See our public website -- http://www.JusticeInHealth.org

 

Tiyatien Health (“Justice in Health” in Liberian Kwa-speaking dialect) is a 501(c)(3) non-governmental, social justice organization that works in partnership with communities in rural Liberia and the Liberian Government to promote equity by advancing healthcare services and the fundamental rights of the poor.  Through services, research, advocacy and training, we are working to improve access to HIV treatment, care and support; pioneer models that deliver primary healthcare fairly and for all; and bolster social justice in rural Liberia – one of Africa’s poorest war-torn countries.

 

 

Tiyatien Health envisions a just global society – a necessary element of which is a world in which people share equity in survival.  For us, this means a world in which communities have eliminated separate, unequal standards of healthcare; political and economic structures are fair to the poor; and fundamental freedoms are enjoyed by all.    

 

 

Where We Work

 

 

Southeastern Liberia is the poorest region of one of Africa’s poorest nations and has been severely affected by decades of war and poverty. Grand Gedeh and River Gee Counties, where Tiyatien currently focuses its attention, are home to 200,000 people, nearly 90% of whom were displaced during Liberia’s civil war. These people can expect to live a mere 42 years, often eroded and embattled by harsh living conditions.  These same conditions kill nearly a quarter of Liberia’s children before they turn five.  Death during childbirth is also rampant, signaled by the shocking statistic that about one in twenty women can expect to die in childbirth.  Interrupted disease control efforts have also bred West Africa’s largest HIV epidemic, with 9% of mothers infected. Amidst such despair, these communities are forced to deal with the reality of being served by only one doctor for 200,000 people. 

 

 

 

 

What We Do

 

 

Tiyatien Health (TH) strives to bring hope and healing to this region by improving the equitable delivery of comprehensive healthcare services to rural communities through the public sector. At the clinical level, TH has provided support to the Government of Liberia in the areas of HIV, primary healthcare, including maternal and child health, surgical services, tuberculosis, mental health and chronic disease care since 2006.

 

 

TH’s flagship program, the HIV Equity Initiative, founded by HIV patients in conjunction with Liberian and US-based health professionals, Tiyatien Health partnered with the Liberian Ministry of Health and the National AIDS Control Program, in February 2007, to launch its flagship program, the HIV Equity Initiative – the country’s first community-based HIV treatment program – at Martha Tubman Memorial Hospital in Zwedru, Grand Gedeh County. Supported by the Global Fund for AIDS, Tuberculosis and Malaria, the HIV Equity Initiative (HEI) is providing comprehensive clinical and social services to a growing cohort of over 200 HIV-infected people – the largest rural public HIV prevention and treatment program in Liberia. 

 

The backbone of the TH’s success is its extensive network of community health workers, called “accompaniers”, who provide long-term medical, economic and social services to patients and their communities. In 2008, Tiyatien accompaniers conducted over 10,000 home visits to people affected by tuberculosis, HIV and chronic diseases and their communities to provide directly observed treatment and health talks, expanding their efforts to include prevention activities, awareness campaigns, and referrals. These invaluable accompaniers have referred over 2000 sick individuals from rural communities for early care seeking and primary healthcare services during prevention and awareness activities that reached over 30,000 people from rural communities.

 

 

In addition to providing comprehensive health services, Tiyatien Health addresses the psychosocial needs of patients and their families by providing over 200 monthly economic stipends, food packages, and individual and group counseling sessions. Agricultural and small business trainings have recently been completed to help break cycles of disease and poverty plaguing our patients lives. These patients were provided agricultural kits and small business grants, helping families rebuild their lives after years of war, displacement, and little to no health care.

 

 

 

The Vision

 

 

Tiyatien’s long-term vision is to expand HIV and primary healthcare services (including child, maternal and surgical care) across southeastern Liberia through a Rural Health Initiative that would rehabilitate abandoned public health clinics and hospitals in the region, including River Gee and Grand Gedeh Counties.

 

 

 

 

Partners & Donors

 

 

The Global Fund for AIDS, Tuberculosis and Malaria

United Nations High Commissioner for Refugees (UNHCR)

OPEC Fund for International Development (OFID)

Liberian Ministry of Health and Social Welfare

Government of Liberia

Harvard University

Clinton Foundation HIV/AIDS Initiative

Massachusetts General Hospital

Partners in Health

Merlin

National Tuberculosis & Leprosy Control Program

National AIDS & STI Control Program

 

Recent Organizational Achievements

• November 2006 – Foundation for Tiyatien Health’s work on rural healthcare and HIV/AIDS is laid when impoverished rural Liberian women infected with HIV work with TH staff to design a comprehensive HIV care program, ultimately the HIV Equity Initiative, focused on poverty reduction and inequalities.  The life narratives of these rural Liberian women affected by AIDS are shared with the President of Liberia, Honorable Ellen Johnson-Sirleaf, and her Minister of Health, Honorable Dr. Walter Gwenigale.
• March 2007 – Tiyatien Health and Ministry of Health launch HIV Equity Initiative and begin Grand Gedeh County’s first HIV patient on antiretroviral treatment.  Within two years, more than 150 patients will be in care—the largest rural HIV treatment program in Liberia. 

• November 2007 – Tiyatien Health and the Liberian National AIDS & STI Control Program release its first official report on Liberia's HIV Equity Initiative, documenting dramatic impact on AIDS mortality and treatment retention at 6 months of implementation.

• January 2008 – Massachusetts General Hospital and Harvard University's Center for AIDS Research invites Tiyatien's HIV Equity Initiative to join its HIV Online Provider Education (HOPE) network.  Tiyatien is one of very few rural clinics which has been invited into the HOPE network.

• March 2008 – Tiyatien receives over $100,000 in funding and in-kind support from the UNHCR and OFID to finance its HIV Equity Initiative.

• July 2008 – Tiyatien welcomes its new medical director, Dr. David Okiror, formerly with the Clinton Foundation HIV/AIDS Initiative in Liberia.  In addition to providing HIV care, Dr. Okiror is one of only two physicians providing obstetric, pediatric and medical care to Grand Gedeh’s catchment area of over 100,000 people.

• August 2008 – In an abstract joined by the Liberian Minister of Health, Dr. Walter Gwenigale, Tiyatien Health and the Liberian Ministry of Health and Social Welfare present findings of the HIV Equity Initiative at the XVII International AIDS Conference in Mexico City. 

• August 2008 - Liberian Ministry of Health partners with Tiyatien to launch first rural Chronic Care Clinic to integrate and strengthen HIV/TB and primary healthcare in Zwedru, Liberia.  This is the only rural center targeting chronic conditions—including asthma, hypertension, diabetes, and congestive heart failure—in Liberia.

• August 2008 - Tiyatien Health members, in collaboration with Harvard Humanitarian Initiative, publish research in the Journal of the American Medical Association, finding that Liberian fighters exposed to sexual violence experience more mental health disorders in aftermath the of the war. 

• August 2008 - Tiyatien Executive Director, Dr. Rajesh Panjabi, along with physicians from Partners in Health and Harvard University, publish an article in the Lancet outlining the role of illness narratives in conflict and post-conflict regions.
• October 2008 – Tiyatien Health Executive Director, Dr. Rajesh Panjabi, delivers keynote presentation at 15^th annual Partners in Health Thomas J. White Symposium, “Pushing the Boundaries: Past, Present and Future” at Sanders Theatre at Harvard University.

• October 2008 – Tiyatien supports more than 150 HIV positive patients and has helped provide testing, counseling, and prevention services for many more.
• November 2008 – Tiyatien Health invited to join National Mental Health Policy Committee, which will draft Liberia’s first national policy and plan on mental health.
• January 2009 – Tiyatien Health works with National Tuberculosis Control Program, Clinton Foundation and Partners in Health to diagnose first cases of multi-drug resistant tuberculosis in Liberia.

 

 

Representative Publications

 

Westerhaus, M., Panjabi R., & Mukherjee, J. Violence and the Role of Illness Narratives.

         Lancet 2008. 372; 699-701.

Johnson, K.., Asher, J., Rosborough, S., Raja, A., Panjabi, R.R., Beadling, C., & Lawry, L. (2008).

Association of combatant status and sexual violence with health and mental health outcomes in postconflict Liberia. Journal of the American Medical Association, 300(6), 676-690.

Panjabi R., Aderibigbe O., & Quitoe W. Towards universal outcomes: a community-based

approach to improve HIV care in post-confl ict Liberia. XVII International AIDS Conference, Mexico City, Mexico; Aug 3–8, 2008:CDB030 (abstr).

 

Panjabi R, Aderibigbe O, Quitoe W, et al. A Community-Based Approach to HIV Care in Rural Liberia: Liberia’s HIV Equity Initiative. National AIDS & STI Control Program. 2007 Nov. Ministry of Health & Social Welfare: Monrovia.

Kraemer, J. & Panjabi RR. Rights to Housing and Health: Critical Links for the Global Poor.

British Medical Journal (20 March 2007). http://www.bmj.com/cgi/eletters/334/7591/460#162666

Kraemer, J. & Panjabi R.R. Better Ideas for Liberia. The Washington Post, May 24, 2007.

 

Panjabi R. (2007) HIV Prevention and Care. In International Donor Community Report Card:

Investment in Liberia’s Future. Institute for Policy Studies & Jubilee USA: Washington, D.C. pp. 7-9.

 

 

Working with Tiyatien Health

  

In the United States:                                          In Liberia: 

Tiyatien Health, Inc.                                          Tiyatien Health 

365 Cardinal Medeiros Ave. Suite 1                    (c/o Martha Tubman Memorial Hospital)

Cambridge, MA 02141                                     Hospital Road

Tel: +18573839506                                          Zwedru, Grand Gedeh County, Liberia

Email: info@tiyatienhealth.org                           Tel: +231-6644719

http://www.tiyatienhealth.org