By: Kenneth Bracwell
In the early days of 2020, news of the appearance of the never before heard of COVID-19 virus was greeted in Liberia, as it was in many African countries, with skepticism and denial. Conspiracy theories were rampant. Some even argued that it was part of the government’s scheme to get donor funds, among other imaginations.
Attitudes quickly started to change and reality began to set in when the disease hit close to home. Friends, relatives, and eminent citizens were felled by the virus, aided by the country’s poorly resourced and fragile health system.
However, to everyone’s relief, in comparison to some other countries in the region, Liberia did not get overwhelmed by the pandemic. In fact, the pandemic found Liberia’s healthcare workers better prepared to deal with this health crisis mainly as a result of lessons learned from the 2014-2015 deadly Ebola Virus outbreak. Ebola ravaged the Mano River Union (MRU) basin, a region which is comprised of the countries of Liberia, Guinea and Sierra Leone. The Ebola toll numbers were staggering –4,810 deaths out of 10, 678 confirmed cases, according to Liberia’s Ministry of Health.
When the pandemic subsided, data showed that Liberia’s COVID-19 numbers came nowhere near the Ebola figures. According to data collected by the National Public Health Institute of Liberia (NPHIL) and according the latest World Health Organization (WHO) figures, as of February 2023 Liberia had 8,090 confirmed cases of COVID-19 and 294 deaths. These numbers are a fraction of the overall death rate in western countries such as Italy, Britain, the US and France. In the West Africa region, Liberia and neighbor Sierra Leone (which WHO notes has had to date 7,762 cases and 125 deaths) fared better than regional neighbors. NPHIL is an autonomous public institution in Liberia responsible for preventing and controlling public health threats.
Another significant factor, in addition to the country’s health care workers being more prepared to face this virus pandemic, was Liberia having access to the vaccine when it became available. In December 2020 WHO approved use of the first vaccine to fight the virus, AstraZeneca. Liberia, like other low income countries, received its first shipment of the vaccine a year after the pandemic began. It arrived in March 2021 and was distributed to the country’s 15 political subdivisions.
In Liberia, despite and amid the swirl of heightened conspiracy theories and vaccine hesitancies surrounding the deadly pandemic, health officials and healthcare workers found a way to reach the public. At first it was slow going and not easy, but then steadily gains were made in getting the population vaccinated and as more people got vaccinated, the infection rate started to decline.
One area of the country, the city of Buchanan in Grand Bassa County, has emerged as a success story when it comes to vaccination rates and in the process, success in breaking through and defying the myths surrounding the vaccine. Buchanan is the third largest city in the country with a population of 34,270 (2008 census), after Monrovia and Gbarnga, cities with populations of more than a million and 45,835, respectively.
In research for this story conducted initially in mid-2022, NPHIL data from December 2021 to May 2022, showed Grand Bassa County had 108 confirmed cases of COVID-19 and six deaths, one of the lowest numbers for any county in the country. By comparison, Maryland County had 226 cases and 13 deaths, and Nimba, 212 cases and 33 deaths.
That Grand Bassa would one day be held up as a success model was not at all evident at the beginning of the vaccination campaign. According to Dr. Sylvester O. Wheh, Grand Bassa County Health Officer, public reaction to the arrival of the vaccines was very mixed. “The medical services had to embark upon robust messaging to disabuse the minds of the public,” he said. This effort was successful, he continued, noting the medical team vaccinated more than 127,000 persons, 615 of whom were medical practitioners working in the county.
Recalling the situation, Dr. Wheh said, “Imagine, immediately the first 200 doses arrived in the County, Superintendent Janjay Baikpeh and I led a confidence-boosting effort along with some health workers for the vaccination of citizens.”
Grand Bassa County comprises five electoral districts and has a population of around 296,000, of which more than 70% have been immunized, Dr. Wheh said. Of the vaccines administered, more people received the Johnson & Johnson (86,059) and Pfizer (42,614) vaccines than AstraZeneca (6,817), he added.
Dr. Wheh lauded the medical team for this success, noting that it has not been a jolly ride to roll out the vaccines for the medical services but their determination never flagged, he said.
There’s been a problem of access, Dr. Wheh noted. However, despite the inaccessibility of many of the community health facilities, especially those in some of the most remote rural areas, the vaccination process continued. Community Health Volunteers filled in the gaps by reaching out to the people, while some citizens are managing to access the hospitals and clinics, he said.
The health team faced backlash and resistance in various forms such as verbal mockery, physical assaults and other unfavorable reactions in some places, said Dr. Wheh. The biggest hurdle they faced, he said, was trust. Trust, has been a major issue, but the county health team was tenacious in reaching out to the residents, he said.
Dr. Wheh credits policymakers in the Grand Bassa County for coming together and taking a cohesive approach towards restoring health stability in the health care system. This strategy prompted community and radio awareness messages as lawmakers, top medical officials, and other stakeholders were heard and seen talking about the importance of getting vaccinated. For example, in an interview on state radio, Dr. Francis Kateh, Liberia’s Chief Medical Officer, extolled Liberians for the tremendous strides made so far in getting the AstraZeneca, Pfizer, and Johnson & Johnson vaccines on a large scale across the country. He noted that around 2.5 million people in the country were already fully vaccinated.
However, despite these very positive efforts, not everyone in the public was easily convinced. Myths and rumors continued to circulate. This made many people afraid, skeptical, and it kept individuals in a state of uncertainty about actually going to the health facilities. One such person was Mercy Abena Johnny, Executive Director of Children Rescue Africa and Grand Bassa Civil Society Council assistant secretary.
Ms. Johnny, 29, recalled that fear overwhelmed her prior to taking the vaccine owing to messages she’d seen on social media (particularly Facebook) and various spurious street rumors she’d heard about possible side effects from the vaccine. These rumors included speculations that upon taking the vaccine females would be unable to reproduce, males would experience infertility, and lifespan of those who got the vaccine would be cut short. All of these messages definitely contributed to her delay in taking part in the immunization process, she said.
Still, she gathered her courage and went to take the jab and, she actually did have a s negative reaction. “Luckily, it didn’t last long, she recalled. “I got admitted for two weeks at the hospital because of high fever experienced immediately after the taking the vaccine,” she said, “but I regained my health.”
Having taken the vaccine, she is now an advocate for it. She said she is encouraging others to take advantage of the vaccine and to be aware of some side effects; emphasizing that being vaccinated helped “build her immune system against COVID-19.”
Mayson Railey, a graduate of the Grand Bassa University, said even though fear could not be rooted out of his mind as he went to get vaccinated, for him, the necessity of being alive and safe was more essential and thus out-weighed his fear. He, too, had some initial reactions to the vaccine, fever and severe headache. He was advised to have bed rest. He did this and, he said, in a couple of days, he was just fine.
Grand Bassa County has six law makers- two Senators and four Representatives. As Dr. Wheh noted, their collaboration contributed to the successful public health and public advocacy messaging about the importance of getting the COVID-19 vaccine.
For Liberia’s lawmakers, this latest health crisis showed there is an on-going need to strengthen the country’s health care system and infrastructures.
Rep. Matthew Joe, Grand Bassa District #3 representative, said the COVID-19 awareness training he received from health authorities motivated him to actively promote community health awareness raising activities. The Honorable, who is popularly called “Fairplay Joe,” said he plans to engage with his colleagues “to spotlight interventions in healthcare” by committing more funding to improve medical facilities and procuring more pharmaceutical drugs.”
Reflecting on the deadly outbreak of Ebola that Liberia experienced in 2014 and now Coronavirus in 2020-2021 and the deaths caused, Joe said there’s also a need to include in the National Budget emergency funding for health response for times like this, a proposal he planned to put forth in the coming legislative budget hearings.