. The country is perhaps best known for the brutal "blood diamond" — or "conflict diamond" — trade that has sent some of the most beautiful diamonds throughout the world, but has also spawned brutality and corruption as the profits funded a rebel insurgency.
The experience in Sierra Leone benefited Macklin twofold. From a medical perspective, Macklin learned to trust her training and her judgment in diagnosing patients. From a social perspective, she took away a new appreciation for the little things in life.
Not only did Macklin realize how much she missed her hot showers and hair dryer, but she realized how many luxuries Americans takes for granted.
"I already live life pretty frugally," she said, "but the biggest thing I realized was how wasteful we are. We're oblivious to it."
