Liberian Doctors Strike Epitomizes Cracks in Health Reform

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Monrovia – Hopes were high of improvements in Liberia’s health system following last month’s dedication of the US$5 million ELWA hospital built by Samaritan Purse International, and the allotment of over US$77 million in the 2016/2017 national budget for the country’s health sector.

But the imminent threat of a go-slow by doctors in Liberia has made many to rethink the validity of the dangling gains made so far since the end of the Ebola outbreak.

In fact, the health sector keeps repeating errors of the past and it’s failing to grapple with this situation.

Building a resilient health sector, according to the government, has grabbed media headlines ever since the end of the World’s worst Ebola outbreak.

Experts weighing in on the catastrophe have alluded that a broken-down and under-supported health system were factors that escalated the outbreak – Killing thousands.

When the virus hit Liberia back in 2014, health workers were then expressing exasperations over delayed salary arrears. Later staged a go-slow and that even put attempts to respond to the early stage of the outbreak out of control.

But the Ministry of Health despite significant allocations in the country’s budget with support from international partners continues to struggle in sorting out an efficient system to ensure the reguar payments of health workers including doctors that are already scarce in the country.

There have been calls to augment budgetary support to the health sector, but a significant amount support has also been forthcoming. In the 2015/16 fiscal year, the sector received an allotment of over US$114 millions out which US$72.61 million was given in grants and loans from donors while US$72.62 million was in direct budgetary appropriation.

For this year budget, the health sector has been allotted US$77.4 million which adds to other complimentary support it received this year from the UNFA and USAID for maternal and child health.

The MoH arguments have sometimes settled on the theory of the country’s budgetary shortfall quagmire and the overwhelming challenges associated with providing health care in a country that is resuscitating from a devastating civil war with all infrastructures in ruins and tatters  – but it has since been over 10 years.

Doctors and health workers are frequently threatening go-slow, health centers lack logistics and in rural communities, there are even more concerns.

Shortage of health workers, bad roads, low and delay in salaries are all serious concerns.

The 72-hour ultimatum given on November 14, 2016 by doctors in demand of their three-month salary arrears has again renewed concerns over the effectiveness of the government’s commitment to building a resilient health sector through the much acclaimed “Investment plan”.

“If the government does not make payment of our salaries, we will take a strike action, we will gather at the Ministry of Foreign Affair where the President resides,” the aggrieved doctors said through their spokesman on Monday.

Liberia already has a massive gap in the number of doctors per patients’ ratio, according to the World Health Organization; something the WHO says should be one doctor to 1,000 patients.

On the contrary, statistics shows that Liberia has a little over 288 doctors which include surgeons, pediatricians, dentists, orthopedics, ophthalmologists, gynecologists and general practitioners amongst others.

And this means, the doctor per patients ration is now 1: 15,000 – a grave concern that may even worsen if the doctors insist on going on a strike.

Recalling the incidents involving aggrieved health workers and the MoH just as the Ebola crisis heightened, many Liberians are weary of the setbacks the impending go-slow might have on the health sector again.

Paying deaf ears to these doctors has serious ramifications, and according to the doctors the MoH is dragging her feet to respond, while they are desperate to take action.

“Today we are about 46 doctors – every doctor is aware and we are together,” said Dr. Jonathan Hart, Spokesman for the aggrieved doctors.

“This is not Montserrado County issue; doctors have gathered from across the country.”

Many Liberian doctors have stressed the challenges they endured and at the same time outlined implications of the MoH wrongly handling their benefits – which they have termed as a ‘major problem.’

Dr. Jerry Brown, Medical Director of the ELWA Hospital – a non-government hospital, said during the official opening of the new hospital facility that augmenting the salaries and benefit of health workers involve with clinical medicines was crucial in the national drive to improve the country’s health sector.

In the much publicized investment plan, amongst other things the government outlines upgrading, training and improving health care workforce to response professionally and spontaneously to unfolding challenges by fit-for-purpose and also stresses the essence of a productive and motivated healthcare workforce to implement an emergency hiring plan; strengthen management and performance for health care workforce.

Neatly crafted on paper is the plan but effectuating the core components of such plan is obviously a challenge for the MoH, considering the multiplicities of challenges the sector faces.

However, sources at the Ministry say negotiations is ongoing with the doctors, but going back and forth with the same challenges despite commitment  to building a resilient health system rings a familiar bell.

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