As Ebola has begun to slow its pace in Sierra Leone and Guinea, and perhaps disappear for now from Liberia, the perils of pandemics still seem to be more than an imaginary fear. The crisis we have just witnessed from afar captures not only local shortcomings but also the unbalanced way healthcare is distributed in some parts of the world as compared to others.

The Ebola stricken regions are lacking in staff, stuff and space to counter the contagion. For instance, in Liberia even before the current crisis claimed many health care professionals, there were fewer than 50 doctors serving a population of 4 million. This amounts to roughly one physician per 100,000 people as against 240 in the United States or 670 in Cuba. The availability of properly equipped hospitals is not as dismal as the situation with staff. As an example, Liberia has about 80 beds per 100,000 people while the United States, with 290 hospital beds per 100,000 people, has more than three and a half times that provision.

Dr Raj Panjabi, who founded Last Mile Health, portrays the grim situation very vividly when he says, “If you lived in a place like Guéckédou, Guinea and your two year old became sick you would hoist him on your back, walk to the river, paddle a canoe, get to the other side and then walk for up to two days to the nearest treatment facility.”

Dr Panjabi speaks from direct experience as he was born and raised in Monrovia but had to leave Liberia to escape its brutal civil war when he was nine years old. He says, “We were lucky and got on a cargo plane. I have never forgotten the people we left on the tarmac.” He returned to Liberia after attending medical school in the U.S. to serve the people he was forced to leave behind. His first hand exposure equips him with the insight required to navigate the dual needs of regular health care challenges and the flexibility required to respond to extraordinary developments such as the spread of Ebola.

By recruiting, training, and mentoring local village residents to become professional community health workers, Last Mile Health provides access to care in remote villages. Teaming up with Partners in Health, Last Mile Health is undertaking a more comprehensive response. This involves not only training frontline community healthcare providers who will undertake prevention and case monitoring in the so-called last mile villages in the remotest areas of Liberia but also providing staffing support for hospital facilities necessary to provide lifesaving care. The coalition intends to use the $2 million received from the GE Foundation to build a force of 500 health workers to staff nearly 47 health centres in Liberia and Sierra Leone, besides training an additional 800 community health workers to address education, surveillance, and monitoring in villages.

In a global society, epidemics can swiftly escalate into pandemics. Hence, under-funded responses can exact heavy prices globally. Adequate resource provision can make a world of difference. As a case in point, Nigeria contained Ebola to just 20 patients as doctors were able to leverage the infrastructure that the Gates Foundation has created to eradicate Polio.

The problem of Ebola is a reflection on the critical dearth of adequate and appropriate healthcare systems and an urgent reminder of the pressing need to bolster these systems in the poorest countries in the world. It is with this intent that Last Mile Health is linking its Ebola response efforts with long-term strengthening of the underlying health care infrastructure to pursue its noble vision – a health system where all, even those living in last mile villages, have an equal chance of securing health care and ensuring survival.

Read more about Last Mile Health and their Ebola response at http://lastmilehealth.org/ebola-response/.

Do more by taking five minutes to reflect on the last six months. How many times have you been to a healthcare provider? How often have you purchased pain killers or other over the counter medicines without any difficulties? Now imagine if you those services were not readily available? How would you respond? How would your behavior change?

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