In Liberia’s hinterland, a constellation of issues makes effective delivery of health care and education difficult and in some cases impossible. Fourteen hours’ drive from the capital Monrovia along horrendous roads lies Barclayville, capital of Grand Kru County. Outside this quiet, hilly town, which boasts a weekly market full of colourfully dressed women selling fruit, vegetables, rice, clothing and household goods, lazy rivers wind through dense jungle. In Grand Cess Town on the coast a half-hour drive away, fishermen in dugout canoes ply waters rich with fish, while boys scale tall palms to bring down coconuts to sell for a few cents apiece.
Leave the towns, however, and the social problems plaguing this beautiful region quickly become apparent. Schools, when not shuttered because staff have not shown up, are crude. Government-run health clinics are bereft of most medicines, and in most cases, qualified staff.
The area’s remoteness (and high cost of living: gasoline is $8 a gallon) makes it hard to recruit and retain health and education professionals, leaving facilities without enough workers to serve the population. When we stop in at a government health clinic, a midwifery student is suturing the chin of a man who had a motorbike accident. In another clinic, the director tells us that they are confronted daily with severe injuries from such crashes, along with grievous wounds resulting from drunken brawls among local mine workers.
Grand Kru is cursed with gold. Boys turn their backs on education to toil in open-pit mines, where they pay fees to owners and run up debt in hopes they’ll strike it rich. Local community leaders traditionally rely on boys and young men to volunteer on projects such as clearing paths for commerce and travel, and maintaining clinics and schools; with this casual-labour force otherwise occupied in mining, already ragged infrastructure continues to deteriorate. Miners’ diversion of water and diggings wash out and undermine stretches of road, hampering transportation and economic development.
Corruption adds to the difficulties. Because there is little or no oversight, a significant number of employees who do take jobs in the villages spend a considerable time AWOL, getting paid without doing their work. Contractors receive payment for work on schools and clinics and fail to do their jobs. Money flows to local officials and disappears. We visited one school which cost almost $40,000 in government funds to construct. Made of mud blocks, the building has only chunks of construction debris and rude bamboo benches for students to sit on. Chalkboards are rusting sheets of bent metal.
Now, the government is moving in Grand Kru to take over seven clinics and a hospital that are supported by the British health-services NGO Merlin. This change must occur sometime: “donor fatigue” has set in regarding Liberia, after 10 years of peace, and the country must be able to stand on its own eventually without international assistance. Funding for the health facilities would still come from international donors, but would be administered by county-level national government officials, ostensibly a step toward independence from foreign aid. But given the current situation, in which government-run health and education facilities are clearly unable to fulfill their obligations to the people, the government’s decision to take over all health care delivery seems drastically premature, and once the results begin to manifest, donors such as the European Union will see little value in continuing support for a dysfunctional system.