In the past two months, Last Mile Health delivered twenty-four Midwife Kits to certified midwives working in twenty facilities across Grand Gedeh County, Southeast Liberia. Designed to meet the needs of clinics and health centers serving Liberian mothers living in remote areas, each kit includes essential equipment and medicines for the provision of safe maternal and neonatal care.
Napoleon Dorbor, Last Mile Health’s Medical Officer for Grand Gedeh, was responsible for distributing the Midwife Kits, in coordination with the local health authority – the County Health Team. Napoleon and members of the County Health Team delivered the kits to facilities across the County, ensuring that staff received the necessary training to use each piece of equipment and type of medication.
The population of Grand Gedeh is sparsely distributed, with some facilities located in very remote areas. Napoleon described how road conditions presented a serious challenge, leading the team to get stuck in the mud while trying to reach Jarwodee clinic. This clinic serves an enormous catchment area in the west of the County, with people from some communities having to travel more than fifty kilometers to access care.
During each distribution, a certified midwife was present, with whom Napoleon would review the contents of the kit. This was very easy, he said, because each kit was packaged well and had a leaflet listing its contents, that could be quickly interpreted. The midwives had used similar equipment either during previous work or in training, so would be able to put the kit contents to good use. To make sure of this, Napoleon would check the knowledge of midwives, particularly their knowledge of the medical supplies, which could be particularly dangerous if used improperly. For magnesium sulfate, a protocol poster was developed and distributed along with the kits, to clarify how the drug should be used, and in what doses.
Napoleon described how in some facilities “they had very serious problems with the instruments they were using: rusty, old, and not well sterilized” – new equipment had often been requested a long time ago, but delays in the procurement process were common. This was a problem Napoleon had faced while working as Officer in Charge of a health facility, before joining Last Mile Health. Thus, he understood what it meant to these staff members to receive the quality equipment they had been waiting for: “they were so happy – it really added to their motivation.”
One particularly touching moment was when the Florence Davis, head midwife at Martha Tubman hospital in the county capital, Zwedru, said “since starting work here, I’ve never received such supplies,” and had been so anxious to receive them that she immediately carried the kit to the ward. In the month of June, Florence’s maternity ward saw ninety deliveries, with no stillborn, and no maternal deaths. Due to the size of the population served, Martha Tubman Hospital received three kits, while health centers would receive two, and clinics one.
To follow up on distribution, the County Health Team is tracking key indicators – such as number of deliveries – for each facility, and measuring consumption to ensure continued availability of supplies. Napoleon is visiting facilities to help staff troubleshoot any problems, to guarantee that the kit contents are being used in the most effective way. He explained that the need to “augment supplies from the current level” is something that should considered a serious part of rebuilding the Liberian health system, and how being part of this initiative through distributing Midwife Kits and enabling facility staff to provide safer and more comprehensive care to mothers had been very personally fulfilling.
This article was contributed by Last Mile Health’s Pete Harrison and is based on an interview with Napoleon Dorbor, Last Mile Health’s Medical Officer. Visit lastmilehealth.org to learn more about a great organization.