Following Community Health Workers
March 25, 2011 § Leave a comment
Last year around this time, the Wellness Program, with the help of an experienced Volunteer in Mission (VIM) team, began teaching Community Health Workers (CHW). CHWs are members of a community who are chosen by that community or the local health committee, to provide basic health and medical care to their community (see Wikepedia-community health workers). Most CHWs receive little to no salary. Some may receive what we call ‘motivation money’- a small amount of money that hopefully does what its name implies-from the sell of medications at the facility. This is the only health care most villagers receive and often it runs out of medicines and supplies.
The Wellness staff has followed the 2010 class of health workers over the past year, having a meeting with them in February when our VIM team returned to teach week one of the three week course for our 2011 class.
For me, it has been interesting getting to know these CHWs and following their progress over the last year. The following descriptions are the bits of information I found interesting about the workers, their communities, and in some cases, their families.
Fatou, Mariana, and Moussa are from Soulouf, population 3,000. They work at Soulouf’s health house which Mariana’s grandmother has managed for the last 20 years. All three are bright, attractive, and personable young adults. Moussa teaches at the community’s primary school but still manages to find time to work at the health house.
Mbayang is from a surburb of Dakar and sells tickets for RN consultations, and collects money from the sell of medications at the local health post. This is a much larger and much busier health post unlike some of the other CHW’s small village health house. She describes how her post has two RNs, one is paid, and the other is a volunteer who also lives at the health post. She is concerned the post has little money to buy more medications and most people who visit cannot afford to pay so they often get free services.
Mamadou from Makla Khay is a tall slim son of a Marabout and father of four. He speaks some English. The health house in that village is in the process of being built so Mamadou is functioning independently as a CHW. When he runs out of medications he buys them at the pharmacy and sells them to the people he sees. He took a patient to the hospital after completing a written assessment and the doctor was impressed and got him to hang around and work in the ER some. He wanted Mamadou to train more in the hospital but since he could not pay him Mamadou declined. When Mamadou runs out of money to run his household he travels to Dakar and drives a Taxi for two weeks then goes back to his village. I think our friend is a real businessman. When encouraged to go to nursing school and he said he planned to.
Antoine from Thieo, a Catholic community, is also a bright young man. He has his own apartment in the family compound. The day I visited he took me to the local health house to meet the CHW/Birth Attendant who has managed the care for the community for the last 12 years. It was neat and clean with a sparsely furnished birthing room. Antoine had just taken a bookkeeping job for the local cement factory, therefore, he did not know how much he would be able to work as a CHW.
Aissatou is from the village of Sebiponty, population 4000. She is a pretty and bright girl who lives in her family’s compound with her 4-year-old son. Her brother and sister and their families also live there. Her brother has studied agriculture in the US for six months the last three years and speaks very good English. Her father has a good job at a nearby cement factory. Aissatou has taken a leadership role, having several CHW meetings at her house and working with the local CHW organization. She helps the staff of the Sebiponty Health Post and she also works independently. When introduced to the RN who manages the post and mentors Aissatou, I noticed an adequate supply of medications and equipment and a clean, friendly environment.
There are several other CHWs, some successful in their new role, others not as much. The literature reports the importance of the new CHWs receiving encouragement and support from their trainers and villages. We will continue to follow these and the 2011 class as long as needed.