Lack of Access to Healthcare in Remote Communities Can Have Devastating Global Consequences.

From 2014 to 2016, the deadliest Ebola outbreak in recorded history held West Africa in its grip. The epidemic, which began in a remote community in the Guinean rainforest, went on to spread to six countries and claim the lives of more than 11,300 people. Liberia was among the hardest hit nations, suffering more than 10,600 cases and 4,800 deaths. The Ebola outbreak challenged us in ways that we never expected, but it also revealed the power of our community health workers and strengthened our resolve to ensure that everyone everywhere has access to healthcare.

Our Comprehensive Response to Ebola

At the community level, our priority was to protect the safety and security of our health workers while continuing to provide the patients we served through our community health worker pilot project in Konobo District with lifesaving health services. To ensure that our community health workers could “keep safe, keep serving,” we developed ‘no-touch protocol’ for patient care that enabled them to safely provide lifesaving primary healthcare services at the community level throughout the outbreak.

In addition to our own community health workers, we trained hundreds of community members to educate their neighbors on the cause of Ebola, how to present its spread, and how to isolate and report a suspected Ebola case.

At the clinic level, we distributed essential personal protective equipment (PPE) including gloves, goggles, and gowns to ensure that clinic staff could safely care for their patients without risking infection. We also trained health workers on infection prevention and control (IPC) protocol to ensure they had the knowledge and skills to “keep safe, keep serving”.

All in all, we trained more than 1,300 health workers and community members and supported IPC efforts at 38 health facilities across Grand Gedeh and Rivercess Counties in Southeastern Liberia.

At the national level, we dedicated full-time staff to support senior officials at the Liberia Ministry of Health throughout the crisis.

Our Impact: Preventing the Spread of Ebola in Rivercess and Grand Gedeh Counties

Controlled the Spread of the Outbreak

With the Liberia Ministry of Health and partners, we helped contain an outbreak in a remote area of Rivercess County called Kayeh where dozens had been infected and died. In Konobo District, where we launched our community health worker pilot project in 2012, our community health workers provided education to their communities on the cause of Ebola and how to prevent its spread. Thanks in part to their efforts and to the training and protective equipment that we supported the Government of Liberia to provide to health facility staff, there were no reported cases of Ebola in Konobo District throughout the outbreak.

Ensured Access to Primary Healthcare Services

Our community health workers and clinical supervisors continued to provide essential primary healthcare services throughout the Ebola outbreak, treating more than 8,800 cases of pneumonia, diarrhea, or suspected malaria in children under five while health services in surrounding areas were often suspended due to a lack of supplies or training, or fears of infection.

Sustained Rates of Facility-Based Delivery

Throughout the outbreak, 80 percent of pregnant women in Konobo District delivered their babies in a formal health facility, while rates of facility-based delivery decreased three-fold across Liberia. We published a research article in the journal PLOS Medicine on facility-based delivery during the epidemic. Read it here.

Moving Forward

While the Ebola Outbreak highlighted the global threat posed by health systems that fail to reach the most remote communities, it also cast a spotlight on the extraordinarily powerful role that ordinary community members can play in strengthening health systems, preventing deaths, and saving lives at the last mile. With a renewed understanding of the urgency of our work, we set out after the outbreak to support the Government of Liberia to strengthen the country’s health systems and ensure that even the most remote community are integrated into the public sector health system. With your support, we’re working to establish Liberia as a global leader in the movement to ensure that all people have access to healthcare.

Our Vision