For months there has been a race to rapidly bolster the health infrastructure by training medical personnel, building clinics and acquiring medical equipment; all in an effort to get ahead of Ebola. In an interview with Politico, Bill Gates discussed the importance of health infrastructure in the prevention and treatment of disease. He believes that the initial delay in reporting of Ebola was one of the reasons that it spread so quickly. This delayed reporting is an indicator that the health system was not prepared to handle an outbreak of this kind.
The Government of Liberia’s (GoL) Ministry of Health and Social Welfare (MOHSW) department, has worked to overcome pitfalls in its system and tackle Ebola. From previous reports from GoL we’ve seen data standards being set and subsequent improvements in reports from clinics across the country. There is increasing pressure on Hospitals, Community Care Clinics (CCCs) as well as Ebola Treatment Units (ETUs) to have designated data managers in order to improve reporting. Additionally, there are 17 new ETUs that are planned and the 21 new CCCs that are scheduled to be completed in December.
These new clinics are being overseen by the local County Health Teams in conjunction with an international partner at each site. There are still reports of communities resisting being treated at these centers and some locations that were chosen for clinic sites are being constructed in communities that don’t want them there.
As new clinics pop up around the country, The Liberia Philanthropy Secretariat hopes to see an inclusive health infrastructure plan that details how management of these health facilities can be transformed to meet the general health needs of Liberians. The health infrastructure improvements are vital to fighting Ebola, but a long term commitment and strategy are needed to ensure the management and maintenance of a robust health system. Our hope is that these new facilities will be the outline for future comprehensive clinics that can provide effective monitoring and reporting of data to help prevent an epidemic, like Ebola, from taking root in the future.
The county updates for the week of November 21st through the 27th show some communities’ uncertainty about the importance of the clinics and details the different needs across the region. For example, In Sinoe County, the community members of Karquekpo had previous agreed to have a CCC built in their community and they are now resisting its development.
In Margibi County there was difficulty last week conducting meetings with contact tracers because of a lack of transportation and communication capacity.
There may still be areas of resistance in Grand Cape Mount County to the safe burial practices being taught. This is drawn from information that a funeral in Bendaja resulted in the infection of one man and several of his family members. Additionally, there are several individuals including two orphaned children that completed their quarantine.
In Bong County the burial teams are making it to communities and assisting with the burials but samples are not always being collected from suspected bodies. It is unknown if this is due to short supplies of test samples, objections from family members, or insufficient training.
Montserrado County health care workers have continued to see high casualties even with the training from international organizations. This week three workers became infected and have been admitted to the local CCC.
Active Case Searches are being conducted by the Ebola Task Force in Bomi County in the Dewoin, Klay and Suehn Mecca Districts. This is part of an effort to stamp out potential hot spots and find individuals that are still in need of treatment.