Underserved villagers set health agenda

Long walk to healthcare facilities keep haunting remote populations in the country. Mzimba is vast and health centres remain few and far apart.

“Rural Malawians risk dying of treatable conditions, including complications caused by pregnancies, as health centres are far away,” says group village head (GHV) Samuel Makwakwa of Ezweleni in the district.

Amid universal access to healthcare services, Ezweleni residents—who travel over five kilometres to get to Mpherembe Health Centre—no longer want government to do everything for them.

Rather, they ask:  What can we do to ensure access to quality services?

In search for life-changing actions, the rural dwellers have built a village clinic complete with a house for a health surveillance assistant (HSA)

“We feel re-energised to do all we can to bring health services closer,” the village leader says.

Not only do the villagers envisage the new clinic fledging into a health centre; they want every GVH to construct one.

This zeal is clear in the villagers putting together thousands of bricks, bucketfuls of sand and heaps of quarry stones; households contributing money for cement, doors, windows and iron sheets; and selfless artisans using their bricklaying and carpentry skills for public good.

The facility taking shape is a monument of a journey with Foundation for Children’s Rights (FCR).

For three years, the non-governmental organisation, with funding from Simav, has been facilitating trainings on how community leaders can take part in eliminating the gaps that often deny women and children the right to healthy lives.

“We settled for Mzimba North because most the health centres are hard to reach. The clinic under construction shows the target communities really understand and own the change process,” FCR project manager Kondwani Botha says.

According to Botha, FCR only facilitated the trainings and it is up to the locals to decide how to use the information gained.

“Information is power. FCR has opened our eyes and it is up to us to decide how to lessen the problems haunting us and to lobby for necessary interventions,” says Health Advisory Committee (HAC) chairperson  Solomon Mithi.

The clinic targets nearly 4 500 people in 29 villages under Makwakwa.

Health surveillance assistant Kumbukani Nyirenda, who lived in a leaky house before taking refuge in a teacher’s house, serves this overwhelming figure though the Ministry of Health recommends a population of 1 000 for an HSA.

“Apart  from the peace of mind that comes with decent housing, the clinic means we will stop conducting clinics under a tree where vital services are sometimes disrupted by rain,” the community health worker explains.

Thanks to the sweeping tide of awareness, more HSA houses have taken shape at Myobe,Thimalala, Mphimbi and Msikiya.

But the buildings are just some of many signs of change testifying to FCR’s walk with the communities surrounding Engucwini, Mtwalo and Mpherembe health centres.

Many villagers have started demanding quality health services, health workers say.

“With awareness, many people rush to hospital when they are sick. Previously, there was a risky tendency of seeking medical assistance when they were either critically ill or almost dying,” Esther Kajadu-Zulu, the nurse in charge of Engucwini Health facility, says.

The race to health facilities is discernible among pregnant women.

“Previously, many women used to die giving birth at home or at the hands of traditional birth attendants. Now they report early for checkups and delivery. Interestingly, most of them come with their husbands,” Zulu indicates.

Up to 14 in an average of 20 women at Engucwini’s maternity ward are escorted by their partners.

Funny Lackson, a 33-year-old who lost her second baby due to delays to seek medical assistance, is one of them.

“Most babies bear the father’s surname because men are part of every pregnancy. It feels good to walk together as we struggle for safe motherhood,” the woman says

She walked about eight kilometres from Madise to deliver her fourth baby at Engucwini.

Male involvement in maternal issues helps men understand what women go through and the health tips they get from health workforce, men say.

“Being involved has put my wife and I on the same page. We even settled for family planning after realising that having babies in quick succession puts her life at risk,”  Jimmy Kamoza Lungu indicates.

In Ezondweni, where teen pregnancies account for up to seven in 10 women queing for maternal services at Mtwalo Health Centre, nurse and midwife Ernest Maunganya spoke of boys and girls accessing sexual and reproductive health services, including contraceptive.

Maunganya said: “The youth, who mostly drop out of school due to early marriages and teen pregnancies, learn social skills in schools.

“Apart from setting aside a youth-friendly corner where boys and girls access information and contraceptives,  health workers visit the youth where they meet, including schools, to talk about changes related to puberty and how to prevent risky sexual encounters, including unwanted pregnancies, sexually transmitted diseases and HIV and Aids.”

HAC, which benefited from FCR trainings along with area and village development (ADCs) committees, are working with health personnel to ensure health centres have adequate drugs and other medical supplies as the demand increases.

“The HACs are playing a vital role in strengthening the relationship between service users and health service providers. They have also help record the health supplies on arrival for transparency and accountability,” Mpherembe Health Centre in-charge Kondwani Kandiero says.

They also lobby the district health office (DHO) to ensure the amount drugs and medical supplies correspond with population growth.

“Health centres are nothing without drugs. They will only push people to backtrack from hurrying to hospital. Fortunately, the DHO is understands our cries,” Mpherembe HAC chairperson Titus Jere says.

The FCR initiative folded up in 2015, but Mpherembe ADC chairperson Amin Lungu says the locals will go flat out to make sure communities walk no more than five kilometres to access clinical services.

As the journey continues, FCR executive director says: “We set out to empower people to take part in improving the wellbeing of children, women and the youth, but communities are now taking the lead.” n