I came to Liberia four and half years ago as JSI’s finance and administration director for USAID’s Rebuilding Basic Health Services (RBHS) project. This was my first long-term overseas post. When I came on board, the project had already been going on for over a year.
I won’t lie; it took me a while to adjust to life in Liberia and learn everything about the massive project that I was working on. The RBHS project has made substantial accomplishments under the great leadership of our chief of party and now, ten years post conflict, Liberia’s health sector has made a number of improvements, such as increasing the number of skilled birth attendants, increasing the number of women who give birth in health facilities, increasing the number of women using family planning methods, improving the health information system, etc.
Now, in the blink of an eye, everything has changed. We are in the midst of the worst Ebola outbreak the world has ever seen. Liberia, once again, after its ten years of peace, is facing immense adversity and challenges that will undoubtedly set back the progress made in the health care system and other sectors over the past decade. Epidemic response management requires significant immediate support — unfortunately, adequate assistance has not arrived quickly enough.
About a month ago, I was at the Ministry of Health and Social Welfare (MOHSW) with my staff, delivering nearly $90,000 worth of medical and non-medical supplies. These supplies were needed to support Ebola response trainings being held for every health facility in Montserrado County (which includes the capital city, Monrovia).
As I walked into the small warehouse run by the MOHSW to make the delivery, I was taken aback by how disorganized and chaotic the room was. I quickly asked the people working who was in charge of the warehouse and I couldn’t get an answer. It was clear to me that they needed direction and support, and, based on my knowledge and skills, I was in a position to improve the situation.
I first spoke with my boss, who had already seen some of the challenges firsthand. I then had a discussion with the deputy country director for the Clinton Health Access Initiative (CHAI), who had been trying to support the warehouse for several weeks. The two of us went to the warehouse together and determined what needed to be done to make the warehouse functional and better able to supply the country during this emergency.
We then had a discussion with the assistant minister for administration. He is not only the head of the logistics committee on Ebola response, but also the overall supervisor for the warehouse. We explained the situation at hand and then mapped out what we planned to do. After securing his approval, we moved forward.
We needed to do several things to get the warehouse in order: 1) do a full inventory, 2) give every item a unique identifier, 3) have visible bin cards, 4) have a manual ledger that includes all requisition information, and 5) develop a user-friendly computerized inventory system. These basic supply chain system components had not yet been put in place by the MOHSW, likely because of the daunting volume of work.
With the help of committed MOHSW supply chain staff who were eager to work hard once given direction, we were able to put the supply chain system in place. Once this was done, we gave all people working in the warehouse specific assignments to help maintain organization within the warehouse.
The warehouse is still a work in progress and much work remains to be done. More donors and organizations have begun providing support in the last few weeks — we hope this means that many areas of the country will get the assistance needed. Without a doubt, the system we put in place has equipped the government to accommodate the increasing amount of Ebola-related supplies being sent into Liberia.
The entire Liberian landscape has changed dramatically in just a matter of weeks. Many government ministries are practically empty, as non-essential staff were placed on 30 days compulsory leave. Roads are empty, as many Liberians are staying at home to remain safe, and a large part of the expatriate community has left the country. Most people are just simply scared — I feel like I spend a lot of my time calming people down and making sure they know what to do if they see someone presenting Ebola symptoms.
Through this experience, we have all become dedicated public health workers and educators. The RBHS team will continue to support the MOHSW in Liberia as best as we can; doing whatever is needed to get ahead of this epidemic.