Liberia’s 14 year civil war ended in 2003 with the loss of at least 250,000 lives and the displacement of hundreds of thousands of people. Six years on, the country is still trying to rebuild much of its destroyed infrastructure. While this fragile peace has proved lasting, living conditions remain extremely poor with 80 per cent of Liberians living below the poverty line, on less than $1 a day.
Due to a chronic shortage of qualified health workers, a dilapidated health infrastructure and insufficient government funds, Liberia’s health care system is only beginning to make the transition from an emergency to development phase.
HOW MERLIN IS HELPING
We are reaching over one million people through hospitals and clinics
Our programme here exemplifies our commitment to work beyond an emergency crisis situation to rebuild health care systems for the long-term.
We’ve been working in Liberia since 1997 and are now a key partner of the Ministry of Health and Social Welfare (MoHSW) in renovating health facilities, supplying medicines and equipment, and training and supervising health workers to build the capacity of County Health and Social Welfare Teams.
Merlin is currently supporting 54 primary health care clinics and four hospitals as well as three youth centres in six counties throughout Liberia. We have 27 international staff, 226 Liberian staff and are giving paid incentives to over 700 Ministry of Health and Social Welfare staff members.
Training health workers
A key focus of our work in Liberia has been to train community health workers and health teams at county level by working in partnership with the MoHSW. We have been building the capacity of staff in management, administration, and technical skills so that national staff will eventually be able to assume full responsibility for the facilities we currently support. We are also helping the Ministry to maintain staffing levels in remote areas by providing health workers with payment supplements and incentives.
Improving reproductive health services
There are just 297 certified midwives in Liberia and maternal mortality rates have risen by 74 per cent since the civil war ended. To tackle this crisis, Merlin and the MoHSW opened a midwifery training school in the remote south-east of the country in December 2008.
The students are trained for 18 months before committing to work back in their communities for at least three years.
We are also improving reproductive health services for over 400,000 women through a programme in Grand Bassa, Montserrado, Grand Gedeh and Maryland counties, which provides support to four referral hospitals and 43 primary care clinics. Services include promoting women’s sexual and reproductive rights in communities, setting up outreach programmes to women in very remote communities and providing traditional birth attendants with training and delivery kits. Approximately 500 health workers received reproductive health training by Merlin, consisting of information on reproductive health, sexual violence and family planning.
Improving access to health care
Diseases such as malaria, acute respiratory infections as well as skin infections and worms represent the most common causes of morbidity and mortality in Liberia. To combat this, Merlin is providing essential preventive, curative and surgical services as well as improving the quality of primary care and community health services. We are also training community health volunteers and hospital/clinic staff to manage and operate sustainable primary and secondary care services. By engaging with community networks Merlin has also been able to boost community-level health education, promote local health services and increase health-seeking behaviour.
Controlling HIV
In response to insufficient access to sexual health education and HIV prevention, Merlin staff offer health education in clinics, schools and communities, distributing condoms and working to reduce stigma and discrimination. Together with our local partners, we are also supporting three local youth drop-in centres in Montserrado and Buchanan. These provide youth-friendly STI and HIV awareness and prevention services, as well as reproductive health outreach services, through methods of peer education and life skills.
We also provide HIV testing and counselling services for pregnant women, and operate a referral service for HIV-positive mothers for safe delivery practices and to access anti-retroviral therapy.
Strengthening health information systems (HIS)
Health information in Liberia is unreliable, but it is essential for planning effective health care interventions and policies. As a key partner of the MoHSW, Merlin was instrumental in establishing a resource centre for HIS at the MoHSW headquarters in Monrovia, and this is now to be rolled out to the 15 counties in Liberia.
The aim of the project is to standardise the health data collected and increase the capability of staff to analyse and exchange data.
Key achievements
• In December 2008, we opened the first midwife training school in the remote town of Zwedru, South-East Liberia. This school will train approximately 30 midwives every two years, helping to tackle Liberia’s appalling rates of maternal death
• Establishing a resource and information centre in the MoHSW to improve the collection, analysis and dissemination of health information in Liberia
• 500 health workers and traditional midwives trained in issues relating to sexual and gender-based violence
• Continued support to remote communities and isolated health facilities through providing medicines, financial incentives, technical assistance and trained health workers
Donors supporting Merlin's work
DFID, ECHO, Irish Aid, the McCall-McBain Foundation, Diakonie, Stitching Vluchteling, Medicor and other private donors
Read more about Liberia
Delivering hope to Liberia's mothers: The role of the midwife
19 Jul 10: Clare Logan, a student from the Liverpool School of Tropical Medicine, has arrived in Liberia to research how mothers access maternal health care in post-conflict reconstruction in Liberia in one of the 81 medical facilities supported by Merlin.
Liberia: "Turning so little into so much for so many"
17 Aug 09: “So it's started,” writes Helen Sole, as her family leave the comfort of Connecticut for Liberia on a journey to the front line of global health. In the company of her husband Peter, who is a trustee of Merlin US, and two of their children, Helen is visiting the post-conflict nation where Merlin is helping the government provide basic health care to over one million people.
Meet George: One of Liberia's first male midwives
17 Aug 09: Meet George S. Seakor, 34 years old, from River Gee County, Liberia. George is one of eight men at the Midwifery Training Program for the South Eastern Region (MTPSER). They are the first male midwives in Liberia’s history.
Field diary from Liberia: One week in Grand Walking County
29 Jun 09: Pam Gordon is a Merlin intern working in Liberia. She joined a week-long assessment to the rural heart of the country – the remote Grand Kru county, close to the border with Ivory Coast.
A wake-up call: Latest field diary from Amy in Liberia
12 Jun 09: Amy Waddell is Merlin's Communications Intern. Having spent six months working with the team in our London Head Office, she's now based in Zwedru, Liberia until September. This is second field diary entry.
|