Revamping Liberia’s Healthcare System

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Liberia emerged from a brutal 14 years of civil war in 2003. This conflict resulted in a near-total fragmentation of all the country’s basic infrastructures. The health sector, an integral part of every nation was no exclusion to this callous fragmentation as evidenced today by its weak competence to efficiently deliver and sustain the provision of excellent health and social services to the Liberian people.  Due to the lack of enhanced healthcare in Liberia today, many Liberians live with cognizance that any curable or preventable disease could culminate into death. Illnesses like tuberculosis, common cold and malaria continue to claim the lives of Liberians; this is utterly unacceptable especially for a country that had already lost thousands of its citizens to a senseless and brutal civil war.

To complicate the situation more, the Ebola pandemic literally bruised and paralyzed Liberia’s fragile healthcare delivery system and essentially exposed the country to more destitution, poverty and belittlement. The first case of the virus was recorded in March of 2014. A few months later the virus prevalently spread across the country making Monrovia, the nation’s capital the epicenter. Observers say the virus was not met with a rigid reaction making it to quickly become an epidemic which was just not affecting Liberia alone but two other countries in the Mano River Basin (Guinea and Sierra Leone). By the end of the year, an estimated 3,608 citizens and 178 trained health workers had succumbed to the virus (Data: Pres. Sirleaf’s Annual Message 01/26/15). The health care system was in total collapse and “Caved-in” and thus Liberia was once again on the “Global peril map.”

Although I am about 5,000 plus miles away from my beloved homeland Liberia, I was emotionally devastated by the terrifying television footages of Ebola patients. I just couldn’t fathom the anguish and misery mainly women and children were facing. However, I stayed literally glued to nightly news coverage especially on local Liberian airwaves and every available international newswire. I always found myself staring in transfixed horror at those graphic images and contemplating how throbbing the experience was for those who were directly affected. At one point in time, pregnant women had literally fewer or nowhere to give birth to their babies, infected bodies decayed on city center streets for days; patients with common health needs like malaria and cholera were turned away from hospitals and left to die. These were just few of the appalling accounts of the entire Ebola chronicle. 

Many thanks to the Government and people of Liberia and all national and international partners that strategically strived to combat the virus. Although the fight is far from over, I must admit that Liberia has come a far in the fight against this virus. Despite Liberia has not been officially declared an Ebola free state by the World Health Organization (WHO), it was welcoming news that the last known Ebola survivor was discharged on March 5th from the Chinese-run Ebola Treatment Unit (ETU) in Monrovia. This is commendable and I want to doff off my cap to those who had to endure a set of health regimen to stay alive. Lest we forget to remember all those who have lost their lives in the fight including medical practitioners who put their lives on the line to save others. To me those were the real heroes in the fight against this decimating disease and their memories should forever remain etched in our thoughts.

Allowing our health sector to be in such deplorable state that we can’t combat treatable diseases is similar to living in the dark ages. Thus, it is a shame and deadly lack of recognition of the Millennium Development Goals (MDGs) which Liberia is a signatory to. However, as simply put by the American Physicist – Frank Wilczek, “If you don't make mistakes, you're not working on hard enough problems. And that's a big mistake.”

Reflecting on the Liberia Ebola saga, it goes without saying that we as a people and nation have made too many bad decisions, disheveled our national priorities; have not exercised prudence in implementing reform programs and strategic choices that would revamp our health sector. I’m of the conviction that it is now time that we take tangible actions to ensure that our health care delivery system can cope and withstand the challenges of the 21st century.

How?

First, there is a critical need to massively invest in training health workers, increase their benefits, and most importantly – encourage competent young Liberian students through scholarship programs to pursue studies in health related fields. This initiative will in the long term help in filling the gaps that engulfed the health sector. It is a prudent initiative because one of the biggest challenges for Liberia’s health sector is the inadequacies of health workers and professionals. Liberia has a population of 4.2 million people with an estimated 51 doctors; 978 nurses and midwives; 269 pharmacists (Statistics: Afri-Dev.Info).

Second, there is a need to reassess the current methodology use in the diagnosis, treatment, and prognosis of illnesses. Although there’s no statistics available, there have been too many assertions of patients meeting their premature death due but not limited to: the involvement of unqualified healthcare providers with their treatment, being wrongly diagnosed, or perhaps due to the lack of state-of-the-art medications that miraculously restore “Good health.” It is essential that the highest level of care be provided to every patient to ensure that the rate of survivability is high. It is not that a patient should be surrounded by awesome medical paraphernalia before it is known that they are receiving higher or proper level of care but there should be a system in place wherein the safety and satisfaction of patients are highly prioritized.

This issue of proper diagnosis even brings to mind a personal tragedy – the premature death of my elder brother who passed away at the age of 24 in 2011. In late 2011, he started to get ill and was taken to at least three hospitals in Grand Bassa County. Over the period of a month, none of these three hospitals were able to diagnose what his medical condition was. His health deteriorated to the point that he could not even be recognized by families and friends. Our family only got to know that he had diabetes few weeks before he passed away. What in the world that three hospitals could not diagnose my brother’s illness until few weeks to his death! What did it take a month to let us know? Till this date, I still doubt that he even died from diabetes which makes it difficult to bring his death to a closure psychologically.

Third, Liberia needs to transition from Paper Medical Record (PMR) to Electronic Medical Records (EMR). The introduction of EMR will aide in collecting and storing a more comprehensive patient history. Moreover, healthcare providers will be able to easily access patients’ records and be able to use these records to see the trend in patients’ health and see how they can help to improve the overall quality of the care for patients. It will also enable healthcare providers to quickly access patient records for a more coordinated and efficient care, which in terms will reduce medical mistakes and inconsistencies in patient medical history.

Finally, let it be known that this wished-for comprehensive health reform that is needed does not only entail the efforts of the government alone. It requires the rigorous and collaborative team efforts of all Liberians, the international community, Non-Governmental Organizations and the private sector. If there was any time to coordinate our efforts and put the safety and value of Liberians first, the time is now and each and every individual’s help is needed.

About the Author:

Stephen Kalimu is a Liberian student at MCC – State University of New York working on a BSN degree as a pre-nursing student. He forestalls doing his master in Public Health (Epidemiology) upon attainment of his BSN; Mr. Kalimu is also a Child Rights activist. He served as Speaker of the Liberian Children Parliament (LCP) from 2008-2010. He had represented the Liberian youth populace at various international confabs. He was Liberia lone youth representative to the World 5th Youth Assembly at the United Nations Headquarters in 2008. Email: [email protected]

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