Monrovia - Liberians spend thousands of dollars annually for medical treatment overseas. It is major jab the Ellen Johnson-Sirleaf-led government has had to deal with since assuming office in 2006.
“You now have available an eye center in Liberia where you can get your problems taken care of.
"Eighty to eighty five percent can be taken care of even today. So, in the next three to five years, it will go up to ninety to ninety five percent.
“So, don’t hesitate, use it. The quality of care of care will be as good as they can get anywhere in the world."
"They don’t have to travel abroad for routine eye problems” - Dr. Gullapalli N. Rao of LV Prasad who facilitated the opening of the Eye Center in Liberia
The criticisms have piled up as one government official after the next hop on outbound flights in search of medical care.
One area that has been a major pain for many is eye care.
Prior to her presidency, most of the hospitals, clinics and equipment were destroyed due to 14-years of civil conflict from 1989 to until 2003, posing enormous challenge to the post-war government burdened by a health sector faced with mounting financial dilemma.
Since 2013, President Sirleaf has been on the lookout for help and a visit to India began a process that has been five years in the making, but finally coming to fruition last week.
Sirleaf, in September 2013, while visiting India, launched an initiative in collaboration with the L V Prasad Eye Institute (LVPEI) for developing a world class eye care system in Liberia.
"Liberia was a very poor country and required help for setting up modern eye care facilities," Sirleaf said at the time as she made a pitch for the LVPEI to establish an institute in Liberia which can help in building a comprehensive eye care system.
Desperate Liberia Eyes Help
Recalling Sirleaf’s India visit in 2013, Dr. Rao told FrontPageAfrica this week that he could not turn down the opportunity after hearing Sirleaf’s pitch.
Said Dr. Rao: “The President came to India in 2013 to receive the Ghandi Peace Prize from the government of India on her way she visited us and during that time we had discussions and she said, ‘why don’t you bring this to Liberia and help us in setting up an eye care center in Liberia because we are desperate and we really do not have any eye care center for our people’.
“So, because she personally asked me we decided to take the responsibility and help in some way and we set about planning it and we approached some international organization for funding, chief among them was the international lions club and other international organization and a Canadian organization called Operation Eye Sight and they readily agree.”
With that funding provided by the two organizations, Dr. Rao explained that all the necessary equipment for the current phase of the eye center was made available.
“The JFK Medical Center people agreed to host it and I came to visit Liberia and we went around the hospital and we identified a particular space and said that this will be good to develop the eye center; so the Kennedy hospital center people were grateful to allocate that space according to our specifications and it looks like a semi-autonomous kind of a place within the medical center.”
Once the space was situated and funding in hand, Dr. Rao said they were able to arrange for a few of the JFK staff to travel to India for training for a period of time.
“We trained the team and our staff made some trips to Liberia back and forth and we were actually ready to go about two or three years ago but then Ebola crisis hit so we had to step back and let that become the priority and after that settled we completed what needed to be done.
“Already, some two thousand patients have been seen and more than 100 surgery done and an organization called one sight foundation put up the eye glasses below what’s on the market.”
Dr. Rao says with the staff in place and infrastructure available today, the center can easily see fifteen, twenty thousand patients a year.
This will no doubt mean a major boost for a post-war nation with a blindness rate of 0.5 per cent up to 50 years of age and 3.85 per cent above 50.
Dr, Rao, who is also the Chairman of LVPEI, says since his organization started some 27 years ago, it has touched the lives of 17 million people and more than 50 per cent of them were treated for eye surgeries free of cost.
Eyeing Long-term Sustainability
For Liberia, the new center comes at the tail end of the Sirleaf-led government which inherited a dilapidated healthcare system, it has been struggling to rebuild and recoup after most of its medical professionals took flight or fled due to the war.
Although the eye center is poised to bring relief for many, Dr. Rao sees local human resources as key to sustainability.
“Our desire is to provide a comprehensive eye care from the center. The only limitation is funding, funding can be found from somewhere. The only limitation is viability of local human resources."
"Because I believe that expats can come and go but that’s a very temporary option for the long-term sustainability and the long-term provision of high quality health care. Anywhere in the world it has to be the local people.”
Dr. Rao says human resource is a very critical component of the project.
“That’s what we are hoping and we’re hoping that it will succeed. I am pretty optimistic that with the necessary support from the government at the highest level and friends like Mr. Singh already supportive and with all that and the international community ready to support this program and they want to see it succeed.”
For now, the center has one doctor on the ground permanently but Dr. Rao hopes that based on the requirement and challenges, the institute will periodically bring more specialists like Dr. Bupesh Bagga, who has been in Monrovia the past week performing surgeries, specifically cornea transplant surgery procedure.
“In future, we plan to bring in experts for retina or glaucoma etc. So periodically, they will be coming. We haven’t laid out any specific timeline schedule but certainly four or five will come a year.”
The government has convinced Dr. Gizzie Dorbor who has been working in next door Ivory Coast to be a permanent fixture at the center.
For Dr. Bragga, the most challenging aspect of the surgeries is the newness of the facility to Liberia and getting Liberians to understand that the center is available and these surgeries can actually be done here.
“Regarding performing surgery, the most critical was to arrange corneas."
"Because of Sight Life, we got a good number of corneas, they are kind enough to send corneas here but because this is the first of its kind, everything is still new to everybody, it will take time.
Medication, One Small Hurdle
Dr. Bragga, who leaves Liberia Friday, hopes to have more trips in the future and perform more surgeries.
“We will continue this momentum of doing transplant. In the last three days alone, I was able to perform surgeries on eight to ten patients."
Despite the early signs of endless possibilities, medication, Dr. Bragga says, is one small hurdle that is being addressed.
“At present, we have provided all the basic medication that is needed but we expect more.”
This means Liberians will no longer have to worry about running next door for eye care.
“You now have available an eye center in Liberia where you can get your problems taken care of,” Dr. Rao says. “Eighty to eighty five percent can be taken care of even today. So, in the next three to five years, it will go up to ninety to ninety five percent."
"So, don’t hesitate, use it. The quality of care of care will be as good as they can get anywhere in the world. They don’t have to travel abroad for routine eye problems.”
The future looks bright. “I think we are already optimistic about that this could become model for this part of the world. Because now, really high care eye services are not available except for a couple of places in Ghana and a few places in Nigeria. Other than that, I don’t recall any other places where this service is available."
"So, our idea is to consolidate this and make it robust and we also plan to start programs for local doctors so that they become ophthalmologist. Eventually, we get out and the local people take over.”
Down the road, healthcare is likely to remain a challenge for Liberia although the administration, on the last leg of its reign appears determine to fulfill its bold plan to deliver healthcare to the nearly 30% of its population that lives in remote areas more than an hour’s walk from a health clinic.
Liberia Still Medically-Challenged
Under her watch, the government, aided by international partners have deployed 4,000 community health assistants between now and 2020.
The eye center is only a minute of the health challenges facing Liberia but it’s a start for a nation limited to only 5,000 full-time or part-time health workers and 51 Liberian doctors to cater to a population of four million, according to a 2006 health survey, equivalent to about 76,000 civilians being attended to by 1 doctor.
For the foreseeable future, Dr. Rao envisions the training more Liberian doctors in the area of ophthalmology.
“It depends on how many people show interest in the ophthalmology and how they perform in training."
"I would imagine a minimum three to four years – or maybe more like five to seven years and then we also want to go out into the counties and set up a system of a few more secondary hospital, maybe four to five but in the long term may be 25 primary care centers across the country, particularly in the more neglected areas where people may not be getting any kind of attention at all. So, that’s the plan.”
Mr. Upjit Sachdeva, the Indian Consul General in Liberia is delighted that Liberia now has an eye center and honored that its partnership with India has made it happen.
“It means so much to me that something we started five years ago when the President visited India has come to reality and it is a real legacy for the government and President Sirleaf herself."
"In whatever way, as me as the counsel general of India, I can do in a personal capacity for this project so that it runs smoothly; I’m willing to do it."
"It’s going to help not just one person but it is going to help the masses of Liberia because there are children in school who cannot see the blackboard because there is no optician to see it. With the support of Dr. Rao and his vast support in the international community, we will be able to help everybody.”