Liberia: Ministry of Health, American-based Partners in Health Celebrate Five Years of Healthcare Delivery in Maryland County

Staff of MOH and PIH during the celebration of their Five years’ partnership anniversary in Maryland County held in Harper City on November 6, 2019

Harper, Maryland County – American-based nonprofit healthcare organization, Partners In Health (PIH) and the Ministry of Health (MOH) through the Maryland County Health Team on Wednesday celebrated their five years of working together to rebuild the health system of the county.

Dressed beautifully in Orange T-Shirts with the inscription “Celebrating Five Years of Commitment to Liberia and Sierra Leone,” staff of both institutions and residents jubilantly marched through the major streets of Harper to the city Hall where an indoor program was held. 

Maryland County Health Officer (CHO) at the event, Dr. Methodius George, on behalf of the Ministry of Health, expressed gratitude to PIH for the partnership that has led to “significant improvement of the county’s health system.

Dr. George said because of PIH’s intervention in Maryland, he is now a proud CHO.

“From the bottom of my heart, allow me to gratefully express my sincere gratitude for your unending support to the people of Maryland. You have made me a proud CHO. Thank you very much” he said. 

What is PIH? How Did IT End Up In Maryland? 

Partners In Health (PIH) is a Boston-based nonprofit health care organization founded in 1987 by a group of medical practitioners and philanthropists including Dr. Paul Farmer and Ophelia Dahl.

PIH goals are “to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair. It provides healthcare in the poorest areas of developing countries.

In Liberia, PIH is headed by Dr. Maxo Luma as its Executive Director.

In an exclusive interview with FrontPage Africa in Harper City, Dr. Luma recalled the partnership began in 2014 during the Ebola pandemic when the Government of Liberia invited the organization to not only give health response to the crisis, but to also contribute toward rebuilding the health system alongside the Ministry of Health.

The Ebola Virus Disease outbreak was the deadliest and longest the world has ever known. Of the more than 11,000 deaths recorded in Guinea, Liberia and Sierra Leone, Liberia accounted for nearly 5,000 deaths.

But Dr. Luma said not all of the deaths were caused by Ebola.

“What we realized was the people basically died because of the weakness of the system, a system that was weaken by 14 years of civil war on top of that Ebola outbreak,” he said.

Since the country was declared Ebola free in 2015, Dr. Luma noted PIH, based on its model has been working with MOH to rebuild the health system in Maryland County. 

“One of the beauty of this model is that we do put a lot of focus on working closely with the Ministry of Health, meaning we work with them so they can do things that will allow them to achieve their goals, to provide healthcare to Liberians not based on PIH agenda. Whatever we do, we do it based on the priority of the ministry and for the ministry,” he explained. 

“That’s our model and that is actually what makes the model sustainable because we invest a lot in local human capital.”

Another essential aspect of the model is the Community outreach program. Through this program, he said trained community health workers accompany patients and link them to primary, secondary and tertiary health facilities.

This, according to health officials has increased patients seeking treatment at facilities across the county. 

During the course of the five years, PIH has been working with the MOH to build this model that could be scaled up in other parts of the country.

J.J. Dossen Hospital is now fully equipped with focused services including obstetrics, gynecology surgeries, pediatrics and internal medicines, thanks to the MOH-PIH partnership

Major Partnership’s Achievements

Following the Ebola outbreak, the Government of Liberia, through the Ministry of Health and its partners have been rebuilding the country’s health system.

Despite several gains made so far, progress in most parts of the country is going at a slow pace.  

Shortage of drugs at primary and secondary health facilities and health workers’ abandoning duties in demand of their salaries and other forms of benefits have dogged the health system of recent.

Low number of trained medical workers to provide healthcare is another serious impediment.

However, in Maryland County, the narrative seems to be different, thanks to the MOH-PIH partnership.

Nobody could better outline the significant impact of the collaboration in building a resilient healthcare system in Maryland better than the County’s chief Health Officer, Dr. Methodius George.

Dr. George, speaking at the five-years’ anniversary celebration of the partnership praised PIH for its numerous interventions including the extension and renovation of the J.J. Dossen maternity ward and operating theater with modern equipment, state of an art Multi-drugs resistance TB ward, Installation of an oxygen plant at J.J. Dossen Hospital and strengthening of the referral pathways in the county.

In addition, he said the provision of incentive to some health workers, support to Community health and surveillance programs, supplies of drugs to health facilities, transportation reimbursement and food ration to patients are some of the services being rendered by PIH.

The list, he said also include the provision of internet services to the entire J.J. Dossen compound and Plebo Health Center, support to county’s mental Health programs, capacity building of health workers, ongoing renovation of the Out Patient department at J.J. Dossen and the deployment of specialist doctors and training of resident doctors and interns.

Meanwhile, commendations came pouring from cross session of residents including officials and patients attending the event.

Josephine Allisson, a representative of the Women group was full of praise: “Partners in health has been our savior. We are seeing the work that you people are doing here, saving lives and restoring hope to our people. We will always believe in you,” she said.

A highlight of the event came when a patient identified as Rose gave her testimony, thanking staff of PIH and MOH at J.J. Dossen for saving her life following a fatal car accident that claimed the lives of several people.

Rose, along with other patients and relatives was being referred to the J.J. Dossen Hospital when the ambulance carrying them was involved in an accident, leaving several people dead.

Also, on separate occasion, several PIH and MOH’s staff at J.J. Dossen and Plebo Health Center told FPA the partnership is impacting the community.

Dr. Sarah Anyango, Consultant Obstetrician and Maternal Health Lead of PIH indicated the two institutions are working closely to improve maternal and new born healthcare and system delivery in Maryland.

The monthly average delivery of 80 and 90 patients at JJ Dossen and Plebo Health Center respectively, according to Dr. Anyango show the number of patients attending the health facilities has now increased.

“We also noticed that there was inadequate essential obstetric care – that is pre-partum during delivery and post-partum. Our coming here as partners in health, we strengthen the department’s referral system, meaning that we have trained all the midwives in Maryland,” she said.

“Together, with the County Health Team, we identified all the high risk mothers so that they are timely refer to the nearest health facility, especially to the safest facility. And all of us are working to make JJ Dossen a referral hospital of choice.”

Liberia’s maternal mortality ratio, one of the highest in the region stands at I,072 deaths per 100,000 live births.

This, Dr. Anyango said, is being tackled in Maryland through strengthening the referral pathway to allow more mothers and newborn have access to health facilities.

 “As we already know, Liberia itself has an unacceptable maternal motility ratio as reported by WHO and UNICEF. We want to make sure that we collaborate and work with the County Health Team to wind down this number. Our goal is zero preventable maternal death, especially in Maryland County, she said.”

Speaking further, she mentioned there has been much improvement on the family planning program put in place by the MOH. Through the partnership, the program is now transitioning from short active methods to long pattern family planning.

Also Speaking, PIH Senior Community Health Officer, Lavela Zayzay said PIH’s community-based model has proved successful in delivering effective care for both common conditions and complex diseases like HIV and Tuberculosis.

More patients, including those with multi drug resistant TB and co-effectants [both TB and HIV] are now on regular medication. 

PIH’s program Manager, Joe Lousaka, weighing in on the impact of the organization, also said PIH is partnering with MOH to implement the expanded program for immunization where health workers visit hard to reach areas to immunize children.

One of the key achievements outlined by PIH’s Executive Director, Dr. Luma is the transformation of J.J. Dossen in Harper into the referral hospital of the Southeastern region.

The hospital is now fully equipped with focused services including obstetrics, gynecology surgeries, pediatrics and internal medicines. 

In addition to attending to the health needs of people from the southeast, J.J. Dossen also take in patients from neighboring Ivory Coast.

“Four years back we used to refer every single case to Tappita [at Jackson F. Doe Hospital]. Today, I don’t know if Tappita can reach their people to us, but we have not been referring lots of people as it used to be. Even for X –ray, we used to refer patients to Tappita. Today we have our own x-ray right here at J.J. Dossen,” he explained. 

Plans for the Future

On top of these milestone achievements, PIH has launched a five-year strategic plan aimed at working with the MOH to build a resilient health delivery platform that moves toward universal health coverage.

In the process, PIH intends to partner with MOH to make Maryland a model that can sustain itself which Dr. Luma said entails enabling the county to respond to unplanned or unexpected health event in the county.

Other strategic priorities over the next five years include the establishment of an evidenced based system that will guide policies at national level and be used as model by the MOH for scale up throughout the country.

In addition, PIH intends to dwell on its success stories in other countries including Haiti, Rwanda and Lesotho to partner with the Government in building a sustainable health system.  

“We focus a great deal investing in the new generation of Liberians to make sure that they get all the necessary skills so that they can get the right disciplinary approach to ensure that Liberian citizens be served by their peers, by their local Liberian brother and sisters,” said Dr. Luma. 

The main objective and the idea, he said, is to make Maryland a learning center for the entire southeast and the country if possible. 

As a beginning of this plan, he revealed that PIH is now partnering with Tubman University and John F. Kennedy Medical Center to train more nurses and midwives to increase the health workforce of the county.

For now, the MOH-PIH partnership is helping to shape the health care delivery system of Maryland and surrounding counties. 

In the foreseeable future, the model could be a game changer for Liberia’s fragile health system.