As with any development desk job, at times there is a disconnect between what you are working on and what is actually happening on the ground. There are questions of whether the endless reporting, complicated spreadsheets, and multiple emails have any impact on what you are trying to achieve. This summer, my goal was to be as helpful as possible with the limited time that I had at the Ministry of Health in Liberia. At first, I felt the disconnect. I’m working for a government entity trying to fix high-level problems and hoping that the projects that I am working on come to fruition in the long run. This all changed once I visited Redemption Hospital.
At the beginning of July, I went to Redemption, the public regional hospital that serves upwards of 2 million people. The purpose of the visit was to identify if there were any “ghost workers” at the hospital. A ghost worker is an employee that is on the government payroll, but does not actually work. Because it is difficult to track public employees in many government entities, many people are often in the payroll system even though they are not working. This is major problem as services are not being provided by those workers and millions are wasted on salaries of non-working employees. This visit to Redemption was just the beginning of my work with the hospital over the past month.
Redemption Hospital is the largest free health facility in Liberia, and the demand for services far outweighs the capacity, often resulting in 2-3 patients per bed. Although Redemption staff try to treat all those in need, after the rapid spread of Ebola throughout the hospital in 2014, it was forced to limit admissions to keep with infection prevention and control standards. In fact, part-way through the epidemic, Redemption was temporarily shut down in an attempt to ebb the spread in the region. As a result, the hospital is run down and there are not enough beds to serve the population. Every day the staff is forced to turn away multiple expecting mothers because they do not have the delivery room space to help them through the birth. This is part of the reason that maternal mortality is the leading cause of death of women aged 15-49 in Liberia and that the country has the second highest maternal mortality rate in the world. Redemption Hospital is also limited in the services it can provide. For example, they do not have the capacity to tend to burn victims, so burn patients are transported to the national hospital in Monrovia, more than an hour away.
After my visit, in which only three ghost workers were identified, I met with the Adviser to the Minister of Health to ask if there were plans to repair and/or expand Redemption in coming years. As it turns out, she was in the middle of negotiations with the World Bank for a $14 million grant to build a brand new regional hospital. This is when the work really began. As part of the proposal, the World Bank requested a Functional Plan that proved that there was a demand for each service the future hospital would offer. So, for the past month, I have been working with the Adviser and the head architect of the new hospital on a method to prove that this hospital is an absolute necessity. Although our research disclosed that the demand severely exceeded the size of a hospital that $14 million could build, the new hospital is still a step in the right direction. The plans for the new hospital especially focus on maternal and pediatric health as the need is greatest for those two service populations. The Functional Plan was sent to the World Bank yesterday and, if approved, they hope to break ground before the new year. So, although the past month has involved research, data analytics, constant phone calls with the hospital administrator, and pages of writing, this project has bridged the gap between desk work and tangible results. This new hospital, when built, will improve the quality of and access to healthcare services for 2.5 million people.