FEATURE

Nurses First

How three women in New York are improving health care in Liberia with one simple but effective strategy.

by Paul Hond Published Winter 2017
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Nursing for All founder Laura Jean Ridge (left) and board members Jessica Buesing (center) and Jennifer Walsh (right). / Portraits By Jörg Meyer

When Laura Jean Ridge ’10NRS travels to Liberia, as she does twice a year, she likes to arrive on a Sunday, which is church day. Life comes to a standstill then, and Ridge, a warm, energetic, go-getting sort of person, can decompress in her hotel room in Monrovia from the seventeen-hour flight from New York. She makes calls (cell-phone service, like Internet access, is spotty) and sets her schedule (plans in Liberia often change at the last minute). Then, on Monday morning, as the West African country resumes its workaday rhythms, she steps into a whirlwind week of meetings and visits.

Ridge, thirty-three, is the founder and president of Nursing for All (NFA), a nonprofit that takes an unusual bottom-up approach to community health: supporting local nurses who devise and run their own health-care initiatives, based on their intimate knowledge of life on the ground.

As NFA board member Jessica Buesing ’13GS, a fourth-year medical student at the College of Physicians and Surgeons, explains, “It’s easy to have ideas of what people need in global health settings and sort of impose our solutions. A lot of organizations — with the best of intentions — aren’t necessarily always addressing what’s essential.” Buesing, Ridge, and Jennifer Walsh ’09NRS compose NFA’s programming committee, offering clinical advice, funding, and wide-open ears to their Liberian counterparts. “Putting the nurses first is what makes this such a novel idea,” Walsh says.

When NFA was established in 2013, there were about fifty doctors in Liberia, serving a country of some 4.5 million people. Liberia was founded in 1847 as a US colony for ex-slaves and free African-Americans, and the society formed along colonial fault lines, as the newcomers subjugated the indigenous population. Political and social domination by the Americo-Liberians over the local tribes became entrenched. Tensions built up, and in 1989 the country spiraled into a protracted civil war, marked by executions, torture, a high rate of civilian casualties, and the use, on both sides, of child soldiers. The conflict ended in August 2003 after the abdication of President Charles Taylor.

Many doctors fled during the war, and nurses assumed the burden of providing medical care. Even today, “nurses are the backbone of the health system in Liberia,” Ridge says. And she is adamant about ensuring that NFA nurses remain where they are needed most. “We don’t want to contribute to an internal brain drain,” she says. “Every nurse that works with us must have at least a part-time job in the health field in Liberia.” With NFA nurses’ contributions to existing health services assured, Ridge can then tout the advantages of joining the organization. “We supplement your income, and you get to run your own initiative,” she says. “You set the budget, make the contacts, and set up the clinical interventions for approval. You’re the boss.”

NFA nurses Gabriel Tounzea (with name tag) / Photograph by Molly Knight Raskin

Kormassah Baysah, a neonatal nurse, is NFA’s Monrovia program director. She’s the first person Ridge meets with on Monday, at a café called the Donut Bar. While all eleven NFA nurses in Liberia send Ridge monthly status reports on their patients, Baysah is the in-country liaison, there to support and advise the nurses and share her observations with Ridge. Over coffee they discuss nurse-midwife Delkontee King’s family-planning initiative, which offers contraceptives and counseling. Baysah says she’s impressed by how well King is known and respected in her community.

The next day, Ridge visits the Liberia Board for Nursing and Midwifery, the body that licenses nurses in Liberia. From the start, the board has welcomed NFA and helped Ridge by managing the payroll, reviewing NFA plans, and giving feedback. When NFA was trying to set up salaries, Ridge turned to the board to get a baseline.

After the meeting, Ridge goes back to her hotel and gets ready for a road trip to Ganta, Liberia’s second-largest city, two hundred miles to the northeast, about a mile from the Guinean border.

 

In 2012, Ridge was working as a nurse practitioner at an addiction treatment center in New York. The job ended at 4:00 p.m. sharp. Finding herself with extra time, she began looking for volunteer opportunities with groups that supported nurses in underserved communities. She was astonished at how few there were.

Ridge began thinking about starting her own nonprofit. But where to serve, and how to begin?

Putting out feelers, Ridge called her alma mater, the School of Nursing, hoping someone there could give her advice. She was referred to Richard Garfield ’86PH, a professor of clinical international nursing who had worked for the UN in Liberia.

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