By Vincent Khonje:
Filona Tafatatha, 36, of Tafatatha Village, Traditional Authority (T/A) Simlemba in Kasungu District, will never forget the day she lost her son on their way to a health centre.
Two years ago, Tafatatha’s two-year-old son fell ill and needed medical attention.
“Because of the illness, my son lost consciousness. At 8 o’clock in the morning, we set off for Ofesi Health Centre to seek medical service,” Tafatatha recalls.
The health facility is 15 kilometres away from his village. Gogode Health Centre, some nine kilometres away, would be an ideal alternative but it can only be reached through a bridge across Dwangwa River. The bridge is not there.
The district hospital is far away from the two health facilities and cannot be accessed without suffering some financial consequences.
As fate would have it, in Tafatatha’s case, he was sent back to the village and the little child succumbed to the illness.
“I lost my child before reaching the health centre,” Tafatatha laments.
People from her village and those surrounding it face challenges to access quality healthcare services.
Poor road conditions and lack of reliable means of transport mean that the villagers suffer a lot more just to access health services, defeating the concept of Universal Health Coverage (UHC).
The World Health Organisation (WHO) says UHC exists when all people receive quality health services they need without suffering financial hardships.
One element of UHC is protection from financial risk associated with seeking health services. But Tafatatha and others are already facing this problem.
For children, especially under the age of five, there is a very big problem.
To help ease some of these problems, the Ministry of Health and Population introduced Integrated Community Case Management (ICCM).
Under ICCM, Health Surveillance Assistants (HSAs) treat cases especially malaria, pneumonia and diarrhoea mostly in under-five children right in their villages while severe cases are referred to health centres and hospitals.
For the HSAs to discharge their duties well, there is need for shelter to work and dwell in.
Dickens Chima, an HSA, says where there are no structures like a village clinic and a good house for the health worker, it is difficult to work.
“Most HSAs shun such areas and people suffer as they cover long distances to get help,” Chima says.
In some areas schools or churches are used but in others the communities construct village clinics. Usually they are just shelters built with mud and roofed with grass.
However, where communities show willingness to have these structures, organisations come in to help.
So far, child centred organisation Plan Malawi has moved in to help construct and renovate five village clinics and five HSAs’ houses in 2018.
Villages in Kasungu north’s Mneni, Nthira, Kawiruwiru, Kavikula and Kantomphola areas have benefitted from Plan Malawi’s initiative.
Despite the organisation pumping K57 million for these durable structures, people’s willingness to participate in the projects was key.
“The community helped to have a village clinic here at Kantomphola,” Chima says. “We gathered the bricks and sand and women provided water for construction.”
Subsequently, the village clinics are reaching out to 4,100 children in Kasungu North apart from adults who also get help there.
For Kantomphola, which is very close to where Tafatatha stays, apart from offering services to under-five children, outreach services include family planning, antenatal clinic and HIV testing and counselling.
Group Village Head Khungwa of T/A Simlemba hails village heads for being development-conscious.
One of his village heads had to give up land where he was farming to pave way for the construction of a village clinic.
“The village heads demonstrated a good spirit by leading the communities to participate in the development. Where there is life, there is need for health services,” he says.
Speaking during the handover ceremony of the village clinics recently, Plan Malawi Country Director, Daniel Muchena was visibly concerned about the long distance people cover to get to nearest health facilities.
However, his impression on community participation and involvement in the whole project was overt.
“Plan Malawi provided the money for the project but it was you who provided more. There are millions of kwachas coming from the community in the bricks, sand, water and, most of all, your commitment and time,” Muchena said.
To Kasungu District Health Office (DHO), the clinics have come just at the right time as they are billed to enhance quality health service delivery in the district.
The vastly cropped district has many hard-to-reach areas due to poor road network which makes it impossible to reach out to many people with health services.
District Environmental Health Officer, Ben Mitochi, believes the spirit of the communities in taking an active role in the construction of the clinics will open up more opportunities.
However, for the clinics to thrive, they need necessary equipment and support, and the DHO, through Mitochi, assures communities that the new clinics will not be white elephants.
Plan Malawi is still constructing more village clinics in other areas. It is also supporting Kasungu DHO conduct outreach clinics in 10 areas in Kasungu North.
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