A great example is Sandra Gordon-Mai Smith, a young Liberian nurse-anesthetist with whom Kaseje first worked in 2018. Over the next two years, Smith eagerly trained with MSF’s international anesthesia providers. When Kaseje returned this year, she immediately recognized the difference. “Sandra was able to independently provide anesthesia care to all our patients, from the 5-day-old baby to the 14-year-old teenager. I mean, if my baby needed anesthesia, I would have no problem with that team doing the anesthesia care,” said Kaseje. “That's how good they've become.”
Having staff with these specialized pediatric surgery skills is essential because children are physiologically different from adults, Kaseje says. “They require age-appropriate clinical management with age-appropriate equipment, infrastructure, and supplies.” It can be very difficult—even impossible—to treat a small child without the right equipment and knowledge of how to use it. Because few Liberian health care workers have had the opportunity to develop these skills, MSF’s internationally supported project has been a valuable and unique resource.
Legacy of Ebola
As COVID-19 starts to spread in Liberia—as of April 12, there were 48 confirmed cases and five deaths, and a state of emergency has been called—it brings up memories of the West Africa Ebola outbreak of 2014-2015. Ebola devastated Liberia, infecting an estimated 10,678 people and killing 4,810 and wreaking havoc on a country that had only recently emerged from two civil wars. Many of the country’s health care workers died during the outbreak, and the health care system has never fully recovered.
“People here are still traumatized from the whole Ebola experience,” Kaseje said. “It is still very, very present. And I think that’s why the overriding emotions that I saw at the start of the COVID-19 outbreak were fear and nervousness.”
The Liberians she spoke with were taking the pandemic extremely seriously, she said, more seriously than many of the Europeans she encountered when she landed back home in Geneva.
“Compared to other countries that have never experienced Ebola, I think Liberia has a head start when it comes to handwashing, and also when it comes to containment measures,” she says. “There are handwashing stations everywhere, temperature checks everywhere.” After the first case of COVID-19 was confirmed in the country, many more handwashing stations started to appear in public places like schools, hotels, and shops.
Liberia’s President George Weah announced a nationwide quarantine starting Saturday, April 11, which prohibits movement between counties and across borders. In several parts of the country, including Monrovia, residents must stay inside their homes for two weeks, with exceptions for food shopping, health care, and essential work.