By Sagita Adesywi, ChildFund Indonesia
In this blog post, we meet Nuren, a woman who worked for REACH, a project in Indonesia run by ChildFund and UNICEF that promoted health care of pregnant women and young children to help lower the infant mortality rate. REACH ended in December 2013, but the health-care training continues to make a big difference in these communities.
Nuren works in East Nusa Tenggara, training community health volunteers (known as cadres) and families about keeping infants and young children healthy and safe. Beginning in 2011, she traveled to homes and clinics in remote villages, where women traditionally have given birth without access to prenatal care or emergency assistance when it’s needed.
Most health cadres come from non-medical backgrounds, so they received regular support and monitoring during the project’s duration. Nuren’s routine visits helped to remind the volunteers how to provide basic health services, and she checked the amount of medical supplies to make sure health posts were fully stocked. Some visits took hours to accomplish.
“When we had two new cadres in Sotual, we went there for a monitoring visit,” Nuren recalls. “We left the city at dawn to reach Nuapin village. We then walked for three hours through the forest from Nuapin village to finally reach Sotual. The return trip was more difficult, because it was uphill. We took a shortcut, and I almost fell off a cliff on the way back.
“The wife of the health cadre gave us pineapples, but unfortunately, none of us carried a knife. We walked all the way up the hill to our car before we saw an old man with a big dagger to help us cut and eat the pineapples. We weren’t even wondering if the dagger was clean or not, we were just so thirsty from the long walk!”
Upon reaching Nuapin, the group stopped by a health center. “The health worker asked where we came from. He was surprised when we told him that we had just visited our health cadres in Sotual, since they had never gone there before,” Nuren says. “With basic medical supplies in such a remote area and limited access, the health cadres are able to provide basic health care for young children. Seeing this is really rewarding for me.”
In 2011, the REACH project covered 40 villages and 14 health centers. By January 2013, it had expanded to 49 villages and 15 health centers, with more than 200 trained health cadres. Since the project ended, Nuren has continued her work with ChildFund in the eastern program areas.
One of the biggest challenges in the project area is the traditional activity called Sei, in which firewood is burned underneath a platform and mattress that a mother and her newborn lie on in a room with very limited ventilation, sometimes as long as a month. It is believed that this practice will make them strong and healthy, but in fact, it contributes to many respiratory problems. Another challenge is that the community’s water source is far away.
Nuren says that although the region continues to face some hardships, “I see the changes happening in the community. People now have a reasonable access to health services. This really helps in obtaining basic health care in critical situations, especially for young children who suffer fevers or stomach aches, as malaria and diarrhea are common in the area.
“I have seen the community is really enthusiastic about the health services they have in their neighborhood. Even though they know the health cadres are trained specifically to help young children, people now choose to go to the health cadres instead of the traditional healer when they are sick,” she adds. “People are also more aware of health issues. They learned not only to be aware of the common symptoms of diseases, but also how to prevent contracting them with healthy living habits.”
by LaTasha Chambers, Communications Associate
Respect for different cultures is so important, and it’s a value I constantly teach to my son. Working in a diverse environment is important to me because it’s challenging to “fit in” to a one-size-fits-all organization — our hair textures are different, our religious faiths may require us to wear a bindi or head covering or our attire may be an ethnic print. The bottom line is that although professionalism should be exhibited in all we do here at ChildFund, our unique identities encourage dialogue, show pride in who we are as individuals and represent the diverse global community we serve.
Recently, Mamadou Diagne and Emile Namsemon N’Koa from ChildFund Senegal visited our headquarters to share the wonderful community health work we are doing there. An African-American woman who happened to be visiting our office that day asked, “How does ChildFund go into these countries and expect change without disrespecting the culture?” That was a million-dollar question I had also planned to ask sooner than later, now that I’m a member of the ChildFund staff.
Diagne shared, in his native French, that ChildFund does not go into a community and force what it believes on a group of people who have long-held traditions, some of which are unhealthy like female genital cutting. He explained that you don’t break traditions with a hammer; you simply show community leaders ways that will improve the overall health of an entire community.
His hammer analogy was so moving to me. I couldn’t agree more. Relationships are not built by beating people down. Yes, many of us are passionate and unyielding in our efforts to eradicate poverty and give children a fighting chance in this world. But the fact that ChildFund engages in dialogue at a grassroots level that fosters new, healthier practices and traditions is the best way to create long-term change.
And that’s exactly what we want.
Over the course of January’s 31 days, we’re making a blog stop in each country where we serve children, thanks to the generous support of our sponsors and donors. Today we learn about ChildFund’s community health grant in Senegal.
When ChildFund began working in Senegal in 1985, much of the country lacked access to adequate health care, particularly mothers and children under age 5. As a result, many young mothers were dying in childbirth and children were succumbing to malaria, diarrhea and undernutrition – all preventable conditions.
In most cases, doctors and health posts are miles and miles away, out of reach. Although the country has a rich resource in its traditional medicine practitioners (often the village grandmothers), these lay health care providers worked outside of the state health care system, with no formal training. If a mother or child’s health condition became life-threatening, the family and the community would have nowhere else to turn for help.
Today, health care access in Senegal is vastly improved, says Emile Namesemon N’Koa, ChildFund’s national director in Senegal. With grant funding from the U.S. International Development Agency (USAID) and a consortium of partners, ChildFund is implementing a large-scale community health project. Mamadou Diagne, ChildFund Senegal’s national health coordinator, is overseeing operations. He points out that by 2016, Programme Santé Santé Communautaire (PSSC) will have reached 12.3 million people (almost the entire country), providing community-based health huts and outreach sites to both rural and urban populations.
In addition to providing day-to-day maternal and child health care, the project will also address neglected tropical diseases and work to educate communities about the health dangers inherent in the cultural practice of female genital cutting.
ChildFund has long recognized the vital role of grandmothers and godmothers who assist and mentor younger women in their communities. Another key component in ChildFund’s strategy is involving and training community health volunteers and traditional birth attendants. By providing these caregivers with additional health information and formal linkages to a growing network of health posts, ChildFund Senegal is seeking to weave them – and the entire community – into the very fabric of the country’s health care system.
As Mamadou notes, “Through the synergy of cooperation with the community and other organizations at work in Senegal, we’re finding solutions to the problems we face.”
Reporting by ChildFund Senegal
ChildFund is working closely with USAID and local partners to improve community health in Senegal, with a special focus on mothers and children. At a regional conference on reproductive health organized by USAID in late July, Senegal won second place for its USAID-funded health program. Awa Diagne (fifth from left in photo), a trained birth attendant supported by ChildFund under the USAID program, made the conference presentation.
In Senegal, ChildFund leads a consortium of NGOs including World Vision, Plan International, Catholic Relief Services, Africare and Counterpart International in implementing the Community Health component of this program. ChildFund helped survey community members to gain their insight and support for future family health projects.
Congratulations to ChildFund’s team in Senegal who contributed to this joint effort. And to Madagascar, first-place winner, and Nigeria, which placed third.