By Jones N. Williams |
Liberia sought and offered a clear mandate during the country’s October 2023 presidential election which was won during the November 2023 runoff. The mandate was and remains a demand for real change – a change that requires reforming and restructuring the country such that its key issues and problems: poverty, high unemployment, skill gap, workforce deficiency, poor or non-existent infrastructure, food insecurity, substandard education classification, and deplorable healthcare system will be addressed finally. In as much as all the problems mentioned are vital, addressing the country’s disgraceful healthcare system must supersede and take priority for the incoming administration to prevent the severe impact the disastrous healthcare system imposes on the Liberian people and nation.
According to the Liberian Ministry of Health, as of December 04, 2023, there are a total of 61 hospitals in the country of 5.2 million people. Sadly, all the hospitals and clinics lack modern or even appropriate medical equipment and medical supplies in addition to a shortage of trained, competent, and experienced medical and healthcare staff. The doctor-to-patient ratio in Liberia is one of the worst in Africa and the world. According to the WHO World Health Statistics 2021 report on the State of the Health Workforce in Africa, Liberia has one physician or doctor for every 20,000 people, a number far below WHO’s recommended 1:1,000 doctor-to-patient ratio. There are also no trained operators for advanced medical equipment if they were even available. While there are efforts to produce more trained doctors, physician assistants, registered nurses, x-ray technicians, therapists, and clinical social workers, inadequate and poor training, low wages, and unpleasant work environments and conditions remain key undermining factors to producing an efficient and effective healthcare workforce. This is one of the major challenges awaiting the new administration from day one – right after the January 22, 2024 inauguration.
Why should the incoming Liberian administration prioritize rebuilding the country’s appalling healthcare system? Simple: many Liberians are dying every day from preventable diseases that include flu, fever, and simple things like the lack of oxygen. The very condition of the country’s main hospitals appears like a death trap. Besides, evidence revealed that a country without a good or reasonable healthcare structure or system is not only unattractive to foreign investment and investors, but it also undermines economic productivity, tourism, and revenue generation, and remains a danger to its sustainability and national security. Moreover, the medical tourism dollars that affluent Liberians, especially politicians, waste just to seek medical care for themselves and their immediate families are huge and remain a drain on the nation while have-nots perish for lack of care. Several healthcare reports including those from the World Health Organization (WHO) suggest that Liberia faces 5 major health issues, and these include a high prevalence of infectious food or waterborne diseases (bacterial and protozoal diarrhea, hepatitis A, and typhoid fever) and vectorial diseases (malaria, dengue fever, and yellow fever), and some non-communicable diseases which are also beginning to loom large. The main causes of death in many Liberian hospitals are administrative, operational, technical, and supply chain failure. Such a failure is also a governance catastrophe.
The fact is Liberia’s healthcare system needs up-to-date emergency units and critical care units and should be equipped with Cardiac monitors, EKG machines, Noninvasive ventilation (Bipaps), invasive ventilation (intubation and mechanical ventilation), advanced diagnostic laboratories, and legitimate pharmacies for emergency and critical life-saving drugs. The country’s healthcare system also needs trained medical staff (doctors, nurses, respiratory therapists, lab technicians, radiologists) as well as pulmonologists and cardiologists. Advanced cardiac Life Support (ACLS) and Basic Life Support (BLS or CPR) structure should be mandatory education for all doctors and nurses and there should be AEDs and Defibrillators in all hospitals. The reason is until Liberians can prioritize their health sector; every other thing in the country will be in vain. What is the point in wanting to develop or reform the country when the citizens who should be the beneficiaries are dying because of a deplorable healthcare system?
Apart from the serious high-level public corruption, misguided governance, and mismanagement, the current state of Liberia’s healthcare system after two successive administrations and a combined 17 years in total, boils down to structural gaps in the previous administrations, the lack of national priorities, and official consciousness at all levels of government, especially at the Executive and Legislative echelons. This must change and the incoming administration must put steps in place to ensure the country has a robust and quality healthcare system that will increase wages for healthcare staff. It is an absolute shame that lawmakers in the country, many of whom are functionally illiterate, earn US$12,000 – $15,000 while physicians, specialized medical doctors, and other trained healthcare workers earn a fraction of that amount. To first step in reforming the healthcare system and food security in Liberia is to provide attractive wage packages to people in those fields. The second step is to make sense of the following recommendations:
Privatize the country’s healthcare system and engage the private sector to seek out investors to invest in the sector. This will lead to the establishment of private primary care physicians’ offices and practices, the extension of telehealth, and investment in mobile clinics.
Establish a public-private mandatory low-cost national health insurance program with room for government subsidy like the Medicare and Medicaid programs in the United States. This will expand health insurance to cover health care costs for all Liberians in addition to improving cultural responsiveness.
Facilitate access to a capital loan guarantee program that assists and empowers Liberian physicians and healthcare workers to establish private medical and healthcare practices.
Establish a donor-supported expatriate medical program that will bring in certified and trained foreign medical and healthcare professionals to staff to teach at the M. Dogliotti School of Medicineand nursing schools at a few government-run institutions of higher learning.
By taking these above steps, the net jobs to be created in healthcare and other sectors and the associated causal benefits to the country in terms of productivity, economic growth, and GDP will be enormous. Besides, tourists and foreign investors will have no medical-related reservations when deciding to visit Liberia for investment purposes or exploration. With advanced medical facilities and trained medical staff, Liberia will be poised to serve as a retirement home for African Americans and others because of the country’s traditional ties to the United States.
Finally, many of Liberia’s domestic governance problems can be addressed. The way to do and start that is to put in place a strong, experienced, innovative, tested, and inspiring domestic policy team within the Office of the President like the Domestic Policy Council in the White House of the United States. Such a team will drive the development and application of the Liberian President’s domestic policy agenda in the Executive Mansion and the country and across the various government agencies, ensuring that domestiGlobal News Network Liberia – Global New…c policy decisions and programs are consistent with the president’s identified goals, and are conducted for the Liberian people and the nation. Such a team, on behalf of the president, will also ensure performance standards and measures across government functionaries in addition to finding solutions to deal with domestic issues and problems.
Jones N. Williams is the interim CEO of the West Africa-based Equity Link Capital-Africa, a former State Administrator of the U.S. Bureau of Labor Statistics programs and labor market information in the State of Maryland, and a former project manager for the U.S. State of Virginia Food and Nutritional Services Program.
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Publish date : 2024-01-03 08:00:00
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