Liberia's Health Sector Faces Major Overhaul

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11 March 2008

Liberia's health sector is facing a rebuilding task of colossal proportions after years of civil war and neglect left behind a destroyed infrastructure and very little staff. This created conditions for very low life expectancy and high maternal death rates. But efforts by the post-war government, volunteer Liberians and foreign aid agencies are slowly bringing about change. VOA's Nico Colombant reports from Bensonville, in a district of Liberia without a doctor.

Joseph Nyanton manually operates decades-old lab equipment at the Bensonville hospital, as there is no electricity, and more recent equipment disappeared during the war.

"During the war, they ransacked this place," he said. "You know the rebels, they came and took away everything. In fact, even the operation lights, they damaged it all. I think they did not even know what to do with it, but they just damaged it. You see."

But the hospital operates, even without a doctor, for the entire Careysburg district of about 65,000 people.

District health officer Rex Moses gives a tour of what is in name a hospital, but basically operates as a clinic. Women patients sit on wooden benches, many of them holding babies.

Moses says with the help of aid agencies and a new ambulance, he is able to save lives again. He gives the example of a woman and her baby from the nearby town of Harrisburg.

"After delivery, she started bleeding severely. We call it post-partum hemorrhage," he said. "Luckily for us, the Africare vehicle went there on supervision and brought the woman to a distance that the ambulance could pick her up. And we did pick her up and immediately referred her to Monrovia. The information we are getting is that she is all right now. She received blood, about four pints of blood. And she is back in Harrisburg. The baby is bouncing all right, the baby is OK."

Basic health packages, including for pregnancy and infant care as well as malaria, are being offered for free, thanks to donor help and the government making health spending its second priority in this year's budget, after education.

Moses says a plan to make the training of much needed doctors, nurses and midwives free as well, could be even more crucial.

"They are saying now it will be free of charge, absolutely free of charge. That is the message we are getting. That will encourage people to be trained and cut down the shortage of nurses and manpower in the country," he said. 'We were told that tests were to be given only in [the capital] Monrovia. But for the last test, they went all over the country to give the test."

In the meantime, volunteers, many of them jobless high-school dropouts looking for something to do, are being trained as community outreach specialists. These first line health consultants go to remote villages, often by foot, to teach about nutrition, basic sanitation, family planning and preventative measures to combat common diseases, like malaria.

One of them, Martha K. Woheel, explains her motivation.

"What led me to want to be a volunteer is because our communities they are lacking. And then it is something concerning about health," she said. "So we have to educate them and it motivated me more, especially in the field of health."

One of 51 Liberian doctors in a country of more than two million people is Health Minister Walter Gwenigale.

"The three things that we want to take care of basically are; one, human resources for health, two, infrastructures for health, and three, the support system," he said.

Gwenigale has pleaded with foreign donors to allow Liberia's government to control more of the millions of dollars in health-related aid money so a more coordinated, long-term approach can be set in motion.

Some foreign donors and U.N. agencies have expressed concern over whether the free health-care system now in practice for basic services, as well as the free training being planned, are viable in the long-run.

But Liberians, interviewed for this report, say they want as many lives to be saved as possible and as many health workers trained in a short amount of time, so that a nation and a health system very much in shambles can be rebuilt.