Bopolu City, Gbarpolu County – Jallah Lone Hospital – the major referral health facility in Gbarpolu County – is in a “semi-prepared” state to identify COVID-19 cases, despite major constraints it faces, says Dr. Musa Zuanah, the County Health Officer.
As of May 16, six persons have been tested positive for COVID-19 in the county. That followed the confirmation of the first case – a 54-year-old man who later died at the hospital in Bopolu City.
With the pandemic drawing concerns from people in the county, there are also doubts about the county health team’s preparedness to respond to the cases, and Dr. Zuanah is keen that disclosing the status of the health system will help allay the fears of locals.
“We have to let the people know about their hospital,” he said. “That is one of the best ways we can attract support or donors as a county [in order] to enhance the response against active cases in this county.”
Built in 2009 and named after a famous paramount chief, the hospital has an outpatient department that enrolls an average of 30 patients daily, an obstetrics department, and a laboratory.
While it continues to face frequent shortages of essential supplies and drugs, it nevertheless provides free healthcare for a population of over 107,000 people.
There are 14 government-run clinics across the five health districts in the county. But getting to them is a challenge for many community members, according to Bennie J. Clarke, the county health team’s epidemiology response focal person.
“For instance, Kongba has one clinic with more catchment communities – so, people that are living 4 to 7 hours away from the clinic hardly attend the clinic,” Clarke explains, adding that “the bad bridges and road [conditions] are another serious issue that can discourage people and healthcare providers in this part of Liberia.”
These clinics have been enlightened about identifying suspected COVID-19 cases, county health authorities said.
Detailing the county’s level of preparedness, Dr. Zuanah disclosed that the major referral hospital in the county has two functional ventilators: one in the Operation Room (OR) and another in the Emergency Room (ER).
A ventilator is a potentially life-saving medical machine that helps people breathe, when they are having trouble breathing on their own.
“This respiratory infection can congest the lung and you will feel like drowning in a river,” he said of COVID-19. “Therefore, when that complicated stage comes, your lung will not be able to take in air again to supply the entire body, so ventilator will be there to push air into the lung to be supplying the body.”
Dr. Zuanah then urged people of the county to avail themselves early when they feel symptoms of COVID-19, adding that early testing will avert pressure on the county’s limited medical resources.
“So, if you get any signs and symptoms of the COVID-19, come to us, report yourself, and then we will put our measure into place and try to help you,” he said.
“But if you keep it away, then you reach complication stage that will require ventilator, it becomes a bit difficult for you and for us to respond.”
There are four medical doctors currently assigned at the Jallah Lone Hospital, two physician assistants, 49 nurses and 47 support staff, according to the CHO.
In addition to the nurses, there are 10 more health workers who are “on the standby to support the reactivation of the COVID-19 case management team at the hospital”, he added.
“We also have skillful nurses and PAs including environmentalists within the county health team on the standby, ready to support the case management team at the Jallah Lone hospital,” said, Dr. Zuanah, pointing out that administrative staff who are health professionals are on the standby to buttress the response efforts.
But there are also concerns that the number of assigned healthcare providers at the hospital is inadequate.
“Remember this is COVID-19, nurses that are assigned at the isolation [area are] supposed to be restricted only to the isolation. So, if you take nurses from the wards of the hospital there will be a vacuum – this means you will be causing serious problem on the ward,” warns Clark, the county’s epidemiologist.
Although the county lacks the capacity to treat COVID-19 patients, it has now identified an isolation center, said Dr. Alex Odularu, Medical Director of the hospital, who added that 44 persons who came in contact with the index case have been traced and are remotely self-quarantined.
They will be transferred upon the completion of the precautionary observation center, said Dr. Odularu, who also leads the county’s case management team.
Meanwhile, the lack of stable electricity – which is critical for the operating of specialized medical machines, such as ventilators – remains one of the major challenges the hospital is stilling struggling with. Quarterly budgetary disbursement of funds to the government is often delayed, Dr. Zuanah said.
“When it comes to fuel support in this kind of situation, we are not able to keep our generator running all day long,” he added.
And the hospital administrator, Madam Sao S. Zoe, added: “We stopped getting allotment from the government in February this year. Since then, we are running this hospital 12 hours a day,”she explains.
“Many days the hospital is off and in darkness, except during emergency times and real working times we power-on the generator.”
The hospital receives support from the World Bank. But the county health authority is keen on amassing more support from all stakeholders – which they stressed is crucial to maintaining quality health services during the pandemic.