Refuge Place International 2018 Annual Report · 2019-03-19 · REFUGE PLACE INTERNATIONAL 2018 ANNUAL REPORT Message from the Chief Executive Officer Dear members of the Board, Partners

REFUGE PLACE INTERNATIONAL 2018 ANNUAL REPORT

Refuge Place International

2018 Annual Report

Table of contents

Perspective from Dr. Mosoka P. Fallah

Year in Review Field notes from across our work

Patient statistics and Financial Summary December 2017, through November 2018

Leadership and staff Our directors, officers, and staff


Patient’s population increase at Refuge clinic 2018

Refuge Place International expanded its facility

due to the over-load of patients

Refuge Place International Newly constructed surgical pavilion


Message from the Chief Executive Officer

Dear members of the Board, Partners and friends of Refuge Place

International. We bring you greetings from all of our staffs, patients and

friends in different parts of Liberia where we continue to provide access to

affordable and quality health care. In 2018 (December, 2017 to November,

2018), we saw an expansion in our services as many people are asking for us to

bring our unique health care model closer to them. We completed our second clinic at Low

Cost Village that was ravaged by ebola leaving 18 dead and leaving several ebola orphans.

We are completing the construction of the third clinic in Nyemah, an isolated Cluster of 32

villages and 10,200 residents. These people walk an average of 4 hours to access health care.

Once our third clinic is completed in the next few months, we will reduce that time and avert

the deaths of innocent women and children. Construction of the fourth clinic has started in

central Liberia, Bong County.

We continue to expand our “co-investment

model”, where the local people contribute towards

the construction of our clinics, while RPI provide

modern and costly materials like zinc, steel rod,

nails and pays for professional contractors (See

Figure). This allows RPI to spend about $25,000

to construct a new clinic in an isolated and poor

village with limited resources except the

determination, resilience and unity of the locals.

In all three of our new clinics, the land, local

materials and labor were provided by the men,

women and children of the communities. This

increases cost-effectiveness and fosters a strong

sense of ownership by the local communities, thus

ensuring sustainability.

In 2018, RPI had 436 safe deliveries (the highest number of deliveries since

our founding in 2014) and treated 14,891 patients, with malaria accounting for nearly 49% of

the cases. On the financial profile, the operational cost of our Refuge Place Central clinic was

$74,265 of which $55,591 was collected from patient fees. This means that 75% of the

operational cost was raised by the patients (from 62% in 2017), while 25% came from

donations by our partners. This is exceptional, as we started with 100% donations while we

provided FREE Service in 2014/2015 during the ebola crises. This means that we spent $4.80

per patient including deliveries.

In 2018, $53,166 was used for construction of the new clinics and the initial

construction work of the new health center. Thus, we raised a total of $127,431 from both

donations and patient fees to cover both the operations of the Refuge Place Central Clinic and

the new constructions. Imagine how much impact we will make in Liberia with $500,000.

Since we started our operation on June 9, 2014, we continue to see increasing number

of deliveries and patients care. It is a testament to the high quality of affordable and

accessible care we provide to our patients. Over the 4 (2014-2018) years of our existence, we

have had a total of 1,276 safe deliveries with ZERO Maternal deaths.This is amazing as

Liberia has the second highest maternal mortality rate in the world (1072 maternal deaths per

100,000 live births). We have treated a total of 49,802 patients at the RPI clinic in Bassa

Town.


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Refuge Place International: How we work

Vision: Our vision is a model of affordable, accessible and quality care for

the poor.

Mission: To create an environment that empowers poor and marginalized

people residing in the urban slums of Liberia and sub-Saharan Africa so that

they can provide their own high-quality maternal, newborn and child (MNC)

care services, and thus reduce mortality and disease burden among women

and children.

Core Values: RPI subscribes to the following values:

Compassion

Accountability

Transparency

Partnership

RPI 2019 CORE PROJECTS

Opening of the surgical pavilion for complicated pregnancies

Dedication of the Low Cost Village Refuge Place Clinic

Continued construction of the Nyemah Village Refuge Place Clinic, Lower Bong County Refuge Place Clinic,

Arttington buckbrush rural Montserrado etc.

Launch of Eye Screening and Lenses program in collaboration with the Eye Division of Ministry of Health

Construction of Cafeteria and patients visitor palava hut at Bassa Town clinic

Expansion of construction for EPI, Communities Health Center and Eye Clinic

Construction of hand pumps and latrines in urban and rural areas

Provision of solar power to RPI health facilities

Collaborating with the communities (Chicken soup factory, Bassa Town) in fixing the road

About Us

Refuge Place International

(RPI) is a registered non-

governmental organization

(NGO) both in the USA and

Liberia. Refuge Place

International Maternal Child

& General Clinic was

officially launched as the

clinical arm of Refuge Place

International on June 9, 2014

with the primary objective of

achieving zero tolerance for

maternal and child deaths

during delivery.

Contact Us

Bassa town, Lower Johnsonville Cell Phone: +231888349115/+231778786017/+231881

560787

Email: [email protected]

refugeplaceinternational.com

Website:

www.refugeplaceinternational.org

mailto:[email protected]

mailto:[email protected]

http://www.refugeplaceinternational.org/

https://www.facebook.com/RefugePlaceInternational.USA/

https://www.youtube.com/channel/UCvw9ZTPgXWwFim8f4zvFIJw/videos?disable_polymer=1

https://twitter.com/PlaceRefuge

https://www.linkedin.com/in/refuge-peace-international-847582169/


Refuge Place International (RPI) was established in response to the high rate of maternal and

child mortality in Liberia, one of the poorest countries in the world. Half of the population

(50.9%) live in abject poverty or are extremely poor according to the most recent household,

expenditure and income survey (Liberia Institute for Statistics and Geo-information

Services). Access to healthcare is limited in post-conflict Liberia in particular among the

poor. The Ministry of Health of Liberia reports that in order to provide access to quality

health care for the poor about 422 health care facilities need to be built. In June 2014 RPI

launched Refuge Place International Maternal Child & General Clinic to serve the population

Of Chicken Soup Factory, Bassa Town, an urban slum in the capital Monrovia, with the

vision of providing affordable, accessible and quality care for the poor.

With maternal and child health a priority for RPI, a goal of having 100% of deliveries within

the catchment area occur at the facility was set from the outset and was achieved quickly.

There are zero home deliveries in the RPI catchment areas and there have been zero maternal

deaths at the facility. Community health workers employed by the clinic track pregnant

women within the community, and additionally, traditional midwives are employed to refer

women to the clinic for delivery. RPI has an ambulance available to transport women with

complicated pregnancies and deliveries to hospital (James David Memorial Hospital, John F.

Kennedy hospital etc.). Maternal health services are provided free of charge to the poor

communities served by RPI. Likewise, child health services are also provided at no cost and

CHWs track children in the community to ensure a high rate of vaccination coverage. Free

immunization services are provided at the clinic in collaboration with the Ministry of Health,

who provide the vaccines for pregnant women and children.

Other services are provided to general members of the community at an affordable cost

($4.75USD; 700LD) that has been determined in consultation with the community. This

amount includes the cost of drugs that are required for treatment. The provision of drugs at an

affordable cost, as well as the provision of quality care has enabled RPI to build a strong

reputation, and the clinic sees patients that travel long distances because of these reasons.

Malaria is the most common condition treated at the clinic followed by urinary tract

infections and acute respiratory infection.

The RPI model is designed so that is accessible to all. For extremely poor community

members who cannot afford treatment cost, RPI has an aid program to enable them to receive

services at the clinic. The cost of this is currently covered by Dr. Fallah. Additionally, RPI

identified early that health care for the elderly was often a low priority for the poor families

within the Chicken Soup Factory community. In 2015 Refuge Place International introduced

a free treatment service to patients aged 65 and above. The elderly are tracked by CHWs, and

they are provided with an identification card by RPI that enables them to receive free

treatment at the clinic. Over 2500 elderly people have benefited from this service to date.

The majority of the population in the poor communities where RPI works do not have access

to clean water and sanitation. To address this situation RPI has constructed two hand pumps

over the past year, one each at the Bassa town and Low Cost Village clinic sites. Construction

of an additional four hand pumps is currently underway. These hand pumps are accessible to

the public.

Having demonstrated the feasibility of this model for quality, affordable and accessible health

care over the past four years, RPI is currently expanding to three additional sites in rural

areas. Two of these are set to begin offering services in 2019. Partnership with the


Members of the communty’s are very much excited

about the hand pump project and they are fully

having access to safe and clean drinking water.

community has been the cornerstone of bringing the RPI model to these areas. We see

involvement of the community as critical for sustainability of the clinics. RPI works in

collaboration with the Ministry of Health to facilitate the provision of trained staff and

medications for the facilities. It is RPI’s vision to ultimately expand this model more widely

throughout Liberia, always putting the needs of the communities at the center of our efforts,

and relying on the communities to invest in the clinics and building a sense of community

ownership.

Well condition before the construction of the hand

pump at Bassa Town

Constructing of new pump project in low-cost village,

rural settlement.

Hand pump constructed by RPI at Bassa Town


Where we work: Update on Refuge Place Clinics

Refuge Place Clinic Bassa Town- Lower Johnsonville

The original RPI maternal, child and

general clinic operates at Bassa Town in

Lower Johnsonville, an urban slum outside

the capital, Monrovia. The clinic serves a

population of 25,000. Ambulance,

pharmacy and laboratory services are

available at this clinic. In 2018 the clinic

saw 14,891 patients and 436 babies were

delivered at the facility with five neonatal

deaths (the Liberian neonatal mortality rate

is 25.1 per 1000 births). From this rate, we

should have lost 11 neonates, but we lost

only 5 (5/11) which is is 55% survivor rate.

Our goal is to increase this to 100%

survivor rate for neonates.

Extensive construction projects were

undertaken in 2018. A new maternal

surgical facility has been built and will

being operating in March 2019, and the

existing clinic has been expanded to

accommodate the patient load and to house

a new eye clinic to provide quality eye

screening for the poor at low-cost. The eye

tests will be free and patients will pay $8

USD for the glasses. Additionally, a wired

fence has been built around the facility to

create a safe and secure environment for

staff and patients.

The clinic has benefitted from the

generosity of donors over the past year

having received a donation of a vital signs

machine (Dr. Laura Skrip), computers

(Angene and Jack Wilson, Ellen Cull,

Krysia), solar lamps (Village Improvement

Project Inc.) and drugs (Mercy Partner).

Refuge Place values and is part of the

community. As usual we closed the year

with a Children’s Christmas Party, Staff

and community leader’s appreciation party

and distribution of food to the elderly


Low Cost Village Refuge Place Clinic, Careysburg

District-Rural Montserrado

Construction of the Low Cost Village RPI

clinic was completed in 2018. This rural

community is located in Careysburg

District, Montserrado County. The clinic

was constructed in a partnership between

the community and RPI. The community

provided labor and local materials (blocks,

sand, water etc.), while RPI provided other

materials such as zinc, cement etc. The

successful implementation of this Co-

Investment model has demonstrated the

feasibility of this approach for building

clinics in hard to reach places at a low cost.

The Low Cost Village community

encompasses 41 villages and towns and the

clinic will serve a population of 7,717. RPI

has trained 20 local Community Health

Workers (CHW). The clinic is expected to

open to the Public in March 2019.

Trained community health worker Low-cost clinic Staff quarter


Nyemah Village Refuge Place Clinic

The third RPI clinic is being constructed in

Nyemah, a hard to reach community in

rural Montserrado and will serve a

population of 10,200. Construction began

in 2015 and has been hampered by a

number of challenges that have slowed

progress.

Access to the village is affected by poor condition of the road. Limited community member availability for provision of labor and heavy rain caused extensive damage to one side of the building. These issues are being addressed by RPI and construction is expected to be completed in mid-2019.

.

Bong County Refuge Place Clinic


RPI is working to establish a clinic in rural

Bong County. This community

encompasses over 60 villages that do not

currently have access to a health facility.

The community is committed co-investing

in construction of a new RPI clinic by

assisting with the provision of labor and

materials. Construction is ongoing with the

foundation built and construction of the

walls underway.


Patient statistics and finances for 2018

FINANCIAL REPORT: In 2018, RPI had 436 safe deliveries (the highest deliverance since our founding in 2014) and

treated 14,891 patients, with malaria accounting for nearly 49% of the cases. We raised a total of $127,431 from both donations ($71,840) and

patient fees ($55,591) to cover both the operations of the Refuge Place Central Clinic and the new constructions In the same 2018, RPI

demonstrated that financial sustainability is achievable in our clinics, while at the same time providing affordable fees to our quality health

services. The operational cost of our Refuge Place Central clinic was $74,265 and of this amount $55,591 was collected from patient fees. This

means that 75% of the operational cost was raised by the patients, while 25% came from donations by our partners. This is exceptional, as we

started with 100% FREE Service in 2014/2015 during the ebola crises. Now the patients are contributing 75% an increase from 62% last 2017. In 2018, $53,166 was used for construction of the new clinics and some of the construction work of the new health center.

Table 1 (patients statistics, facts and figures on diseases, source of income and major expenditure)

Months Dec

2017

Jan

2018

Feb.

2018

Mar.

2018

April

2018

May

2018

June

2018

July

2018

Aug.

2018

Sept.

2018

Oct.

2018

Nov.

2018

Total

Number of patients Statistics

# of patients 1028 1270 1118 1253 1406 1663 1651 1451 1135 858 1127 931 14891

Facts and Figures on Select Diseases and Conditions

ARI 216 304 273 317 374 324 393 437 335 257 508 410 4148

UTI 356 765 546 634 748 866 910 688 809 474 692 557 8,045

Malaria 750 869 728 901 1136 1218 1303 1114 725 663 1000 752 11159

Typhoid 176 215 201 154 214 208 314 241 216 156 293 268 2656

Worm 25 16 3 20 38 77 87 118 100 50 171 232 937

Canadensis 108 92 74 76 106 138 89 114 61 56 143 98 1155

Total 1631 2261 1825 2102 2616 2831 3096 2712 2246 1656 2807 2317 28100 Free Services

Delivery 36 42 35 47 36 49 53 47 19 22 29 21 436

65 years above 78 80 60 73 88 90 95 84 59 68 71 64 910

Dr. Fallah Aid 11 13 7 12 12 15 12 20 14 12 18 14 160


Total

RPI Health Center Bassa town Expenditures

Drugs 1,716 1,419 516 1,420 1,643 2,321 2,580 2,108 1,999 978 1,740 1, 673 20,111

Salary 3,600 3,836 3,720 3,849 4,643 4,196 5,072 4,734 3,934 4,093 4,093 5,178 50,947

Requisition 518 231 134 112 198 132 201 315 251 177 233 57 2,559 Operation

funds 65 48 65 65 65 65 0 65 0 65 65 84 648 Total 5,899 5,534 4,435 5,446 6,549 6,714 7,853 7,222 6,184 5,313 6,131 5,319 74,265

Source of income (USD) Patient Fees 4,138 4,570 3,986 4,352 4,759 5,856 5,439 4,585 5,038 3,699 4,922 4,245 55,591

Amount

donated 3,791 2,396 1,620 2,608 2,219 1,541 4,944 3,322 2,004 1,562 1,820 3,261 31,091 Sub-Total 7,929 6,966 5,606 6,960 6,978 7,397 10,383 7,907 7,042 5,261 6,742 7,506 86,682

Others expenditure RPI

Construction 0 1,311 4,361 968 2,054 3,017 220 2,341 304 0 0 8,270 22,845 Low-cost

Construction

work 865 1815 1260 400 910 3550 360 355 665 718 4333 1123 16354 Nymeah

construction 0 0 100 0 200 0 400 450 150 0 0 0 1200 Bong

County

Constriction 0 0 0 0 0 0 0 350 0 0 0 0 350 Sub-Total 865 3126 5721 1368 3164 6567 980 3496 1119 718 4333 9393 40,749

Grand Total …………………………………………………………………..86,682+40,749=127,431


Graphical illustration of Number of patients 2018 Fact and Figures on selected diseases and conditions 2018

A R I U T I M A L A R I A T Y P H O I D W O R M C A N A D E N S I S

7865

1524020726

49421828 2088

Total of selected diseases treated at refuge place in 2018

0

200

400

600

800

1000

1200

1400

1600

1800

1 2 3 4 5 6 7 8 9 10 11 12

# of patients December-2017-November 2018

64%

36%

% for source of income (running cost)

Amount generated by clinc

Amount donated by partner


Patient statistics 2014-2018 Since opening on June 9,2014 in Chicken Soup Factory, Bassa Town, RPI has been providing quality health care to a growing number of

patients in this previously underserved poor community. The number of safe deliveries perform are 1,276. There was zero maternal deaths. This

is amazing as Liberia is the second country with the highest maternal mortality rates in the world (1072 maternal deaths per 100,000 live births).

During the 4 years since our inception (2014/2015-2018), a total of 49,802 patients were treated at the RPI clinic in Bassa Town.


Thanks and appreciation to the hard working staff at Refuge Place in 2018

Administration

Dr. Mosoka Fallah

Decontee Walker

Alaine F. Seenah

Jim S. Suah Jr.

Lewis Wesley

John M. Lamin

Harris K. Korkulo

Clinical and Support

Staffs

Sarah Aboloy

Augustine T. Shepoh

Lulu C. Tarblo

Victoria Bearpeen

Fintesa F. Josiah

Agnes F. Shelwah

Jeneve Bainda

Ellen Y.W.Ben

J. Abeningo N. Jimmy

Ezekiel M. Kombo

Momory Saah

Soliar M. Kolako

Ruth Bacon

Martha M. Joe

Nimely W. Weah

Cecelia S. Howard

Joseph T. Bundor

Davidetta Mark

Teah Weah

Kaimah Golafily

Kenneth D. Nyanford

Emmanuel

Joseph Fayiah

Bill Wandah

Fayiah Lenor

Shabaku A. Brosious

Martha Airport

John Flomo

Nowai Kanasuah

Abigail Ruth Varney

Onikeh Summerville

Priscilia B. Suduail

Yamah S. Belleh

Rachel Davis

Veronica Sopah

Susan M. George

Agnes S. Fallah

Lois N. Teah

General Community

Health Volunteer

Ade Wilson

Mardea David

Samuel S. Brima

Patience Robertson

Patrick Porka

Hawa Palley

Esther Monquuio

Joseph N. Karjue

Josephine Gardiner

Torgar G. Tarr

Krubo Kollie

Patricia Tarnue

Moses Whaleah

James Sieh

Mama S. Sumo

Clarence E. Tarr, Jr.

Charles T. Fendoe

Feticial B. Johnney

Jeremiah Whaleah

Josephine K. Weah

Princess S. Solo

Cecelia W. Taylor

Abraham T. Holloe

Lovo S. Tamba

Joseph Howard

Patience Monger

Volunteers Health

Workers

Mary Saah Bendo .

Nancy F. J. Tulay

Naomi M. Muhen

Tenneh S. G. Fahn

Trained Traditional

Midwives

Mary Vinton

Marie Mulbal

Martha Yormie

Ma. Zoe Williams

Low-cost Security

Isaac Borbor

James Tamba


Board of Directors

Partners and Donors

Over the years Refuge Place International would not have accomplished what it

has without the collective support of its partners and donors.

Partners

Name Location Amount

Royer Charitable Foundation USA $40,000

Mercy Partner USA $18,000

Ministry of Health (MOH) Liberia Vaccines

Americare USA Drugs

Einhorn Family Foundation Sweden $2,500

Total $60,500

Individual Contributors

Ragon Family USA $1150

Angene and Jack Wilson USA $1500

Jim Brazim USA $2000

Jim Fett USA $500

Shane and Lara Olson USA logistics

Mosoka P. Fallah Liberia $6,190

Total $11,340

Patient Fees

Payments by Patients Liberia $55,591

Total Donations- $60,500 + $11,340 + $55,591 =127,431

Jim Balz, MD USA

Jack Wilson USA

Angene Wilson USA

Shane Olson USA

Lara Olson USA

DeAnne Rogan USA

Lila Rogan USA

Ravi Nirmal, USA

Rachel C. Lewis USA

Mosoka P. Fallah Liberia

Refuge Place International 2018 Annual Report · 2019-03-19 · REFUGE PLACE INTERNATIONAL 2018 ANNUAL REPORT Message from the Chief Executive Officer Dear members of the Board, Partners

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