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MSF in Liberia, 2008
Field Staff: 875
Reason for Intervention:
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Though Liberia has made significant moves towards stability and reconstruction following its brutal 14-year civil war, many Liberians still live in crushing poverty, and the weak health sector cannot provide adequate health care. Women and children remain particularly vulnerable.
Doctors Without Borders/Médecins Sans Frontières (MSF) provided free secondary healthcare in Montserrado county in the northwest of the country, home of the capital, Monrovia. In the suburb of Paynesville, MSF worked in Benson, a women’s and children’s hospital, helping to deliver more than 3,000 babies and conducting more than 770 emergency gynecological surgeries. Handover of this project to the ministry of health is under way.
MSF also provided free access to health care in Island Hospital, a pediatric hospital in Bushrod Island. This overcrowded area in Monvrovia is home to more than 500,000 people; admissions exceeded 12,600 in 2008. Care was focused particularly on mothers and children, on malnourished children who have medical complications, and on integrating care for chronic diseases such as HIV/AIDS and tuberculosis (TB) into the system. MSF teams helped deliver more than 3,900 babies.
MSF also helped provide primary care in two centers run by the ministry of health in Clara Town and New Kru Town. Teams supported a range of services for mothers and children such as antenatal and postnatal care, vaccinations and prevention of mother-to-child transmission of HIV. Together the centers provided more than 122,300 consultations in 2008.
Incidence of sexual violence remains high in Liberia. In Benson, MSF provided care for victims of sexual violence, treating more than 880 rape survivors. In July the project was handed over to Think, a local NGO, though MSF still provides technical and material support. The partnership carried out more than 2,260 psychological consultations in 2008.
Victims of sexual violence were offered medical and psychosocial support at Island Hospital, as well as at both health centers. In 2008, MSF teams treated more than 770 people in Bushrod Island, more than 70 percent of whom were younger than 19 years old. Some 11 percent were younger than four years old.
Primary care handover
MSF manages a health center in Saclepea in Nimba county, northeastern Liberia. Plans are under way for handing the project over to the ministry of health, but in 2008 the center conducted more than 3,000 outpatient consultations. More than 100 people took advantage of free anonymous tests for HIV. MSF is also collaborating at the center with the ministry of health, the center for Research and Field Epidemiology (Epicentre), and the Drugs for Neglected Diseases Initiative (DNDi) on a study aimed at making artemisinin-based combination therapy (ACT) available for malaria sufferers throughout Africa.
Treating Lassa hemorrhagic fever
In 2008 approximately 80 people with Lassa hemorrhagic fever were admitted to Saclepea’s special hospital unit for treatment. The fever is deadly if not treated quickly with ribavirine, a costly medicine protected by a pharmaceutical monopoly. As part of its planned 2009 withdrawal from Saclepea, MSF is trying to ensure that ribavirine becomes affordable in Liberia. Teams are also lobbying health officials for continuity of care for HIV-positive patients after the withdrawal. It has now been agreed that HIV-positive patients will be able to receive treatment at Ganta hospital in northern Nimba county, and that screenings for HIV and TB will continue in Saclepea.
Lobbying for free healthcare
In 2006, the government introduced a policy of free healthcare across Liberia. However, not all of the country’s health structures are able to offer services free of charge, so in some places people cannot afford to be treated. MSF is lobbying for consistent implementation of free care throughout the country.
MSF has worked in Liberia since 1990.