A community health worker screens patients at the Ganta United Methodist Hospital in Nimba County Credit: World Diabetes Foundation
GANTA, Nimba County — McArthur Davis was 18 when doctors told him to burn his clothes to cure what they thought was an infection. His vision was failing, sores covered his body, and though clinic after clinic had treated him, he never got better.
By Tetee Gebro with New Narratives
It wasn’t until he reached the Ganta United Methodist Hospital in this dusty border town that a nurse gave him the diagnosis that would save his life: Davis had diabetes, a chronic health condition where the body cannot properly process sugar from food, leading to high blood sugar levels. With lifestyle changes and medication he has managed the disease. Nearly ten years later he is still grateful.
“If there was no means of getting to Ganta Methodist Hospital, I could have gotten blind right away,” said Davis, now 27 studying General Management at Cuttington University in neighbouring Bong County.
Diabetes patient MacArthur Davis injects himself with insulin.
Davis is one of a growing number of people caught up in a health crisis sweeping across Liberia and much of sub-Saharan Africa, where chronic diseases like diabetes and hypertension are rapidly becoming leading causes of death. The World Health Organization reported that such diseases accounted for one in every three deaths in Liberia in 2019 — a figure that health experts say has only grown. So-called non-communicable diseases (NCDs) now account for 73% of global deaths, with diabetes, hypertension, obesity, and smoking being major risk factors for death. In sub-Saharan Africa, diabetes is expected to affect 40.7 million people by 2045. Two thirds of those will go undiagnosed, due to poor healthcare quality.
Lifestyle factors are the main causes. Eating a diet heavy in fat, sugar, alcohol and refined grains and lack of exercise and sleep, plus stress and environmental pollutants, are underlying causes. The saddest part, say experts, is that most can be prevented but many people don’t know how to protect themselves.
The situation is particularly bad in Liberia where the health care system remains severely weakened by 14 years of civil war and the devastating 2014-2016 Ebola outbreak. Most medical facilities lack necessities like reliable electricity, running water or diagnostic equipment. Scrambling just to get resources for emergencies, they have not had the capacity to deal with the surge in chronic diseases. Experts say the Health Ministry has also largely failed to deliver awareness information that would help Liberians adopt diet and lifestyle choices that would keep them safe.
Emmanuel Kpon Saye in front of the Ganta United Methodist Hospital Credit: World Diabetes Foundation
Against this backdrop, the modest Methodist hospital has quietly emerged as a national leader in treating conditions that most facilities simply cannot handle. The hospital’s diabetes program, launched in 2006 and formally established as a dedicated clinic in 2010, has become a lifeline for hundreds of patients across the region.
Today, Nennie Kollie, the nurse, oversees the diabetes clinic, which not only treats its own patients but also trains staff at national referral hospitals. With support from international partners including the World Diabetes Foundation and Life for a Child, an Australian nonprofit, the hospital has developed what health experts call a replicable model for addressing Liberia’s emerging chronic disease crisis.
The protocol begins when the patients first walk through the door.
“Everyone who enters this hospital for the very first time, you have to go through diabetes screening,” said Kollie. With such high prevalence among the population because of diet and other lifestyle factors, staff here test people’s blood sugar levels routinely regardless of what patients say are their symptoms. “We will be able to capture all of our cases right there because some people don’t know about diabetes.”
When patients test positive for diabetes, doctors first confirm the diagnosis and check blood sugar levels. Staff educate patients about diabetes, how it affects the body and the lifestyle changes they will need to make such as diet, exercise and weight management to regain their health and avoid the worst impacts of the disease. They then create a treatment plan with medications like insulin, teach patients how to monitor blood sugar at home, and schedule regular check-ups to prevent complications.
The program’s impact extends beyond medical treatment. In 2019, the World Diabetes Foundation approved a $180,000 grant to train health care workers in 15 towns across Nimba County. A subsequent $1.5 million grant helped expand the program to 24 hospitals nationwide, training more than 800 clinicians.
The reach of this network is evident in patients like Lorena Nyah, a schoolteacher and single mother whose life was transformed after her diagnosis. Lorena noticed something was wrong when she started eating constantly but kept losing weight. She was always thirsty and had to urinate frequently, which caused painful sores. Ants would gather around where she urinated. She now knows that is a sign that her blood sugar was too high.
At first, Lorena tried herbal remedies that friends suggested, thinking she had an infection. Her illness began affecting her appearance and energy. Even her personal relationships suffered.
“My son’s father, when the sickness was starting, we lived together, did everything together, but when he saw me start changing, getting dry and reducing, he started to insult me,” Nyah said.
When her condition got worse, her father asked his wife to take her to Ganta Methodist Hospital. Doctors found her blood sugar was dangerously high. Since then Lorena, now 27, has received free treatment through a special program at the hospital. Ganta Methodist Hospital worked with an organization called Life for a Child to provide free care for diabetes patients up to age 30, instead of the previous limit of 26. This gives young adults like Lorena four extra years of support while they learn to manage their condition.
“I never paid $5, even for checkup,” said Nyah.
The hospital’s success has inspired broader ambitions among the team. Emmanuel Kpon Saye, the diabetes project manager, who helped supervise the clinic’s expansion before transitioning to other roles, said he was motivated partly by his father’s death from a cancer – another noncommunicable disease. Cancer is often misdiagnosed in Liberia, and he didn’t get the treatment that could have saved his life.
Saye helped establish a national organization called the Liberia NCD Alliance in collaboration with the Ministry of Health, aiming to scale up chronic disease care nationwide.
One of the challenges faced by clinics around the country is difficulty accessing the medicines and tests needed to treat chronic diseases. To address this, the hospital partnered with Direct Relief, a California-based nonprofit that began sending essential medications directly to the hospital in 2021. The Ministry of Health relies on international partners like WHO, USAID, and Partners in Health for diabetes medications distributed through its National Drug Service. A 2022 General Auditing Commission report found health facilities still struggle with limited supplies and expired drugs.
Ganta Methodist now serves as a distribution hub for medications obtained from Direct Relief, ensuring that both public and private facilities across the country have access to critical drugs.
But as this year’s massive cuts to U.S. aid by President Donald Trump have shown, dependence on donors makes Liberian patients vulnerable. As a private, mission-run facility, Ganta Methodist provides free treatment to hundreds of patients annually, often without reimbursement from the government or insurance programs.
“If tomorrow our partners decide to leave us, my fear is that so many people will die from this condition,” Kollie said.
The hospital has taken steps to build resilience, encouraging patient-run gardens, conducting screenings at schools and churches, and educating people about diabetes prevention including through Diabetes Awareness Month each November. But deeper systemic issues — weak infrastructure, chronic understaffing and irregular supply chains — continue to plague the broader hospital in the same ways they plague the country’s broader health system.
The office of Dr. Louise M. Kpoto, Liberia’s Health Minister, did not reply to numerous requests for comment on this story before deadline.
Still, in the corridors of Ganta Methodist Hospital, there are plenty of reasons for optimism. Patients like Davis, who once faced a grim prognosis, now live full lives with proper treatment and care.
“From that time up to now, I can’t experience that problem again,” Davis said.
For health care advocates, the Ganta Methodist model offers lessons for addressing chronic disease across resource-constrained settings. The combination of international partnerships, local capacity building and community awareness has created a template that other facilities are beginning to adopt. As chronic diseases continue to surge across West Africa, experts recommend models like this be scaled quickly to meet the growing need.
Each morning at Ganta Methodist still begins with nurses and doctors gathering in the hospital chapel for devotions and prayer. By midmorning, long lines of patients sit waiting for care, some having travelled for days from neighbouring counties and even Ivory Coast.
For many, it remains their only hope of survival.
This story was produced in collaboration with New Narratives. Funding was provided by the Swedish Embassy in Liberia. The funder had no say in the content of the story. Jerome Saye contributed reporting.
