Phebe Hospital makes improvements during 2006

March, 2007

The year 2006 saw many changes at Phebe Hospital and School of Nursing. After the resignation of Emmanuel Sando as Medical Director, the hospital operated much of the year under the supervision of a four-person management team. New Medical Director Dr. Garfee T. Williams now has been joined by a new Hospital Administrator, Mr. Kerson Saykor (Chief Financial Officer), who is supported by Accompaniment Administrator Rev. John Lunn, who serves as an ELCA missionary.  Dr. Jefferson Sibley serves as Chief of the medical Staff. Another Liberian national, Mr. Augustine Jallah, has been recruited as Site Engineer, this position is fully paid for by the ELCA during the first year. Kollie Massaquoi serves now as Maintenance Supervisor. Mary Tiah continues to serve as Nursing Director. Rev. Victor Padmore continues to serve Phebe as Chaplain.

Renovations and Improvements
In addition to repairing roof leaks, improving water delivery to the campus, and upgrading power generators, the hospital was able to complete repair on three more houses, two of which are occupied by staff while one is leased out to another organization.  Phebe also began to construct an annex to their Pediatrics Special Nutrition Unit due to increasing admissions and lack of space. This new 12-bed facility will provide more space separate from the general pediatric ward.

In February 2006, the Morgue Service was reestablished and a mortician has been contracted to run that facility.

With Phebe’s kitchen now fully functional , (supported by UNICEF) the hospital is providing two meals a day for in-patients. Through the Danish Mission, Phebe received $23,000 for setting up a cafeteria service at the compound’s multi-purpose building to provide meals, primarily for students of the Nursing School.

During 2006 Phebe increased staff by more than 10%. Its lab is now nearly fully equipped with new chemistry and hematology machinges. With support from the Global Fund, Phebe received a new CD4+ counter that has greatly improved care for HIV/AIDS clients. A new x-ray machine has recently been installed. Phebe is the only Liberian hospital with an entire medical ward section isolated for Lassa fever (thanks to funding from WHO).

Challenges
2006 saw the financial situation at Phebe stabilize somewhat as Phebe is now supported as a government agency for health care services. Of course, there continue to be challenges in serving an extremely low-income population. The current system of payment by patients in most case is “payment after service.” Coupled with the devaluation of the Liberian dollar, this has resulted in a downward trend in the collection of fees. As a result, patient care income constitutes a little over 10% of the total cash income of the hospital. Phebe is now considering a prepayment system for admission for those patients able to pay. There is hope that a new social worker position will help to better assess financial resources and determine a patient’s ability to pay.  Overall, Phebe has reduced fees for some medical and surgical services, in line with a national policy to increase access to health services.

Statistics
The out-patient department treated 18,579 patients during 2006. 64% of these were adults and 36% were children. The leading causes of visits were attributed to: malaria, diarrhea diseases, respiratory tract infection in children, worm infestation, and anemia. 

The in-patient department is divided into three wards: pediatrics, obstetric and gynecology, and medicine and surgery. The hospital has a total bed capacity of about 150, with an even bed distribution among the three wards.  A total of 65,365 patients were admitted in 2006, with 2,670 pediatric admissions, 1,577 obstetrics and gynecological admissions, and 2,118 medial-surgical admissions. A total of 1,101 surgeries were done, with 752 of these emergencies and 349 categorized as elective. A total of 1,577 children were born at Phebe in 2006. The Emergency Room forms another arm of patient care at Phebe Hospital. In 2006 the Emergcy Room saw a total of 10,232 patients.

Because of a continual shortage of doctors, Phebe’s international partners and friends continue to assist with temporary personnel to cope with the increased demand for health care delivery.  During 200, a number of short-term visiting doctors from the Swedish Doctors Bank (under the sponsorship of the Rotary Culb) made working visits. Also a Chinese trained Liberian acupuncturist joined the staff of Phebe in November and makes bimonthly working visits to the hospital.  During 2006, Phebe said goodbye to Dr. Emmanuel Sandoe, formed Medicla Director, and Dr. Emma Okoli, one of two Nigerian doctors at Phebe.

Phebe’s eye care unit continues to be improved. In 2006 the eye unit saw 449 patients at Phebe and saw another 524 patients on outreach visits. 263 patients underwent eye surgeries (mainly cataracts cases).

Phebe’s Community Health Department continues to support most of the smaller health facilities in Bong County (almost 30 in number). Nearly 300,000 cases were seen by these facilities, with over a third of these patients under the age of five years. Malaria is the primary area of concern.  The Community Health Department also continues to treat tuberculosis and leprosy cases, and has expanded its program on immunization. Community Health Teams also provide education on sanitation issues, assess water quality in the county, and train local people on the critical importance of clean drinking water.  During 2006 Phebe recruited two persons who will concentrate on malaria and HIV/AIDS activities. This has improved Phebe’s reporting timeliness to the Ministry of Health and Social Welfare.

Phebe’s Para-Medical Training Program is the teaching arm of the hospital. It produces qualified health workers to serve mostly in the rural sectors. During 2006, there were 82 students enrolled in four different programs: 1) a 2-year Midwifery program,2) a 3-year Medical Laboratory Technician program,3)  a 2-year registered Nurse Anesthetist program, 4) and a 3-year Professional Nursing program. The School of Nursing has 24 staff, including six full-time faculty, six part time instructors, 7 clinical instructors and 5 support staff. It is still in need of at least 4 qualified full-time instructors for the Midwifery and Anesthetist program.  Carol Rasmussen, long-time U.S. volunteer completed her service in June of 2006.