PAs in Liberia: Challenges and Opportunities

In November 2012 and January 2014, I traveled to Liberia to conduct a needs assessment of the health care system there and discovered that the physician assistant profession has been in existence in Liberia since 1965—the same year that it started in the United States. During my time there, I became close friends with Jerry Kollie, PA, President of the Liberian National Physician Assistants Association (LINPAA). I recently interviewed him to learn more about his organization and the PA profession in Liberia.

John Oliphant (JO): Please tell me about your country’s physician assistant organization.

Jerry Kollie (JK): LINPAA is an umbrella organization of physician assistants that has been legally established since 1974, when a group of PAs saw the need for an association with a board of directors that would advocate for PAs, monitor and provide supportive supervision, evaluate their performance, create job opportunities, conduct capacity-building training, administer state board exams to new graduates, and issue professional licenses annually, among others functions.

In terms of structure, LINPAA has a board of directors headed by a chairman, an executive committee headed by the president, and a large membership. LINPAA hosts a convention biannually, during which elections for executives are held. Every year, on the second Saturday in November, LINPAA celebrates National Physician Assistants Day across the country.

JO: How culturally diverse is your organization?

JK: LINPAA’s membership is inclusive of PAs from a lot of diverse cultural backgrounds, tribal lines, and religious affiliations.

JO: What do you consider LINPAA’s greatest strengths and weaknesses at this time?

JK: Our greatest strength is unity among PAs, and the establishment of local chapters across the 15 political subdivisions of Liberia. The major weakness is the delay in license renewal due to low salaries and incentives.

JO: What are the biggest challenges and opportunities for the PA profession in Liberia?

JK: Right now, our biggest challenges include lack of permanent office space, equipment, and supplies for our national headquarters, lack of vehicles with which to do monitoring and supportive supervision, and lack of subsidies from the government of Liberia (GOL) and financial support from other partners.

Also, there is poor recognition of PAs by the GOL and a sense of marginalization and neglect by Ministry of Health (MOH) officials. PAs do not have a career ladder in Liberia; there are no specialist or subspecialist programs, and the government refuses to elevate the PA program at Tubman National Institute of Medical Arts to a degree-granting institution. Currently, it offers a three-year certificate program.

On the more positive side, what we consider our biggest opportunity for now is the gradual recognition by our international PA colleagues, such as the American PAs.

JO: How do you plan to address these challenges and explore your opportunities?

JK: We plan to write proposals to solicit funding to build our headquarters and procure office equipment, supplies, and vehicles. We want to engage stakeholders for proper recognition and support, and work on legislation recognizing LINPAA’s board and providing funding for PAs in the national budget. Through talking to international partners, we hope to prevail on our government to see the reasons to give us the kind of recognition we need and deserve. We must also appeal to partners through proposals to help establish programs for specialist or subspecialist training for us, either in country or out.

JO: If you could talk directly to the PAs of America and the rest of the world, what would you want to tell them about the PAs of Liberia?

JK: The PAs in Liberia are eager to get connected to and seek recognition from our international colleagues. We are striving for a degree-granting program, and so we are asking our international colleagues to help us achieve our goal. We are appealing to international colleagues to buttress our efforts in talking to our government for better recognition. We are in search of assistance from individuals, organizations, or institutions to build our LINPAA headquarters. Our office lacks a vehicle, LINPAA stationery, and other office supplies, and we will highly appreciate however people can help us.

JO: What sort of relationship would you like to see exist between the AAPA and LINPAA?

JK: I would like to see AAPA and LINPAA having a very good relationship in terms of inviting one another to programs, conferences, and other annual activities; having exchange programs to share knowledge and experiences; and engaging our government to ensure that we have better care.

JO: What are some practical ways that the international PA community could support your efforts in Liberia?