This paper describes the implementation of curricula for Liberia's first-ever psychiatry training programme in 2019 and the actions of the only two Liberian psychiatrists in the country at the time in developing and executing a first-year postgraduate psychiatry training programme (i.e. residency) with support from international collaborators. It explores cultural differences in training models among collaborators and strategies to synergise them best. It highlights the assessment of trainees’ (residents’) basic knowledge on entry into the programme and how it guided immediate and short-term priority teaching objectives, including integrated training in neuroscience and neurology. The paper describes the strengths and challenges of this approach as well as opportunities for continued growth.

Effective supply chain management is a critical pillar of well-functioning health systems ensuring that medical commodities reach those in need. In Liberia, the national neglected tropical disease (NTD) programme supports health systems strengthening for case management of NTDs. Integration of NTD commodities into the national health system supply chain is central to the integrated approach; however, there is minimal evidence on enablers and barriers. Drawing on qualitative evaluation data, we illustrate that perceived benefits and strengths to integrating NTD commodities into the supply chain include leveraged storage and management capacities capitalized at lower system levels; the political will to integrate based on cost-saving and capacity strengthening potential and positive progress integrating paper-based reporting tools. Challenges remain, specifically the risk of reliance on donor funding; difficulty in accessing commodities due to bureaucratic bottlenecks; lack of inclusion of NTD commodities within electronic data tools and poor coordination leading to an inability to meet demand. Collectively, the negative consequences of ineffective integration of NTD commodities into the supply chain has a detrimental impact on health workers (including community health workers) unable to deliver the quality of care to patients. Trust between affected populations and the health system is compromised when treatments are unavailable.

This article traces histories of the Kru in West Africa from the fifteenth to nineteenth centuries, arguing that divergent identities of fifteenth- to eighteenth-century Kru canoers became unified when that unified identity was necessary for maintaining political, economic, and cultural autonomy during and after the slave trade. In conjunction with earlier multilingual work on the Kru mariners of the nineteenth and twentieth centuries, this article seeks to place the narrative of Kru identity and labor in a larger context of maritime history across the region at large. This article argues that the Kru relied on longstanding maritime traditions from localized groups to capitalize on the need for work and cash in a capitalist economy driven by growing European imperialism. The historical narrative of Kru maritime power shows how local and global identities in Atlantic Africa shifted in response to exploitation, blurring the lines between response and resistance.

Scabies is a parasitic infestation with high global burden. Mass drug administrations (MDAs) are recommended for communities with a scabies prevalence of >10%. Quantitative analyses are needed to demonstrate the likely effectiveness of MDA recommendations. In this study, we developed an agent-based model of scabies transmission calibrated to demographic and epidemiological data from Monrovia. We used this model to compare the effectiveness of MDA scenarios for achieving scabies elimination and reducing scabies burden, as measured by time until recrudescence following delivery of an MDA and disability-adjusted-life-years (DALYs) averted. Our model showed that three rounds of MDA delivered at six-month intervals and reaching 80% of the population could reduce prevalence below 2% for three years following the final round, before recrudescence. When MDAs were followed by increased treatment uptake, prevalence was maintained below 2% indefinitely. Increasing the number of and coverage of MDA rounds increased the probability of achieving elimination and the number of DALYs averted. Our results suggest that acute reduction of scabies prevalence by MDA can support a transition to improved treatment access. This study demonstrates how modelling can be used to estimate the expected impact of MDAs by projecting future epidemiological dynamics and health gains under alternative scenarios.

What was the turning point in the world's largest and deadliest outbreak of the Ebola virus disease? Public health interventions tend to focus on supply-side provision of public health goods. These goods are clinical resources such as medicine or equipment. However, no nation has enough resources to ‘treat’ its way out of a widespread epidemic. Behavioural changes, such as social distancing, are needed too. Behaviours are the demand-side of public health goods and if unaddressed, perpetuate disease transmission. Community-based institutions addressed demand-side barriers during the 2014 Ebola epidemic in Liberia and Sierra Leone. Sixty-seven interviews were conducted in several provinces in Liberia and Sierra Leone. The findings show that information asymmetry and collective action challenges lowered the demand for clinical resources. Community-based institutions intervened via health sensitization and emergency regulations. Therefore, health seeking and public cooperation improved. This research study demonstrates a need to integrate community-led action into public health emergency management.

Historians have correctly interpreted the Gilded Age and Progressive Era as periods in which African Americans faced unpreceded violence, a significant decline in franchise, and the loss of many civil rights. These years however, were far more complex when viewed from the vantage point of African American families who attempted to empower themselves through education, securing employment in white-collar occupations, such as teaching, and working to advance themselves through race betterment groups, including women’s clubs and civil rights organizations. Yet some middle-class Black families like the Stewarts not only rejected white society’s widely held belief of Blacks as racially inferior and incapable of progress. They also embraced migration as a constructive strategy to advance their individual careers and to elevate the race. In an era when the majority of Black workers had minimal literacy and worked unskilled menial jobs, T. McCants Stewart and his children each graduated from college or professional school, worked in white-collar or professional jobs, and paved the way for the next generation. Yet each also understood that migration outside of the Jim Crow South, including to Africa, the U.S. Virgin Islands, and the territory of Hawaii, held the key to their success. Thus, the Stewarts constructed a new vision of freedom and opportunity and believed that even despite the repressive conditions imposed upon Blacks during the Gilded Age and Progressive Era that there was room for growth and an opportunity to advance their careers. Migration, therefore, should be reconsidered as a viable strategy that some Black families adopted to find their place in American society.

Research on Africa’s monetary history has tended to focus on the imposition of colonial currencies while neglecting the monetary upheavals which faced the colonial powers after the collapse of the gold standard during World War I. Gardner profiles three crises—in The Gambia, Kenya, and Liberia—resulting from shifting exchange rates between European currencies during the 1920s and 1930s. These three cases illustrate the degree to which colonial policies struggled to keep up with the economic turmoil affecting metropolitan states and bring Africa into the story of global monetary instability during the interwar period, which is often told only from a European perspective.

Building on 15 months of ethnographic fieldwork, this article draws from military sociology to revisit past portrayals of Liberian former combatant networks and assesses four central assumptions connected to them: that formal wartime command structures continue as informal networks long after the end of the war; that former combatants are united by a wartime identity and form a community to an extent separated from the surrounding society; that wartime experiences have had a major disciplining effect on former combatants; and that former combatants are both good mobilisers and easy to mobilise in elections and armed conflict alike. Finding limited evidence close to two decades after the end of war to support these assumptions, I ultimately ask whether it would be more productive to both theory and Liberians alike to widen investigation from former combatants to structural issues that affect many more in the country.

In the early nineteenth century a centralized political entity, the Galinhas kingdom, emerged in southernmost Sierra Leone. Based on sources from Cuban, British, American, Spanish, and Sierra Leonean archives, this article examines the factors accounting for the emergence and consolidation of Galinhas. I argue that the postabolitionist (1808) redeployment of North Atlantic slave trading actors, networks, routes, and spaces, particularly the connection with Cuba and resources from the island, created the conditions for Galinhas's commercial growth and the centralization of its political power. I then problematize the relationship between warfare, the Atlantic slave trade, and state making. During the foundation of a predatory state, before a slaving and political frontier existed, wars were detrimental to trade. When warfare and commerce — or any social activity — coexisted in the same physical space, the interdependent balance between them, which supported the slave trade itself, was disrupted. After the end of the war, political stability boosted slave trading operations.