Peter's second post!

Liberia is in a phase of reinvention with a very ‘00s spin. Everything is about participatory-ness. Let’s hear from the “cross-cutting” issues of gender and HIV/AIDS while we plan which roads we need to build. Let’s take time to call the small number of entrepreneurs into a room with the Minister of Finance so that she can hear their concerns. Let’s acknowledge that there was a brutal war and lay our feelings on the table so we can move past it. Perhaps all of the touchy-feeliness is inevitable in a country whose new leadership spent most of their adulthood in the US, but it surprises me every time. Every other aspect of our setting drips with reminders that we are in Africa. (The UNICEF consultant leading the workshop I was in yesterday morning was literally drenched with sweat. His pants too—- where he’d rested his elbows on his knees when he sat down briefly.)

When I first traveled to Monrovia 6 months ago I had what I thought was a simple job: to write a new set of HIV/AIDS treatment guidelines. What a unique opportunity, I thought. To be involved in something from the beginning. But no. It turns out that there’s an opportunity like that just about every week: poverty reduction, social welfare, adoption, telecom, mining, education... The policies are all being started from nothing. It’s crazy. There’s scarcely been a law written here since 1979.

This week I am writing the Terms of Reference for a consultant to assist in creating a safe blood supply system. As far as I can tell I am one of two people in the country who is willing to put time into making this effort happen. It is not that the Ministry of Health or the government doesn’t care-- the Chief Medical Officer has expressed support for my activities when we’ve discussed them in private. But how many issues can take priority at one time? She’s got less than 40 doctors to serve the whole country. The infrastructure is lying in ruins around her. Blood supply? Yes, please make it safe for us. I have no pathologist to assign to your team. No hematologist. No modern transfusion laboratories. No money to pay for quality assurance or to advertise for voluntary blood donation. If you know anyone who is interested in helping-- yes, please have them come.
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And they better come quick— cause we’re already onto the next plan. The Malaria Control Program had its workshop to develop its strategic framework yesterday. No doubt they started off their meeting with a song and a discussion of the impacts of the war as well.