Using local leaders to achieve positive health outcomes

By Yamikani Yapuwa:

It’s 12 midday and the sun is scorching hot in the area of Traditional Authority Lundu in Blantyre district.

Right at the TA’s court, several men and women are gathered listening attentively to what one man flanked by health officials is saying.

It is Lundu himself addressing his people. They are discussing the Covid- Cholera Integrated Campaign which is being championed by United Nations Children Fund (Unicef) together with the Ministry of Health.

According to Lundu, they had a meeting at the DHO’s office where they were told about the Tithetse Cholera campaign as well as reminding them that Covid is still around, hence the need to never relax a bit.

“So we were told to get this message to our GVHs in our respective areas who in turn have to take the same message to village heads and the people.

“That is why we are gathered here today telling them how we should spearhead the campaign in their villages to ensure that we achieve positive outcomes in both,” says Lundu.

Blantyre DHO’s Chief Preventive Health Officer Penjani Chunda says the idea of integrating Covid-19 and cholera awareness and vaccination efforts as well as engagement of local leaders was proposed in at a recent District Environmental Health Officers’ conference.

“We brainstormed on having such type of model which would involve local leaders and Unicef responded very quickly after the appeal from the presidential taskforce.

“The first thing is we looked at it that people in the villages have their leaders so the first entry point in the design of this campaign is to engage the local leaders.

“Generally, when something comes from their local leaders, people believe. So, we have designed it in such a way that it is the leaders that are going to be on the forefront telling people about the messages,” says Chunda.

On the effectiveness of working with local leaders, Lundu says the procedure has proved to be fruitful as evidenced by how households are using chlorine in dispensers placed in all the boreholes in their areas to ensure that water is safe for consumption.

“We know there have been misconceptions about the chlorine dispensers placed at each and every borehole but as local leaders we have been able to dispel such stories and people are now comfortably disinfecting their water right at the borehole after drawing. People were saying there is poison in chlorine.

“Chiefs have a huge role to play to give their people messages on how they can fight against cholera as well as Covid-19,” Lundu says.

Group Village Head Petros Kalanga under TA Lundu says as chiefs, they are monitoring their people by going round the households to ensure that they are following and adhering to the given hygiene practices like taking care of their drinking water, washing hands with soap and cleaning their surroundings.

“We are also making sure that every household has a toilet as well as trash pits for proper disposal of waste.

“Moreover, there is also a good relationship with health officials from Lundu Health Centre. We are doing a lot together,” Kalanga says.

Just as in Blantyre, Senior Chief Chikumbu in Mulanje is also working tirelessly to fight the two pandemics.

She explains that through their engagement with people, they have been able to dispel misconceptions that people have had over the Covid-19 and on cholera vaccines.

“At first people had misconceptions and beliefs that the vaccine is there to reduce population; as such people were refusing to be vaccinated. But after awareness and constant engagement with them, they started changing their attitude towards vaccine and uptake has increased,” says Chikumbu.

Chikumbu says she has been on the forefront to receive both vaccines with her people witnessing.

“I invited health officials here at my house as well as all my village heads to come and people witnessed me and the other chiefs getting the vaccines. Fifty-eight people were vaccinated right there after seeing me being vaccinated.

“I did the same with cholera vaccine, my household was vaccinated and 51 people also received their oral vaccine,” she adds.

Chikumbu also encourage her people to seek medical care once they develop signs and symptoms of cholera and Covid-19.

“We had a church in my area which did not allow its people to go to the hospital. I sent them away to avoid causing harm to others who are willing to get vaccinated as well as seek medical care when sick,” she says.

According to Chunda, the involvement of chiefs has seen a dramatic increase in numbers of people receiving cholera and Covid vaccination.

“We have registered some good numbers in terms of people that have taken the vaccine as well as the households that have been visited with the cholera messages and demonstration of chlorination.

“We have also seen less resistance from people, the same who proved difficult and resisted to take vaccines are now coming forth because their local leaders have been in fore front,” he says.

Chunda notes that the integration has provided a platform where the community has been reached like a one-stop call.

“Cholera numbers have gone down in Blantyre from over hundred cases in day in the past month to less than 30 a day today.

“I know that as we are continuing with the campaign, the messages going everywhere and each and every household visited, chlorination happening everywhere, the numbers will drastically reduce,” he says.

Unicef’s head specialist specialized in maternal and newborn care as well as focal point for non-communicable diseases, Jacqueline Chimkonde also expresses optimism that they will achieve positive outcome since there is a positive reception from people.

“We have the cooperation of all chiefs and we know that by the end of the campaign we will have positive results.

“We are working with chiefs within the communities to make sure that there is positive communication and behavioral change among community members.

“Of course, we are not working on our own but with Ministry of Health and other key partners like World Health Organization who are making sure that the vaccines and the campaign reach to the last mile,” says Chimkonde.—Mana