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Through an MBA project, I was on the ground in Liberia in March of this year (less than 2 weeks before Ebola crossed the border into Liberia) helping the JFK Medical Center develop a public awareness campaign for the public to seek health care servic

Through an MBA project, I was on the ground in Liberia in March of this year (less than 2 weeks before Ebola crossed the border into Liberia) helping the JFK Medical Center develop a public awareness campaign for the public to seek health care servic

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I see both sides of this coin. On one side, I agree, through the lenses of someone in a developed economy, where healthcare workers are among the most highly valued professions in the country, $300 per week is a measly sum. Given the risk these workers are accepting (sickness and/or death), why can't someone come up with more money to pay them? Not only do we ask them to treat the sick while wrapped in suits they can only wear for an hour before overheating, but we ask that they trust these suits will preserve their own lives, we ask that they remain positive about one's chances to survive and not give up, among many other expectations. It's daunting to say the least, and to say that these workers are our primary hope for containing the disease in places like the slums of the big cities of Western Africa is an understatement; they are the only hope in the eyes of the sick.

That said, there's another side of that coin. I worked on a project for JFK Medical Center in Monrovia, Liberia (the only tertiary care hospital in the country) this past March, just a couple of weeks before Ebola hit Liberia, and one of our teams of MBAs was tasked with evaluating the cost structure of the hospital to find savings. That did NOT include reducing salaries, I'd like to add. But it did expose us to what the staff makes. Let me state that JFK Medical Center pays the absolute highest wages of any government or quasi-government organization in Liberia, but workers do receive an education stipend on top of their salaries, so total compensation is very high compared to the vast majority of Liberians (whose unemployment rate is 70+%). A nurse with a Bachelor's degree in nursing earns around half of what these workers are earning. And that salary affords many of them to support their families (many men do not work, or sell goods on the streets, while the women have careers), including multiple generations. Many even have saved up to purchase property and own their own homes. On $150/week. Doctors make about $400/week. This is not the kind of economy that supports high salaries. It's cheap to live there, and if you have a job, you're among a 30% minority to begin with.

So I present this not as an argument against what you're saying. I share it to remind ourselves that through the eyes of someone in a developed nation, such salaries seem insulting and ludicrous. To someone on the ground, that is more than a comfortable living. It's all a different perspective. I think they deserve more, but I also know the struggles the governments there have ahead of them in terms of funding the fight. The US and other developed nations need to do more to support the fight, but ultimately, if you need vast numbers of workers to fight the disease, and $300/week is at the high end of a middle class wage (perhaps equivalent to US $60,000+/year), is that too different from how we pay our EMTs and nurses? Just food for thought.


Rob commented on TelePresence Improve the Quality and Speed of Care

Telemedicine is indeed increasing in use in developing nations, and it can provide access to specialized doctors who can't be onsite in these locations to provide expert care without stepping foot on a plane. When I was in Monrovia, Liberia this past March, we found that the JFK Medical Center (the only tertiary care hospital in the country) had a room designated for telemedicine, containing some basic equipment donated by the Indian government, with whom they have a close relationship. The problem was that no one ever used it. From a lack of training, to a lack of resources to dedicate to the time it took to organize, schedule, and execute a session with a specialized doctor somewhere else in the world, the doctors and nurses overlooked a valuable resource.

While we were consulting with the hospital immediately preceding the Ebola outbreak, we recommended as part of their long term strategy to utilize the equipment at their disposal. Instead of exclusively partnering with foreign doctors to do rotations on the ground at the hospital, they could have more doctors with more specialties working alongside them via telemedicine than in person.

It's a great idea to bring up, and I believe it needs to be part of the overall strategy for education of doctors and nurses.

That said, their biggest deficiency is lack of protective equipment, which makes healthcare workers afraid to do their jobs. When they're afraid to do their jobs, the fear spreads. It's a vicious cycle that I hope is soon broken, because tools like telemedicine can take the fight to the next level.