Q&A with Ibrahim Ajami photo

Q&A with Ibrahim Ajami

Dr. Ibrahim Ajami with colleagues, dressed in full PPE while caring for COVID-19 patients in the military hospital

June 2020

Liberia has a very low doctor-to-patient ratio, which presents many challenges for routine health care, let alone a pandemic. What are some of the other hurdles that your country is facing in controlling the COVID-19 outbreak?

The COVID-19 pandemic exposed flaws in our healthcare system that ought not to exist in this given time and age. Government and partners tend to do things for the heat of the moment, and once the heat dies down everything is back at square one.

Take for example, the use of makeshift structures during the Ebola outbreak that were torn down afterwards, leaving a huge gap in the availability of facilities that would accommodate COVID admissions. Upon confirming the index case, we were caught between the scissors of admitting amongst those on the general ward while maintaining routine health services in that same facility. This would have, of course, led to exposure of both staff and patients alike. We ended using the military hospital that is still undergoing construction for that patient and all subsequent confirmed coronavirus cases.

Another hurdle is the lack of active community engagement and education, something that Liberia had championed during the Ebola outbreak (a strategy that yielded great results). Those in charge could not draw from the experience, thus we bore the consequences of massive clusters of cases in specific communities that to this day remains the pool of confirmed cases.

Having been on the frontlines of the Ebola crisis in Liberia, what lessons have you been able to apply to the coronavirus pandemic?

The Ebola outbreak, blessedly, left a better knowledge of handling infectious diseases than we had previously. One of such knowledge was the strong principles of Infection Prevention and Control (IPC) that stayed embedded in our routine health services after the outbreak. With the aid of W.H.O., we were able to draw out specific IPC schemes for the prevention of airborne and droplet spread. These schemes were soon rolled out to every facility nationwide with the National COVID Case Management team conducting training in each county. Also, there has always been great success in quick identification, diagnosis, and immediate management of patients. This, as in the case of any other disease condition, proved valuable during the EVD outbreak and is doing same as we battle COVID-19.

How can the international community and multilateral organizations like the W.H.O. better assist developing countries?

I always use this quote, “Give a man fish and he will return for more but teach him to fish and he shall become independent to feed himself”. W.H.O. and the likes ought to teach these nations how to build independent health care systems with local experts in strategic positions to plan and implement what it entails to acquire such systems. Help train more locals who would return with bright ideas from the West and proffered measures to achieve success. Cut down project duplications by partners. Implement cost recovery mechanisms at facility levels with transparency and accountability amongst all, both government and NGO alike. Push the equity principles of healthcare for all no matter the economic status, let each man pay what he can afford based on his earnings. There can be no solid gain if you do not put the ball in the hands of those who should take the shot.

Tell us briefly why you decided to become a doctor.

The passion to see to it that others are well, and their needs are cared for has been the greatest drive in me becoming a physician. There are so many other things I am great at and that would have earned me lots of money, but nothing beats the idea of going home, lying in bed and reminiscing on the thought that just minutes ago you had bridged the gap of life or death of a child, a mother, a husband, a sister and had enabled that person a second shot of being with their loved ones. Being a doctor in one of the poorest countries in the world where you most often help to pay for patients care from your own pocket leaves you with nothing but an immense passion to remain in the service of the ill.

You were a World Fellow in 2017. Looking back on your time at Yale, what stands out as the most long-lasting or life-changing impact?

The World Fellows Program remains one of the best things to ever happen for me. It goes beyond having the title of an Ivy League school attached to my resumé. It transcends the idea of being privileged to sit in a forest of books of the great Sterling Memorial Library, or having the honor of walking through the hall of Yale-New Haven Hospital alongside professors I had only read about in books. The greatest impact has been the relationships created with strangers who became everlasting friends over the six-months period I spent with them. The bond with a real-life Wonder Woman, Emma Sky, and the confidence she has instilled in me. The family ties I built with Professor Kristina Talbert-Slagle and Yale alumni JT Flowers and Serene Li, the three people who encouraged me to take the path on Hillhouse Avenue, a path that has forever changed my life. These are the priceless pieces I can speak of, including all the World Fellows staff of Horchow Hall who helped make me better.

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