Ebola-hit Liberia rebuilds devastated child healthcare system

Monrovia (AFP) - Estella Verdier keeps vigil by her sick four-month-old grandson's hospital bed, praying for his recovery but placing her faith in the earthly healing powers of Liberia's first ever children's hospital.

The 46-bed unit, just opened in Monrovia by Medecins sans Frontieres (MSF), is part of the country's response to the challenge of repairing its wrecked health service as it emerges from the nightmare of Ebola.

Like countless young women in impoverished Liberia, Verdier's daughter died in childbirth, leaving the 63-year-old the infant's main guardian.

"Since then he continues to get sick. Anything he eats, he vomits it. No need to ask me how I feel -- I am feeling bad, of course -- but with this well-equipped hospital I have hope that the kid will survive," Verdier tells AFP.

Liberia is one of three countries, together with Guinea and Sierra Leone, that were ravaged by the worst outbreak of Ebola in history.

The epidemic has killed at least 10,600 people since December 2013, some 500 of them healthcare workers.

Clinics which could not cope with the highly infectious virus were forced to close as the death toll rose, and with it the number of Liberians dying from easily treatable diseases.

"We saw people dying simply because they could not access timely medical care. They were usually suffering from illnesses like severe malaria or typhoid," said Philippe Le Vaillant, MSF's head of mission in Liberia.

"Pregnant women facing obstetrical complications also have suffered the same fate."

- Recovery phase -

Meanwhile the vaccination rate "took a very deep dive", according to Sheldon Yett, the Liberia representative for UNICEF, the United Nations children's agency.

UNICEF's own contribution to building up paediatric healthcare includes supporting a government campaign planned for May to immunise more than 600,000 under-fives against measles and polio.

"Polio immunisation was at 88 percent in 2013 compared to 49 percent by November 2014. Measles coverage among one-year-olds fell from 74 percent to 46 percent," Yett told AFP.

Liberia is now in the Ebola recovery phase with no new cases reported for weeks, but like Sierra Leone and Guinea has missed a goal of being "Ebola free" by mid-April.

The country of four million people had been on course to meet the target but on March 20 authorities recorded a new patient who died a week later, meaning the 42-day countdown to Ebola-free status had to start again.

With its Ebola clinics now empty, Liberia's priority is curing the ailing healthcare system.

"We basically decided to come and help the medical system in the effort of restoration after Ebola hit," MSF project coordinator Ondrej Horvath told AFP.

"We were thinking how to do this (so) we sent a small team of specialists who explored Monrovia... One of the suggestions was to focus on children."

MSF began by helping clinics welcome back parents who kept their children out of clinics for fear they might become Ebola carriers.

"We decided to open an in-patient department, specialised in the hospitalisation of children, so it is not a clinic where you go in, get consultation and medication and get out," Horvath said.

- 'I feel ready' -

The hospital was opened on March 23 in an old three-storey block of flats rented from a former cabinet minister in the northern suburb of Bardnesville.

Inside the L-shaped concrete block, MSF healthcare workers triage young patients, ensuring they do not have Ebola before admitting them for treatment for a variety of other illnesses.

The unit, which can extend its capacity to 100 beds, is equipped to cope with any illness other than AIDS, tuberculosis and Ebola, says MSF, known in the English-speaking world as Doctors Without Borders.

"In our hospital we treat kids with common diseases like malaria, malnutrition, pneumonia, et cetera," says paediatric specialist Stephanie Taylor.

Newborns who become ill after home births are a significant proportion of the intake, says Taylor, along with infants malnourished because of prohibitive increases in food prices caused by the Ebola crisis.

MSF has also been assisting James David Junior Memorial Hospital in Monrovia's Paynesville neighbourhood to upgrade its paediatric and maternal services to standards that now take account of Ebola.

"The virus has taught us all a lesson in the hardest way," Beatrice Jlaka, nursing supervisor in the intensive care unit at JDJ hospital, said in an interview posted on MSF's website.

"Many of our colleagues have died fighting the disease without proper training or equipment. To honour them, we must always be careful. I am no longer afraid to work. I feel ready."