Fewer Than 25 Doctors Run
Public Health Sector In Liberia

By Peter Kahler, Panafrican News Agency,
6 December 2000

Monrovia - Liberia's health minister, Dr Peter Coleman sent shock waves across the country Wednesday when he announced that less than 25 doctors were running the nation's public health sector.

This is peculiar, but more doctors are leaving the public health sector due to poor incentives, Coleman said in reply to a reporter's question about the absence of doctors at hospitals in some regions of the country.

He said it was now impossible to place medical doctors at all major health centres and hospitals around the country.

Coleman said prior to the war in 1989, there were about 400 trained medical doctors working for the government, but the number reduced to 87 by 1997 when the Liberian civil war ended with the holding of presidential and general elections.

But three years following elections, public health service delivery seems to continue a nosedive as poor incentives, according to Coleman, drives away Liberian doctors.

The disincentives range from low salaries, lack of housing, transportation and non-availability of drugs and medical supplies at the public health facilities due to funding problem from a government that has yet to prioritise social services.

The highest paid doctor in the public sector makes 100 US dollars, while the majority earn between 75 and 85 dollars monthly, according to Liberia's chief medical officer, Dr Nathaniel Bartee.

The bulk of the drugs and medical supplies for public health come from donation by the European Union, UNICFF, international NGOs and friendly governments, with the Liberian government making periodic interventions as the donations run low.

The public health sector consumes between 2 and 2.5 million US dollars worth of drugs per annum, a figure that will increase to about 3.5 million dollars when more health facilities ruined by seven years of civil war are re-opened, Bartee said.

At the moment, some 243 out of 325 health facilities that operated before the war, have been restored, according to Bartee.

The brain drain in the public health sector has bitten so deep that even health minister Coleman, a surgeon, makes regular rounds at the surgical theatre to save lives, sources at the health ministry told PANA.

Bartee said 90 percent of the doctors who left the public health sector were Liberians trained in the country, sent abroad and returned as specialists.

The rural health facilities are meantime run by physician assistants and nurses who often refer major cases to hospitals with doctors, using ambulances if the patient can foot the fuel bill for the trip to the next health post.

But institutions like the A.M. Dogliotti College of Medical and the Tubman National Institute of Medical Arts TNIMA), responsible to train doctors, physician assistants and nurses have not been spared their share of neglect.

The medical college which turned out 25 to 30 graduates annually in pre-war years, now puts out an average of ten doctors, while TNIMA products of physician assistants, nurses, mid wives and environmental health workers, have turned out to be insufficient due to low intake at the school.

Many nurses have also left the system for greener pastures, he said.

Some doctors currently in private practice told PANA they left the public sector due to government's gross neglect of the health facilities, particularly a general disregard for doctors and their welfare.

The situation has left the majority of impoverished Liberians at the mercy of the private health facilities now burgeoning across the country charging skyrocketing for services rendered.

Meanwhile, TNIMA students went on a strike Tuesday to demand six months salary arrears for their instructors and the reopening of the institution closed a month ago due to financial crisis facing it.