Voices for the Voiceless on Health Matters

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Amid endemic public health crises and government mismanagement, investigative reporting may be Liberia’s best hope for change.
The rain was pelting down and the mud churning on the day last August in Monrovia, Liberia, when young reporter Emmanuel Tophic Degleh made his way, slipping and sliding on a borrowed motorbike, up the mountainous road severed by a collapsed culvert.
On one side of the gaping ditch were 12,000 residents of rural Margibi county, about an hour’s drive from Monrovia, many desperately in need of medical care. On the other was a clinic that could save lives.
No one had made it across the gaping hole to the clinic — the washed out road was the only possible access point — for months, and pleas for a fix were being ignored. Not until Degleh, a young reporter wrote about it.

Degleh’s article on the road collapse in the isolated Gibi District of Liberia got the attention of the public and government officials and that got the road fixed. This was no small victory in a country where lives are too often lost as a result of endemic government mismanagement, and where an anemic health care system couldn’t slow the deadly Ebola virus epidemic of 2013–2016. But it took just one day in the reporting life of Degleh, and set him on a new professional path that has led all the way to a fellowship with Thomson Reuters Foundation this year as a result of his health reporting. He is one of a growing number of journalists in Liberia supported by Internews marshalling new skills to report on health and health policy in a country where the news is rarely good about either.
“Health remains a serious challenge to the nation, and until we report on it regularly, from the perspective of ordinary people who are being affected directly, I cannot imagine our institutions responding, really responding,” said Samuka Konneh, health communications officer at Internews’ “Information Saves Lives” program designed to bolster health reporting in Liberia. “Health care is about politics. It is about policy. It is about funding. And it is about the most compelling story for a journalist of all, life and death. It is urgent.”

Health in crisis
Even before the Ebola virus swept through Liberia, Guinea, and Sierra Leone, killing 11,300 people, the health care system of this nation on the west coast of Africa, like so much else in Liberia, was in crisis. Twenty years of political upheaval and violence as a result of violent political coups and civil wars that ended in 2003 killed 150,000 people and displaced another 850,000. At the time the Ebola virus was confirmed, the country far too few working physicians serving a population of four million. As of July 2016 there were just under 300 doctors, making the doctor-patient ratio 1:15,000. According to the World Health Organization, without a national strategy to deal with infection prevention, health care workers were between 21 and 32 times more likely than those working outside the health-care system to contract the virus. In total, 189 health care workers died in Liberia from Ebola during the outbreak. Across the region, more than 800 became sick.
At the peak of the crisis, the closure of hospitals and clinics meant that many patients, particularly those injured in traffic accidents or suffering from common ailments like malaria, were left to fend for themselves.
During the epidemic, pregnant women had to give birth on the street because they could not find a hospital where they could deliver, and the United Nations Population Fund estimated maternal death rates in Liberia doubled. Immunization campaigns were suspended, leading to outbreaks in both measles and whooping cough.
Even with Ebola on the wane, Liberia’s healthcare system is stricken. The foreign disease experts, healthcare workers, and crisis response teams who finally helped contain it have largely gone. The virus keeps flaring up. The country is beset by poverty, corruption and hunger. Though awash in donor money, aid is inconsistently accounted for, leaving hospitals without cash for equipment, staff or medicine. Liberia is the world’s eighth-poorest country. The country’s high maternal mortality rate remains among the world’s worst. Female genital mutilation (FMG) is practiced by 10 of Liberia’s 16 tribes, affecting more than two-thirds of women and girls. Bushmeat, a cheap source of protein and a source of Ebola, is now banned, but it is still sold at markets throughout the country.
Reporting for Health
Against that backdrop, the challenge for Liberian journalists is immense. But for young journalists like Degleh, endlessly compelling as well. Three years after Internews first established the program to train and empower journalists in the country to report accurately about health issues, the effort is bearing fruit.
Along with Degleh, over a a dozen Liberian reporters have undergone intensive training programs with Internews, since 2014, some for as long as 7 months, This has enabled them to develop special columns on health reporting in their newspapers that were not present prior to this program. Another five or six have active radio slots reporting on health issues. The reporters — most of them young, focused, and willing to work very hard for very little, make their way to rural clinics, trek out to the jungles and regularly work to dispel rumors about disease.
“Information saves Lives. The name says it all, right?” Konneh said. “Liberia is a very politicized society, so reporters gravitate to politics. But Internews introduced this new specialization where reporters could focus on health reporting, on the human toll, the impact, the challenge.”
“It was hard to convince reporters and editors to report on health, because media managers thought that health stories didn’t sell papers the way political or entertainment news did,” Konneh said. “But Liberia is a small country, so we leveraged both professional and personal relationships to let them know that health, written about effectively, is about stories so compelling, so critically important that it captures the attention of readers. Health reporting not only saves lives, but creates empathy.”
In a series of seminars, Internews exposed the journalists to experts on public health, medicine and the health industry. Contacts were made and fostered with Liberian Health Ministry officials, and the journalists learned how to research and share resources.
One reporter trained by Internews wrote a story on a teenage girl, suffering complications during her pregnancy with twins, who had been transferred from home to a maternal waitin room because of a lack of a health facility in her community. Reaction to the story mobilized readers to send her clothing, food and funds.
Another reporter did a story on an outbreak of skin lesions among residents in neighboring Sierra Leone. The story explained how the condition can spread and how to prevent it — critical explanatory reporting in Liberia, where there is only one dermatologist in the entire country.
“People read these stories and were able to help others, to protect themselves and to dispel rumors,” Konneh said. “Our ambition is that each story should call people to action, and in these cases they did,” Konneh said.
Ambitions aside, the obstacles to Liberian journalists are high. The country is so poor that most media companies, starved of advertising and subscribers, struggle to survive. Support has come from foreign aid and non-profits, but even so, journalists have a hard time making ends meet. Konneh said that the radio station he worked for before joining Internews gave him two dollars in expense money per week to buy batteries for his camera and fuel his car. Often reporters wait months to be paid.
Degleh, whose story on the isolated medical clinic got a road opened again, has become, in his words, a “voice for the voiceless” with a consistent drumbeat of stories exposing wrongdoing, corruption and mismanagement.
Last year his reports on a hospital which had fallen into disrepair started a flow of funding that saved the facility. Degleh worked intensively on the reports with Konneh.
The Bong Mines Hospital, built and run by Chinese mining companies to serve about 40,000 residents, many of who worked at mines they developed, had been turned over to the government by the companies when their revenues from the mines began to decline. But under government management, staff went unpaid, the supply of medications dried up and electricity was spotty. That left the 100-bed hospital, the only public facility in the region, facing closure, even as the number of patients seeking care there ballooned. – Reporter Emmanuel Degleh. Degleh for Internews.