In 2003, Liberia emerged from more than a decade of civil war. After years of violence, the country’s health infrastructure was devastated. Only 50 doctors remained to treat a population of more than four million people. If you got sick in the city, you stood a chance. But if you got sick in a remote community – many of which are hours or even days away from the nearest clinic – you could die anonymously of a treatable condition like malaria, a complicated childbirth, or untreated infection.
In 2007, a group of Liberian civil war survivors and American health workers came together to address these challenges. Raj Panjabi, Alphonso Mouwon, Weafus Quitoe, Marcus Kudee, Theo Neewrayson, and Amisha Raja co-founded an organization committed to seeking truth and justice for Liberia’s rural poor. They called themselves Tiyatien Health, meaning ‘justice in health’ in a local language. Joined by Peter Luckow in 2009, Tiyatien Health began Liberia’s first rural, public HIV program, which treated patients in a gutted closet in a war-torn building in Zwedru, Liberia with only $6,000 in seed money.
Almost immediately, our growing team realized that the greatest needs were at Liberia’s last mile, where people in remote communities lacked access to healthcare due to distance and poverty. Their solution was to recruit, train, equip, manage, and pay community members to provide lifesaving health services to their neighbors. In so doing, they were also able to create a strong link between remote communities and the government’s public sector health system.
With a refined focus and an ambitious vision for the future, Tiyatien Health came to be known as Last Mile Health in 2013. Since those early days, we have grown from a small team working out of a supply closet to a growing organization that serves as a dedicated partner to the Liberia Ministry of Health. And our journey has brought us through challenges we never could have predicted.
On December 26th, 2013, an 18-month-old boy from a remote community in the Guinean rainforest fell ill and died of cholera-like symptoms. Within weeks, several of his family members had succumbed to the same fate. But by the time local authorities were first notified on January 24th, 2014, it was too late to stop the spread of what would soon become the worst outbreak of the Ebola Virus Disease in recorded history. More than 11,300 people died of Ebola across Guinea, Liberia, and Sierra Leone while the outbreak closed schools and brought local economies to a standstill.
Through the generosity of our dedicated partners, we supported the Government of Liberia to train more than 1,300 health workers and community members to prevent and contain the spread of Ebola. In 38 clinics across Southeastern Liberia, we supported health workers to “keep safe, keep serving” in the midst of the outbreak through distribution of Personal Protective Equipment (PPE) including goggles, gloves, and gowns, and through training on best practices in disease prevention and control. At the community level, we trained our community health workers and other community “mobilizers” to educate their communities about the cause of Ebola, how to prevent its spread, and how to manage and report suspected cases.
The Ebola outbreak, which was finally brought to a halt in 2016, was a defining moment in our growth as an organization. A tragedy of unfathomable scope, it highlighted the need for stronger, more resilient health systems that reach even the world’s most remote communities. And at the same time, it also highlighted the key role that ordinary community members can play in transforming health outcomes by bringing lifesaving healthcare services – including infectious disease surveillance – to the community level.
Around the world, one billion people lack access to healthcare because they live too far from a health facility. Today, we are more committed than ever before to bridging the gap between clinics and remote communities by deploying community health workers to bring primary health services to the doorsteps of people living far from care.