Liberia suffered through a disastrous civil war from 1989 to 2003 which destroyed much of the country’s medical infrastructure, medical workforce and medical training programs. The war has also taken its toll on the children of Liberia:
- Nearly 50% of the population is under 15 years of age
- Neonatal and under 5 mortality rate is among the top 5 highest in the world
- 40% of children suffer from stunting due to malnutrition
- Malaria and measles are among the leading causes of death
- HIV prevalence rate is 5.9% (many believe it to be higher)
- Only about 50 physicians are presently practicing in country
- There are only 2 pediatricians in Liberia
A non-governmental organization called HEARTT (Health Education and Relief Through Teaching) was created in 2005 by Dr. James Sirleaf, son of President Ellen Johnson-Sirleaf, to address the critical shortage in medical workforce capacity in Liberia. The goals of this organization are 1) to provide interim direct patient care 2) To aid in capacity building through education and training of medical students, interns, residents and mid level health care providers (NPs and PAs). 3) Monitoring and evaluation through data collection.
HEARTT’s pediatric program was started as an academic consortium of pediatric programs almost 3 years ago initiated and led by the University of Massachusetts Medical School (UMass). The sites that we partner with in the capital city of Monrovia, Liberia are the John F. Kennedy Medical Center and Redemption hospital both of which are the flagship teaching hospitals for the A.M. Dogliotti Medical School and the Tubman National Institute of Medical Arts. The overall goals of the pediatric program are: 1) to educate 3rd and 4th year Liberian medical students and Interns in clinical pediatrics 2) to provide training to Liberian interns and residents to enable them to pass the West African Board exam, improving progress towards training practicing Liberian pediatricians and 3) to provide education to nurses and physician assistants on pediatric care.
Recognizing the need for broad collaboration, UMass has built an academic consortium of pediatric programs including Children’s Hospital Boston to fulfill the clinical, education and research needs at this site. As a group we provide 12 months of pediatric attending level coverage (one faculty member at each hospital) and opportunities for U.S. residents to work at either location resulting in year round continuous coverage. This provides for more organized clinical hand-offs, ongoing clinical projects and reduction in redundancy of didactic teaching of trainees.
Children’s Hospital Boston program in Global Surgery has recognized the need for surgical care in Liberia as there is only one full time practicing surgeon in the entire country. With only one full time faculty member there is significant need for surgical education among Liberian trainees. Starting in February 2012 the Program in Global Surgery is building a collaborative of attending level surgeons across specialties to provide direct clinical care and education at the JFK Hospital site in Monrovia, Liberia. The goal of this collaborative is to provide year round clinical care and education, while monitoring and evaluating their impact on care and education with the ultimate goal of improving surgical training for Liberian physicians. Currently we are seeking attending level surgeons to participate in this multi-institution collaborative. As anesthesia care is similarly scarce in Liberia the opportunities for an anesthesia collaborative or anesthesia faculty volunteers are being explored as well.