The civil war brought about many changes for physician assistants in Liberia. Liberia lost many of its healthcare professionals – most likely because their degrees were transferrable to other countries, unlike Liberian physician assistants’ diploma degrees. As a result, physician assistants played a huge role in serving the country’s healthcare needs during the war. Many even served as country health officers – a role typically reserved for doctors. Up until 2 years ago, physician assistants were still serving as county health officers.

The high visibility of physician assistants during the civil war led to increased interest in the profession, causing a dramatic increase in the number of applications for physician assistant programs.

I expected Mr Momolu to tell me that physician assistants receive a lot of support from the government because they serve such a major role in Liberia and it is a highly sought-after profession. Sadly, he told me that this is not the case. When NGO support ended, the Liberian government was then responsible for funding physician assistants’ salaries, which has led to many professional frustrations.

When asked to elaborate on the government’s position regarding physician assistants, Mr Momolu explained that while the government does appreciate their work, politicians’ promises of support often do not materialize. After graduation, physician assistants face a difficult job market. If they are hired, their salary remains largely the same throughout their career. Physician assistants work mostly in publicly run health centers; thus they need to be connected to the government to receive employment and benefits.

Mr Momolu believes that the profession can benefit from a more defined career ladder and thus better pay. He also supports the opportunity to specialize in a particular field rather than having all physician assistants work in general medicine. If physician assistants could earn a bachelor’s degree instead of a diploma, Mr Momolu believes that it would give them more options for educational advancement.

I wanted to know how Mr Momolu and his colleagues fared in light of the Ebola outbreak in Liberia. When the outbreak first occurred, physician assistants all pitched in to help in regions affected by the outbreak. However, as time passed, they received little outside support, and they lacked food, essential supplies, and protective gear. Mr Momolu knew of 1 doctor, who died after being infected. The 2 nurses and 3 nurse’s aides who cared for the doctor also died from the infection.

A recent World Bank article outlined the toll that Ebola has taken on West African countries most affected by the Ebola breakout, which, in addition to the suffering and loss of life, includes major losses in economic growth, employment, harvests, and food security. As of December 1, 2015, the World Bank mobilized $1.62 billion for the Ebola Recovery and Reconstruction Trust Fund to provide budget support to governments as well as medical supplies, foreign healthcare workers, and health education outreach.

I closed our conversation by asking Mr Momolu what he wants the world to know about physician assistants in Liberia. He told me that physician assistants need support to further develop their profession in Liberia.

After my conversation with Mr Momolu, I am particularly struck by the key role that physician assistants have had in Liberia presently and in their greatest time of need. As a physician assistant in the United States, I wonder what we can do to help our fellow physician assistants in Liberia. We may live in different countries, but we all do the same work while fighting our professional battles.

Marie Meckel, PA-C, MPH, is a physician assistant who works in western Massachusetts. She spent a year in South Africa at Walter Sisulu University where she taught clinical associates. Marie has spent the last year interviewing PAs and NPs and their international equivalents and American PAs and NPs working abroad.

References

  1. 2014 Ebola Outbreak in West Africa – Case Counts. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html. Updated February 10, 2016. Accessed February 16, 2016.
  2. Unprecedented Number of Medical Staff Infected with Ebola. World Health Organization Web Site. http://www.who.int/mediacentre/news/ebola/25-august-2014/en/. Published August 25, 2014. Accessed February 16, 2016.
  3. World Bank Group Ebola Response Fact Sheet. The World Bank Web site. http://www.worldbank.org/en/topic/health/brief/world-bank-group-ebola-fact-sheet. Updated February 2, 2016. Accessed February 16, 2016.