On May 12, 2021, Last Mile Health’s Liberia Country Director Marion Subah gave the following remarks in Monrovia, Liberia in honor of International Nurses Day.
The President of the Liberian Nurses Association, Nurse Managers, Hospital Administrators, Fellows of the West African College of Nurses, Fellows from sister colleges and associations, lined ministries and all related health programs represented here; Government officials; members of the fourth estate; distinguished ladies and gentlemen; fellow nurses: As we commemorate another year of hard work and commitment, allow me to join the rest of the world to say to us all “HAPPY NURSES DAY”.
I am so glad to be here with you all today. I’m Marion Subah and I currently have the good fortune to lead Last Mile Health’s work in Liberia. We are currently working with the government to scale up and sustain our country’s National Community Health Assistant program. Nurses are a critical part of this work.
For the past 40 years, I have worked to improve maternal and child health in Liberia: as a nurse and registered nurse midwife, as a director at the Ministry of Health, and as a global health leader. What I have seen again and again in my work is the power of community health care to save lives. This is the future of healthcare and a place where nurses can take the lead.
I think of nurses like Albertha Freeman, a community health nurse supervisor in Gbarpolu County. While on rounds in 2019, visiting the community health workers she supervises, Albertha was brought to the home of a 4-year-old boy named Nathaniel. Nathaniel was suffering from severe malaria, and would likely have died if Albertha hadn’t recognized the gravity of his symptoms and carried him to a health clinic herself.
Nathaniel is now fully recovered and one of nearly 700,000 cases of malaria, pneumonia, and diarrhea that have been diagnosed at the community level – and treated – through Liberia’s National Community Health Assistant Program.
Nurses, we are doing a great job in every sphere answering duty’s call, especially throughout the last year, in the face of so many challenges and so much uncertainty. As I look to the future – and toward a vision of healthcare for all – I know we need to focus at the community-level.
There are many challenges influencing the health of our communities. Infectious diseases, like COVID-19, Ebola, and tuberculosis, can spiral out of control in both rural and urban settings. Children’s health is still threatened by preventable diseases like malaria, anemia, and pneumonia. And unequal access to health care continues to drive morbidity and mortality among infants, pregnant women, and other vulnerable populations.
Amid these challenges, nurses are at the frontline ensuring that help arrives, and smiles return to the faces of the ill and the injured. And nurses are working directly with communities.
Community health nursing transcends the provision of curative or promotional care to community members. It strengthens health systems that can be surged during crises to keep essential services going. It focuses on how we can transform the community through family-focused interventions and behaviors that will improve the health and wellbeing of everyone, everywhere. No matter who you are, you are part of a community.
Here are three key ways I have seen community-health nursing improve care in Liberia through the National Community Health Assistant Program:
The first is that community nursing improves care because it relies on trust. Working in communities is complex because it requires working with diverse people from different cultures, religions, socio-economic status or political orientations. Community health nurses live and work with the patients they serve. They understand their cultures, traditions, and daily challenges and so they are trusted.
The second key way that community nursing can help us improve health in Liberia is through the power of early diagnosis. Infectious diseases like Ebola start in communities. If we can diagnose cases early, we can prevent greater damage and the risk of future epidemics. And it’s not just infectious diseases. Surveillance and early diagnosis can prevent many of the long-term impacts from threats like malnutrition and malaria.
And finally, community health nursing improves the management of chronic conditions. This is evident in our current efforts to identify, reach, and treat people living with HIV and AIDS. And it is evident in work to help elderly people manage their chronic health problems from home, especially during emergencies like COVID-19 and Ebola.
Having access to basic health services that improve your physical, mental, and social wellbeing is one of life’s greatest assets. There is no platform better than community health nursing to deliver this.
May all nurses in this hall please stand.
Today, I salute each of you, for the enormous effort you put into your daily work to ensure that people are cared for. This work is not without sacrifice. I know many of you leave your children at home and go to health facilities to care for other people’s children. I know many of you oversee critical components of our health system, like governance, financing, supply chain, and monitoring and evaluation. I know each of you has continued to serve this year despite the risks from COVID-19. I salute your extraordinary courage and your willingness to provide needed care and leadership. Thank you. May you continue to be the voices that lead and the hope for all who look up to you.
As nurses, our voices must be heard. We must continue to use all of the platforms we have available to tell our stories and to make sure our experiences are represented at the decision-making table. I encourage each of you to use your voice and your story to lead and to improve health for all, beginning in your community.