Helping Liberia

LiberiaThe West African nation of Liberia is currently dealing with deadliest outbreak of the Ebloa virus that the world has ever seen. With hundreds dead and thousands more impacted, Liberia and its neighboring countries are at the center of a serious health crisis that is proving extremely difficult to control.

The images coming out of the area are troubling for everyone to see, but especially so for Michelle Niescierenko, MD. As director of Boston Children’s Hospital’s Global Health Program and the Academic Collaborative to Support Medical Education in Liberia, Niescierenko has spent years working with Liberian health care workers to strengthen the country’s medical education programs. Knowing her friends and colleagues in the area are now working frantically to contain the deadly disease, often without proper equipment and training, Niesciernko finds herself asking what many of us are thinking: “How can I help?”

Developing a global perspective at an early age

Prior to medical school, when Niescierenko was still in college, she traveled to Alaska to work with the First Nations people, researching the link between environmental contamination and health problems. She took to the work immediately, and the experience sparked a life-defining interest in how medicine and treatment are made available to people in underserved populations. It’s a passion that stayed with her throughout her training as a doctor and has been the driving force in her career ever since.

Inspired by her time in Alaska, Niescierenko enrolled in medical school after college and was one of a small group of medical students who ran a free clinic that was solely responsible for providing care to the urban poor in Buffalo, New York. At the end of medical school, she traveled to China to study the country’s medical system, specifically looking at how it supported people in need in urban areas. By the time she came to Boston Children’s to complete her pediatric residency, it was clear that her future was in global health. At Boston Children’s, she partnered with doctors who had similar interests, eventually leading her to join a program that coordinated care for street children in Bolivia.

IMG_1139“Trying to understand and guide the many factors that go into caring for vulnerable populations all over the world is both challenging and fascinating to me,” she says. “And because it’s a field of medicine that often requires close collaboration, it has allowed me to connect and work with with so many inspiring and brilliant people. It’s been eye-opening in every sense of the word.”

Niescierenko’s work as a resident eventually took her to Lesotho, a small South African country with one of the world’s highest HIV rates. It was here she really learned the demands of delivering health care in a high acuity, low resource area. While Lesotho was a demanding environment for a young doctor, Niescierenko felt at home with the hands-on nature of the work. When she returned to Boston, she used the experience to secure an opportunity to practice medicine in Liberia as a member of the Academic Consortium to Support Medical Education in Liberia. (A partnership between Boston Children’s Hospital, the University of Massachusetts and other academic medical centers.)

That trip was just the beginning of what Niescierenko says would eventually become a strong and deep-rooted love for Liberia and its people.

Inspiring optimism

When Niescierenko first arrived in Liberia, the West African country was still reeling from the effects of a recently ended civil war, which had raged for over a decade and virtually destroyed the country’s medical infrastructure. But despite the challenges faced by the Liberian medical community, Niescierenko says the people she met were filled with positivity and a desire to rebuild, creating an environment that was surprisingly uplifting.

“It didn’t take long for me to fall in love with the people of Liberia,” she says. “Our colleagues welcomed us immediately, and from day one there was a true sense of partnership among us. The hope, optimism, dedication and drive these men and women showed in re-establishing their country’s medical training systems is awe- inspiring.”

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In the seven years since she first came to Liberia, Niescierenko and her colleagues have made great strides in returning the country’s medical education system to its pre-war condition. Today Liberia has its own hospital-based clinical practice guidelines, several primary care initiatives around non-communicable diseases, a new-born follow-up clinic and several other critical health programs that treat the nation’s people and educate its growing medical community. Less than a decade ago, Liberia had zero pediatricians and programs. Today there are two full-time Liberian pediatricians and dozens in training.

Unfortunately, these gains have done little to slow the recent Ebola outbreak, which has all but crippled Liberia’s health care system. The country’s two major hospitals were forced to shut down so they could be cleaned and decontaminated. The lack of centralized care—in combination with an existing shortage of resources, equipment and proper training for health care workers facing an outbreak of this magnitude—have hindered efforts to track and quarantine the disease while exacerbating other, already existing problems.

To help provide health care workers in the area with desperately needed protective equipment and training, Niescierenko and her consortium colleagues are working on an independent fundraising campaign. Through their efforts, she hopes to help raise money that will help pay for additional treatment centers (the current ones are overwhelmed with patients), get protective wear and training to Liberian health care workers on the frontlines, and secure additional contact and quarantine-tracing methods to help control and stop the outbreak. To date, they have raised over $30,000.

“The situation in Liberia is truly heartbreaking right now,” Niescierenko says. “Clinics and hospitals are being forced to close due to lack of protective equipment for their staff. When facilities are closed, what happens to the child who comes there for malaria treatment or asthma? What happens to the man with the incarcerated hernia or the women in obstructed labor? Ebola is not just affecting those who catch the disease—it’s attacking the country’s entire health care industry. To help, we have to try to get them the equipment they need to protect themselves and save the lives of patients. Liberia has only 264 doctors and 1,200 nurses. Ebola has taken the lives of over 60 health care workers; how many more can they afford to loose?”

To learn more about Niescierenko’s efforts to support health care workers in Liberia, please read this story in the Boston Globe.