‘Children’s health in our hands’

Women opposed to long trips to get children vaccinated in Lilongwe have constructed a clinic in a thick forest that proclaims their unity for the greater good.

The clinic surrounded by a community forest in Kawalika, a tobacco-growing plain near President Lazarus Chakwera’s birthplace of Malembo, personifies a burning desire to bring basic health services closer to where they live.

“We struggle to get the medical services we need. As women who bear the brunt, we know that vaccines are trusted weapons against deadly diseases, but we had to walk over 10 kilometres for a child to get immunised at Malembo Health Centre. We had to do something about it,” says Judith Noah, chairperson of Kawalika Women Care Group.

Every month, the women go door to door encouraging parents to ensure every pregnant woman and child aged below five gets immunised.

Just like that, the women trained in October 2019 by Malawi Health Equity Network (Mhen) in partnership with the Organisation for Sustainable Socio-Economic Development Initiatives (Osedi) have become foot soldiers in the war on diseases prevented by vaccines.

To give every child a shot at a healthy life, Noah and her group also track defaulters, identify gaps slowing immunisation and suggest solutions requiring duty-bearers’ action.

 “For the health unit taking shape, we had a fruitful meeting we held with group village Kawalika and he shared our concerns about the long walks to the nearest health centre. He identified land and asked all 49 villages in his territory to contribute bricks, sand and water for the construction of the clinic,” she says.

The group has since set sights on constructing a house for health surveillance assistant Edward Msyamboza, who travels long distances to vaccinate children in the rural locality.

Kawalika terms the care group “his eyes and ears” in terms of public health. The traditional leader says their constant travels to rally men and women to safeguard children from diseases have increased immunisation rates in his area.

Before the care group supported by Mehn with funding from Gavi, the global vaccine alliance, the Ministry of Health intensfied periodic routine immunisation targeting unimmunised children in the area to catch up.

Kawalika says the clinic taking shape is a monument testifying to their zeal to ensure everyone gets quality health services closer to where they live.

“With this, there is no excuse for the area to have unimmunised children,” he says. “People in my area are united when it comes to development issues and these women personify that determination to improving our health and well-being,” he explains.

The women volunteers are also instrumental in ending a culture of defaecating in the open.

By pursuading every household to construct a latrine, they are eliminating deadly diseases fuelled by poor sanitation and hygiene. According to the Ministry of Health, sanitation-related illnesses account for slightly over half of the outpatients treated in health facilities nationwide.

For the women volunteers, the national immunisation programme mainly sponsored by the Gavi will be fruitless unless communities tackle major causes of preventable diseases.

“Most people understand the importance of vaccines because we talk about it during public gatherings, including funerals. We want every child to grow healthy, but our work will not bear fruit if we neglect common causes of diseases, especially poor sanitation,” says Noah.

While the rota vaccine has dramatically reduced diarrhoea cases, she says children will remain sickly and malnourished unless sanitation and hygiene improve in the area where President Chakwera grew up “without safe water and electricity” in the 1960s.

Currently, Malawians without access to safe water remain at risk of dying from preventable waterborne diseases.

When it rained, run-offs washed human excreta from the contaminated bushes into the unprotected sources of drinking water. Similarly, flies used to swarm from the foul-smelling sites to perch on their food, thereby increasing the risk of disease outbreaks, including cholera.

“Cholera symbolises poor sanitation and hygiene. We were in trouble, but everything changed when we discovered that sanitation is a vital vaccine. The fast-killing diarrhoeal disease has become history,” says Hanna Makoko, a care group member.

She is happy that children are not frequently bedridden by common illnesses.

“For us, this is a reason to smile. We don’t get any pay, but we are only happy when children are healthy,” she says.

Msyamboza says the home visits and follow-ups by the volunteers have enhanced immunisation rates and health-seeking behaviour in the area.

“Previously, the clinics for children below five used to happen in tree shades, where a volunteer would examine the children and refer cases that were beyond his or her ability to Malembo, which is a long distance. These women want this to change,” says the community health worker.

Osedi project officer Florence Madzianyemba says the care groups currently at work in Mzimba, Kasungu, Lilongwe, Blantyre and other districts are accelerating the race for universal access to immunisation.

“Had we established such groups several decades ago, Malawi would not be worried about some children who grow up without receiving vital vaccines. They are dedicated, united and trusted in their cultural setting she says.

 The women worked in neighbouring farms to raise funds for buying iron sheets for the clinic to be equipped with a refrigerator for storing vaccines once construction is complete.

Beverly Bhima, from Mhen, salutes them for taking the health of their children in their hands, setting an example for other communities to follow.