Melissa Bornico

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For a lot of people, the coronavirus pandemic was the first time they took an ongoing interest in epidemiological events. At some point since news broke of the virus late last year, nearly everyone has at least transiently viewed it as something that could happen to them at any moment. While the typical person outside of the healthcare field doesn't spend most of their days thinking about infectious disease, what about those who have been in this position before? What prepared them to handle the pandemic, especially in the most remote and vulnerable parts of the world? Last Mile Health’s powerful work offers a glimpse of the deeply rooted foundation that their teams' pandemic responses built off of, and how prior work and experiences prepared them to respond strategically to this moment in time.

The West African Ebola epidemic in 2013-2016 taught tragic, but important lessons to LMH. Some of which were that interruptions to primary health care during an outbreak can have detrimental consequences, that protecting frontline workers is critical, and that coordination between government and organizations is necessary to tackle diseases. With this knowledge, they teamed up with the Ministries of Health in Liberia, Malawi, Ethiopia, and Uganda to continue dispensing primary health care and distribute health safety materials through the COVID crisis. Community health workers, many of whom were on the front lines of the Ebola epidemic, have been educating their communities on illness prevention, screening and referring COVID patients, continuing routine health services, and working as community-sourced contact tracers to keep the virus from spreading out of control. These services have persisted through a global shortage of PPE thanks to VillageReach and Liberia’s Supply Chain Management Unit, who used their supply chain expertise to help quantify materials to maximize safety for frontline workers, and therefore the rest of their communities.

Each country’s strategy grew from their own unique skills, capacities, and experiences. In Ethiopia, for example, LMH supported their COVID response by building off a year-long development that digitized health worker curriculum to train community health workers and distribute health education materials on government-provided digital devices. This allowed compliance with physical distancing protocols to continue while two apps were produced that equipped community health workers with the information they needed to perform life-saving work. 

LMH wasted no time with implementing new COVID knowledge, as their work in Malawi was partly informed by their experience in Liberia just weeks prior. In collaboration with the country’s Community Health Services Section, they assisted in the production of a national health worker operational guide and supported a distanced workshop in April where key health sector stakeholders developed inclusive health communication materials that spread COVID safety awareness, emphasized the importance of prevention, and tailored it’s messaging to specific groups of people, depending on what role they played in the community.

With all that being said, these measures would not have succeeded the way they did without the participation of the community itself. We know that individual compliance with safety measures is an important component of containing infectious diseases, in conjunction with nationally coordinated strategies. By listening to experts, following health safety guidelines, and making personal sacrifices, the people in these communities in Liberia, Ethiopia, Uganda, Malawi and more played a critical role in keeping themselves and each other protected.

Most of us will undoubtedly emerge from this time period more attuned to good hygiene and illness prevention, but the insight doesn’t have to stop there. The phrase “when this is all over” has been thrown around a lot lately, usually in reference to the day when we can put the pandemic behind us and move forward with our lives, but what if we all continued on in a new direction? LMH shifted gears to respond to COVID by using their own skills, prior experience, partnerships, and accumulated knowledge. What if, when this is all over, we also used this experience to shift gears and reshape the way we look at disease and inequality? What if we all looked at every injustice as something that could, like COVID-19, happen to us and our loved ones at any moment? Maybe if we all took on a share of this mindset, especially as other crises are ongoing, then maybe even the most daunting of issues could become solvable. There’s a lot we can learn from Last Mile Health’s commitment to bring medical care to the world’s most out of reach communities, but perhaps the most universal is that we’re all connected, and the well-being of others is something we can and should protect no matter what field we’re in.