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In Southwestern Liberia, Resilient Power and Medical Oxygen Bolster Lifesaving Care
Liberians in the country’s southeast rely on F.J. Grante Memorial Hospital as their only access to emergency surgeries and treatment. A new project, funded by Direct Relief, will provide resilient power and medical oxygen to support all the hospital’s clinical needs.
Editor’s Note: This story is the third of three profiles documenting new energy and medical projects funded by Direct Relief in three West African countries: Sierra Leone, the Gambia, and Liberia. The first two can be found here and here.
Doctors and medical students from Johns Hopkins University, visiting Liberia’s F.J. Grante Memorial Hospital, were horrified when a two-year-old girl arrived in respiratory distress.
The F.J. Grante Memorial Hospital depended on diesel generators to power its lights and medical equipment. In Greenville, an area often called the “Mississippi of Liberia” — the region was settled by formerly enslaved African Americans from Mississippi, USA, who integrated with the area’s indigenous groups — there is no electrical grid, and diesel generators are the primary power source.
However, the steep cost of diesel fuel limits electricity at the hospital to just a few hours per day — unless a sick person’s family can afford the staggering $100 daily expense to keep the generators running continuously.
Desperate to buy enough time for the little girl to recover with antibiotics and breathe without the aid of an oxygen concentrator, the visiting medical team pooled their money to fund 24 hours of electricity. They wondered: Would her condition stabilize, allowing her to go home with her family? Or would her oxygen needs surpass the concentrator’s capacity?
On the second day, when the diesel fuel ran out, the worst happened. The two-year-old slipped into respiratory distress and died.
“This is something that’s happening all the time when our team is not present,” explained Dr. John Sampson, a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine who works closely with medical partners in West Africa, including Liberia.
Liberia has large medical centers in its capital, Monrovia, but for many patients in the country’s southeastern regions, such as Sinoe County — where F.J. Grante Memorial Hospital is located — accessing these facilities is nearly impossible. During the dry season, the journey takes about 12 hours, and in the long rainy season, travel to Monrovia is often completely cut off.
A physician examines a patient at F.J. Grante Memorial Hospital in Greenville, Liberia. (Courtesy photo)
In this remote area, reliable power and medical oxygen have long been inaccessible, creating a demoralizing reality for the hospital’s dedicated doctors and nurses. Despite their extensive training, they are often unable to apply their skills effectively, forced instead to watch patients die due to lack of oxygen. The hospital’s few oxygen concentrators provide only 5 liters per minute of low-pressure oxygen — insufficient for many critically ill patients. Worse, all electricity-dependent medical technology, including these concentrators, shuts down daily due to the high cost of diesel fuel.
Even when the lights are on, Dr. Sampson recalled, the dimly lit hallways and rooms conserve electricity but create a “sad condition.”
However, the F.J. Grante Memorial Hospital will soon benefit from a new oxygen-generating facility and a solar installation, including a battery-based renewable energy system designed to power the oxygen generator. Medical equipment and systems will be reliably powered at all times. A continuous supply of oxygen will be piped directly to patients’ bedsides. The hallways will be brightly lit.
Dr. John Sampson meets with hospital representatives in Liberia. (Courtesy photo)
The medical oxygen facility and solar installation are part of the larger Africa Infrastructure Relief and Support, or AIRS, project — a Society of Critical Care Medicine (SCCM) collaboration with the Johns Hopkins Global Alliance of Perioperative Professionals, or JHU-GAPP, and the Institute of Global Perioperative Care. (Dr. Sampson founded the last two organizations, and is GAPP’s executive director. He also represents the Chicago-based Society of Critical Care Medicine in the execution of the AIRS project.)
Through AIRS, Direct Relief is funding reliable power and medical oxygen projects in Sierra Leone, the Gambia, and Liberia, with a $5.5 million grant.
“The opportunity to survive”
Beyond the immediate medical impact, the financial burden of purchasing thousands of dollars’ worth of diesel fuel and oil drains the hospital’s already limited budget. This prevents investments in essential improvements such as upgraded technology, better patient care, and fair salaries for staff. For the hospital’s determined healthcare workers, the situation is not only frustrating: It is profoundly disheartening.
“The number of patients who come to the hospital is huge,” said Dr. John Yarngrorble, the Sinoe County health officer. “You can have a surgical crisis interrupt” if the power goes out.
Dr. Sampson emphasized that many patients at F.J. Grante Memorial Hospital require urgent, life-saving care. However, unreliable power and limited access to medical oxygen pose serious risks—even for a highly skilled and dedicated team of healthcare providers.
A hospital staff member records a patient’s weight. (Courtesy photo)
The hospital’s maternity ward plays a crucial role in providing safer deliveries and reducing maternal and infant mortality rates in Liberia. Meanwhile, emergency surgeries and critical treatments not only save lives but also significantly improve overall health outcomes.
“If their condition is serious, they don’t really have the opportunity to survive” when the generators are off, Dr. Sampson said.
In addition, the hospital has the potential to contribute essential medical research to the global community, and provides essential education on preventive health care and hygiene practices to Liberians in surrounding areas.
Staff provide this care, Dr. Sampson said, even with shortages of medicines and supplies, a need for support and providers, a lack of reliable medical oxygen — and power that keeps going off.
“The most dramatic transformation”
Careful consideration was given to selecting an energy-efficient oxygen generation technology, Dr. Sampson recalled. The chosen system, a Vacuum Swing Adsorption (VSA) unit, consumes much less energy than traditional methods, reducing the number of solar panels required for operation. Once the project is completed — by late March, he anticipates — the hospital will be the only one in Liberia with both renewable energy and on-site oxygen generation.
Because of the hospital’s rural setting, “we had the space to create a solar farm,” Dr. Sampson said. “It will support all clinical needs in the hospital. It brings together the solar that we used for our Sierra Leone project with the climate-friendly, energy efficient medical oxygen of the Gambia oxygen delivery system that the SCCM AIRS project has constructed.”
Construction begins on a new solar farm and medical oxygen facility at F.J. Grante Memorial Hospital in Greenville, Liberia. (Courtesy photo)
The project, he added, is unique in West Africa. Not only will it provide reliable power and high-quality medical oxygen; it will also allow the funds previously spent on purchasing diesel for electricity generators to go directly toward patient care instead. International groups have worked to supply major hospitals around the world with oxygen plants for years, but when repairs are needed and support is slow to arrive, hospitals are without medical oxygen once again. To prevent this, the AIRS project also includes extensive training for local biomedical engineers and technicians, who will maintain the plant and oxygen distribution system.
“This project will reach every aspect of the hospital,” said Dr. Yarngrorble. “The people are so happy; this oxygen project is going to do a lot in Sinoe.”
A laboratory worker at F.J. Grante Memorial Hospital examines a sample through a microscope. (Courtesy photo)
He highlighted the benefits of reliable access to computers, uninterrupted operation of lab equipment, and consistent temperature control for blood bank supplies — all critical to meeting urgent medical needs.
While the F.J. Grante Memorial Hospital does need more healthcare providers, Dr. Sampson emphasized that reliable medical infrastructure — such as power and oxygen — is an even more urgent priority.
Westerners often misunderstand healthcare in West African countries, assuming a lack of trained professionals. In reality, these nations produce highly skilled physicians and staff their hospitals with dedicated doctors and nurses. However, when essential resources or reliable infrastructure are unavailable, even the most accomplished medical providers may feel their expertise is underutilized, limiting their ability to offer effective care.
“Projects like this improve morale, effectiveness, and efficiency,” Dr. Sampson said. For instance, an obstetric surgeon trained in state-of-the-art techniques to save infant lives and improve maternal health outcomes cannot perform those procedures in darkness.
“This is the most dramatic transformation of how health care is delivered in this area,” he told Direct Relief.
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