Stories: Children, Communities, Futures

Oumy, a mother of six from rural Senegal, rests easier these days because she can now stay ahead of her children’s health. Four years ago, a child’s illness could be terrifying.

Back then, if it wasn`t one thing, it was another: The baby might have diarrhea while the 3-year-old spiked a fever. The district-level government health post, nearly 3km away, might as well have been the moon when Oumy imagined making the trek with baby Thiawdo tied onto her back, and feverish Babacar in her arms. With her husband away seeking work, Oumy would have to leave her other children in the care of Mohammed, her eldest child.

Oumy is relieved to have left such experiences behind, ever since a volunteer-run community health hut became active in her village.

Part of the nationwide Community Health component of USAID`s current Health Program, Oumy`s health hut is one of 2,553 like it, and 1,674 outreach sites (for areas where there are no health huts) throughout Senegal`s 14 regions.

Now, Oumy says, “Whenever the children are sick, I don`t delay. I`ve learned to detect symptoms of things like malaria. When a child has a fever, I take them straight to the health hut.”

ChildFund is leading a consortium of organisations to carry out the project, and is collaborating with Senegal`s government to ensure health huts and outreach sites link more than 9 million people, 70 percent of the country`s population, especially those in the most remote areas to Senegal`s health system.

Like all of the project`s health huts, the one in Oumy`s community offers much more than basic pediatric care and management of common illnesses like malaria, diarrhea and pneumonia. With 17,000 trained community health workers (CHWs) supporting this nationwide project, assistance on maternal and newborn health, birth spacing, and nutrition monitoring is also being provided.

CHWs know the danger signs that require referring cases to the government health post for professional care. Nurses from the health posts also visit the communities monthly to provide immunisations, basic treatments and educational outreach.

Additionally, trained traditional birth attendants, known as matrones, work with pregnant women to provide prenatal care and promote safe delivery in a health centre setting, rather than at home. Other community volunteers, known as relais, also carry the messages of the health hut to their neighbours, teaching them how to protect themselves from disease and identify symptoms when they arise.

In each village, a CHW also works with a complement of grandmothers who leverage their leadership roles to provide special support and wisdom to young mothers, promoting healthy practices and prevention techniques. One of the grandmothers, Maimouna, remembers a case from before the health hut opened a woman who hid her out-of-wedlock pregnancy and did not seek prenatal care. Without any support, she passed away from complications. “But since the health hut was created in the village,” says Maimouna, “we know how to prevent these cases. We carry out home visits, we educate people, and we advise them about the services that are available to them.”

Even men, who in rural Senegal traditionally consider family health to be a woman`s concern, have been encouraging their families to make use of the health hut`s services. When Omar, a father of five, kept hearing from other men in his community about their families` improved health thanks to the health hut, he took notice. He had been worried for some time about his wife, who had experienced postpartum hemorrhage with every delivery, and he finally brought her in for support. Now, with basic care and information, Omar`s family is healthier and more secure.

A recent independent evaluation found that the project has significantly strengthened access to health care in underserved communities throughout the country. In turn, government health posts` loads have been lightened, and Senegal`s nationwide health system is working better overall. Moving forward, the project hopes to transfer the ownership and operation of health huts to their communities.

Diagnosing tuberculosis (TB) in two remote parts of Central Province has been made simpler with the donation of two microscopes by ChildFund Papua New Guinea.

The donation of the A$2,400 Olympus CX23 microscopes to the Inauai and Aigevairu Health Centres will speed up the delivery of TB results from sputum tests, and forms part of ChildFund`s Healthy Communities for Healthy Children Program.

In the past, sputum was collected from patients and then transported to Port Moresby for smear microscopy at the Central Public Health Laboratory (CPHL), or Bereina Health Centre. This is because the two local Health Centres were not equipped for TB testing and analysis. It would take several days before the results could be sent back to local health workers.

“The donation has been a blessing. I am thankful to ChildFund PNG for listening to our need and for helping us. This microscope has eased our workload and provides quick results for the clients. With this microscope, I will no long waste time to travel for smear tests and use those hours to save more lives,” said Francis Aupu, Lab Technician at Aigevairu Health Centre.

“Since the announcement of the availability of the testing services, Agevairu Health Centre recorded 87 clients between the ages of 11 – 70 being tested, between September 2015 and April 2016,” said Olive Oa, ChildFund PNG Senior Program Officer for Health. From this, she added that nine cases of TB have been confirmed.

Inauai Health Centre received their microscope in April and have already commenced testing for patients.

CPHL Medical Scientist, Jennifer Banamu, said: “CPHL is responsible to purchase such equipment for Health Centres in the country, but currently, there are no funds available. We have asked the Provincial Health Departments to support their districts. CPHL appreciates ChildFund`s effort with this much-needed donation for the two Health Centres.”

Despite TB testing now being available at two local Health Centres, many patients from rural communities still face difficulty accessing support. The issue of having to walk for hours or drift on banana rafts down rivers still remains; and in more severe cases, patients may have to be carried on stretchers by men. This is due to a lack of road links and deteriorating road conditions in Central Province.