In Lofa County, Liberia, A Legacy Long Remembered

In 2003, International Medical Corps arrived in Lofa County, Liberia as part of an effort to address a critical shortage throughout the region of emergency surgical facilities and skilled health workers. Fast forward almost eight years, 6,000 operations, 19 Primary Healthcare Units (PHUs), and a re-generated hospital later, emergency surgical care is not only available in Lofa, but so is primary health care.

International Medical Corps was the first non-governmental organization (NGO) in Lofa to provide primary health care services to a local population devastated by war, and to refugees returning from neighboring Guinea who often were coming home to nothing.

Dr. Zenebe Bekele Woldemedhin led the International Medical Corps team from 2006 until June 2010, when they handed over the Tellewoyan Memorial Hospital in Lofa’s capital Voinjama. “The work International Medical Corps did throughout Lofa and the work we did rehabilitating the Tellewoyan Hospital was quite tremendous,” says Dr. Zenebe. “I’m very proud of it. The work International Medical Corps did will always be remembered there; it will always be evident.”

When Dr. Zenebe arrived, there was just one small emergency hospital in Lofa, which was built by International Medical Corps.

When the first International Medical Corps doctors arrived in Lofa, they discovered that there were no emergency surgical services in the district at all, and in cooperation with the local district health medical team, they quickly converted a residential house into a functioning emergency surgery facility.

The project had already come a long way, but more advanced care was still needed.

With high demand for surgery, particularly emergency obstetrical surgery, and with no ambulances in the area, patients were forced to travel the four to five hours south to Gbarnga for operations.

Funded by the U.S Bureau of Population, Refugees and Migration (BPRM), the Emergency Obstetrical Hospital International Medical Corps built was a significant step forward from the converted house. It had a surgical unit, laboratory, pharmacy, space for out-patient services, and 25 beds.

Alongside his duties as head surgeon, Dr. Zenebe immediately started building the capacity of the hospital’s local staff in nursing, anesthetics, and emergency surgical procedures.

“I was busy day and night,” says Dr. Zenebe. “Unless I was on R&R they would come for me any hour; it was normal. You can’t turn people away. We averaged around 70 cases per month for the time I was in Lofa – 3,000 to 4,000 operations in the four years I was there.”

International Medical Corps opened 19 PHUs across the region and was the only NGO to provide ambulance services to transfer patients to the BPRM-funded Emergency Obstetric Hospital or, if necessary, as far as the capital Monrovia.

Between 2006 and 2008, the Swiss Agency of Development and Co-operation (SDC) rebuilt the Tellewoyan Hospital in Voinjama. The hospital had served the area since the 1970s and been completely destroyed by rebels during the war. Overgrown with jungle, it was little more than a waste depository. For its rehabilitation, the SDC came to International Medical Corps for its expertise and experience in the region.

“We didn’t have an agreement to manage the hospital, but we were involved with the rehabilitation at every step,” says Dr. Zenebe. “We had a meeting every month where we were consulted as to what was needed and how the hospital should be run – the design, the essential provision of services. I made a monthly presentation on how we thought the hospital could be best rehabilitated.”

Due to its close working relationship with the Ministry of Health as well as its depth of experience and tangible success in the area, International Medical Corps was chosen to manage the hospital on its opening in May 2008.

“I don’t believe the hospital could have opened without International Medical Corps,” says Dr. Zenebe. “For the first six months or so there were huge problems, and we solved them. We were paying salaries, provided essential equipment, and around 85 percent of the drugs came from International Medical Corps supplies. In addition, when the Tellewoyan opened, we moved all of our staff, equipment, drugs, and of course our patients from our BPRM hospital.”

In addition to leaving Lofa County with 19 PHUs and a cadre of fully trained medical staff, International Medical Corps left the Tellewoyan Hospital in Voinjama fully equipped and with substantial supplies of medicines and medical supplies.

“We had done so much there we were determined that the hospital and the county would continue its development; we wanted the Tellewoyan to succeed,” says Dr. Zenebe. “We wanted to stay, but when we left the Tellewoyan, we left them everything required for operation there – eight months supply of drugs, medical equipment, computers, food. We left it all for free in the hope that the hospital would continue to effectively treat the people of Lofa.”

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