Maternal and Child Survival in Liberia
Interviews with Victor Taryor, missionary, Ganta United Methodist Hospital administrator, and Bakary Sidibe, senior program manager for Curamericas, Liberia
In building capacity in targeted African countries for Imagine No Malaria programs in local communities, many valuable lessons have been learned. These lessons are transferrable in delivering other kinds of health care and disease prevention measures to those same communities. In some places in Africa, in fact, United Methodists have been working through their health institutions for decades to bring community-based primary health care to the local level.
Ganta United Methodist Hospital in Nimba County, Liberia, is one such place. Victor Taryor, a United Methodist missionary, serves as the administrator for the hospital, which is part of the larger Ganta United Methodist Mission Station. “We started our community health programs in 1987,” Taryor explains. “The training of community health workers is not something strange to us,” he continues, “since we already had a structure in place. Doing safe water and sanitation work was not new for us. These are all things we had done before.”
Unfortunately, civil strife in Liberia in the 1990s took its toll on the Ganta facilities. The hospital suffered heavy damages, sustaining great losses in supplies, equipment, and personnel. United Methodists in Liberia—assisted by their counterparts in the wider global connection—began to rebuild the Ganta facilities, only to have them hit again in resurgent fighting in the early 2000s. A decade later, the mission station and the hospital have rebounded again. In fact, the Ganta United Methodist Hospital is planning a major construction project to build new facilities, seeking to meet the needs of 600,000 people in its catchment area.
UMCOR encouraged Ganta Hospital to apply for a program funded by profit organization that concentrates USAID through Curamericas, a non-profit organization that concentrates on mother and child health. The Nehnwaa Child Survival Project, now in its fifth and final year of operation, has been working in collaboration with the Ganta United Methodist Hospital to reduce child mortality by 60 percent. This is done through community-based programs that address the principal causes of death among mothers and children—obstetric complications, neonatal conditions, malaria, pneumonia, diarrhea, measles, and HIV infection. According to Bakary Sidibe, senior program manager for Curamericas in Liberia, the organization uses a census-based, impact-oriented (CBIO) methodology that reaches every person in the community.
In a census-based service delivery program, community volunteer health workers are a key factor in the program’s success. The Nehnwaa program actually has several levels of volunteer health workers, Taryor explains. There are traditional midwives, trained by the hospital, who educate village women about women’s health issues and childbirth. They urge local women to give birth in the hospital if they can get there in time. Otherwise, the well-trained and well-equipped midwives deliver the babies. Each community or village has one Community Health Worker who has been trained for the position. This person oversees health concerns in the community, including knowledge of who is sick at any given time and of what environmental factors might be contributing to the problem. Community Health Workers (volunteers) are provided with cellphones so that they can call and ask the hospital to send a vehicle in case of emergencies.
Community Health Workers are assisted by Care Group Volunteers. These volunteers check on the health of 5 to15 families in their community. They visit the households in their care, check up on the health of individuals and families, and make sure that prescribed treatments are being followed. In a census-based approach, everyone in the community is signed into a register maintained by the Community Health Worker, who gathers information from the midwives on births and deaths and from the Care Group Volunteers on illness in the community.
Taryor notes that this very thorough approach is highly time-consuming. He is a little concerned about how to sustain the project when the Nehnwaa funding ends. But caregiver networks are now up and running in the communities, and the careful notes in the registry show a great decrease in child deaths where the program is in operation. In fact, the Nehnwaa program is on target with Curamericas goals of 60 percent reduction in child mortality.
Because of the Nehnwaa program’s integrated approach, malaria, HIV/AIDS, the water supply, and immunizations are all considered part of mother and child health. The program “brings together a social science aspect and a primary public health aspect,” Sidibe points out, in which “each aspect complements the other to serve people in the community effectively.” Explaining how the census-based program reduces malaria, Sidibe notes that the core group volunteers are able to address problems on a family level, making sure each mother has mosquito nets for herself and her children and that she knows how to use them properly. If she and her children are sick, they can be tested for malaria and receive treatment. If the mother is not using the nets, the volunteers seek to find out why. The goal is to change the behavior of the whole family so that children are raised to understand the foundations of public health. Then they can seek to ensure public health in their communities as they grow up and start families of their own.
Victor Taryor encourages United Methodists across the connection to come and see the health work in Ganta. “Some may feel that the money people spend to come from the United States to visit could be better spent if they just sent the money and stayed home,” he admits. “I can see the logic of that. However, when people come, they become inspired when they see what we are doing, and they may want to be part of the service that the church provides to the community. There are so many different ways to serve that a visitor will easily find one that is personally heart-moving. Also, when visitors come and see our challenges, they can go back as good-will ambassadors for our work.”
These interviews were conducted by Christie R. House, editor, New World Outlook.
This article originally appeared in the New World Outlook March-Apirl 2013 edition. Used by permission.
Care for pregnant women is one of Curamericas’ priorities in the Nehnwaa Child Survival Project, a partnership with Ganta UMC Hospital in Ganta, Liberia.
Photo: Courtesy Curamericas
Bishop John Innis, Irene Innis, UMC missionary Victor Taryor, and the staff of Ganta Hospital in Nimba County, Liberia, following chapel service.
Photo: James Rollins/UMCOR