Observational And Situational Report: Liberia Medical And Dental Association Of The USA (LMDA-USA) Visiting Professorship Program At The A. M. Dogliotti College Of Medicine, University Of Liberia
By Dougbeh C. Nyan, M.D.
As Liberia dawns into another critical era in our country’s history, there is a need to contribute to the reconstruction efforts in various sectors of the society in order to direct the country on the path of academic progress and socio-economic development. On this note, the Liberia Medical and Dental Association of the USA (LMDA-USA) initiated a Visiting Professor Program to assist the A. M. Dogliotti College of Medicine of the University of Liberia with instructional materials and manpower. Few Liberian doctors in various medical and scientific disciplines therefore signed up to participate in the program. Against this backdrop, I departed the United States for an unpaid voluntary service at the University of Liberia to lecture medical Microbiology at the A. M. Dogliotti College of Medicine. I arrived in Liberia on October 9, 2005 and made contact with the Medical School a few days after the October 11 general elections in which my party, The New DEAL Movement participated. I spoke with Dr. Tabeh Freeman, Acting Dean of the A.M. Dogliotti College of Medicine at the University of Liberia and informed him of my arrival. My lecture schedule was then arranged by Mrs. Victoria Ireland, the administrator at the Medical School.
With the academic year going to an end, first year students had not had Microbiology due to the lack of instructor. The second year students had some aspects of Microbiology – that is, Bacteriology and Virology. Therefore, the schedule was arranged such that two classes (first and second years) were combined for the Microbiology course. My lectures were presented three days a week (Monday, Wednesday, and Friday) for 1.5 hours beginning at 4:30 PM. Classes were sometimes shortened, partly due to the unavailability of electricity (and when my laptop computer ran out of power).
From October to December/January I was able to cover a crash lecture-series in Bacteriology and Mycology, having postponed my departure to sufficiently meet up with this obligation. Scheduling of an assessment test in December and January has been conflicting with previously arranged schedules of other professors.
Microbiology lecture in session (Right- Dr. Nyan; Left-First and Second year Students)
Condition of the Medical School:
Located along the beautiful beaches of the Atlantic Ocean, in Monrovia, Liberia, the A. M. Dogliotti College of Medicine is in a very dilapidated state. The main dormitory building still remains a worn up structure since it was affected during the civil war. Its windows are broken; there is no electricity and no running water. The only source of water supply is the hand pump installed on the campus by a Non-governmental Organization or by the United Nation Mission in Liberia (UNMIL). This pump also serves the local residents. The classrooms and main lecture theatre are without suitable seating facilities. Most of the classrooms have no chairs except for a few broken ones. There are practically no lectures gears, facilities, and equipment. The laboratories (Microbiology, Biochemistry) are practically empty as there are no microscopes, chemical, reagents, and equipments needed for biochemical analysis. The library is also empty, with just a few books on the shelves as much of the books were either destroyed during the war or stolen. There are no printing facilities as the medical school lacks photocopy machine, computers, printers, and other equipment.
The main dormitory building on the A. M. Dogliotti Medical College Campus
The medical school continues to struggle for survival. Although in the last seven years there have been two successive governments (Charles Taylor and Charles Guyde Bryant administrations) with access to enormous state and international resources, the Medical College and the teaching hospitals were overtly neglected. In the face of this, government officials continue to accumulate wealth, live in luxury, and seek medical care abroad (that which the ordinary citizens cannot afford). The John F. Kennedy Medical Center, the main teaching hospital remains poorly equipped and functions below standard. How much the Ministry of Health has done toward assisting the JFK and the Medical School remains questionable and continues to claim the attention of the public.
The administrative building that house the Dean’s office also remains ill equipped. There is no electricity, let alone any access to the Internet. The J. F. K. Medical Center conference room provides an access to electricity and Internet access (when available) in order to facilitate his work. The academic calendar is irregular, most often with a semester taking a year or two to complete. The medical school apparently does not have a fixed teaching staff. Almost all of the instructors/professors have primary jobs with different agencies and hospitals, which claim a high degree of priority in their professional duties since the University of Liberia is neither facilitating nor providing the requisite instructional and learning atmosphere, and salary compensation. For example, a medical school professor earning an equivalent of $20.00 US Dollar per month is no encouragement for work. The Dean had transport problem for a long while, until he was able to repair an old pick-up truck. Besides, the only bus that transports clinical students has been non-operational for a very long time due to mechanical problems and was parked in the compound of the St. Joseph Catholic Hospital that shares a fence with the Medical College. On the whole, the government, particularly the Ministry of Health, has neglected the Medical School, while the Dean and a few colleagues continue to exert more efforts in keeping the school open with practically no support. These are among the many challenges our health care system is faced with.
Situation of the students:
During the William R. Tolbert administration and partly the Samuel K. Doe era, medical students were practically on full scholarship, with monthly stipends and other benefits. Medical students had three meals a day. The situation dramatically changed for the worse since December 1989 when the civil war erupted. The students reside on campus, but practically have to fend for themselves. They count on the assistance of friends and relatives for survival. There is no electricity and running water in what is remaining of the dormitories in which they reside. In spite of the above numerated conditions, the students remain determined to learn, courageous in the academic pursuit, and resilient in their resolve to becoming the next batch of medical doctors in our country. They are very humble, respectful, and studious. Although these adverse conditions have engendered a high drop out rate from the medical school, these students are academically stimulating and determined to remain in school, with the hope of better days ahead.
The main lecture theatre (L) and lab (R) at the A.M. Dogliotti College of Medicine, Univ. of Liberia
Efforts of the Medical School Faculty:
Since his appointment as Dean of the A.M. Dogliotti College of Medicine, Dr. Tabeh Freeman has been working assiduously to rebuild and improve the deplorable condition of the Medical School. To this end, his efforts led to the renewal of the bilateral relation between the University of Turin in Italy and the University of Liberia for a rejuvenated cooperation and hence assistance to the A. M. Dogliotti College of Medicine. Unfortunately, the government of Liberia has not supported his efforts in order to finalize the arrangements and put its implementation into practice. Also, Dr. Freeman was instrumental in having the roof of the main academic building repaired/renewed through the help of the Minister of Education. This was able to stop the leakage through out the building, particularly the leakage in the main lecture theatre where the Minster of Health also conducted lectures in Anatomy. Furthermore, on his trip to the United States as part of the University of Liberia delegation in April 2005, Dr. Freeman visited an array of medical schools to solicit help in resurrecting Dogliotti and furnishing it with instructional materials. One of the institutions sent a box of new Microbiology text to Dogliotti and was distributed among the first year students. Importantly, Dean Freeman negotiated a donation from the Liberia Bank for International Development (LBDI) for the renovation of the main dormitory. At the recently held oath and honor day program, the LBDI authority confirmed and committed themselves to their promise that work on the building will begin soon, as the funds have been approved. On another note, because JFK Medical Center was destroyed and unequipped to handle clinical students, Dr. Freeman arranged with the Firestone Hospital and the ELWA Hospital, among others for upper level students to do their clinicals.
One of the laboratories at the Medical School with few chemicals, reagents, and empty cabinets
Meeting with Colleagues and Authorities:
I made numerous attempts to meet with health authorities and colleagues in order to exchange notes and discussed the plight of the medical school as well as the general situation of health care in the country, but was partially successful in meeting only a few. I met with Dr. Dolopei, who controls the HIV/AIDS program and Dr. Jones, who heads the Malaria Control Programme. I also met with Dr. Lawrence Sherman, one of our colleagues, a young surgeon who is at the John F. Kennedy Medical Center. I was unable to meet with the Health Minister, Dr. Peter Coleman.
Oath and Honors Day:
I was invited (and hence represented the LMDA-USA) at this year’s Oath and Honors Day. Dean Freeman used the occasion to thank and appreciate the Visiting Professorship Program organized by the LMDA-USA. He expressed the need to strengthen the program. Importantly, the Dean utilized the occasion to call for the established of the College of Health Sciences that will bring together A.M. Dogliotti and the Tubman National Institute of Medical Arts (TNIMA). He also proposed that students of the School of Pharmacy and students of medicine be combined for courses in the basic sciences so as to alleviate instructional burden. Seven students graduated from Dogliotti on November 26, 2005. The actual graduation ceremony of the University of Liberia was postponed and is yet to be rearranged.
Media Appearances for Public Appeal:
My presence and duties in the country was greeted with a positive response from the Liberian people. Hence, the media engaged me on numerous occasions. I appeared on several radio talk shows as well as in the print media: on Crystal FM 95.5, Truth FM 96.1, and Power FM 93.3 and in the Daily Observer, a widely circulated daily in Liberia. The media exercises accorded me the opportunity to publicly express our (Liberia Medical and Dental Association of the USA) concern about the deplorable state of our health care delivery system and our endeavour in helping to improve the major health care training institutions, mainly the A. M. Dogliotti College of Medicine and Tubman National Institute of Medical Arts (TNIMA).
Memorable moments and Fun-Time:
Usually after class, a number of students and I stood around as usual, discussing the future of the country, especially the weaknesses in medical care and the need for improvement in public health in the country. One day in November we were engaged in a serious discussion when, about minutes into our chat a news filtered in that the food being prepared at the dormitory was ready. So the boys invited me for supper. Later, my cousin Saye and I caught up with Phillip Ireland, a first year student, at a local pub where we had a few non-alcoholic drinks, while discussing the decline in health and education in the country, the apathy of the government, and the importance of education. Also, one week after the Oath and Honors Day, I sat with a few members of the A.M. Dogliotti Class of 2005 and we discussed issues related to the challenges of the health care system and how we could improve it.
L-R: Saye, Dr. Nyan, P. Ireland at a local pub; photo shows destroyed lab on the right
In order to obtain an objective feedback from the students about the first stage of the program, I organized an evaluation process. Through this, students were able to give their opinion about the lectures series, and suggestions to the LMDA-USA.
Immediate needs of the Medical School:
Suggestions towards finding a solution:
Labs destroyed during the civil war and still remain in ruin during the last seven years
1. The LMDA-USA in conjunction with the Medical School and Science College authority could revise and update the curriculum of the two colleges so as to match up with the contemporary advances in medical science and technology. For example, introductory courses in Molecular Biology and Biotechnology could be added.
2. Put out an international appeal in Europe, America, and Asia, among others for assistance to the medical school.
Survival Kit for LMDA-USA Visiting Professors:
a. Laptop computer
b. Portable printer
c. Projector (if possible)
d. Accessories such as floppy disk, writable CD, etc.
e. Transportation (you need a car!!!)
The country is on the path of reconstruction. As such it is the responsibility of all Liberians to contribute to its renaissance. The LMDA-USA needs to play a greater role in this endeavour so as to begin addressing the challenges faced by our health care system. With the expressed concern and interest of the incoming government, coupled with the genuine sacrifices of our colleagues in the country, I am optimistic that the A. M. Dogliotti College of Medicine will rise again and ascend to heights beyond its pre-war status.
First, a million thanks goes to my family: my wife and two beautiful daughters, for their patience and for understanding the significance of my time away from them. Many thanks to the Acting Dean, Dr. Tabeh Freeman and Mrs. Victoria Ireland of the A. M. Dogliotti College of Medicine for their warm and cordial reception and assistance amidst limited and meager resources. My appreciation to Dr. Dolopei for allowing me to use his facilities; to Dr. Stephen Kennedy and Dr. Francis Kateh of the LMDA-USA for the numerous calls, concerns, and encouragement during the execution of my voluntary duties; to Mr. Thomas G. Du of the National Democratic Institute (NDI), to Mr. Ezekiel Pajibo of the Center for Democratic Empowerment (CEDE) and the entire CEDE family, to Mr. Samuel Kofi Woods, Mr. James Shilue and the staff of the Foundation for International Dignity (FIND) for allowing me to use their facilities to photocopy my lecture notes for the students. I like to thank Mr. Kenneth Y. Best and Sando Moore of the Daily Observer, Ambrose Mah and Jerome Toe of Truth FM, Pinky and Francis Dahn and the Crystal FM Family, Solomon Nelson of Power FM and Medina and Conmany Wesseh for their support and assistance. Thanks to the students for their cooperation, resilience and courage, especially to Phillip Ireland for the spectacular photography.