Monrovia - Maciya Martins (Not her real name for the protection of family identity) recalls her distress the day she walked into the John F. Kennedy Hospital to learn her 72-year-old mother had been left lying in bed sheets soiled with feces overnight.
Martins accuses the nurses of not keeping up with the amount of time needed her ailing mother needed to go to the bathroom.
Martins’ mother was involved in a fatal motor accident and was taken to the JFK, so Martins, who lives in Kakata, had to travel to Monrovia with her husband to take care of her mother.
"I came in one morning, and she'd been sitting in it (feces) all night long. She had called for help, and it just didn't come," Martins recall the terrible incident in disgust.
Martin's story is disturbingly similar to many others that are complaining about patient experiences, FPA can confirmed as part of ‘Rate My Hospital' - a sweeping week-long series looking at the state of Monrovia’s hospitals.
Nearly one third of interwiewes, including patients, health-care workers, relatives and friends of patients, complain that hospital rooms and bathrooms are not kept clean.
The J.F.K Public Relations Officer says that there should be no politics in the medical field.
The interviewees describe soiled bathrooms, patients left lying in their own waste and appeal for seemingly harried nurses that went unanswered.
Peter Browne, 61, who was treated for bleeding at a Redemption Hospital February, says he ended up wiping down the bathroom himself after his complaints about the dried liquid waste he found on the floor and toilet seat failed to get a reaction.
He worried about older, less mobile patients.
"If I was a little sicker, I would have walked through that spill," he says.
"I wouldn't have wiped the seats off and that's what's so sad."
At John F. Kennedy and Redemption – two of Liberia’s major hospitals - it seems like the poor reception and services accompanying filthy bathrooms remain a major problem.
Patients, relatives doing cleanup
Martin says she had to take her own tissue to the hospital where her mother, who suffers from HIV/AIDS, was being treated after she discovered urine on the floor and the toilet seat.
She says she always cleaned the bathroom before her mother used it, changed her mother's soiled bed sheet after a request for new sheets went unheeded and gave her mother sponge baths because she found water was not available.
Despite all her efforts, Martin says she has no doubt that her mother contracted severe infection after surgery due to the hospital's untidiness.
David Mulbah, a medical student at the AM Dogolitti, says with such untidiness at heath facilities, bacteria can be found on door handles, bed rails can be common sites of bacteria transmission.
"I know everybody nowadays has to work more with less [resources], but to me, a hospital should be absolutely clean," Mulbah says.
Of the people who spoke to FPA about being harmed in hospital, most said the harm was a hospital-acquired disease that are infectious. Mulbah says MRSA and C. Difficile are infections that can be contacted in hospital.
MRSA develops on the skin and is transmitted through skin to skin contact with an infected person or a surface they've touched. C. difficile is spread via surfaces or skin that has come in contact with feces infected with the bacteria.
For Armah Kaitamba, resident of New Georgia, untidiness is serious problem at various government hospitals and said nurses, PA and doctors are always fronting ‘for hefty salaries that they don't deserve’.
“Can you imagine I accompanied a friend of mine daughter at the Redemption hospital, we arrived at 2:30 am with an emergency case and up 3:00 nobody could come to our aid and a nurse on shift was sleeping and I woke her up only to tell me the man on duty is not around and she went back to sleep without making any frantic effort,” Kaitamba explains
“Do we have people who have passion for this job, or are they just looking for the money? This how our people continue to die because of the kind of people we have in our various health systems.”
Vera Nimely, a resident of a Sinkor, calls for privatization of Liberia’s government own hospitals, asserting that outsourcing these hospitals will ensure proper management of funds.
Those who work in hospitals have pointed also for the hospitals to be outsourced because in recent years lack of outsourcing is one reason behind the decline in hospital cleanliness that patients and hospital workers have observed.
"There's no question there's been an impact on the quality of cleaning, and you can see that throughout the years as various hospitals have struggled with very high-profile superbug outbreaks," Nimley says.
Some say lack of outsourcing of cleaning services has led to fewer cleaners and lower standards in public health sector.
A housekeeper at J.F.K who asked for anonymity says "Keeping a hospital clean is based on the number of people doing that job, so when you cut that down, you have to make choices on what areas get cleaned [and] how often they get cleaned.”
A more humane hospital
Many people also talked about feeling alienated by the hospital system and getting the brush-off when they tried to raise issues of concern with staff.
Most of them say they sympathized with nurses and doctors who seemed rushed and overworked but wished these professionals would communicate more openly and sympathetically with patients and family members.
"She lost her quality of life in hospital," explains another woman who says her 91-year-old mother began blind and died at J.F.K hospital. "I think she lost her dignity as well because everyone talked about her but not with her."
Many people said they left the hospital feeling demoralized and disillusioned with the healthcare system.
"We waited for hours to be seen with no explanation why," says Facia Dahn of Clara Town. "The entire emergency room staff desperately needs training on how to work with people. I always leave angry and wishing we had just stayed home instead."
"We also don't care that much about the floor; because it's less likely you're going to pick something up off the floor than you're going to pick something up off your bed."
About two-thirds of hospital-acquired infections are preventable, Mulbah said, but making a direct link between cleanliness and infection is not as straightforward as it might seem.
"People don't really think of them as part of the team, but if you think about how infections are spread in hospitals, they're actually an incredibly important part of the team that goes far beyond just the cosmetic appearance of the room."
But the Public Relations officer at the John F. Kennedy Amara Mohammed refuted the assertions describing it as politically motivated.
“I don’t respond to social media propaganda unless at the extreme case, they always want to picture our country gloomy; J.F.K is a public area and its public institution.”
He says the John F. Kennedy is a premier hospital and disclosed that there are numerous challenges and massive renovation ongoing at the hospital.
“We too can face challenges and we all must work together to build a resilient health system in our Country, this is the only place we have.”
At the same time the head of relations at the Redemption Hospital could not be reached up to press time when contacted by FPA.