Honorable Joseph N. Boakai, Sr. Vice President of the Republic of Liberia Delivered The OFFICIAL OPENING STATEMENT at the 2ndAnnual General Scientific Meeting of the Liberia College of Physicians and Surgeons (LCPS)

  • Honorable Joseph N. Boakai, Sr. Vice President of the Republic of Liberia Delivered The OFFICIAL OPENING STATEMENT at the 2ndAnnual General Scientific Meeting of the Liberia College of Physicians and Surgeons (LCPS)


    Monrovia City Hall, Monrovia, Liberia

    Friday, November 4, 2016


    Honorable Members of the National Legislature Present;

    Minister Bernice Dahn of the Ministry of Health;

    Other members of the Cabinet Present;

    President Roseda E. Marshall and Officers of the Liberia College of Physicians and Surgeons;

    Officials & Representatives of our Health Institutions;

    Members of the Diplomatic Corps;

    Representatives of our Development Partners;

    Our Good Friends of the Press;

    Distinguished Ladies and Gentlemen:



    I find it a great deal of honor to be back in this fold today, nearly three years since I was with you to launch the Liberia Post Medical Residency Program.


    Today we are here to compare notes on the relevant and thoughtful theme, MEDICAL EDUCATION – A Critical Ingredient in Building a Resilient Health System in Liberia.


    We all acknowledge that, since then, a lot has unfolded in our health sector, noticeably, the onslaught of the deadly Ebola Virus. The fragility of health systems has never been of greater interest or importance than at this moment, particularly in the aftermath of that scourge that caught our health care delivery systems unaware and unprepared.


    The loss of lives, massive social disruption, and  near collapse of even the most basic health-care services shows what  happens  when  a  crisis  hits  and  health  systems  are  not prepared. Let’s examine what we can safely say constitutes a resilient health system should be.


    A resilient health system can be defined as the capacity of health actors, institutions, and populations to provide appropriate health services, prepare for  and  effectively  respond  to  crises;  maintain  core  functions  when  a  crisis  hits;  and,  be informed  by  lessons  learned   during   the   crisis and  reorganize   if   conditions   require  it.


    In other words health systems  are  said to be resilient  if  they  protect  human  life  and  produce  good  health  outcomes  for  all  in normal conditions and during  a  crisis  and  in  its  aftermath. Resilience is much more than just the absence of vulnerability; it is about whole system capacity.


    Response to a crisis, be it a disease outbreak or other disruption resulting in a surge of demand for health care (e.g.,  a  natural  disaster  or  a  mass  casualty  event),  needs  both  a highly  proactive  and  functioning  health-care  delivery  system  and a vigorous  public  health  response.


    Health-care systems  are  complex  adaptive  systems  and  resilience  is  an  emergent  property  of  the  health  system  as  a  whole,  rather  than  a  single  dimension.  Building  resilience  is  thus  context dependent  and  iterative,  needing  advance  assessments   of   system   capacities   and   weaknesses,   investments  in  vulnerable  components  of  the  system  before  a  crisis,  reinforcements  during  the  emergency,  and  review  of  performance  after  a  crisis.


    The   Rockefeller Foundation has developed substantial data about resilience.

    Building on this Foundation’s initiative, we can readily figure that a resilient health system might be characterized by the following five elements:


    • Awareness of potential health threats and risks to the population from biological and non-biological sources. It will need an up-to-date map   of   human,   physical,  and  information  assets  that  highlight  areas  of  strength  and


    • Endowed with the capacity  to  address  a  broad  range  of  health  challenges rather than a targeted few. In  times  of  calm,  a resilient health system  addresses  diverse  health  needs  and  increase  the  number  and  quality  of  people’s  interactions  with  the


    • In this, it enhances public trust, promotes broad-based provision of health services in line with the Universal Health   Coverage (UHC), and protects vulnerable families from financial hardship, helping to ensure health-seeking behavior.


    • Has the capacity of self-regulating with the ability to contain and isolate health threats while delivering core health services and avoiding propagating instability throughout the system.


    • Potential to bring together diverse actors, ideas, and groups to formulate solutions and initiate action. These include private   sectors,   non-governmental organizations,   local   community leadership, and civil society to   bring   crucial   complementary   capabilities and perspectives.  In  particular,  communities  need to be recognized as a central actor in health systems and  not  simply  a  recipient  of  health


    • The ability to  transform  in  ways  that  improve  function  in  the  face  of  highly  adverse    Adaptability does not manifest only in crisis.


    Resilient  health  systems  demonstrate  the  capacity  to  adapt  in  normal  times,  such  as  to  changing  epidemiological  and  demographic  needs  of  people.


    In  the  context  of  natural  disasters  or  other  mass-casualty  events,  health  systems  face the demand to adapt  to  health  needs  of  refugees,   or   internally   displaced   people. Adapting   to   emergent challenges needs strong and flexible leadership, well-trained medical staff, and organizational structures and management systems that allow pivot.


    Distinguished Ladies and Gentlemen;


    The history of humankind is replete with evidence of the life-saving intervention of solidly built health care systems and the devastation allowed by fragile ones.


    Globally, events such as the Haiti and Nepal earthquakes and West Africa Ebola outbreak, have demonstrated, now more than ever, that a resilient health system is vital to ensuring stability and well-being in society. In Liberia, the Ebola epidemic has shown the fragility of the health system. The most basic health-care services collapsed and demonstrated the lack of resilience,   illustrating   that   several   preconditions for a resilient health system are lacking, particularly relevant manpower and healthcare infrastructures.


    Consequently, there  is  a  need  for  a  trained, strong  and  committed  health  workforce,  characterized  by  specialists in diverse medical fields  who  can show  up  for  work  that  might  be professionally technical and difficult.




    According to World Health Organization (WHO) and UN partners’ Report in 2015; HIV/AIDS, Tuberculosis, Malaria, Acute respiratory infections, maternal and neonatal conditions constitute major causes of death in Liberia. Others include; malnutrition, cardiovascular diseases, diabetes, cancers and other non-communicable diseases.


    The under-five mortality rate and maternal mortality ratio are still high according to recent WHO source, notwithstanding gains we have made in this area.  Undergirding the problem is the fact that about 44% of WHO member states are reported to have less than 1 physician per 1000 population. This includes Liberia.


    According to the Liberia Medical and Dental Council, there are currently 298 medical doctors with the huge burden of catering for the country’s 4.5 million population. This constitutes a woeful doctor–to- patient ratio of 1:15,000. Of the 298 doctors, 203 are Liberians while 95 are foreign doctors.


    Though we should be proud toacknowledge a gain represented by an increase of 22.5% from 2015, the number is still a far cry away from the 1:1,000 doctor-to-patient ratio, as recommended by the World Health Organization. A recent report from the Liberia Medical and Dental Council revealed 207 general practitioners out of 298 registered doctors in the country.


    Of the specialist doctors, less than 10 percent are Liberians. Consequently, inadequate number of specialists becomes a serious bottle neck in addressing health emergency issues, high child and maternal mortality rates, particularly in the rural areas.


    While the limited number of specialist in the country is alarming, the uneven distribution formula across the country constitutes even a greater challenge as most of the specialists are domicile in Monrovia. For instance, one obstetrician each is in Nimba and Bong counties; 8 are in Montserrado. The remaining counties have none according to the Medical Council report.


    In view of the above, the Government of Liberia through the Liberia Post Graduate Medical College has recruited 53 medical doctors in various teaching hospitals in the country.


    We take this to be a critical ingredient in trying to jump start a resilient health system in Liberia. Indeed, it is a historical land mark in the history of our nation which requires the embrace of all Liberians, giving utmost support with every concern and agility.




    It is against this background that you convene here today for this Meeting. Much is expected out of this historic Conference to further expand the scope of efforts at reinforcing our health care system as kicked off at last year’s Meeting.


    Our population stands in anticipation for workable and sustainable formulations from this Meeting of such fine collection of the country’s health care practitioners. While we prepare for cure, prevention should be our main goal.


    Before I close, let me particularly register my thanks and sincere gratitude to you, our medical practitioners, for all the sacrifices you make to save our lives.


    On this note, I now take great pride and excitement to declare this 2nd Annual General Scientific Meeting of the Liberia College of Physicians and Surgeons officially open on this 4th day of November 2016, in the City of Monrovia, Republic of Liberia.


    I wish you very incisive, productive, and life-impacting deliberations, to the benefit of our people and their health.


    Thank you.


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