Weafus Quitoe’s Story: From War Refugee to Community Health Pioneer
By Rajesh Panjabi, MD, MPH
Liberia’s story will frequently be retold through the perspective of recognized extraordinary leaders like President Ellen Johnson Sirleaf. But Weafus’ story is about Liberia’s unrecognized people and their power to accomplish the extraordinary. Weafus’ inspiring transcendence from hell towards hope led him to make an unlikely transformation from a refugee kerosene peddler into a community health pioneer.
When I first visited Weafus in his home in 2006, what I found most remarkable was his tenacity for progress despite adverse circumstances. Deep in the heart of southeastern Liberia’s impenetrable forests, Weafus had built a mud-brick hut in a small rural town called Zwedru. Living in a space no more than the size of most Americans’ closets, he and his five-year-old son (Weafus was a single father then), invited me to sit on one of their two pieces of furniture – a mattress on wood stilts.
It was damp. One of Liberia’s torrents had just barreled through Zwedru and rain had seeped through his leaky thatched roof. The only pieces spared of the damp were his books, sheltered by his only other piece of furniture – a bookshelf. Weafus’ bookshelf stored his most valuable possessions. He had been saving these books for years. He had managed to collect thirty or so dating as early as when he was child refugee in neighboring Cote d’Ivoire. He and his family had fled there on foot during the civil war. He grew up in a camp and to etch out a survival he learned to peddle kerosene across the Ivorian border, crisscrossing military fronts to bring fuel for home lamps being lit by Liberians who had stayed behind.
After 15 years in exile, Weafus finally returned to Liberia.
The most recent additions to his book collection were texts on nursing care. He had accumulated them while serving as a volunteer nurse aide at the local Tubman Hospital. In that immediate post-war period, Liberia’s nursing schools had been damaged, so Weafus signed up for a six-month crash course to become a nurse aide. I had just begun working as a medical student at Tubman Hospital, providing care along side the only doctor for over 300,000 people.
We had just begun to notice an influx of very sick young people with AIDS. The problem was bigger than we initially thought. Among pregnant mothers seeking care at Tubman, a government survey had just found nearly 1 in 10 tested positive for HIV. If nearly 10% of our adult patients were infected, Tubman Hospital and southeastern Liberia had the highest rates of HIV in the country. We were facing a crisis. Life-saving antiretroviral treatment had never been introduced at a public facility outside of Monrovia. A lack of doctors – there are only about 50 in Liberia – and a ravaged infrastructure were the key barriers preventing rollout of HIV treatment to rural sites. At the time, not a single rural public hospital was delivering HIV treatment. With our patients, Weafus and I set out to change that.
We started Tiyatien Health (or “justice in health”), an organization to establish a rural public AIDS clinic and strengthen primary healthcare. In a little over two years, Tiyatien and the government have built Liberia’s largest rural public AIDS clinic, training and employing community health workers and mid-level health workers to lead it. Tiyatien Health seeks to prove a community-based initiative can rebuild a model rural health system in the poorest corner of Liberia. And Weafus’ tenacity for progress in the midst of despair has prevailed. Just a year ago he did not know where the “on button” was for a computer. Since then, he has taught himself (and others) to use email, manage budgets, and work with donors. He continues to lead all of this as Tiyatien Health’s project director.
I once asked Weafus why he decided to volunteer at Tubman Hospital after the war. He told me a horrific story. When he was a refugee, he watched his cousin-sister die in childbirth as she was denied access to healthcare because she could not afford the hospital’s fees. “This is why I decided to get involved,” he said, “to change the injustice I witnessed.”
Rajesh Panjabi, MD, MPH is Co-Founder and Executive Director of Tiyatien Health and a Resident Physician at the Department of Medicine at Massachusetts General Hospital/Harvard Medical School. Born in Liberia, Raj and his family escaped the Liberian Civil War in 1990. He returned to Liberia as a medical student in 2005 and launched Tiyatien Health with Weafus Quitoe and colleagues.
