Supporting Surgical Systems in Liberia

Supporting surgical systems and perioperative providers in Liberia respond to the COVID-19 pandemic and beyond.

Lifebox is working alongside Mercy Ships and the Liberian Ministry of Health to implement a range of programs to make surgery and anesthesia safer in five Liberian hospitals for the COVID and post-COVID era.

With a population of 5 million people, Liberia is ranked 175 out of 189 on the Human Development Index (0.48) and has a GDP per capita of 700 USD. The country has significant healthcare capacity needs in terms of quality, accessible, affordable, and equitable surgical delivery. The surgical workforce is under-resourced to address the large burden of surgical disease. There are just 20 surgeons across the country and only one anesthesiologist, with anesthesia provided by 80 nurse anesthesia providers. 

Lifebox began working in Liberia in 2012, with distributions of pulse oximeters and training workshops. In 2019, we built upon this work with a Checklist Implementation Strategies workshop with surgical team members from five hospitals, alongside the distribution of 50 surgical headlights for testing as part of the development of the Lifebox Light.

We are now working to support the provision of training and essential tools to surgical and perioperative teams in the five Liberian hospitals of Redemption, CB Dunbar, Phebe, Bomi, and C.H Rennie. 

This year Lifebox has conducted 11 in-person or online workshops with a total of 266 participants. Workshop topics included Best Practice Personal Protective Equipment (PPE) Use, Pulse Oximetry, and the COVID-19 Surgical Patient Checklist.

“C. H. Rennie Hospital (CHR) is faced with so many challenges ranging from the availability of medical supplies and equipment to shortage of experienced medical staff. Lifebox has over the years been trying to help CHR overcome some of the challenges, especially with regards to surgical care. Most recently, the Lifebox pulse oximetry training made me realize that often I was mispositioning the pulse oximeter and acting upon wrong readings. Having an experienced anesthesiologist as a key facilitator was a boost and helped us to understand the fine details of pulse oximetry. CHR is better trained and equipped to use pulse oximeters correctly and safely. Thanks to LIFEBOX!”

Yarvoh Moore-Wilson, MD
Medical Director, C. H. Rennie Hospital, Margibi, Liberia.

Lifebox will distribute 120 pulse oximeters with the support of our partner Mercy Ships to follow on from the pulse oximetry workshops.

“The use of pulse oximeters has been a game changer in improving safe surgical practice, hence the need for healthcare workers to be trained on how to use this tool properly. The response has been positive and more successes have been recorded both in terms of accessibility and competence of these health workers in pulse oximetry. All of this would not have been possible without Lifebox. Thank you for making our operating theatres safer and our anesthesia providers more competent.”

– Dr. Musa Kallamu Suleiman, consultant anesthesiologist, John F. Kennedy Medical Center, Liberia, and Lifebox Pulse Oximeter workshop Trainer. 

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. Upcoming work includes training perioperative providers on Infection Prevention and Control in the surgical system and refresher training on the implementation of the WHO Surgical Safety Checklist. 

With the support of Mercy Ships and the Stavros Niarchos Foundation, Lifebox is currently implementing its surgical site infection reduction program – Clean Cut –  at C.B. Dunbar Maternity Hospital, with two further hospitals to begin implementation this year.