By Kandakai Sherman
This commentary is my contribution to the ongoing conversation on how best to move our country forward, as it is obvious from our 167 years of existence that our level of development – whether in infrastructure, civil rights, or human resource capacity- does not commensurate with our age. There’s an abundance of historical literature already out there on our checkered nationhood: missteps, wrong choices or lack thereof, missed opportunities, etc, etc. Our failure to undertake meaningful, sincere and concrete steps throughout this time for inclusive nation building laid the groundwork for what culminated into an explosive outcome, dubbed our civil war.
Now that we are attempting to course correct, it is important to remember that if we aspire to get different results that are better than those of the past, we have to be creative and innovative in our national decision making processes. We have to be careful not to reintroduce or apply some of the same old stale and tired policies of yester- years which did not yield valuable or treasured results for our people. (A recent Daily Observer editorial provided a refresher on the wisdom of manufacturing finished products from our natural resources, as opposed to exporting the raw materials as we’ve been doing since the 40’s 50’s,60’s – “Charlie King time”). I shall return to the discussion on exporting our raw materials another day. For now however, I like to turn to our healthcare system, since it is the most prominent topic at this time due to the Ebola epidemic we’re currently facing.
As I read through the many reports from Liberian news outlets and international accounts, one of the most meaningful pieces of information that we should not lose sight of is the number of Medical Doctors in the country, reported to be anywhere from 150 to 200. Now, if you consider the number of Medical Doctors that are produced/graduated annually (estimate between 20 to 35 per graduation class), it is clear that we have a long way to go in meeting our Doctor to patient ratio in the near term. We’re not producing fast enough, and our population is growing. In the meantime, here are some immediate and long term action steps to consider as our health care administrators and medical professionals work diligently to contain this outbreak, and then move on to improving our health care delivery system:
1. We should utilize the multiplier effect of technology through telemedicine to allow our few Doctors to reach twice as many patients as possible throughout the country. This will require not only a commitment, but also a significant investment in quickly developing and expanding our technology infrastructure, especially our fiber optic and Wi Fi capabilities. A Doctor in Monrovia should be able to ‘virtually’ visit or consult with a patient in Vahun, Lofa County thru an established, functional system. This is within the realm of possibility and reality. The telephone landline remained a pipedream for many in Liberia of yesterday. Today, the cell phone has traversed almost every corner of our country.
2. We should negotiate for complimentary foreign Medical Doctor assistance from other nations to help us while we build our capacity. I’ve heard of Nigeria contributing in this regard. Maybe we should also consider reaching out to Cuba for assistance. They are reputed to have one of the best Doctors to patient ratios in the world (according to the World Health Organization). Cuba currently has many doctors seconded to other South American countries to assist those neighbors’ health care delivery systems.
3. Let’s decentralize the Ebola response hotlines (if not already being done). Some of our citizens are complaining that when they call, no one answers or response, hence one of the reasons some bodies are dumped in the streets. The different Ebola reception and holding centers around the country should have their own hotlines for easy access. In the event where operators are not reachable because of demand, callers should have the option of leaving a voice mail so that they can get a return call as soon as possible, followed by prompt action. This will help to reduce the tension and frustration arising out of the communication breakdown.
4. In addition to the education campaigns promoting preventative steps like washing of hands, and avoidance of contact with infected victims, the disease control unit/division of the Ministry of Health should also be actively collecting and analyzing valuable data that will help us perhaps find a cure for Ebola, or better control and contain future outbreaks. We should also be collecting blood samples/specimens from our survivors to use in clinical studies. The antibodies that the survivors created against the disease will prove beneficial in researching for a cure. I would bet if we are not collecting specimens or blood samples, other organizations are already doing it.
5. As a lesson the Ebola outbreak is teaching us, we can no longer lean heavily on the reactionary and response approach to problem solving. In this age of rapid globalization where international travel is making interconnectivity among nations and peoples more common, we can no longer wait for epidemics to hit us before we start scrambling for solutions. Let us begin to study many, if not all of the various communicable diseases throughout Africa that have not yet afflicted us. Let’s learn from those regions and countries well in advance so that we can prevent outbreaks, or that we are better prepared to respond should we be hit.
Our problems are many, enormous and daunting. We need creativity, outside the box thinking and unrelenting execution to solve them.
About the author: Kandakai Sherman is a Service Desk Team Lead at Ascension Health, the largest Catholic & nonprofit healthcare system in the United States, whose mission-focused health ministries employ more than 122,000 associates serving in more than 1,400 locations in 21 states and the District of Columbia. He can be reached at: email@example.com