Clean Cut Launches in Liberia

Lifebox partners with two hospitals in Liberia to launch its surgical infection reduction program – Clean Cut.

C.B. Dunbar Maternity Hospital and the Eternal Love Winning Africa Hospital (ELWA) are the first hospitals in Liberia to implement Lifebox’s surgical site infection (SSI) reduction program, Clean Cut. 


SSIs are the leading hospital acquired infection in low- and middle-income countries – where rates of infection are more than double that found in the United States1. C.B. Dunbar and ELWA hospitals are partnering with Lifebox to save lives by reducing the rates of SSIs in surgical patients with the Clean Cut program.

Clean Cut implementation team at C.B. Dunbar Maternity Hospital, Liberia.

C.B. Dunbar Maternity Hospital, in the north-central city of Gbarnga, is a 38-bed hospital that has recently been turned from a dedicated maternity hospital to a comprehensive facility for all surgical procedures. It caters to around 55 surgical cases a month – the majority of them essential C-sections. ELWA is the latest hospital to launch Clean Cut and is an 87-bed hospital in the capital of Monrovia with a surgical case load of 150 patients a month.

“Patient safety is very important. The very first thing on your mind should be to prevent surgical site infection. You want to make sure that the surgery you are performing is safe for your patient so that no complications arise.”

Dr. Kezelebah Goyah, obstetrician and gynecologist, C.B. Dunbar Maternity Hospital, and Lifebox Fellow. Read an interview with Dr. Goyah here

The surgical workforce of Liberia is under-resourced to address the burden of surgical disease for the country’s five million people. Lifebox is working with the Liberian Ministry of Health, with the support of Mercy Ships and the Stavros Niarchos Foundation (SNF), to strengthen surgical systems in the country. One hundred and forty patients in Liberia have already been impacted by the Clean Cut program.

Launching of Clean Cut program at the Eternal Love Winning Africa (ELWA) Hospital.

Clean Cut is a quality improvement intervention developed by Lifebox that supports surgical teams to address the causes of surgical site infections (SSIs) by improving adherence to six infection prevention practices, including the appropriate timing of antibiotics and confirmation of instrument sterility. This month, the results of the lasting impact of the Clean Cut program were published in The Journal of the American Medical Association (JAMA) Surgery.

This work is being led by a small team of clinicians based in Liberia, and is part of Lifebox’s long-term engagement to strengthen surgical systems in the country. Lifebox plans to partner with a third hospital to implement Clean Cut in the coming months.

Read more about Lifebox’s work in Liberia here or watch this thirty minute conversation on Lifebox’s work in Liberia with obstetrician and gynecologist Dr. Kezelebah Goyah, Lifebox CEO Kris Torgeson, and Lifebox Program Coordinator Dr. Clarence Yaskey.

¹ Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet Lond Engl. 2011 Jan 15;377(9761):228–41.