What was the defining moment that led you to this innovation?
All innovation, all the tireless effort of Tiyatien Health is defined by Liberians committed to transforming their country. Weafus Quitoe fled with his family to neighboring Cote d’Ivoire on foot during the civil war. He grew up in a refugee camp, and learned to etch out a survival by peddling kerosene across the Ivorian border—crisscrossing military fronts to bring fuel for home lamps to Liberians who had stayed behind. After 15 years in exile, Weafus returned home.
He built a mud-brick hut (no larger than the average American closet) in a small, rural town called Zwedru and began to raise his young son as a single-father. Yet, Weafus cared beyond personal survival. He began to notice the influx of very sick young people with AIDS, nearly 10% of adults. But life-saving antiretroviral treatment had never been introduced at a public facility outside the capital. AIDS was not the only crisis, with women dying in childbirth because they couldn’t afford private hospital fees, and chronic diseases utterly ignored. Weafus decided, “I want to change the injustice.”
Along with Raj Panjabi, a Liberian-born doctor, Weafus founded Tiyatien Health to prove a community-based initiative can build a model rural health system in the poorest corner of Liberia. Weafus taught himself nursing skills, and went from not knowing how to use the “on” button of a computer to learning email, budget management, and fundraising work. He continues to serve as TH’s project director, teaching his local colleagues the healthcare management and delivery skills that are vital to building hope in Liberia.
Tell us about the social innovator behind this idea.
Innovation requires three steps: seeing a problem, designing a solution, and dedicating action toward this solution. While professionally directed research accomplished the second step in Rebuilding Hope After War, the first and last steps are driven by local Liberians.
In 2008, CHWs already employed to deliver HIV therapy signed on to administer a mental health survey. They walked hundreds of miles, through heavy forest, to visit more than 1500 households across 40 villages. Through this survey, they discovered the mental health impact of forced conscription and sexual violence against both men and women—the terrible effects of war. Anecdotally, they also reported on stigma witnessed in their own villages. A single worker identified more than 200 epilepsy patients in communities near her own, realizing these people not only had no access to care, but were also marginalized by their disease.
Tiyatien Health joins forces with leaders in both community and mental health, to adapt existing “best practices” to the Liberian situation. Partners in Health, the organization which pioneered training CHWs to deliver anti-retroviral therapy in Haiti, gives TH direct, personal advice on implementing a similar model in Liberia. We have adapted their CHW training materials to the Liberian context. Additionally, we collaborate with Dr. Vikram Patel, a globally recognized leader in mental health; he and others advise TH on diagnostic and therapeutic protocols—novel interventions for contexts lacking in physical resources and trained professionals.
Any innovation would fail without strong desire to implement, and here again, the Liberian team members lead. Although Rebuilding Hope After War has just begun, local TH staff has identified patients at highest risk. They already combat stigma in their communities, and are now ready to work for equitable mental health care.
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