Success Story from Liberia: Dr. Rajesh Panjabi’s Last Mile Health

Rajesh Ramesh Panjabi narrowly escaped a civil war in his home country of Liberia. As a 10 year old, he stood on an airstrip in the capital city of Monrovia in lines of refugees hoping to leave the country for the USA by cargo plane. He knew that many in the lines, unlike him, would never have a similar chance because they could not afford a ticket.

As a refugee in the USA, Mr. Panjabi worked hard and against steep odds, but was able to get an education and even gain admission to medical school. During his third year of medical school Mr. Panjabi traveled to Afghanistan to understand how to create functional post-war health systems. When he returned to the USA, he completed a master’s degree at the Johns Hopkins Bloomberg School of Public Health, before returning to medical school at the University of North Carolina—Chapel Hill.

By 2005, the situation in Liberia was improving and the government was calling on those overseas to return home. Dr. Panjabi moved back to Liberia, where he worked as a policy adviser to the government and later co-founded the non-governmental organization Last Mile Health known locally as Tiyatien Health (TH). Tiyatien Health, which loosely translates to “justice in health,” was sorely needed, but severely underfunded. The organization was started with a $5,000 donation. At the time Liberia had only 51 physicians in the public sector for around 3.8 million people.

In 2006, Dr. Panjabi met Mr. Weafus Quitoe, a Liberian refugee recently returned after 15 years in Côte d’Ivoire, who was volunteering as a nurse’s aide. The two realized that many HIV-infected pregnant women couldn’t afford antiretroviral treatment or were too sick to make a 12-hour journey to the capital where the medications were available. In 2007, Dr. Panjabi and Mr. Quitoe launched an ‘HIV Equity Initiative’ that trained community members to deliver medicines to patients and support physicians assistants that diagnosed and administered the drugs.

TH currently runs the largest rural AIDS clinic in Liberia and it has been an important center for work on Ebola. TH’s community health workers originally trained to work with AIDS patients, now also treat chronic diseases like depression and post-traumatic stress disorder. TH aims to address the stigma of disease, raise awareness, provide access to drugs and works with patients to ensure that they take their medication regularly and with the correct dietary supplements. TH’s innovative holistic approach to disease, that considers root causes such as poverty, unemployment and malnutrition, is a model for sustainable, community-based healthcare.

Last Mile Health (Tiyatien Health) has received praise for its effective approach to health care from Partners in Health co-founder Paul Farmer, the overseer of the United Nations High Commissioner for Refugees in eastern Liberia, former US President Bill Clinton, Liberian President Ellen Johnson Sirleaf, and Big Bang Philanthropy. Dr. Panjabi has received several honors. He has been named a “Social Disruptor” by the Forbes 400 Summit on Philanthropy. He is a fellow of the Draper Richards Kaplan Foundation, Mulago Foundation, and an Echoing Green 2011 Global Fellow. He is an Advisor in Global Health to the Clinton Global Initiative and has received the Global Citizen Movement Award, the Segal Family Foundation Rising Star Award and the 2010 Johns Hopkins University Outstanding Recent Alumni Award.

Dr. Panjabi is an Associate Physician in the Division of Global Health Equity at Brigham and Women’s Hospital in Boston and an Instructor in Medicine at Harvard Medical School in Cambridge, Massachusetts in the USA. He travels back and forth between the Boston/Cambridge area and rural Liberia where he continues to build the post-war healthcare system.

Based on the literature on international development and personal success, why has Rajesh Panjabi (and his non-profit organization) been so successful?

Some key characteristics come to mind:

Young Rajesh’s (“Raj’s”) conscience was troubled by the wealth differentials that allowed him and his family, but not hundreds of other poorer Liberians to board a plane to safety and freedom. After 15 years abroad where he obtained the specialized training he needed, Dr. Panjabi returned to Liberia. With 90 percent of the country’s clinics destroyed, he did NOT WAIT FOR HELP FROM THE OUTSIDE, but looked within and worked with local residents and patients to start Tiyatien Health.

Last Mile Health’s/Tiyatien Health’s SUCCESS led to a call from the Government of Liberia to TH to work with other partners to SCALE UP what they had achieved in a single rural location and apply their model to the entire country.

By Heidi G. Frontani

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