A Health Perspective from Liberia: Part 2

  • September 03, 2017
  • Health Initiatives, Communicable Disease, Africa and Middle East, Ebola Outbreak, Disease Outbreak, Global Health Blog
Jed Selkowitz

Jed Selkowitz

Saturday, August 5, 2017: Buchanan and Grand Bassa County, Liberia

Our first glimpse of Buchanan is the next morning when we set out on the drive to our clinic in Zondo Town, which is a district in rural Grand Bassa County. Tough road conditions (especially during the rainy season) put Zondo about 2.5 hours away.

It’s Saturday, so Buchanan is relatively quiet. We see children out and about, and, like all kids, they’re bringing their imaginations to life with whatever they can get their hands on — puddles seem to be a favorite. There is little to no electricity in Buchanan. Power comes from generators and our hotel works off two.

As we continue our journey, we know we’re driving through impoverished communities. Families live very simply, houses are small and hand built, there is no sign of basic development like running water or electricity. There’s something so beautiful about the outdoor morning scenes we witness through our car windows. Moms get kids up, dressed and fed. Dads head out to try to generate income. A dog sits dutifully by his 4-year old master. Women deftly balance their goods on top of their heads as they walk toward the market to set up shop. Smoke rises through thatched roofs and clothes are set out drying.

We pass through Liberia’s second largest rubber plantation. Owned by the Liberian Agriculture Company, it’s absolutely gorgeous. The trees are in perfect rows and have very thin trunks and branches. Only the tops of the trees have leaves, which form a delicate canopy. Each tree has a spout stuck into the trunk with a small cup to gather the dripping latex.

Liberia used to be one of the top producers of rubber in the world. But now, civil war and reduction in cultivation by Firestone have driven it outside the top 10.

Finally, the road begins to narrow and becomes less distinct — we’re in Zondo. Amidst largely green foliage, muted-color homes and red clay roads, the bright blue and white clinic is immediately noticeable. It’s stunning. Seemingly small from the front, the Zondo clinic expands off the back of the building, where there are separate structures for the generator and the incinerator that burns all of the clinic’s waste.

The clinic has a pharmacy, drug dispensary, screening and records room, two exam rooms, birthing and recovery rooms and one room for pregnancy exams and family planning counseling. The waiting area, which is rare in a Liberian rural health center, is outside in the open air, but covered. Other rare assets include tile flooring, in-building and under-cover bathrooms, a new-mom rest and recovery room and, perhaps most coveted, an ambulance.

The clinic is closed on Saturdays, but many of the staff who live in the community are happy to spend their day off showing off the facility. Our goal for this trip is to capture photography and videography that will help tell the story of the Zondo clinic and the impact Americares support is making.

Americares strategy around the world is to support local clinics and health centers to help them thrive, which is critical to helping communities in need. When the Ebola crisis hit, the Zondo clinic was only half-built and empty. Americares helped finish construction, brought in trained staff and provided medicine and medical supplies to ensure primary care was available in the community.

After meeting the staff and touring the clinic, we sat down to interview town elders, including a current and former chief, as well as Americares-trained traditional midwives and community health workers. Each and every person was extraordinary. Their stories ranged from completely sad and tragic to inspiring. The midwives and community health workers were so proud to serve their community and bring health education and quality care to their very own neighbors. Everyone we spoke to was appreciative of Americares and the support of our donors.

The clinic has made an incredible difference in this community — literally saving many, many lives. It has improved overall health by providing greater access to medicine and supplies, inviting patients to meet with trained health workers performing community outreach and implementing maternal, newborn and child health programs.

After a long, but inspiring and productive day, we made the bouncy drive back to Buchanan and had dinner at our hotel before checking emails and uploading photos and videos.

Sunday, August 6, 2017: Buchanan, Liberia

It’s Sunday, so Zondo Clinic is closed today.

This morning, we headed to church with our amazing colleague, Magdalene. We didn’t know this at the time, but the church was just two blocks from our hotel. Gibson pulled up to the hotel, we loaded our cameras and gear (we’d arranged in advance to capture the service), and he then proceeded to drive us the two blocks. Quite embarrassing. After dropping us, he headed to Magdalene’s house to pick her up and her kids.

The church was simple but beautiful. Painted windows and worn benches exuded warmth. When we walked in, Sunday school was in session. The lecture was about the “natural man” and the “spiritual man” and was a great energizer for the service. Magdalene is in the choir and strode toward the church in her white robe and hat, ready to play a leading vocal role in the morning service.

The collective voice of the choir was the highlight of the service, but I especially loved hearing Magdalene sing and seeing the joy in her face. Her daughter was also in the choir, which clearly filled Magdalene with pride.

In the afternoon, Marc and I headed to the beach with our drones to shoot video of the coastline. While the beaches are narrow and often littered with trash, there is still magnificence in them — particularly the waves breaking on rocks and the fishing boats stacked along the shore line waiting for their owners to come down at midnight to go fishing.

Monday, August 7, 2017: Buchanan to Zondo Town, Liberia

Today looks like it will be a gorgeous day, a rarity during the rainy season. We set out at 7 a.m. for our journey to Zondo for another day of interviews with members of the community.

Our first stop on the way to the clinic was to speak with Rachel, a mom of four living children. In Liberia, when parents are asked how many children they have, they often answer with the number living. That’s how common it is for women to lose pregnancies or suffer the loss of an infant or child under 5.

Rachel’s home is about a 10-minute walk from the clinic. Her home has one bedroom, what seems to be a common room and the equivalent of a pantry where she stores bowls, brooms and tools. The fire and stove are outside the house under cover, which is good, as many children suffer respiratory health issues when there is a stove inside their home. Fifty yards from Rachel’s yard is a running creek where they fetch water.

 

Rachel is the daughter of the town’s previous chief. Before the clinic became operational in 2015, she had difficult pregnancies. She was fortunate that nothing became life threatening, but is certainly grateful for the clinic and trained midwives who cared for her during her most recent pregnancy. Now, Rachel has a very healthy, happy and adorable 10-month old girl.

Before Zondo Clinic opened, women here had no access to prenatal care education or vitamins, no resource for natal care and no access to vaccinations for their newborns. Based on my interviews and discussions with members of our Liberian team, it’s clear many women were skeptical about giving birth in a health facility because they feared facilities in the aftermath of Ebola. Most women gave birth at home. If a woman had issues during pregnancy, she would need to walk or be taken to the closest hospital on a motorbike–anywhere from a 2–5-hour journey. Many women, some of them teenagers, died en route.

We filmed Rachel with traditional video cameras and also shot 360 video of her home and its surroundings, which I’m excited to see. Then, we pulled out the drone to film Rachel’s walk to the clinic. It was really fun to see the children react to the drone–some taking steps back, clearly a bit frightened by the technology, others pressing forward with inquisitive looks.

When we got to the clinic, Magdalene hosted a discussion with traditionally trained midwives and mothers from the community. We shot it with our 360-camera, so it was essentially a focus group shot “in the round.” The conversation was conducted in Bassa, but I could hear the emotion in their voices. One woman broke down in tears.

It was an emotional day, but a really good day.