Today we set out early to visit Kalangba, a much more rural clinic than the ones we have previously visited. We first spoke to a nurse in charge who has been working at the clinic since 2008. She told us that her clinic has a major shortage of medication, also that they hardly do any outreach programs with the catchment villages because of the far distance the clinic is to the neighboring communities. She stated that the closest village is 15 miles away. Women often deliver babies on the way to traveling to the clinic because they don’t know the age of gestation, and only start to go to the clinic when they are in pain. The clinic delivers about 20 babies a month, and the most popular month is January (during the dry season). She currently manages 24 CHWs and gives refresher trainings to them every 3 months to make sure they are performing the correct job duties. She was very pleased with our venture and thought of it as a way to motivate CHWs to do work.
pictured: the nurse in charge
Later, we met with 4 CHWS. Three of them have been working since 2013, and the other since 2017. They all said they have trouble convincing community members that they are there to help and serve them. A lot don’t understand the reason for visitations and are shy to revel symptoms. The most common illnesses they see are malaria, pneumonia, diarrhea and malnutrition. All of them have to pay for their own phone calls to clinics for patients and hospitals, and wanted to have access to the freeline service. When we told them about our venture, they said sensitization and community engagement will be crucial to gain peoples trust and willingness to get screened.
pictured: the four CHWs
After, we drove to M’bunduuka to talk to CHWs. However when we got there, the CHO told us that they all left because we took too long to travel to meet them. Our interview at Kalangba took too long unfortunately.
We still proceeded to interview the CHO, who has been working at this clinic for 3 years. He was promoted about a year ago, and still has not received any change in his payroll.
He says he could be working in the city making a lot more (due to his education), but he cares deeply about the health and wellbeing of his community. He says most of the nurses in the clinic are not even on payroll.
pictured: the outside of the clinic
He told us that there is currently no outreach programs because of the lack of mobility. Because of no outreach programs and far reaching distances, very few people come to his clinic. He aims to have 22 people visit a month, but he’s only been getting about 15. He currently advises 12 CHWs and 1 peer supervisor. He hasn’t given a CHW training or skills refresher in over a year, and so some of the CHWs are not performing their job duties correctly and referring patients. He says he can’t give the training because of the lack of resources to teach and transport people.
One of the challenges the clinic faces is a lack of supplies. In the labor and delivery room, he said they don’t have forceps or scissors or any type of delivery kit. He said that almost all women come in to the clinic to give birth because if they give birth at home, the government fines them.
Overall, he really liked the idea of our venture and will pass on the message to his CHWs the next time they meet (25th of every month).
pictured: the CHO