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Restoring Trust: Polio Vaccines in Liberia

Polio Vaccines in Liberia
After enduring a surge in COVID-19 cases during the month of June 2021, Liberia may be experiencing some relief in its battle to beat the pandemic. According to Dr. Francis Karteh, a chief medical officer in Liberia, the country’s COVID-19 cases declined in the week leading up to July 12, 2021. However, Karteh also emphasized that the Liberian people must remain diligent in their COVID-19 prevention measures. The highly contagious Delta variant may regain strength if individuals become too relaxed. Nevertheless, this news offers hope for the country’s desire to move toward reopening businesses. But, even as COVID-19 infections decline in Liberia, vaccine hesitancy persists. This distrust of vaccines does not solely apply to the coronavirus vaccine though. UNICEF is currently undertaking efforts to reassure Liberians about the safety of polio vaccines in Liberia.

History and New Vaccine Hesitancy

In 2008, Liberia declared itself a polio-free country as a result of its mass vaccination success. However, Liberia recently discovered a circulating vaccine-derived poliovirus (VDPV) strain that stems from what was originally contained in the oral polio vaccine but has evolved to behave “more like the wild or naturally occurring virus.” Consequently, VDPV is more transmittable to the unvaccinated, especially in areas with inadequate sanitary conditions.

For this reason, the eradication of the poliovirus relies on the continued vaccination of children. Unfortunately, the COVID-19 pandemic forced Liberia to halt immunization programs, and as poliovirus infections increased, in February 2021, Liberia’s Ministry of Health announced the poliovirus outbreak as a “public health emergency” for the country.

On top of this, as Liberia begins to resume its polio vaccination operations, individuals are more hesitant about the polio vaccines. Following a year of COVID-19 vaccine misinformation circulating the globe, many Liberians wonder if one can trust any vaccine. Comfort Morphe, a midwife at Hydro MERCI Clinic, says she can “feel the weight [of the misinformation].”

Additionally, Mohamed Shariff, a teacher in the Liberian city of Monrovia, said that the campaign for polio vaccines in Liberia has had to evolve since there have been “so many refusals.” Many find the polio vaccine hesitancy peculiar since Liberia has “been using [the poliovirus vaccine] for years.” With vaccine uncertainty festering throughout the country, it is more challenging to quell the current rise in poliovirus infections.

UNICEF Partnership

Fortunately, in an effort to reduce vaccine hesitancy, UNICEF is partnering with Liberia’s Ministry of Health to communicate factual polio vaccine information through “radio talk shows, community engagement meetings, SMS” as well as posters and banners. The use of SMS notifications is especially beneficial since some communities in Liberia do not have stable internet access.

Volunteers also use the door-to-door approach to speak with parents on the importance of vaccinating children. Ummu Paasewe, for example, who works for Liberia’s Ministry of Health as a community mobilization officer, described how her team assures mothers that the vaccine is “the same kind of oral polio vaccine but more advanced” to combat this specific variation of the poliovirus. As a mother herself, Paasewe’s children are vaccinated and she contends that “immunization is a preventative method.”

Looking Forward

Other countries also see the benefits of supporting Liberia’s vaccination efforts. The Japanese government has supplied UNICEF with $2.7 million since 2020 to support women’s and children’s health in Liberia. Moreover, one of the Japanese government’s chief objectives is to get Liberians vaccinated against the poliovirus and COVID-19.

UNICEF representative to Liberia, Laila Omar Gad, stated that “just one child affected by polio is a risk to all children.” However, UNICEF volunteers remain optimistic and report that they have convinced many Liberian families about the polio vaccine’s safety and reliability. Through the dedication of Liberia’s Ministry of Health and support from UNICEF and Japan, vaccinating communities against the poliovirus looks to be an achievable goal.

– Madeline Murphy
Photo: Flickr

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On-the-Ground Global COVID-19 Relief

Global COVID-19 Relief
Under the visionary leadership of Dr. Paul Farmer, Partners in Health is setting an example for an effective and compassionate response to the COVID-19 pandemic. It is a global nonprofit organization that has been fighting for access to quality healthcare. The organization has catered to low- and middle-income countries (LMIC) since 1987. It does a good job of supplying strong on-the-ground global COVID-19 relief.

The Way Partners in Health Works

Partners in Health has developed on-the-ground networks of local healthcare professionals, community workers, facilities and government partners. These networks are poising Partners in Health to support strong on-the-ground global COVID-19 relief. They are also challenging the traditional “control over care” that LMICs traditionally use to combat pandemics.

Dr. Paul Farmer is chief strategist and chair of the Partners in Health board of trustees and recently won the $1 million Berggruen Prize for Philosophy & Culture for his impact at the intersection of global health and human rights and his leadership in advocacy for a global COVID-19 response that is humane as well as effective. Farmer is chair of the Department of Global Health and Social Medicine at Harvard Medical School. He is also the Brigham and Women’s Hospital’s chief of Division of Global Health Equity, a physician and anthropologist.

Replacing “Control Over Care” with “Global Equity”

Farmer feels that the global health arena needs to overhaul the dominant “control over care” approach, which focuses on containment and isolation during epidemic outbreaks. The COVID-19 response has heavily emphasized isolation and social distancing more than rapid testing and treatment. In a recent Forbes interview, Farmer noted that LMICs lacked ventilators and oxygen masks for treatment during the onset of the pandemic. Instead, Farmer advocates “global health equity” so everyone has access to trained staff, medicines, supplies, appropriate facilities and best practices.

In Rwanda, Partners in Health supports community health workers who do contact tracing and accompany sick people. Farmer feels that the Partners in Health COVID-19 response in Rwanda has been stronger than the United States’ response as the U.S. does not utilize community health workers in the same way.

Investment in Local Health Systems

The Partners in Health COVID-19 response is succeeding. This is because Partners in Health has already deeply invested in the local health systems of the 11 countries it supports. In each country, Partners in Health focuses on systems building through training strong medical staff. It also focuses on securing facilities with electricity, running water and ample space. From there, Partners in Health works very closely with local governments to implement universally shared best practices to ascertain quality care. Partners in Health employs community health workers to help community members access to care. It employs 18,000 staff with 99% from countries served by Partners in Health. It also supports at least 12,000 community workers who make more than 800,000 annual home visits to patients and families.

The Partners in Health COVID-19 response includes testing and contact tracing. It also includes free care and treatment for all COVID-19 patients at all Partners in Health-supported health facilities. The Partners in Health COVID-19 response includes assisting local governments by providing personal protective equipment (PPE). It also includes training in infection protection and control measures. Mobilizing community health workers is a third facet of the Partners in Health response to the pandemic. Partners in Health’s extensive experience with infectious disease outbreaks in several countries has informed it significantly. The organization supports the “People’s Vaccine” and COVAX global movements for free and readily accessible COVID-19 vaccines. Two examples of Partners in Health’s COVID-19 response include the building of a quarantine center in Liberia and an initiative to aid disadvantaged girls in both Rwanda and Haiti.

Partners in Health Liberia’s Quarantine Center

Partners in Health Liberia opened a 26-bed quarantine center in the coastal city of Harper in April 2020. It accomplished this by working with Liberia’s health ministry and other local health partners. The center provides medical and psychosocial services 24/7. It includes dignified care amenities such as hand-washing stations and gender-friendly washrooms. It also includes appropriate medical equipment such as blood pressure and oxygen saturation monitors. This is a great example of providing more on-the-ground global COVID-19 relief.

Partners in Health Haiti Supports Teens Coping with Emotional Stress

The Partners in Health Women and Girls Initiative (WGI) offers a spectrum of activities. This includes drawing, yoga and guided meditation in Haitian Creole for teens overwhelmed with COVID-induced stress. The organization is also raising funds to provide each of the 80 Port-Au-Prince WGI participants with internet access and solar lamps. The resources will help them continue their studies during COVID-19 lockdowns. Partners in Health established WGI in 2008 to empower disadvantaged girls in both Haiti and Rwanda.

The world is beginning to grapple with the global COVID-19 vaccine rollout. Farmer and Partners in Health will play an important role in ascertaining that LMICs receive them too. “[COVID-19] is a sharp reminder that everyone should be concerned with making vaccines available, regardless of ability to pay, the country in which you happen to be born or live, or any of the other criteria that have long been abused to deny equitable access to the fruits of modern science,” he said.

– Shelly Saltzman
Photo: Wikipedia Commons