Jet-black, slicked hair neatly piled into a tight bun reveals a warm, kind face. Wide brown eyes, a rich chocolate color, look out into the audience in front of her. Standing tall, poised in her vibrant floral shawl, she is a woman whose grace and composure is noticeable at first glance. This is Dr. Christiana Hena, a Liberian physician who is visiting the United States to share her perspective as an Ebola front-line care provider.
Dr. Hena was born in Liberia and later attended medical school in Russia. Afterwards, she practiced medicine all over the world; for instance, she lived in Kazakhstan for several years treating patients who were affected by nuclear testing. Meanwhile, in her home country, Liberia was facing a civil war, at the end of which 200,000 people had died—a staggering number, given the fact that the country has a population of about 4.2 million.
In the face of this situation, Dr. Hena felt called to return home to Liberia. Always finding a way to serve the people around her, Dr. Hena began a clinic in her front yard. The clinic, while simple and constructed mostly of hanging shower curtains, served a tremendous role in the surrounding communities. Dr. Hena was one of only 51 doctors in the country, and the dentist who worked at the clinic was the only one for the 200,000 people in the area. Together, they saw about 50 patients a day for hours on end, with patients still waiting in lengthy lines at the end of the day. Meanwhile, 22 community health workers ventured daily into the surrounding 36 communities, treating patients and referring more serious cases to the clinic. The clinic bridged the gap between the community and other services, too. Dr. Hena has now instituted an After School Program in her yard, and she also teaches young men and women various life skills like sewing and collecting data. The clinic has been so successful that Dr. Hena, in partnership with the Building Goodness Foundation, is now building a larger, more permanent structure that will open its doors in the summer of 2016.
When the Ebola outbreak began in Liberia, Dr. Hena’s clinic provided her a unique firsthand perspective of the problems on the ground. Firstly, because many of the doctors currently practicing in Liberia at the time of the outbreak were foreign, they were required to leave Liberia once Ebola took hold of the country. This left Liberia, a country that already had a shortage of physicians, with about 30 doctors. Furthermore, as Dr. Hena explained to us, one of the most difficult aspects of the situation was the incompatibility between cultural practices and the necessary actions to end the crisis. For example, all corpses, whether the cause of death was Ebola or not, had to be cremated, despite that cremation was not the traditional burial practice. Moreover, people could not shake hands or hug one another—a difficult restriction in such a tight-knit community.
Fortunately, the community eventually realized the gravity of the situation. As Dr. Hena told us, “once the community came together, we immediately saw the decline of Ebola.” According to Dr. Hena, the most significant intervention was the implementation of buckets full of chlorine for washing hands in each community. As a result, Ebola slowly stopped spreading, and the crisis came to an end.
Now, it is time to look to the years ahead. For Dr. Hena, the main goal should be “to use limited resources more carefully.” For the short-term future, she suggests that the country should turn to doctors from abroad. These doctors will be able to respond to the extremely high demand for primary care physicians that Liberia currently has. However, in the meantime, these doctors should also focus on training locals in Liberia in order to have a stable supply of physicians in the long run.
While there is much work to be done, I am excited to see what comes of calls to action like these from Dr. Hena. This discussion of next steps is not only crucial for Liberia but for all of us as avid participants in the exciting world of global health.