A journey of a thousand miles begins with one step. So says a Chinese proverb. What happens after the first step? Many give up, some change routes, but others are determined to see the end. Jalang Conteh, a senior in the College of Nursing at Michigan State University, recounts how, after taking a step to intern in Liberia for the first time, she journeyed to the “last mile”.
In the summer of 2016, Jalang joined Last Mile Health (LMH) in Liberia for an internship. LMH is a health organization that provides assistance to communities in Liberia where distance and poverty restrict access to primary healthcare. It was her first time traveling to Liberia and all she knew “was the media’s depiction of a post-conflict country struggling to get back on its feet, and then gets hit by Ebola.’ With this in mind, Jalang’s feelings were mixed and nervousness seemed to take over her, but at the same time she was “thrilled at an adventurous opportunity and new experiences in public health,” she writes.
Jalang arrived in Monrovia, Liberia’s capital city, where she stayed for a week before taking off to her internship site in Zwedru, a town in Grand Gedeh County, southeastern Liberia. She knew she was going to work in remote communities, but in all honesty “nothing could have prepared me for a 9 hours drive on a muddy and bumpy road in a dense forest trip to Zwedru.” At that time, Jalang was observing a fast in honor of the Muslim holy month of Ramadan. By the time they got to Zwedru, “I could barely see straight.” Jalang tells us. This is resilience in the face of hardship.
Once in Zwedru, she settled in very quickly, making friends with the staff in no time. “But my most memorable friends were a cat named Teashop; a dog, Push, and Emmanuel, a 6-year-old in the neighborhood. He would come around every Sunday, and we would eat lunch; the delicious boiled plantains and stew, and then review the week.We eventually made this a weekend ritual.”
As a Programs Intern, Jalang assisted in the successful execution of LMH-coordinated projects such as the Gboe Integrated Medical Outreach (IMO) and the Family Planning and EmONC (emergency obstetric and neonatal care) training. Gboe is a rural community in Grand Gedeh that does not have any hospital, and LMH delivers a week-long monthly health program in that area. As the point person for LMH, Jalang lived teamwork and coordination with the county’s healthteam; a close partner of LMH, supporting program planning and logistics for the outreach. “It was about cooperating with different stakeholders and keeping times to make sure that projects were fully executed, procuring drugs and delivering to the Gboe community. The Gboe community was thrilled to have us and, over a 6-day period, the outreach provided clinical services to about 400 people through malaria, HIV, and syphilis testings.”
Spending a month in the office handling logistic issues, Jalang soon realized she was yearning to fulfill her purpose; going to the field and meeting the people.
“Interacting with people receiving healthcare from LMH was a refreshing reminder of the importance of the organization, the impact it is having on people, and why I chose to be there in the first place.” Jalang recounts an instance when a 3-year-old was rushed into their facility with complicated malaria (spasms). “I can’t imagine what would have happened to this baby if we were not out there at that time. As something bigger than herself, it felt good. Jalang also worked on the Family Planning and EmONC training, building capacity with government healthcare workers.
Overall, Jalang says her experience at LMH was fulfilling. Her patient internship supervisor, she says, genuinely cared about her making the most out of her experience. “My supervisor would assess me to see if I accomplished my set goals, and explained the planning and implementation approach of an international organization like LMH linking it to broader concepts in public health.” Working independently Jalang took ownership of the tasks while receiving feedback.
Jalang describes her time spent in Liberia as one of new experiences and immense growth.
“When I got to Liberia, I witnessed challenges in health access for individuals living in remote communities which raised important questions for me about issues of inequitable health systems. It also highlighted the importance of the need to strengthen primary healthcare delivery systems in developing countries.” Jalang was further encouraged just seeing passionate young people striving to better healthcare in their communities, one of which built a health clinic from scratch.
Drawing from Chimamanda Adichie quote about a single story; “the problem with a single story often isn’t that it is wrong, it is incomplete”, Jalang knew a single story of post-conflict and Ebola-stricken Liberia and it was wrong. She writes “experiencing the culture and meeting amazing Liberians who had overcome so much yet so resilient taught me a lot of life lessons.”
Jalang advises anyone interested in public health in a developing country to have such an experience “so that policies and health program decisions are rooted in the realities of the people.”