Drs James Teprey and Sei Parwon represented WHO on the trip. The team embarked on the ship MV Rotterdam on Wednesday 3^rd December 2003 and arrived the following day early in the morning. After recognizant missions by UNMIL, the team disembarked to begin the assessment. The assessment was conducted for two days before the return of the team.

A relatively large and enthusiastic crowd met the team. The leadership of the team met the City Mayor and the other community leaders. Greetings were exchanged between the guests and the hosts. The objective of the mission was explained to the hosts, questions were asked and answers provided accordingly.

The population of Robertsport is estimated at between 2000 and 2500. No accurate data of the population was available.

Children below the age of 5 years, women and the elderly formed the majority of the population. Teenager males were in the minority. Women were also in greater proportions when compared to their counterpart males. Many pregnant women and mothers of young children were seen.

Presently there is no health care service in the community and the district at large. ICRC donated basic Kits to the LNRC several months ago and no replenishment had taken place and the clinic had closed. People rely on local quack doctors and drug peddlers. Severe cases are taken to Monrovia, which takes 3 hours by road. The community members complained of high transportation fares to Monrovia. All health promotional and prevention activities including immunization came to a halt after the town was attacked earlier this year.

The hospital has been looted, vandalized and abandoned. The road to the hospital and the hospital premises are overgrown with weeds. It may not be possible to go to the hospital or go round it on foot because of the weeds.

The hospital used to have a 32 bed capacity. It was renovated and commissioned in 1999.

From initial observation, it shows that it was not used much after the recent renovation in 1999 before the war. The physical structure (consisting of the standing building, roofings and ceiling), OPD, wards, theatre offices looked intact. However, all furniture, doors, hospital equipment, mattresses, have been damaged or looted. The theater bed is still intact and may require some servicing before use. The new looking two 37 KVA generators have been tampered with but not looted. It will require assessment by an expert.

The commonest diseases seen include malaria, Acute respiratory Infections, diarrhea among children. They also reported high prevalence of Sexually Transmitted infections among the youth. There were no serious disease epidemics. The CHT reported two cases each of jaundice and bloody diarrhea who later died.

There are in all 15 health workers presently available in the County Health. Nine (9) of them are in Sinje and includes the CHT members, five (5) in Lofa Bridge and two (2) in Robertsport. In addition there are three (3) Traditional Birth Attendants who assist deliveries.

Almost all the children seen were looking healthy and not malnourished. This could be due to the fact that it is a major fishing and farming community.

The hospital used to have a water pumping system using a pumping machine run on electricity. This could not be assessed because of the bushy nature of the premise. However, most of the water closets, sinks and pipes are intact. In the town, there are functioning hand pumps. From interview with some community members, it came to light that the people do not drink water from the hand pumps because they claim the pumps are located on lowland areas and are believed to be polluted. They therefore use water from the community wells and the nearby streams.

1. A vehicle was hired to convey the County Health Team presently relocated in Sinje to Robertsport. The CHT and the LNRC staff in Robertsport then held a meeting with the WHO/ UNICEF and WVI team. Decisions of deliberations include:

• Basic health care services will commence in the LNRC clinic on Saturday 6^th December 2003. Both the Health workers and the Red Cross staff will run it.
• Within two months the weeds on the premises of the Government hospital will be cleared and the premises cleaned for OPD services to begin in the hospital.
• World Vision International will begin mobile clinic services to the District to compliment the efforts of the Clinic and will consider opening static facilities in the near future.
• Guidelines for Micro planning for measles immunization campaign was discussed. The CHT was charged to come out with a plan as soon as possible for the campaign to be conducted.
• Chlorination of the community wells will also be conducted as soon as possible. WHO will build capacity for the chlorinators; supply the chlorine and the Chlorine Testing Kits.
• CHT have been requested to collect Cary Blair kits and blood collection specimen bottles from WHO over the weekend for stool and blood samples of cases that may occur in the future.

1. WHO donated two basic Kits to the newly opened clinic and another one to the County Health Team in Sinje.

 

 

 

RECOMMENDATIONS:

Immediate term

2. Basic health care services should begin immediately in the Liberian National Red Cross clinic. Within the next few months’ community efforts should be made to weed and clean up the Government hospital premises to allow rehabilitation of the OPD and one wing of the hospital.
3. Immunization against measles campaign should be conducted as soon as possible to compliment the basic health care services.
4. Chlorination of community wells in Robertsport and its surrounding environments.
5. Capacity building for the County Health Team and the District Health Team to promote Family and Reproductive Health in the area.
6. WHO or the LWSC should test and investigate the water from the hand pumps for suitability for human consumption. Health promotion on basic hygiene and safe water use should be conducted in the city and the surrounding areas.

• Rehabilitation of the OPD, emergency surgical and obstetrical care, and one wing of the hospital for in-patient care.
• Re introduction of major health programs such as Routine immunization, sub- NID, health promotional activities etc.

The health delivery system in Robertsport, Grand Cape Mount is collapsed and non-existent. The most health pressing needs are immediately include.

• Reactivation of the basic health care services,
• Immunization of children 6 months to 15 years against measles
• Family and reproductive health promotion including STIs , HIV/AIDS, and family Planning.