The challenges facing health and education in Liberia

Liberia is one of the world’s poorest countries, ranked 177 out of 188 in the UN development index.

Between 1989 and 2003, it was ravaged by civil war, which left 250,000 people dead, and in 2013 a devastating Ebola outbreak decimated its already fragile healthcare system. During this period, Sightsavers continued to operate as the only major eye health NGO in the entire country.

In July 2017, I travelled to Liberia as part of a delegation coordinated by the EYElliance, a coalition of development experts involved in eye health from the non-profit and private sectors. There, we met President Johnson Sirleaf – a Nobel peace prize winner who in 2005 was elected the first female head of state in Africa – and her ministers. She had requested that a group of experts work with the Liberian government towards eliminating avoidable blindness in her country. Before President Sirleaf leaves office in October 2017, she also wants to ensure that Liberia has the foundations in place to improve health and education for future generations.

Globally, 10 per cent of school children are affected by poor vision. 80 per cent of learning is visual, meaning that poor vision affects a child’s ability to attend school, stay in school and learn in school. Liberia, like many other countries in Africa, has a high proportion of children – 40 per cent of its 4.5 million population are under the age of 15 – thus a robust school health programme is crucial. During my visit, I spent time with Ministers Dahn and Werner at a working session to plan a national school eye health programme.

Sightsavers has previously developed a model of integrated school health (in partnership with Partnership for Child Development, GPE and the World Bank), which I suggested as a foundation for developing and scaling-up school health in Liberia. The premise is that the teachers will screen students for poor vision and work with eye care professionals to ensure that students are examined and given glasses as needed.

But what challenges will a school eye health programme face, and what can we do to help? A lack of infrastructure and trained human resources, compounded by the aftermath of civil war and Ebola, are the main issues.

Sightsavers has worked closely with the Liberian government for more than 15 years to support the Eye Care secretariat, conducts research to measure the causes and levels of of blindness, train professional eye health staff including surgeons and nurses, and establish eye health units within five of the country’s referral hospitals. Between 2011 and 2016, we supported 3,046 eye surgeries in the south-east region of the country. We’re also working in partnership with the Ministry of Health to expand into the north west by supporting infrastructure development and staff training. These new eye units will strengthen the delivery of essential eye care, and support a robust school eye health programme.

Poor infrastructure, lack of human resources and inadequate funding for basic services are ubiquitous in developing countries, and I have seen first-hand how these challenges affect the delivery of essential health and education programmes. Despite this adversity, one thing has always struck me on visits to countries like Liberia – the incredible resilience of people. Whether working with communities, service providers or government partners, the people I meet always strive to move forward, never losing hope that tomorrow will be brighter.

I was particularly struck by President Sirleaf’s vision and commitment, and her dedication to improving health and education. For me, it is an honour and privilege to support the realisation of President Sirleaf’s dream of a prosperous Liberia through improving the health and education of the country’s children. We hope this programme reflects our ongoing commitment to the Liberian people.

Imran Khan
Imran is Chief Global Technical Lead at Sightsavers.
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