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Moses Massaquoi: health leader in humanitarian crises
Perspectives
Profile Moses Massaquoi: health leader in humanitarian crises
Published Online June 8, 2017 http://dx.doi.org/10.1016/ S0140-6736(17)31569-6 For the Lancet Series on health in humanitarian crises see www.thelancet.com/series/ health-in-humanitarian-crises For Clinton Health Access Initiative see http://www. clintonhealthaccess.org/
2232
In 1996, Moses Massaquoi and several thousand refugees boarded a Nigerian freight ship to escape the ravages of Liberia’s civil war. Within 3 days the ship began to founder in the waters off Cote d’Ivoire, before Massaquoi, acting as the ship’s doctor, decided to take charge. “The crew were unable to communicate a SOS radio message. I fixed the radio aerial, and was able to recall from memory the radio signal for MSF in Liberia. Fortunately they got the message out, and we were rescued before the ship sunk”, Massaquoi recalls. Massaquoi has been Liberia’s Clinton Health Access Initiative (CHAI) country leader since 2009, based at the Ministry of Health in the capital Monrovia. This admin istrative position could seem alien to an experienced clinician and public health leader, but to Massaquoi it’s a logical extension of everything that has gone before. “My CHAI team’s main focus is to have technical input into a strategy that the Ministry of Health is implementing to strengthen Liberia’s health system post civil conflict, and after the 2014 Ebola outbreak”, he explains. Massaquoi’s roots in public health and clinical medicine are part of his working routine, as he chairs the board of the recently created National Public Health Institute of Liberia, and practises at an adult general medicine clinic once a week. One of six children, Massaquoi was the only member of his family to receive a formal education. He excelled at school, and graduated from the A M Dogliotti College of Medicine at the University of Liberia in 1989. Plans to train in reconstructive surgery were thwarted by the outbreak of Liberia’s civil war. He was kidnapped by rebel forces and, like thousands of others from his home area of Lofa County, had to live as an internally displaced person in a warehouse with no running water. As a recently qualified doctor, he was forced to undertake basic emergency care to treat injured rebel soldiers. After his 14-year-old-sister was raped, Massaquoi and his family escaped one night, walking for many hours until they were able to cross the front-line of the war zone, where they managed to leave Liberia, becoming refugees in neighbouring Guinea. Massaquoi returned to Liberia in 1991, where Médecins Sans Frontières (MSF), which was about to leave the region, had provided an emergency medical clinic with the help of Catholic nuns when the civil war had been at its worst. “I helped out by doing an inventory of all the remaining medical supplies, and realised that I could keep the clinic going, with the help of the nuns”, Massaquoi says. MSF later returned and saw the clinic in action; it was the beginning of a long and fruitful association between the agency and Massaquoi. He began expatriate work for MSF in 1996, soon after the Nigerian boat crisis. In Chad, Massaquoi supervised a district hospital and gave emergency medical and surgical
training to health-care staff—and found himself in charge of response efforts to meningitis and cholera outbreaks. “It was in Chad where I realised I had something to offer in responding to humanitarian crises. I was always calm, and would often drive for several hours and communicate in French to coordinate and mobilise the resources we needed to deal with emergency situations”, he recalls. Massaquoi was present with MSF when the organisation received the 1999 Nobel Peace Prize for their international humanitarian work. After completing a Masters in International and Humanitarian Health at the Institute of Tropical Medicine in Antwerp, Belgium, Massaquoi moved to Kenya in 2002 to help set up an MSF HIV treatment clinic. “The MSF operation was extremely proactive, being one of the first clinics to offer twice daily HIV antiretroviral therapy, including paediatric treatment”, he says. Massaquoi built on his experiences in Kenya by helping Malawi scale up its HIV antiretroviral treatment programme, before returning home to Liberia. Massaquoi was appointed as chair of Liberia’s national case management committee in response to the 2014 outbreak of Ebola virus disease. He was responsible for case in vestigations, ambulance services, disinfection, burial teams, and treatment centres before external aid arrived. “I took my MSF training protocol and designed a programme with a few colleagues to set up our response team. We received kits from MSF in Guinea to deal with the first wave of the epidemic.” Massaquoi is unequivocal about the slow international response to the crisis. “The response was not just slow, but too late. By the time the avalanche of international aid arrived, we had developed many local solutions ourselves. We had the potential to set up 29 treatment centres when the aid eventually arrived, but ended up using only nine of them as the epidemic had already peaked”, he says. Stephen Kennedy, Coordinator for Ebola Virus Disease (EVD) Research at Liberia’s Emergency Operations Center, has witnessed the impact of Massaquoi’s work over many years, and comments: “Dr Massaquoi’s contribution to health emergencies is well recognised, especially the outstanding leadership and coordination roles exemplified during the recent EVD outbreak in Liberia. His mentorship of young Liberian clinicians and researchers is also remarkable. The post-EVD resilient health model for the improvement of Liberia’s health sector cannot be documented without Dr Massaquoi’s legendary contributions. I am extremely humbled to have worked with Dr Massaquoi for over a decade to formulate sustainable research programmes, to help make Liberia a safer and healthier country”, he says.
Richard Lane www.thelancet.com Vol 390 November 18, 2017
Profile Moses Massaquoi: health leader in humanitarian crises
Published Online June 8, 2017 http://dx.doi.org/10.1016/ S0140-6736(17)31569-6 For the Lancet Series on health in humanitarian crises see www.thelancet.com/series/ health-in-humanitarian-crises For Clinton Health Access Initiative see http://www. clintonhealthaccess.org/
2232
In 1996, Moses Massaquoi and several thousand refugees boarded a Nigerian freight ship to escape the ravages of Liberia’s civil war. Within 3 days the ship began to founder in the waters off Cote d’Ivoire, before Massaquoi, acting as the ship’s doctor, decided to take charge. “The crew were unable to communicate a SOS radio message. I fixed the radio aerial, and was able to recall from memory the radio signal for MSF in Liberia. Fortunately they got the message out, and we were rescued before the ship sunk”, Massaquoi recalls. Massaquoi has been Liberia’s Clinton Health Access Initiative (CHAI) country leader since 2009, based at the Ministry of Health in the capital Monrovia. This admin istrative position could seem alien to an experienced clinician and public health leader, but to Massaquoi it’s a logical extension of everything that has gone before. “My CHAI team’s main focus is to have technical input into a strategy that the Ministry of Health is implementing to strengthen Liberia’s health system post civil conflict, and after the 2014 Ebola outbreak”, he explains. Massaquoi’s roots in public health and clinical medicine are part of his working routine, as he chairs the board of the recently created National Public Health Institute of Liberia, and practises at an adult general medicine clinic once a week. One of six children, Massaquoi was the only member of his family to receive a formal education. He excelled at school, and graduated from the A M Dogliotti College of Medicine at the University of Liberia in 1989. Plans to train in reconstructive surgery were thwarted by the outbreak of Liberia’s civil war. He was kidnapped by rebel forces and, like thousands of others from his home area of Lofa County, had to live as an internally displaced person in a warehouse with no running water. As a recently qualified doctor, he was forced to undertake basic emergency care to treat injured rebel soldiers. After his 14-year-old-sister was raped, Massaquoi and his family escaped one night, walking for many hours until they were able to cross the front-line of the war zone, where they managed to leave Liberia, becoming refugees in neighbouring Guinea. Massaquoi returned to Liberia in 1991, where Médecins Sans Frontières (MSF), which was about to leave the region, had provided an emergency medical clinic with the help of Catholic nuns when the civil war had been at its worst. “I helped out by doing an inventory of all the remaining medical supplies, and realised that I could keep the clinic going, with the help of the nuns”, Massaquoi says. MSF later returned and saw the clinic in action; it was the beginning of a long and fruitful association between the agency and Massaquoi. He began expatriate work for MSF in 1996, soon after the Nigerian boat crisis. In Chad, Massaquoi supervised a district hospital and gave emergency medical and surgical
training to health-care staff—and found himself in charge of response efforts to meningitis and cholera outbreaks. “It was in Chad where I realised I had something to offer in responding to humanitarian crises. I was always calm, and would often drive for several hours and communicate in French to coordinate and mobilise the resources we needed to deal with emergency situations”, he recalls. Massaquoi was present with MSF when the organisation received the 1999 Nobel Peace Prize for their international humanitarian work. After completing a Masters in International and Humanitarian Health at the Institute of Tropical Medicine in Antwerp, Belgium, Massaquoi moved to Kenya in 2002 to help set up an MSF HIV treatment clinic. “The MSF operation was extremely proactive, being one of the first clinics to offer twice daily HIV antiretroviral therapy, including paediatric treatment”, he says. Massaquoi built on his experiences in Kenya by helping Malawi scale up its HIV antiretroviral treatment programme, before returning home to Liberia. Massaquoi was appointed as chair of Liberia’s national case management committee in response to the 2014 outbreak of Ebola virus disease. He was responsible for case in vestigations, ambulance services, disinfection, burial teams, and treatment centres before external aid arrived. “I took my MSF training protocol and designed a programme with a few colleagues to set up our response team. We received kits from MSF in Guinea to deal with the first wave of the epidemic.” Massaquoi is unequivocal about the slow international response to the crisis. “The response was not just slow, but too late. By the time the avalanche of international aid arrived, we had developed many local solutions ourselves. We had the potential to set up 29 treatment centres when the aid eventually arrived, but ended up using only nine of them as the epidemic had already peaked”, he says. Stephen Kennedy, Coordinator for Ebola Virus Disease (EVD) Research at Liberia’s Emergency Operations Center, has witnessed the impact of Massaquoi’s work over many years, and comments: “Dr Massaquoi’s contribution to health emergencies is well recognised, especially the outstanding leadership and coordination roles exemplified during the recent EVD outbreak in Liberia. His mentorship of young Liberian clinicians and researchers is also remarkable. The post-EVD resilient health model for the improvement of Liberia’s health sector cannot be documented without Dr Massaquoi’s legendary contributions. I am extremely humbled to have worked with Dr Massaquoi for over a decade to formulate sustainable research programmes, to help make Liberia a safer and healthier country”, he says.
Richard Lane www.thelancet.com Vol 390 November 18, 2017