Analysis of Healthcare In Liberia

July 15, 2015

By Thomas Omogi, Healthcare Commercial Markets Analyst ( Guest writer).

When Liberia’s 14 year civil war ended in 2003, it left the nation’s health care infrastructure, which had been one of the most progressive in Africa, in shambles. The access people once had to health care was destroyed, as well as the nation’s health care facilities. The civil structure in Liberia after the war left little opportunity to improve things, because people lost their livelihoods, their access to education (so they could become health care providers), and their ability to get jobs to pay for education. Even worse, many diseases that had largely been eradicated in the area came back, crumbling public health conditions by burdening them with diseases that are easily treated and, in some cases, entirely preventable when a solid health care infrastructure is in place.

The Red Cross and Liberia

The Red Cross has provided some relief in the form of community education on disease prevention and hygiene. The Liberia Red Cross has a number of community-based programs supported by the British Red Cross that handles these initiatives (1). Other initiatives sponsored by the Red Cross in Liberia include getting clean water to communities through digging new wells, improving latrines and building new ones to improve hygiene, providing prenatal care for expectant mothers (as well as post-pregnancy care for new mothers), and giving community training programs in first aid, so members of communities can respond to certain health care situations themselves. These initiatives can and do save lives, especially in circumstances where care is needed right away and the nearest health care outpost is miles away, as is the case in many rural communities. The goal of the Red Cross in Liberia is to make Liberian communities, no matter how remote, self-sufficient in terms of basic to intermediate health and hygiene needs.

Community-Based Organizations and the Red Cross in Liberia

The Red Cross partners closely with community-based organizations all across Liberia. In fact, when the Red Cross comes into a community in Liberia, that community is expected to take an active role in working with the Red Cross to improve health conditions in that community. With a goal of making each community self-sufficient, community participation is absolutely required.

If a community-based organization does not already exist somewhere the Red Cross goes, they will help the community form one. That organization is then expected to assist the Red Cross with such things as:

Supplying basic materials for building wells and latrines
Working to help Red Cross members build these structures
Participate in educational programs on disease prevention and hygiene so the community-based organization members can, in turn, teach these things to the community
Continue operating to assist the community even after the Red Cross leaves it

The Red Cross brings in materials a community may not be able to afford, such as zinc roofs, nails, steel rods and beams, and other more expensive things.

Ebola in Liberia

The recent outbreak of Ebola in Liberia exposed many of the serious flaws in the health care infrastructure of the nation. Despite the improvements that are being made to rebuild the health care system of Liberia since the civil war, the Ebola outbreak showed much of the country is still vulnerable to health care issues. It wasn’t just Ebola that ravaged the nation; during the investigation of the Ebola outbreak, it was discovered that the country is still plagued by a high number of cases of preventable and easily treatable diseases. Most crucially, Ebola showed that Liberia’s health care structure is skeletal, even after 14 years of peace, and that it requires a modern health care system in order to ensure the health and stability of the nation. The current basic structure of health care in Liberia simply cannot reach most of the citizens in any meaningful way.

If anything, the Ebola outbreak should provide an incentive to the nation’s government to develop a real strategy for rebuilding Liberia’s health care network. The failures of the health care network in Liberia during the Ebola outbreak can offer excellent ideas to those in charge of the nation for how to improve things for its citizens should another outbreak occur of Ebola or anything else, and even show the way to preventing future epidemics.

What Liberia Needs to Improve its Health Care Infrastructure

The Liberian health care infrastructure is only a very basic one right now, as the civil war set it back decades. Sweeping reforms are needed to rebuild the system and make it accessible to most citizens. A 21st century way of thinking is needed to make this happen, as Liberia’s health care infrastructure needs to be thoroughly modern to deal with the issues it faces.

Thus far, the health care structure in Liberia has been mismanaged and neglected, despite substantial contributions from private and government donors from around the world. These contributions have not made a noticeable difference in the lives of average Liberians because of the mismanagement of funds. Right now, only the wealthiest Liberians can access quality health care, usually by going abroad for it. This contributes to a severe and obvious health care inequality among the Liberian elite and the average Liberians who make up the bulk of the country.

There are 4.3 million people living in Liberia. The first order of business is to establish a means of delivering quality, affordable, and sustainable health care for all of the nation’s citizens. This includes establishing a means to deliver quality health care to rural Liberians that is just as good as the care they would receive in the cities. Not everyone is able to travel long distances to receive care, so bringing care to even the most remote areas of the nation is a must. There has to be health care equality in Liberia. The divide between the elite and the average citizen needs to disappear, because this kind of health care inequality leads to resentment between the different segments of society. People with health issues are often prevented from working or otherwise improving their social positions now. With health care equality, this would not be so much of an issue, and people of all classes could access the health care they need to improve their lives in a variety of ways.

The Importance of Education in Improving the Heath Care Infrastructure in Liberia

In addition to having its health care infrastructure destroyed in the civil war (and the lack of governmental interest in rebuilding it so far), there is the problem of the lack of qualified health care workers in Liberia. With inadequate access to higher education for most citizens, the country is not producing local health care workers at the rate required for the country to be self-sufficient in its health care needs. Directing some of the private and international governmental donations to improve the resources at the nation’s medical schools is one solution to the issue. Making education more affordable and the health care profession within the nation more rewarding for people to join are other ways to produce more Liberian health care workers.

Right now, there is one qualified doctor for every 71,000 people in the country. More developed African nations average one physician for every 10,000 people (2). Obviously, the doctors in Liberia are overworked and underpaid. Producing more doctors and other health care workers from the nation’s medical schools will change this by lessening the load on existing doctors and making the profession more lucrative and enjoyable for those who show and interest in it.

The vast majority of doctors who do reside and work in the country are located in the large, urban regions. This leads the rural areas to have almost no health care coverage at all. If they do, it is usually one doctor at a very busy clinic who treats people who come from miles around, all on their own. This has to change for health care in Liberia to improve to any significant degree. More health care workers must be moved into the rural areas of the country.

Health Care in Liberia: The Final Word

The health care environment in Liberia was once one of the most top-notch systems in Africa. Now, it is a shambles. With mismanagement of funds meant to go to improving it, a government that shows little interest in it, a dearth of local doctors to serve every area of the nation, and lack of educational opportunities for citizens to become qualified health care workers, thanks largely to expensive schools and a lack of teachers (3), the situation is not going to improve any time soon. This does not, however, mean it will not improve. In fact, all of the necessary ingredients for improvement are there. They just have to be put to proper use.

With better oversight of funds donated toward health care, so they aren’t mismanaged, a renewed government commitment to improving the nation’s health care (which can be accomplished with international coalitions and education), better health care education at affordable prices, and an increased number of doctors with access to modern equipment, Liberia’s situation can be turned around. When these pieces are put into place, Liberia won’t have to rely on the Red Cross for health care anymore. They will be able to run their health care system themselves. What’s more, Liberia will once again be able to become the African example for modern health care excellence it once was.

Sources

« Emerging Africa: An Analysis of New Markets and Areas for Social Reform Kenya and Healthcare: The Opportunities of an Emerging Market »