{"id":8604,"date":"2022-02-03T10:56:32","date_gmt":"2022-02-03T10:56:32","guid":{"rendered":"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities"},"modified":"2022-02-03T11:14:04","modified_gmt":"2022-02-03T11:14:04","slug":"how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities","status":"publish","type":"post","link":"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities","title":{"rendered":"How the legacy of Liberia\u2019s Ebola outbreak is improving the health of rural communities"},"content":{"rendered":"

Africa-Press – Liberia. <\/strong><\/span>In the shade of a grand old mango tree, John Flomo is carrying out one of his routine checks for child malnutrition in Donfah, a remote village in Liberia\u2019s Bong county.<\/p>\n

Flomo takes out a colour-coded tape to measure for malnutrition and wraps it around the arm of a two-year old boy, with a beaming smile. \u201cYour boy\u2019s doing just fine,\u201d Flomo tells the boy\u2019s mother, Linda Williams. \u201cHe\u2019s going to grow up to be a big, strong man. But make sure that you feed him plenty.\u201d<\/p>\n

Flomo is a community health assistant for Donfah, where he was born, went to school, and for many years worked as a farmer before being nominated by his community for this important new role.<\/p>\n

There are around 4,000 community health workers like Flomo across the west African nation\u2019s 15 counties, providing health services to remote villages. Together they are a crucial cog in Liberia\u2019s fragile healthcare machinery. The country\u2019s health system is currently undergoing a bold revolution, after being pushed to the brink by brutal civil wars between 1989 and 2003 that killed 250,000 people. By 2008, there were only 51 doctors in Liberia serving a population of 3.7 million, roughly one per 70,000 people.<\/p>\n

That year the government overhauled its health system, with the aim of encouraging the use of community-based health volunteers. Then, in 2014 a deadly Ebola outbreak hit Liberia, and this served as a catalyst for the national deployment of the workers. From 2016 they began to receive proper pay and training as their role was formalised.<\/p>\n

\u201cThat was one of the lessons learned from the Ebola outbreak,\u201d says Sumo Lomax Flomo of the National Public Health Institute of Liberia. \u201cWe saw a lot of cases coming from the community who were very ill or already dead. The community was not used for surveillance. Once it was, our fight was transformed.\u201d<\/p>\n

The primary role of community health workers is the diagnosis and treatment of children under five for malaria, pneumonia and malnutrition. But they also focus on community health education, disease surveillance and maternal health.The health workers\u2019 mission is to provide treatment in remote areas far from health clinics. As they come from the local community they are also more likely to be trusted by their fellow villagers when it comes to thorny issues such as vaccination. The scheme has the added benefit of bringing income and employment to poverty stricken rural areas with few job opportunities.<\/p>\n

\u201cI\u2019ve been very impressed with the scheme,\u201d says Robert Yates, director of the global health programme at policy think tank Chatham House. \u201cIt’s very cost effective and it reaches a lot of people. But the benefits go way beyond the immediate health sector. It creates employment and improves women\u2019s livelihoods. It\u2019s very clever.\u201d<\/p>\n

Since the community health scheme officially launched in 2016, it has made startling progress. About 70 per cent of Liberia\u2019s 700,000 rural residents now have access to care and some 1.8 million free screenings and treatments for diseases such as pneumonia and diarrhoea had been carried out on under fives as of June 2021.<\/p>\n

A study published in August found that community health workers now treat 45 per cent of all malaria cases among children under five in those areas, with that figure rising year-on-year. And, crucially, children get treated faster. The number of malaria cases treated in less than 24 hours rose from 12,807 in 2016 to 93,530 in 2020, according to Ministry of Health data.<\/p>\n

In Dofah, it can take several hours to walk to the nearest health facility under the energy-sapping Liberian sun. But residents say treatment and diagnosis is now faster, convenient and accessible. \u201cWe felt bad when we had to go to the clinic,\u201d says Linda Williams. \u201cIt was exhausting if you couldn\u2019t afford the motorbike. Back then I had to rush to the hospital, but now I just go to Flomo\u2019s house.\u201d<\/p>\n

Flomo was nominated by the Donfah community for the role in 2016. The job requires a minimum of primary level education and completion of a written literacy test. Each community health assistant must go through four modules of training over several months, from household registration to family planning and malaria diagnosis. They are then paid $70 (\u00a352) a month for around four hours work a day, but must be on call for emergencies.<\/p>\n

\u201cI enjoy the job, I\u2019m proud,\u201d says Flomo. \u201cThese are my friends, family and former classmates. I\u2019m preventing their sickness. I feel respected in my community, people see me as the Big Dada. They thank me so much. They call me if they need anything. \u2018John, my child has a fever\u2019, \u2018John, I need to go to the clinic\u2019.\u201d<\/p>\n

For Linda, this deep-rooted connection with the community can\u2019t be replicated by outside health workers parachuted in for brief visits. \u201cI\u2019ve known the man since I was small, we grew up together,\u201d says the 35-year-old mother. \u201cI trust the man in a way I couldn\u2019t with some stranger.\u201d<\/p>\n

George Tamatai, a Ministry of Health official in Bong, says the scheme has reduced the workload in the county\u2019s clinics, freeing up capacity for more specialised work. \u201cCommunity workers identify illness earlier, which means there are fewer patients for clinics to deal with and fewer severe illnesses that develop,\u201d he says.<\/p>\n

The early detection offered by community-based health workers is also seen as a vital tool for stopping the spread of emerging infectious diseases. The Independent Panel for Pandemic Preparedness and Response has said community health workers made a \u201ccritical difference\u201d in countries\u2019 responses to Covid, establishing trust in government policy, extending services and relaying scientific information. In Donfah, given the relatively narrow focus of Flomo\u2019s remit \u2013 easily treatable diseases for under fives \u2013 much of the support he gives to the rest of the community involves early diagnosis and clinic referrals rather than in-situ treatment.<\/p>\n

At the Zeansue Clinic, four miles away from Donfah, there are signs that those referrals are running smoothly. Esther Bonndo, a mother from the nearby Palala village, has come to get her three-month old vaccinated for pneumonia after being reminded by her community health assistant. \u201cIt wasn\u2019t any effort at all,\u201d she says.<\/p>\n

Yet despite the huge strides taken in Liberia\u2019s provision of care, one of the great challenges remains timely and sufficient supply of drugs in the face of funding shortfalls and the logistical difficulties presented by the country\u2019s poor roads. There are fears these could undermine the entire community health programme.<\/p>\n

\u201cWe often don\u2019t have enough medicine,\u201d says Massayan K Jallah, community health department director for Bong\u2019s nine health districts. \u201cAnd when it\u2019s insufficient, it\u2019s bad for the community. If the drugs aren\u2019t available, they might have to walk two or three hours to the facility. And they might not even have any there. It can be really demotivating and risks undoing all our good work.\u201d<\/p>\n

Another crucial obstacle on the horizon is securing financial sustainability. Liberia\u2019s community health programme is currently heavily reliant on funding from organisations such as USAid and the International Rescue Committee (IRC), which are backing the scheme in the counties of Bong, River Gee, Grand Kru and Lofa. \u201cThe government\u2019s ownership of the project is something that must be worked on,\u201d says Dianah Bedell-Majekodunmi, the IRC\u2019s project director in Liberia.<\/p>\n

But for now, Liberia\u2019s poverty-stricken, remote and rural communities are benefiting from improved access to healthcare in a way that is revolutionising the fight against infectious disease in sub-Saharan Africa.<\/p>\n

During the civil war, Sianneh McCarthy was forced to flee violence in the capital Monrovia, walking roughly 100 miles to Donfah. Her three-year-old son suffered chronic anaemia due to iron deficiency and died. \u201cWe had no car to take him to the hospital,\u201d she says.<\/p>\n

Now she is visited by Flomo two or three times per month \u2013 but if any of her children get sick, he comes straight away. Just two days before, her three-year-old son, Emmanuel had a \u201crunny stomach\u201d, and was given oral hydration solution (ORS) by Flomo.<\/p>\n

\u201cHe can take care of us quick,\u201d says Sianneh, clasping her skinny young boy tightly. \u201cBy the grace of God, it\u2019s much better. It\u2019s different now. My son wouldn\u2019t have died if it was like today.\u201d<\/p>\n

For More News And Analysis About Liberia<\/a> Follow Africa-Press<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Africa-Press – Liberia. In the shade of a grand old mango tree, John Flomo is carrying out one of his routine checks for child malnutrition in Donfah, a remote village in Liberia\u2019s Bong county. Flomo takes out a colour-coded tape to measure for malnutrition and wraps it around the arm of a two-year old boy, […]<\/p>\n","protected":false},"author":84,"featured_media":8603,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,6,8,16],"tags":[233,237,234],"class_list":["post-8604","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-all-news","category-files","category-homepage-english","category-twitter","tag-africa-press","tag-africa-press-liberia","tag-liberia"],"yoast_head":"\nHow the legacy of Liberia\u2019s Ebola outbreak is improving the health of rural communities - Liberia<\/title>\n<meta name=\"description\" content=\"In the shade of a grand old mango tree, John Flomo is carrying out one of his routine checks for child malnutrition in D ...\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How the legacy of Liberia\u2019s Ebola outbreak is improving the health of rural communities\" \/>\n<meta property=\"og:description\" content=\"In the shade of a grand old mango tree, John Flomo is carrying out one of his routine checks for child malnutrition in D ...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities\" \/>\n<meta property=\"og:site_name\" content=\"Liberia\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/AfricaPressTunisiaa\" \/>\n<meta property=\"article:published_time\" content=\"2022-02-03T10:56:32+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-02-03T11:14:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/static.africa-press.net\/liberia\/sites\/37\/2022\/02\/img-61fbb8e4ac940.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"960\" \/>\n\t<meta property=\"og:image:height\" content=\"600\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"cfeditoren\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"cfeditoren\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities\"},\"author\":{\"name\":\"cfeditoren\",\"@id\":\"https:\/\/www.africa-press.net\/liberia\/#\/schema\/person\/068c7ab4e9634ae78ec5d54ec46598bb\"},\"headline\":\"How the legacy of Liberia\u2019s Ebola outbreak is improving the health of rural communities\",\"datePublished\":\"2022-02-03T10:56:32+00:00\",\"dateModified\":\"2022-02-03T11:14:04+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities\"},\"wordCount\":1405,\"commentCount\":0,\"image\":{\"@id\":\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities#primaryimage\"},\"thumbnailUrl\":\"https:\/\/static.africa-press.net\/liberia\/sites\/37\/2022\/02\/img-61fbb8e4ac940.jpg\",\"keywords\":[\"Africa Press\",\"Africa Press-Liberia\",\"Liberia\"],\"articleSection\":[\"all news\",\"files\",\"homepage-english\",\"twitter\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities\",\"url\":\"https:\/\/www.africa-press.net\/liberia\/all-news\/how-the-legacy-of-liberias-ebola-outbreak-is-improving-the-health-of-rural-communities\",\"name\":\"How the legacy of Liberia\u2019s Ebola outbreak is improving the health of rural communities - 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