Building Resilient Health Systems Access to Better Health Services Gives Hope to Ebola Survivors in Liberia

In Liberia, Ebola survivors and the health systems that serve them are still recovering from the effects of the Ebola virus disease outbreak. The USAID-funded Advancing Partners & Communities (APC) project is helping to improve the health system so Ebola survivors can access health services and regain their livelihoods after devastating losses. The APC project is training health workers to provide better services. The program also connects Ebola survivors with the specialty care they need.

A celebration for the graduates of the first of two mental health clinician training programs supported by APC.

Treating the complex health problems of Ebola survivors

Dr. Senga Omeonga, himself an Ebola survivor working at St. Joseph’s Catholic Hospital in Monrovia, treats some of the country’s many Ebola survivors. APC supports two private faith-based hospitals, St. Joseph’s Catholic Hospital and Eternal Love Winning Africa (ELWA) Hospital in Monrovia, to provide primary and secondary health services for Ebola survivors. To get survivors connected with specialty services, APC has helped improve referral pathways within the country’s public health system.

"Survivors have a lot of health conditions…with the help of USAID, survivors get free treatment."

More than two years after the end of the outbreak, survivors struggle with the lingering effects of Ebola, including hearing and sight loss, joint pains, and mental health problems.

Through APC’s support to these faith-based hospitals, Ebola survivors have been able to access routine health services such as diagnostics and surgery, including bone fracture repairs and cesarean sections. Ebola survivors suffer disproportionately from problems related to eyes, joints, and mental health. These issues often require specialty services that are hard to find in Liberia. To improve the availability of services in ophthalmology, psychiatry, and rheumatology, APC partnered with the Liberia College of Physicians and Surgeons and brought in four clinical specialists. Over a 10-month period, these specialists provided direct services to survivors and trained general-practice physicians, mid-level health workers, and medical interns, residents, and students.

With the help of the project, William, an Ebola survivor, received cataract surgery on both eyes and regained his sight. Photo taken by Joshua Yospyn/JSI.

In collaboration with universities, faith-based organizations, and government partners, APC helped 24 Liberian Ebola survivors and a control group of 10 close contacts receive cataract surgery. Five of the 34 patients had surgery on both eyes.

Empowering survivors through Liberia’s National Ebola Survivors’ Network

Naomi, an Ebola survivor, is a member of the Montserrado county chapter of the National Ebola Survivors’ Network of Liberia (NESNL). She is one of many survivors who are finding hope by empowering fellow survivors to help improve their lives. APC has supported the growth of the network to empower survivors to regain their health and become fully integrated within their communities.

"I want to help make a difference for survivors."

Members of the Montserrado county chapter of NESNL gather for a meeting to discuss issues of concern to Ebola survivors.

In counties across Liberia, survivors have come together to support each other through NESNL, which advocates for their needs.

APC has helped NESNL increase its membership and capacity to advocate for issues relevant to all survivors, such as improving health outcomes and access to specialized medical care. Financing and technical support from the project has spurred strong national leadership and created a robust organizational structure that will help NESNL become self-sustaining.

Creating a workforce of mental health clinicians

Ebola survivors suffer disproportionately from post-traumatic stress disorder, anxiety, and other mental health problems. Dr. Muron, a trainer at the Phebe School of Nursing Rural Training Institute, conducts a class to educate mid-level health workers on how the Ebola outbreak has contributed to mental health issues in Liberia and how they can help respond to improve the lives of their patients. To help the communities recover from the devastating impact of the outbreak, APC has supported mental health training and mentoring of mid-level health workers.

APC works with the Phebe School to implement the Mental Health Clinician Training Program. Nurses, registered midwives, and physician assistants from the four counties hardest hit by Ebola received a six-month intensive training program on mental health and are helping survivors and people in their communities recover from trauma. The first cohort of 15 mid-level health workers graduated in March 2018; in July, another 22 clinicians will finish this five-month course.

“The overall impact, we hope, is improved mental health for the survivor affected communities…”

Nurses, registered midwives, and physician assistants from the four counties hardest hit by Ebola received a six-month intensive training program on mental health and are already helping survivors and people in their communities recover from trauma.

About the Program

The Ebola Transmission Prevention & Survivor Services program, funded by USAID and implemented by the APC project, has helped survivors and health systems recover from the Ebola outbreak in Guinea, Liberia and Sierra Leone. The program has worked to mitigate the risk of Ebola resurgence and improve access to health care services for survivors. Interventions have included improving access to health services for survivors by training health workers and reducing stigma, renovating selected health facilities, and providing and building health system capacity for specialized services.

In Liberia, the program has trained almost 500 health care workers on the Ebola virus disease clinical guidelines, and more than 150 health workers have received training in mental health care. A critical component of the program is working with the Ministry of Health in Liberia and USAID partners to support the implementation of the Liberian government’s Ebola Survivor Care and Support Policy, which addresses many of the challenges Ebola survivors face in accessing health services. To help Ebola survivors gain self-reliance, the program has also supported the National Ebola Survivor Secretariat within the Ministry of Health, which coordinates and supports health care for survivors. These efforts have strengthened coordination and capacity within the health system, leading to better care for survivors and the general population.

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Photos taken by Eidolon Films unless otherwise noted.

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