Partners in Health

Hello all…yes, it has taken me a whole month to collect my thoughts together to write the first blog. I have went through the stages of conditioning to my new life here. First, major culture shock, lots of downs and lots of whys. Then, I began meeting A LOT of people, locals and international workers who are involved in all different types of work raging from public to private sector (employees of numerous NGOs, CDC, Ministry of Health, embassies and journalists). Learning little by little about what this country is all about and what type of efforts are happening to make this ship stay afloat.

Day of departure from US. I seem to be overly excited for Liberia! Little did I know that I will never wear leggings or long sleeve again for the next 4.5months. Living on the 6th parallel away from equator is no joke!

My mind is filled with new information and my own observations that I am making here. I honestly did not know where to start when time came to share my experience. So I decided that I will write my blogs one at a time on different topics that I want to share with you guys. This first one will be about the work of my NGO.

What does my NGO do? In short, PIH helps deliver healthcare to communities in need. I am still learning about PIH, the actual work that they do and the impact. PIH responded to plea for help by Liberian Ministry of Health at the time of the biggest Ebola outbreak in 2014. One of PIH’s mottos “where we go, we stay”. Now that Ebola is under control, PIH is growing and focusing on other sectors such as HIV prevention, Tuberculosis, maternal health and mental health just to name a few. I personally love the last one because being treated for a disease such as TB or HIV is only part of the battle, the other is dealing with the negative stigma of having such illness and integration back to families and their communities.

You may wonder, what stigma is there around an illness like TB? It was quite eye opening to learn from my PIH colleagues. In some communities something like TB is not even recognized as a disease but is rather considered a spell or witchcraft for which the only treatment is prayer. Let that sink in. Secondly, treatment can take anywhere from 9-20 months. Imagine if you’re a sole provider for your family, it would be very unlikely that you would have the means to go to the only few clinics in the country that provide treatment which are probably hours away from your home. Many don’t go to see a doctor until it is too late, and one can only wonder how many others have now contracted this infectious airborne disease. To make matters even more complex, patient is admitted to an inpatient clinic during the first 4 months and then is released back home. However, they must return regularly to continue receiving their treatment for the following 5+ months. For some, travel between the clinic and home may be as long as 10 hours, if possible at all during rainy season. For those that do get persuaded to come in for treatment, PIH provides immense level of support besides medication such as transportation, meals for the patient and their families and any other necessities that may hinder patient from effective treatment. In addition, a PIH counselor works with each patient to help them integrate back into their communities.

The only TB clinic in Monrovia. It used to have 2 wards (male/female) for TB patients. Just several years ago, PIH refurbished 3rd ward for multidrug resistant TB patients. This is where patients spend their first months of their treatment until the disease becomes not active.

Monthly “Enabler Package” that is given to each TB patient: 25kg of rice, sardines, can of dry milk, bag of beans and bag of barley.

As part of my orientation, PIH took us to see TB patients in the clinic who are already in remission (not active disease state). We were given respirator masks to wear. I asked one of the nurses if that would be sufficient means of protection. To which she responded with a smile “Yes my dear, you had a meal today, and your body is strong to fight”. I had to let that sink in. One does not simply think that because we have access to food, at what immense advantage are our immune systems. A luxury that these TB patients don’t have.

With PIH medical colleagues who work with the TB programme.

Recently, PIH have introduced home visits. Where all employees are ought to go see a patient. Previously, it was only PIH medical staff who got to have patient interactions as part of providing medical care, but now the vision is for all staff even from supporting functions (HR, Finance, Grants and Procurement) to have an opportunity to meet our patients (PIH calls them our bosses) who are behind our day to day work.

Doing our first visit to the TB clinic, multidrug resistant ward. These patients do not have active TB anymore and are getting ready to be released back to their communities. Some don’t want to leave and ask to stay longer because quality of their lives is subpar to the care that they receive in the clinic.

Now, you may ask – Darya, but what is your role with PIH? It is known that NGOs operate on grants and donations. Some grants are received from private donors who are inspired by PIH’s mission and would like to support the good deed. Other grants are received from organizations and institutions who as part of their own vision are interested in supporting specific areas of improvement and thus provide funds to NGOs who drive such specific efforts of their interest. Such grants are considered “restricted” because NGO can only put that money towards a specific use or project. Most recently, such donors began implementing periodic audits, reviews and other reporting requirements to receive assurance around how their donated funds are being spent by NGOs. An unfavorable audit outcome can lead to reduced funding. With my background, I will be helping PIH strengthen their Grant Management processes and controls by identifying current gaps, implementing structured solutions and training employees to help instill a compliance & risk based mind set.

Apologies for insanely long blog. Next one may be just as long (because there is so much to share). In my next blog I will talk Liberia and what it is like to live here!

Meanwhile mosquitos here are viscous and are eating me alive. This happened within minutes without me even noticing! And it is impossible to catch them because they fly so fast ☹