Liberia is a West African country with a population of 4.6 million, and is classified as a low income country by the World Bank. Many years of civil wars, eventually ending in 2003, caused great loss of life and the displacement of hundreds of thousands of Liberian citizens. The prolonged conflict negatively affected the medical infrastructure and depleted the already limited number of healthcare professionals in the country. Rebuilding the country and its healthcare capacity proceeded following the ceasefire in 2003. However, the nascent recovery of the medical system in Liberia suffered a setback with the Ebola outbreak of 2014-2015. Over 4800 people died from Ebola over that period, including medical health professionals, reducing the already limited Liberian health care capacity. The acute crisis from that event resulted in a greater global awareness of Liberia, concomitant with increased foreign aid.
The access to radiology in Liberia is limited. In 2017, RAD-AID conducted a radiology-readiness assessment and found that 1) there are gaps in both radiology professionals and equipment; 2) there are only 2 radiologists serving the whole country, separated 6 hours by dirt road, and only about 22 technologists (2015); 3) there is no radiology residency training program; 4) technologists were trained under a 2-year structured course which closed in 2008. Training is otherwise done on the job and lacks consistency; 5) equipment, physical resources, and training varied between facilities; and 6) diagnostic imaging is limited to x-ray and ultrasound, with plans to implement advanced imaging modalities in the near future, including CT and MRI. As of January 2019, there are 2 recently installed CT scanners in the country. Plans for adding additional CT and MRI is underway.
RAD-AID in Liberia
RAD-AID is working with Icahn School of Medicine at Mount Sinai to build medical imaging capacity in Liberia. With support from the World Bank, RAD-AID is focusing on radiology education. RAD-AID has continuous teams deployed in Monrovia to educate physicians and diagnostic imaging professionals about radiology best practices.
We are currently teaching at local Monrovia hospitals (JFK Memorial Hospital, Redemption Hospital, ELWA Hospital, and A.M. Dogliotti Medical College) and were previously teaching at one rural site, Phebe Hospital, in Bong County. Our educational activities cover didactic lectures, hands-on radiography/CT training, hands-on bedside teaching of point-of-care ultrasound, ultrasound-guided procedure workshops, and interactive lectures/case presentations. Our teams have consisted of radiologists, radiology residents, radiology physician assistants, sonographers, CT technologists and radiographers. We are in need of volunteers to continue our educational efforts.