NEWS

This space has been reserved for professional and well written articles on how to develop a small business, community development projects, such as drilling a well for safe and clean drinking water, and tips for mothers on how to take care of their young children/child, as well as any other subject on development, etc. The article should be at least two pages.

We will welcome papers form Liberians and other nationalities world wide. The purpose is to assist anyone in Liberia who wants to help himself improve
his community and family. Please, it should not be political or on any subject that will be destructive, controversial or create chaos. Please send your response by e-mail only.

Thank you

By: Andrew P.Tuazama

THE NEED FOR IMPROVED HEALTH CARE SYSTEM
FOR THE PEOPLE OF THE TOWNS OF
BAHN, ZAYGAY, AND NYPLAY
NIMBA COUNTY, LIBERIA
WEST, AFRICA

A Grant Proposal Presented to
Dr. Harlem Brundtland
The Director General of
The World Health Organization

By: Andrew P.Tuazama

Healthcare System for Bahn, Zaygay and Nyplay Grant Proposal

Proposed Project Description:
To Create and establish a better healthcare system by obtaining grants from the World Health Organization (WHO). It is important to establish this healthcare system and build a healthcare facility for the following reasons. (1) For more than 100 years the people of these three towns have gone without any improved healthcare system. (2) The inhabitants of these three villages always have to travel more than 110 miles to the nearest community health center. (3) Due to lack of an improved healthcare system, between 1965 to 1975 more than 500 women died during childbirth. (4) The condition of the aging population continues to decline at a faster rate if confronted with any minor or major illnesses. The main outcome of this proposal is to bring a necessary and improved healthcare system closer and reduce the mortality rate of the inhabitants of Bahn, Zaygay and Nyplay.

Evaluation:
This proposed healthcare system will be evaluated best by the citizens from these three villages and surrounding areas it serves, by conducting a general survey biannually to determine how well the system is meeting the demands and needs of the people. In addition the state of Nimba healthcare advisory board and the ministry of Health and Social Welfare, Rural Healthcare Unit will help in evaluating the success of the healthcare system and the maintaining of the facility.

Cost of the Project and Other Financial Information:
The total cost of the project, which includes laboratory equipment, medical drugs, furniture, construction of the facility, yearly maintenance of the facility, shall be about $100,000.00 each for the three villages, which will be a grant from the World Health Organization (WHO). Other expenses include the salary of medical doctor, four registered nurses, two laboratory technicians; two business managers and other employees shall be $155,000.00 annually. These funds will come from a contribution from the Liberian government, citizens of the state of Nimba residing in the United States of America, Europe and other African nations and some non-government organizations in the United States.

Description of the Building:
The healthcare center facility will be a single story building and about 8,613 square feet. The building will comprise of a large waiting area for patients, four offices for the doctors, nurses and administrative staff. There will also be eight bedrooms for over night patients waiting to be transfer to a larger hospital. There will be a laboratory room to study specimen. The building will also consist of five (5) toilets, three (3) bathrooms, nurses working stations, a patient medical report filing room, three (3) injection rooms, and a covered entrance porch for cars and ambulance.

Furthermore, to reduce cost in construction of the building, the local population will assist in construction labor and provide some needed building materials such as timber, molding of concrete blocks and river sand for masonry to finished exterior and interior wall plastering. In addition, the exterior wall will be made of 8" concrete blocks and interior walls will be made with 6" and 4" concrete wall for storage and partition walls. The front face of the building shall be 4" brick facing.

Historical Background of Bahn, Zaygay, and Nyplay:
The town of Bahn, Zaygay, and Nyplay mostly consist of the Dan and Mah ethical tribal group, located in the state of Nimba, North Central Liberia, West Africa. As mentioned before, the population is about 98,000. Due to the lack of economic growth, a successful healthcare system has never been established. As the result, the population from that region has gone without improve healthcare system for more than 86 years. Numerous problems relating to healthcare occurred daily among the inhabitants. One example was a 26 years old lady named Kur Volka. Mrs. Volka died from complications during her seventh month of pregnancy. In her fourth month of pregnancy, she developed internal bleeding and a sore stomach. Her condition declined until she miscarried and finally died. Another example is malaria. Malaria has killed more than 500 people from the three towns combined since 1970. In addition to the sickness mentioned, one discouraging factor that has hindered healthcare growth for the people of Bahn, Zaygay, and Nyplay is the lack of better motor roads that will transport doctors and other healthcare professionals to attend to the medical needs of the people.

METHODOLOGY:

Summary of the Problem
Poverty, A Major Problem For Health Care Growth:
The poor economic condition and improper management of vital resources by the leadership within the Liberian Government, and nationally has led to most of the poor health conditions of the three towns ( Bahn, Zaygay, and Nyplay). The inability due to poverty has not only excludes the people from these three towns from the benefits of healthcare system but also restricts them from participating in decision that affect their health.
Fundamental to the success of these efforts, however, is the need for the people to be able to participate and negotiate their own inclusion into their healthcare system and demand adequate healthcare from their leadership and national government. However new forms of communication and cooperation are required at all levels of Liberian society, nationally and internationally, to ensure equitable exchange of views and knowledge to formulate appropriate action to redress and improve their health and well being.

Additionally, poor coverage and inadequacy of health facilities for the population of these 3 towns means that people die of disease and hunger without even being able to communicate their needs to the outside world.
In an article published on September 2, 2000, in the Ebscohost , title "Public healthcare in developing countries", estimate that 1.3 billion people live on an income of less than $1.00 a day. Over 40 million people are disfigured and disabled by lock of better healthcare and predicting their death. Deaths from non-communicable diseases are expected to climb from 28.1 million a year to 49.7 million by 2020 (Lancet, 2000,vol.356).

Statement of Objectives:

Objective One-Training And Education
Training and some form of education in the medical profession is another important factor to be consider in providing a successful quality health care system for the people of the three towns been discussed. A director who will be a medical school graduate from an accredited medical school and appointed by the State of Nimba Governor will head the proposed healthcare facility. His three divisional heads should also have knowledge about medicine and how to run a medical clinic. Each with a college degree in nursing, pharmacy, and general organization or business management to run the day-to-day operation of the healthcare system.
One example of a successful grass root healthcare with it personnel been educated at various local educational institutions was in the East African country of Tanzania. The 1967 Arusha declaration of socialism and self-reliance was focused on the achievement of equality between the people, and led to practice in public health. First the Tanzania Government focus on the education of some of her citizen and encouraging than by giving scholarship to study various disciple in medical school at home and aboard. After server years of study the citizens return to contribute what they have leaned to their various community healthcare centers (Lancet, 2000, vol. 356).
Therefore, the success of this healthcare center will depend on the various members of the system on how well they are train to carry out their various function, as doctors, nurses, and administrators.

Objective Two- Government Involvement:

No matter how successful this proposal for a better healthcare system works, the involvement of the Liberian Government, and local leader is very important for the success and smooth operation of the healthcare program. According to the World Bank March 1992 publication on better health for Africa, recommends the creation of an environment for health through the involvement of nation Government and communities leaders. But also suggest that a lock of Government commitment to health and poor management of health care services have inhibited progress in some African countries. Without supportive leadership and good government, many institutions in poor country are ill equipped to face the fundamental change in the pattern of need and demand for health services and challenges of health sector reform and healthcare financing.
One sucessuful story of government involvement in its citizen healthcare was in the West African country of Ghana. In 1988 Ghana inaugurated its health reform programs recognizing the government lack of responsiveness, to the needs of consumer and its difficulties in coping with the external pressure and demands on the use of resources from central government and donors. Accordingly its programs strengthening district health system focused on decentralization and empowerment of the bureaucracy at the lower level, integration of vertical and horizontal health programs at a district level, and participation. Planning also enabled local staff to deal with the potentially damaging effects of narrowly conceived vertical programs imposed on the communities, and to continue protesting centralized budgeting and financial control as destructive of local initiatives. In the Navrongo district of Ghana, for example there are now indication that during the past decade maternal and child health has improved, and malaria prevention is beginning to take effect (World Health Organization, April 1999).

Objective Three- Strategy Against Poverty & Improved Health Care:

The primary goal of this proposed is to provide quality and improve healthcare service for the population of the three towns under consideration at an affordable cost within the reach of the people and to those who cannot afford the cost of healthcare, rather than offering low quality care at cheaper prices. Since the access to healthcare services have been affected by several factors.

Listed below are some strategies that will help the services.
After the construction of this healthcare facilitate and the system is in place, it will reduce the time and distance travel between the patient's home and where the service is provided.
As mentioned previously, training of the staff members in various tropical region medicines, will give the patient confidence in the ability of the provided for them to keep coming back for treatment when needed.
Most patients will have the ability to pay for the required service, since the service will be within their own community.
Unfortunately for the people of the three towns, most modern approaches such as health insurance and cost sharing which are geared toward in paying for healthcare cost is locking. Most of the people cannot afford to pay insurance premiums or even reduced fees, and in many cases will not have the cash to pay for their service when they are seriously sick. Therefore it seen clear that what is needed is a system that ensures for the population a reasonable access to a health services with a minimal economic burden. Including specific benefits within a compulsory social insurance system or making available interest free loans from group savings to be used in case of sickness.

Objective Four-Promoting Awareness & Access:

Another important fact is promoting the healthcare awareness to the people and how they can reach the service. No matter how well this proposed healthcare system might work for most of the local population, it is certainly clear that some of the population will have little source for the need of healthcare and may have no means to commute to the facility. In these circumstances, it is obvious that promoting free low cost access to the health services is one crucial way, which could enable those who cannot afford to reach the healthcare service. In some house whole family spent between 15% to 20% of their income to travel to healthcare center and pay for drugs. So increasing the people accessibility to the health service within their ability to pay could positively change their treatment-seeking behavior. Also, most of the population would resort earlier to health service and hence benefit from early detection, diagnosis and treatment. This would subsequently enable them to save expenditure on chronic or complicated cases. It is worth noting here that women and children are more affected by poor accessibility to health services, and this situation is more common amoung many who have to walk for hours before reaching the service.

Hypotheses:

The project generated two hypotheses. They are as follow:
Hypothesis One: Who is affected by the problem
Hypothesis Two: Why is this a problem?

Hypothesis One:

Who is affected by the problem? The population of the villages of Bahn Nyplay and Zaygay. By establishing this healthcare system, this means that the inhabitants from the three villages will not die from common diseases and the time travel to medical facilities will be reduced. Data has shown that many young kids between the ages of two months to 7 years old have died from the common cold and malaria, because most parents of the villages have no financial means to travel almost 125 miles on foot to the nearest medical center (see appendix D for graph). The completion of this healthcare center will result in cutting 85% of the distance, and cost of travel can be redirected to other daily needs, such as education and farming.

Hypothesis Two:

Why is this a problem? Due to the wide spread of corruption and the misappropriation of developmental funds in the past, local leaders and the central government have failed to provided provisions for adequate healthcare. As the result of inadequate healthcare, many women have died from complications during pregnancy and many children have died before reaching there first birthday. Many research results have proven that local authority and its people empowerment in healthcare through better community service programs can reduce or prevent the risk of spreading contagious diseases.

SUMMARY, CONCLUSION AND RECOMMENDATIONS

Summary:

The purpose of this A Project is to obtain a developmental grant (HealthCare Development system), from the World Health Organization to create and establish a better healthcare system and build a healthcare facility for the people of Bahn, Zaygay, and Nyplay in the chiefdom of Zoe-Gen district, Nimba State, Liberia, West Africa.

Conclusion:
The research study generated (3) conclusions. They are as follows:

Conclusion One:
From the data collected from the survey amoung the citizens of the villages of Bahn Zaygay, and Nyplay indicated that there is a dying need for improved healthcare for the citizens of these three villages.

Conclusion Two:
Further results from North-Eastern Liberia where the three villages are located suggest that the aging population, between the ages of 50 to 79 are rapidly declining due to poor health and lack of finance and means for improved healthcare. Furthermore young children between the ages of one month to five years old are the primary targets of common diseases like malaria, whooping cough, and cholera.

Conclusion Three:
The future outlook for the younger generation from these three villages look brighter and great. Therefore, it demands the support and attention of anyone that has the means and is willing to help them achieve their medical needs while there is still a chance for effective improvement.
Objective 1 - Ask the World Health Organization for a grant to establish a better healthcare programs and build a clinic.
Result - A better healthcare program will help save lives and stop the spread of contagious diseases.
Objective 2 - Train healthcare providers and workers.
Results - The training of more health care workers will assist the villagers with knowledge and importance of good health practices.
Objective 3 - Involve community leaders and local government authorities.
Results - With the help of strong leadership, the villagers will be encouraged to take part in their own healthcare decisions making.

Recommendations:

The research study generated (4) recommendations. They are as follows:

Recommendation One:
The success of this proposal will also depend on the condition of the surrounding areas. The construction of better infrastructures such as roads, wells for clean and safe drinking water will be a vital part to this project. This will assist in delivering good healthcare to the villages.

Recommendation Two:
The establishment of a community based organization which will be like a fund raising club to raise funds that any member of the villagers can borrow a low interest rate for the purpose of paying for medical treatment, pharmaceuticals, and providing food for families in need.

Recommendation Three:
Identify other sources of support beyond the villages, local leaders and regional government authorities such as religious organizations and private business owners within the state of Nimba.

Recommendation Four:

Finally I would further recommend that continued research be carried out by the World Health Organization and the Liberian government, to find better solutions to curing the health problems of the entire region of the state of Nimba most especially the Zoe-Geh district where these three villages are located.

Bibliography:
Lauer H. Robert. (1998) Social Problems and the Quality of Life. (7th edition). Chicago IL, McGraw Hill, Inc.

Rubington, Earl and Weinberg, S. Martin. (1995) The Study of Social Problems. (5th edition). Oxford New York, NY Oxford University press.

Mondy, R. Wayne, Noe, M. Robert & Premeaux, R. Shane. (1996). Human

Resource Management. Prentice Hall, Upper Saddle River, NJ

Ebscohost magazine, (September, 2000 publication). London press.

World Health Organization, (April, 1990 publication).

APPENDICES:

APPENDIX A

Reflection on the Project
The choice made for this Project was a very touching subject for me. For many years I have always thought of the deteriorating health conditions of those who I left behind in my native village.
In my personal experience, I remember the death of my grandmother. My grandmother was using a rusty knife to cut vegetables on her farm and cut herself. The cut became infected. A tectonics shot could have cleared the infection. However my grandmother went without medical treatment for a long time and her condition began to get worse. At times we would travel for many days by foot to the nearest regional hospital for medical treatment.
During my literature review research, many articles were found on healthcare improvement in developing nations. Similar stories like those of the inhabitants of my home village were occurring in other developing nations. Some of which had a solution to their health care and a happy ending.

APPENDIX B
Problem Analysis Worksheet
State the problem in as clear and concise a manner as possible:
For more than one hundred years, the people of the villages of Bahn, Zaygay and Nyplay have gone without an improved healthcare system.

Why is this a problem?
This is a problem because, the villagers must travel more than 175 miles to the nearest community hospital to receive medical attention. It is also a problem because from 1965 to 1975 more than 200 women died in childbirth.

Who is affected by the problem?

The population of the three villages (Bahn, Zaygay, and Nyplay), who has no means to reach medical care.

Description of Current Status
Many young children die before their first birthday from common diseases.
Preganate women have no prenatal care before childbirth.
The aging population is getting older faster and dying.
Description of Desired Status
Establish an improved health care program for all that live in the three villages.
Construct a better infrastructure that will host the proposed clinic.
Eliminate common sickness and diseases among the general population of the three villages.

Symptoms vs. Causes
The main symptom is the inability of the Liberian government to provide adequate healthcare for its people.

List all possible explanations for the problem.
Many corrupt government officials have been put in charge of overseeing the affairs that would provide health care.
Community leaders have no means to encourage the villagers to try harder on providing for themselves.
Lack of educated and trained health personnel among the villages.
Explain why the above explanation is relevant to your study.
Because, I grew up with most of the villagers and their children and experienced the poor setting of the health conditions. As relative to most of the villagers, and having the education, and the opportunity, it is my duty to seek ways and means of improving the health conditions of those that are less fortunate than myself.

Indicate any relationship among the most relevant explanation identified.

For many decades the Liberian government has been given grants by other nations for the development of an improved healthcare system, and eight out of ten times, the funds end up in the pockets of the government officials. The end result is, many projects fail to materialize for the general population.

APPENDIX C
ACTION RESEARCH PROJECT TOPIC PROPOSAL
Problem statement
The villages of Bahn, Nyplay and Zaygay have gone without a better health care system for many decades.

What is your personal involvement with the problem, and to what degree do you have control?

I have personally spent my own funds to assist needy families in paying medical bills, buying food, and other vital needs for living. Personally, I hope that this proposed grant will be accepted by the World Health Organization, which will enable the establishment of a better healthcare system for the general population of the three villages.

On the basis of your problem analysis, what are

your explanations and assumptions about the cause of this problem?

The greatest cause of this problem is the poor economic condition and the improper management of vital resources by the leadership within the Liberian government. Furthermore, the lack of trained healthcare and community service workers.
Specifically in what practical ways will the situation improve if the problem is solved?
The Primary benefit in solving this healthcare problem means that, a) the spread of contagious diseases will be reduced, b) the distance traveled to seek medical care and attention will be shorter, and c) more lives will be saved, if women receive better prenatal and postnatal care.
What are the first two or three steps you need to take?
Obtain a grant from the (WHO) to establish a better health care system.
Involve non-profit organizations and other caring citizens in contributing resources to establish the healthcare system.
Give opportunity to younger generations from that region to receive general education.
How do you plan to go about gathering your information?
I plan to interview several citizens from Liberia, most especially those from the Zoe-Gen district who recently settled within the states of North Carolina and Georgia. I also plan to take a survey at the annual meeting of the United Nimba Citizens Council (UNICCO) which is held every year in September in Atlanta Georgia.

APPENDIX D
Field work report #1

Andrew P. Tuazama
Participants

Dr. James Seymour-Advisor
St. Augustine's College-Raleigh, USA

Site Contact Person
Prof. John Kei Unversity of Liberia

World Health Organization
Non-profit Organization
Research completed: Research past record on healthcare practices in developing nations.
Problem encountered: Not enough information on all three villages or distract about effecting diseases.
Possible solutions: Make more research via the Internet and research other healthcare records in the library.
Initial Successes: Information obtained from various books in the school library was helpful. Survey and site contact is helpful.

TYPE OF WORK HOURS SPENT
Internet 50
Wake County Library 27
St. Auguestine's College Library 55
E-mail 12
Phone calls 10

Field work report #2
Andrew P. Tuazama
Participants

Dr. James Seymour-Advisor
St. Augustine's College-Raleigh, USA

Site Contact Person
Prof. John Kei Unversity of Liberia

World Health Organization
Non-profit Organization

Topic Proposal: A) Obtain a grant from the World Health Organization; B) Create and establish a better healthcare system; C) Train health care and community service workers.

Data collected: Most data was collected from the World Health Organization web site, and Liberians living in North Carolina.

Agency and organization support: Support staff that work along with the Director General of the World Health Organization has been very helpful by providing advise and moral support.

Changes in focus of thesis: There is no change in focus of the thesis at this time.

TYPE OF WORK HOURS SPENT

E-mail 10
Internet 35
Reading 40
Phone calls 6

Topic Proposal: To obtain a grant from the World Health Organization (WHO); To establish a better healthcare system; To construct a facility to host the health care system; To train more healthcare and community service workers.

Evaluation completed: Results of my research shows that healthcare is a major issue for most developing nations and most of them are lacking the resources to provide and be competitive with other developed nations.
Feasibility of original proposal: Mr. Johnson Kei who has been my contact in Liberia has continued to provide me with more information and reasons why the project is essential to the village.

I have already designed and completed a full set of construction working drawings, estimates and all construction documents. If you or your organization is interested in a copy please let us know

Please send donation to:

The Healthcare Funds for the
Villages in Lofa and Nimba
c\o The Nimba Educational & Medical Funds
P O Box 50563
Atlanta, Ga. 30302

The Nimba Educational and Medical Funds is a non profit organization that is currently assisting many Liberians meet their medical and educational needs in serveral towns and villages in Liberia. The funds were established six years ago by The United Nimba citizens Organization within the United State of America.

My goal is for these clinics to be built in many rural locations around Liberia. If you are thinking about such development for your home district, town or village please contact us at the address on page 5.

Thanks