The Reality of Inadequate Healthcare: One Liberian Pregnant Woman’s Story

rented car full of people

Hello, I am Chie, the Founder of Diamonds for Peace.

As I have been deeply involved with international development work for the past 20 years, I had come to accept the standard of living in many African countries, without much thought about how extraordinary the absence of basic healthcare must look for people from more developed countries.

However, my eyes were opened again in the fall of 2022 and I would like to share my experience here, hoping it might help you to understand what it’s like to live in Liberia. This is a modified version of an experience I previously posted about on social media exclusively for my friends, and I intentionally leave it in the same tone to convey the sense of realism as it is.

I had planned to stay in Liberia for two months starting in October 2022, and this event occurred after the first 3 weeks had passed. I was working on a project in Weasua, an artisanal diamond mining community about 7 hours by car from the capital city, Monrovia.  The schedule was to stay in Weasua for 10 days but the engine of my rental car died on the 3rd day.  The mechanics went to the capital twice to buy parts and they were able to fix the engine finally after spending some extra days in Weasua so that I could travel to the town where the DFP Liberia Office is located.

On the morning of my departure our local DFP staff informed me that there was a health emergency in the community; a pregnant woman had become too ill to be cared for at the local clinic, so she needed to be taken to an advanced maternity hospital in Tubmanburg, 4 hours away from Weasua on a rough unpaved road. We were the only ones leaving the community by car on that day, and of course, we offered to bring her to the maternity hospital.

One of the cooperative members we are working with in Weasua came to see me off. As he also works at the local health clinic, I told him about the sick pregnant lady. He said, “I did not know that. I need to record who is to be transported to where,” so I took him to the pregnant woman’s home. Such transportation is not uncommon in rural communities according to the health clinic worker/cooperative member. It is unusual that Weasua actually has a healthcare clinic (many other rural villages do not), but there are no doctors at the clinic in Weasua, only a nurse, an associate nurse, and health officers.

The pregnant woman could hardly walk and was even bleeding. Her husband and community health nurse carried her and placed her into the back seat of the car, where she was accompanied by two other health nurses. I took the passenger seat while our male DFP staff sat in the bed of the truck.

The rental car driver (when you rent a car in Liberia a driver is included) seemed restless and tried to leave even though we were not ready yet. Maybe he wanted to go home early, he looked annoyed when our staff told him to be patient as the pregnant lady was not feeling well.

In addition, the driver’s seat was tilted back (about 135 degrees), and the space for the health nurses to sit and to put their feet was quite narrow. I asked the driver to move the seat a little forward but he insisted this angle was essential for such a long drive. “Only by a little,” I requested again, as he was not the only one enduring the hard long drive, and the driver reluctantly moved the seat forward. Then we finally set off.

For the drive three mechanics from Tubmanburg followed us on one motorbike so that they could fix the car right away in case it broke down again.

Because it was the end of the rainy season, the road was especially muddy and bumpy. The mechanics’ motorbike actually got a flat tire after a couple of hours drive so they all moved into our car.  Two sat on the car roof because the bed of the truck was fully occupied.

All this time, the pregnant woman looked like she was experiencing so much pain, she gave a moan every time the car bumped. Being transported by car itself was tough and she in her condition had to deal with the rough road for four hours. I remembered the sad face of her husband when he said “thank you” to me at the departure from Weasua. He might have been considering that his wife might not survive the trip.

It just made me feel sorrow to imagine how desperate I would feel in her place, and how I would hate being born in this country.

The bad condition of the road is another example of how life in Liberia is not getting better.    The rural roads showed little improvement in 2022 from when I first traveled to Liberia in 2014. It even seemed the bumpiness got worse rather than getting better. First time visitors in Liberia get the wrong idea when using Google Map to see that Weasua is only a two to three hour ride from the capital. If the road was paved it could be, but the reality is totally different. If the roads were paved, local farmers could easily transport farm products to the capital before they start to go bad. In reality however the trip to bring their produce to market requires a four-wheel drive car even in the dry season with relatively good road conditions, and it still takes six to seven hours at least. Crops get deteriorated and their value drops while waiting for transportation. Growing crops is hard in Liberia and the effort is not rewarded because the way to the market is long and rough.

Rough dirt road in Liberia
A rural road in Liberia taken in 2016, but the condition has not changed now. ©Diamonds for Peace

Upon our arrival at the maternity hospital in Tubmanburg, staff who appeared to be doctors and nurses came out with a wheelchair and took the pregnant woman inside. The hospital appeared deserted to me with no other patients. When I worked in Kenya every hospital was crowded but not here. I wondered why…

Maternal hospial
Arriving at the maternity hospital in Tabmanburg ©Diamonds for Peace

I then got back on the road again with the driver and other passengers, praying for the safety of the woman and the baby. After a while, an ambulance passed us and the passengers waved their hands at us. They looked like the nurses attending the pregnant lady, so it seemed she could not get the proper care at the hospital in Tabmanburg and was being taken to another hospital in the capital.

Subsequently we saw the ambulance refueling, so our car stopped and DFP staff asked about the pregnant woman’s condition. As had been expected, they were on the way to take the pregnant lady to the tertiary level hospital in the capital since the one in Tubmanberg did not have the adequate equipment for her.  Thankfully her condition seemed stable at that moment.

The ambulance carrying the pregnant lady. ©Diamonds for Peace

Our DFP staff also told me that while there are ambulances at the hospital but they do not run unless patients pay for the gas. As for any necessary equipment, patients also are required to pay for the hospital to buy or to import the equipment. According to a person working for the United Nations, JFK, the highest level public hospital in Liberia, was made fun of as being better known as the “Just for Killing” hospital.

Shortly after our arrival in the capital Monrovia, we got a call from the nurse attending the pregnant woman. The baby’s heartbeat could not be heard at the ultrasound examination given in the hospital and the doctor prescribed a medicine which the pregnant lady was about to take.

When I lived in Kenya I visited rural hospitals many times as I was involved in a project of the Ministry of Health. I do not think they were as bad as what I was hearing about the hospital system in Liberia. How can we say it is an “advanced” maternity hospital, if they cannot even give an ultrasound examination?  No wonder there were no other patients.

This country is just awful. The national budget is collected through taxes but it is misappropriated by politicians without any achievements to show for the funds. People say various measures were implemented during the term of the former president but no progress is being made now. I was surprised to hear that many people in Weasua would vote for the same presidential candidate again next time. Even more shocking is that they keep supporting the same one for no particular reason. Moreover, people told me that young people are often paid to vote for particular candidates. As more than half of the people live under the poverty line set by the country, it is easy to imagine that they accept money to vote without hesitation. Citizens like the pregnant lady must carry all the stress of it in the end…

I felt so helpless that day. And it reminded me of the motivation I had when I started studying international development: it is not right that someone’s life and the opportunities available to them should be so different just because of where they are born.

Update (1)    

When I returned to Weasua the following month (November 2022), an older lady came up to me unexpectedly, and said, “thank you, thank you!” She turned out to be the mother of the pregnant woman we had transported. We could not save the baby’s life unfortunately, but we did at least still help to save the mother’s life. I heard she was already back in Weasua.

We should not take this particular experience  as unique because it unfortunately happens daily in Liberia.
Such events make me aware of my own limitations, but I will not give up. Just act on my belief: we are weak but not powerless.

Update (2)

When I came back to Weasua in May-June 2023, I saw her (the woman we transported) and she was doing well. I am pleased to let you know she has fully recovered.

The person we carried to the hospial
The person we carried to Tubmanberg ©Diamonds for Peace


Opening photo: Rented car, with motorbike on the bed of the truck and mechanics on the roof ©Diamonds for Peace