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09 10 years of health care in Liberia
Transforming a hospital devastated by war
Nurse Lawrence Jallah attends to a patient on the surgical
ward at Liberian Government Hospital in Buchanan.
Liberian Government Hospital in Buchanan, which serves
an estimated 600,000 people, has been transformed
over the last four years thanks to the direct support
of Merlin and its donors.
The hospital, which had been severely looted and
damaged during the war, underwent major renovation
in 2003 and 2004.
Electrical and plumbing work was carried out; furniture,
equipment and medicines were supplied; and clinical staff
were recruited to get the war-battered facility back up
and running.
“Before, the condition of the hospital was very bad
indeed. We didn't have the workforce or the equipment
and support needed for proper clinical work," says longstanding
employee Albert Saykpa, a former Nursing
Director of the hospital. “When Merlin came we really
noticed things changing.”
2005 saw the construction of a new outpatients
department (OPD). Previously, outpatient services had
been conducted in the main hospital building, which led
to overcrowding and made it difficult to maintain an
organised service. The new wing was officially opened by
Liberia's president, Ellen Johnson-Sirleaf, in April 2006.
“It has become easier to see more outpatients in any
given day,” says Stanley Otunga, Merlin's hospital
matron. “We have a good emergency room, and a short
stay area where we can observe people. It is making a
big difference to patients and to the operation of the
hospital as a whole.”
In 2005, the OPD saw an average of 4,496 patients
every month. Last year, this figure had risen to 5,008–
more than 500 extra patients per month.
Better organised wards, staff training initiatives and
an incentive scheme have also led to an improvement
in clinical standards over the years.
“In-patient care has definitely got better. Now we
have a lot more nurses who are properly qualified and
who are benefiting from Merlin's incentive payments,”
says Otunga.
“I would also say that because of regular training
sessions we have given to staff – especially on the
management of medical conditions – the physicians
and nurses are becoming much more accurate in their
diagnoses and treatment.”
President Ellen Johnson-Sirleaf officially opened the new
outpatients department at the hospital in Buchanan in 2006.
In a country where many public sector employees
are still not on the government payroll, Merlin’s payment
of monthly incentives is helping to attract and retain
skilled health workers who might otherwise relocate
to Monrovia.
“As well as the regular supply of medicines, one of the
great things that Merlin has done is to offer incentives
to staff here,” says Dr Jerry Brown, the hospital's doctor
and the County Health Officer for Grand Bassa. “If it
hadn't been for Merlin, some of the qualified staff would
not be here.”
There are several other challenges for this rural hospital
to overcome. Perhaps the most immediate concern is the
lack of qualified medical specialists, particularly doctors.
“Currently I'm the only Liberian doctor here at the
hospital, and I also act as County Health Officer,” says
Dr Brown. “It can be a real headache when I have to leave
the hospital to attend meetings.”
Merlin has secured funding to support the hospital until
February 2008 but further donor support will be vital to
ensure that the significant improvements to health care
provision are maintained.