Universal Health Coverage Includes People at the Last Mile

The day began just like the one before. A small team of national NTD program staff and American Leprosy Missions’ technical staff set out early in the morning to visit health facilities in Lofa County, one of the five counties ALM’s AIM program is supporting as part of the piloting of integrated treatment, diagnosis and rehabilitation of people affected by NTDs in Liberia. The AIM program provided technical support to the national team as they conducted their routine supportive supervision to verify data of cases reported and examine the accuracy of diagnostic and treatment procedures.

However, this day was different. It reminded us what our work is all about: people.

We walked up to a man who was seated on a locally made bench in front of his house with his wife. His name was Morris. He welcomed us into his home and offered us seats. Once we were all seated, he pulled up one leg of his jeans and unwrapped some bandages to unveil his best-kept secret, which astonished his neighbors, a large scar covering almost the entire left side of his lower leg. Morris had been diagnosed with Buruli ulcer and was close to his final dose of antibiotics. While the large scar showed what the sore looked like before treatment, all that remained was one, small wound.

Morris explained, with much excitement and pride, how he can now walk freely and do much of the work he did prior to Buruli ulcer. But it hadn’t been an easy journey. He had visited several traditional doctors and had used traditional herbs to get rid of the sore, but nothing had worked. Morris had lost all hope and resorted to wearing long trousers all the time to hide the sore from others.

But one day, a community health worker, trained in NTD diagnosis thanks to the Ministry of Health’s partnership with ALM’s AIM program, met Morris and he was referred to the nearest health facility. After just a few weeks of taking antibiotics, he could see the difference. The wound was smaller and less painful. An accurate diagnosis, free medication and encouragement from the health workers who called to check on him, made all the difference in Morris’s speedy recovery. When asked by the NTD Program Director, Karsor Kollie, why he was now prepared to share his story, Morris smiled and said, “Because I am cured!”

Morris’ testimony was a reminder that there are still many barriers to accessing NTD care. But with the support of organizations like the American Leprosy Missions, and the commitment of national NTD programs like the one in Liberia, we can reach the last mile to some of the poorest communities, providing quality, affordable treatment and care. With innovative new approaches to disease and morbidity mapping, strategic planning, and implementation of integrated interventions, we can ensure every person like Morris has access to NTD treatment and care, and accelerate progress toward universal health coverage.

By Tiawanlyn G. Akpan, Project Officer, American Leprosy Missions