The Beginning and Growth of Modern Medicine in Liberia — The Book

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…and the Founding of the John F. Kennedy Medical Center, Liberia.

By Joseph N. Njoh, MD

The history of modern medicine (or scientific medicine or Western medicine) in Liberia is long, but the story told about it is very short. The history features early Liberian physicians who should be regarded as national heroes, who should be emulated, and for whom the nation should be eternally grateful.

But, these days, they are hardly ever mentioned in discussions on national issues of importance. It is as if they never existed or have been completely forgotten, or as if the history of modern medicine in Liberia has been inadvertently amputated.

Instead, countless stories have been told, and continue to be told (and I have heard some of them) about Liberian physicians, who graduated a little over seventy years ago, who are presented as pioneers in the medical profession in this country.

That is a gross and unmitigated error, for nothing could be further from the truth. It is astonishing that this incorrect version of the nation’s history of modern medicine has persisted for so long. Consequently, we have failed to use this part of our proud history as one of the ways to inspire generations of our young, energetic, talented and determined students, especially young medical and nursing students, to aspire to attain lofty goals in their chosen fields.

The truth that must be told, and that ought to be taught to the coming generations, is that some of the pioneers of the medical profession in Liberia practiced here around one hundred and seventy years ago, when Liberia as a new nation was in its infancy.

That was the period before, and during the time, when Liberia declared her independence and became a republic. Those brave, intelligent and skilled men were also the pioneers of modern medicine in West Africa, perhaps in all of black Africa.

Notable among those early Liberian physicians were: – Dr. Samuel Ford McGill (the first Liberian to graduate M.D. from a medical college, and the first black man to graduate M.D. from a medical college in the United States, 1839), Dr. Dempsey Rollo Fletcher (a former student of Dr. Samuel F. McGill and the 2nd Liberian to qualify with an M.D. degree, 1847), Dr. Henry Jenkins Roberts (1847, younger brother of His Excellency Joseph Jenkins Roberts, 1st President of Liberia), Dr. James Skivring Smith, Sr., (1848, later became the 6th President of Liberia), Dr. Charles Benjamin Dunbar (educator, farmer, entrepreneur and politician, 1853), Dr. John Naustedla Lewis (1st Liberian of indigenous origin to become a medical doctor, 1873), Dr. John Anthony Parm, Dr. Julius W. Y. David, Dr. Henry W. Dennis H’ne, Dr. John H. Roberts (son of Dr. Henry J. Roberts and nephew of ex-President J. J. Roberts), etc.

They, and a few other medical doctors from Freetown, Sierra Leone and the Gold Coast, now Ghana (e.g. Dr. James Beale Africanus Horton, William B. Davies and Benjamin Quartey-Papafio), and Lagos, Nigeria, and South Africa (e.g. Drs. Nathaniel King, Obadiah Johnson, John K. Randle, O. Obasa, William A. Soga, John M. Nembula and William Alexander, the last was better known as Dr. Oguntola O. Sapara), were some of the earliest medical college-trained doctors with M.D. degrees who practiced commendably in Africa at a time when most of the continent was still embroiled in the infamous stave trade or just emerging from the long, dark period of the ravaging trade in human flesh.

Unfortunately, with the passage of time, and the lack of proper documentation, these great Liberian men and women and their noble deeds were forgotten. “A man or woman without a knowledge of his or her past is like a tree without roots,” so often said Marcus Aurelius Garvey, the early 20th century Jamaican pan-Africanist and Back-to-Africa movement activist. It is sad that that forgotten past is a glorious one from which we as a people could, and should, derive much national pride and satisfaction.

It is in this context that the new arrival in Monrovia of copies of a book, recently published (April 2018) and entitled “The Beginning and Growth of modern medicine in Liberia and the Founding of the John F. Kennedy Medical Center, Liberia,” carries a huge significance. It is the product of a long and painstaking research, and it will help to fill the gaping void left open for so many years by lack of information in this particular area of interest.

The book traces the early history of modern medicine in Liberia, and the gradual evolution of the nation’s health care delivery system from its inchoate stage to what it is today – a highly organized nationwide health care delivery system. Within it, there is information about the early physicians and nurses, when and where they practiced, the nature of the health issues they grappled with (e.g. chronic diseases of general debility, nose bleeds, dropsy and anasarca, dysentery and diarrhea, intestinal worms, consumption, remittent and intermittent tropical fever, various ulcers, enlarged liver and spleen, etc.), the various treatments they administered, and the fate of the physicians themselves who worked under some of the hardest conditions.

Also available is information about some of the nation’s earliest hospitals (St. Mark’s Hospital, Cape Palmas (1860) of the Protestant Episcopal Church – 1st hospital in Liberia; McKane’s Hospital and Training School, Monrovia (1895) of Dr. and Dr. (Mrs.) McKane – 1st hospital in Monrovia; Tubman National Hospital, later renamed James Jenkins Dossen Memorial Hospital, Cape Palmas; St. Timothy’s Hospital, Robertsport, Cape Mount County of the Protestant Episcopal Mission, the only hospital in existence in Liberia in early 20th century (1918); Phebe Hospital, Muhlenburg, Montserrado County of the American Lutheran Mission (1916); Holy Cross Hospital, Bolahun, Lofa County, of the Episcopal Mission of Holy Cross (1925); Carrie V. Dyer Memorial Hospital, Monrovia, of the Women Baptist Mission – 1st Maternal and Child Health Hospital in Liberia (1926);United Methodist Dispensary, later Methodist Hospital, Ganta, Nimba County (1926); Firestone Hospital, Harbel (1926); the Liberian Government Hospital, Monrovia – the 1st Government Hospital in Liberia (1927); etc.) – their founders, when and why they were founded, where they were located, and how they fared.

Inside this volume is the account of how, with severely limited resources and a little help from foreign sources, there slowly evolved in Liberia what we know today as the Health Care Delivery System, a system of care that, for the first time, covers the whole country. Much credit in this area goes to the combination of President William V. S. Tubman and the health team in the National Public Health Service headed by Dr. Joseph Nagbe Togba, Sr., M.D., MPH, FAAPH, FWACP, from 1946 to 1960. They laid the solid foundation of today’s health care delivery system in the 1940s and 1950s.

Liberia’s apex health institution, the John F. Kennedy Medical Center, Monrovia, is discussed in considerable detail – why it was founded, the long and delicate negotiations between officials of both the Liberian and U.S. Governments that preceded its construction, why Liberia’s National Medical Center was named in memory of the assassinated U.S. President, John F. Kennedy, the Medical Center’s impressive dedication ceremony in June 1971 led by late President William V. S. Tubman, (President Tubman unexpectedly died before the actual opening of the Center for services to the public) the eventual opening that took place in July 1971, just 4 days after the President’s death, leaving Tubman’s Vice President, the late President William R. Tolbert, Jr., to welcome the first patient into the Medical Center, and the beginning of clinical medical training for medical students for the first time on Liberian soil in August 1971.

Some of the medical and nursing experts who worked at the Kennedy Medical Center in its earliest days (Drs. Joseph N. Togba, Sr., Public Health expert/Administrator, the Medical Center’s Executive Director, 1968-1972); Henry Nehemiah Cooper, Surgeon/Oncologist and 1st Chief Medical Officer, 1972-1980; Walter L. Brumskine, Surgeon/Urologist and 1st Head of Department of Surgery; Robert D. Patton, Internist/Cardiologist and 1st Head of Internal Medicine Department; Kate C. Bryant, Child Health expert and 1st Head of Department of Pediatrics; Archibald Johnson, Obstetrician/Gynecologist and 1st Head of Department of Obstetrics and Gynecology; Abayomi O. Sobo, Radiotherapist/Oncologist and 1st Head of Radiotherapy Unit, Joseph Diggs, Radiologist and 1st Head of Radiology Department; J. C. Chiori and Rubell E. Brewer, 1st and 2nd Heads respectively of the Department of Pathology; Elder Thebaud, Psychiatrist and 1st Head of the Department of Psychiatry; Zolu D. Traub, Ophthalmologist and 1st Head of Ophthalmology Unit; Roger de Siebenthal, Orthopedic Surgeon and 1st Head of Orthopedics Unit; and Jacob Jones, Dentist and 1st Head of the Department of Dentistry; and the Heads of the Nursing teams – Mrs. Adeline Wesley, RN., Mrs. Theresa Caine, RN., Mrs. Sarah Mensah, RN., etc.) and the early medical and nursing students who trained there were also discussed. As the reader will find, some of those medical students of yesteryears are the medical experts of today in Liberia. Some are serving in important positions in the health care system of the country.

Included is information about the founding of the various medical/paramedical nursing training institutions – the nursing schools (Phebe Hospital and Nurses Training School, Muhlenberg (1916); Liberian Government Hospital School of Nursing (1927); Carrie V. Dyer Nursing School, Monrovia (1929); Tubman National Institute of Medical Arts, Monrovia (1945); Esther Bacon School of Nursing and Midwifery, Zorzor (1945); Winifred J. Harley School of Nursing, Ganta (1950); Phebe School of Nursing, Suacoco (1965); etc.), the medical college (formerly Monrovia-Torino College of Medicine, now A. M. Dogliotti College of Medicine of the University of Liberia (1966), and the latest one, the postgraduate medical college in Monrovia (Liberia College of Physicians and Surgeons, 2013).

The reader will find, within this book, why, when and how some of the important institutions within the nation’s Health Care System came into existence. Some of the institutions covered are the Ministry of Health and Social Welfare (MOH&SW) itself, the Liberian Medical and Dental Council (LMDC) and the Liberian Medical and Dental Association (LMDA). The MOH&SW, which began forming as the Bureau of Public Health and Sanitation in the 1930s, became the National Public Health Service (NPHS) of Liberia in the 1940s, Department of Health in the 1950s, and finally the Ministry of Health and Social Welfare in the 1970s.

It is the government’s headquarters on health matters, the nerve center of all health-related activities in the country, where virtually all the major policies and decisions on health matters originate. The Liberian Medical and Dental Association (LMDA), the professional body of all registered and practicing medical doctors and dentists in the country, came into existence in the mid-1960s. It co-ordinates doctors’ activities and it is where issues of interest or concern to doctors are discussed, decisions are made, and if necessary, actions are taken. The Liberia Medical and Dental Council (LMDC) began in 1927 as the Medical Board through the effort of the Hungarian physician, Dr. Rudolph G. Fuszek. It is the government’s office where physicians and dentists, who qualify from approved training institutions, are registered before they are allowed to practice in the country. It also registers medical clinics and hospitals, regulates and monitors the practice of medicine throughout the country in order to maintain an acceptable standard of medical practice.

The history of modern medicine in Liberia is long and fascinating. It is now published and can no longer be ignored, denied or amputated. It is a story of a rich heritage. This book is a valuable source of very useful information about the past and the present of the Health Care System in Liberia. It is highly recommended to Liberian students and their teachers in particular.

It is the hope that it will also be read and used by those interested in the evolution of modern medical care in West Africa and to those interested in research in the history of medicine in Africa. To Whom It May Concern June 22, 2018 RE: DR. DAIYABU ALHAJI IBRAHIM The bearer of this statement, Dr. Daiyabu Alhaji Ibrahim, is a Consultant Rheumatologist from Aminu Kano Teaching Hospital, Kano, Nigeria.

Almost ten months ago, he joined the staff of the Department of Internal Medicine of the John F. Kennedy Medical Center, Monrovia. This is the Teaching Hospital of the University of Liberia. In addition to his other responsibilities, he has actively participated in the training and the examinations for both medical students and medical residents in this department. He has also been involved in the care of patients during his stay in this hospital.

Dr. Ibrahim adapted easily to life in Liberia, following his arrival, and he has worked hard, in harmony, with the staff and trainees. The staff and patients of this department have benefited immensely from his involvement in the activities of this department. This report is, therefore, being written in appreciation of the contribution Dr. Ibrahim has made to patient care and to the advancement of undergraduate and postgraduate medical training in Liberia.

Professor Joseph N. Njoh, M.D., FWACP, FRCP, FLCPS, KCHOAR Chairman, Department of Internal Medicine, John F. Kennedy Medical Center, Monrovia, Liberia; Department of Medicine, A. M. Dogliotti College of Medicine, University of Liberia, Monrovia; and Past Chairman, Faculty of Internal Medicine, Liberia College of Physicians and Surgeons, Monrovia.

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