How training of health-workers will reduce mortality in WASSA IDPs camp

For many decades, Community-based health workers (CHW) have been playing key roles in improving the health status of people especially women and children in rural and remote areas, IDPs where skilled Doctors, pharmacists, and midwives are absent. In this report, DOOSUUR IWAMBE X- rayed how training of CHW will reduce high mortality in WASSA IDPs camp.

24- year –old Mrs Monica Yunusa is one of the thousands of people who fled from Bama Local Government Area of Borno State, she was dislodged from her ancestral home in 2017 when the Boko Haram insurgents invaded their community burning down houses and killing people in the process.

Mrs Yunusa, her husband and three children have been living in WASSA Internally Displaced Persons Camp in WASSA community, a suburb in the Federal Capital Territory for about six years now.

She told the Daily Times that it’s been years of torture for them at the camp especially, in cases of health emergencies where they have to walk long distance before they can get help.

‘’I have been living in this camp since 2017 with my husband and three children. My husband does menial jobs and we use the proceeds of whatever he makes every day to take care of ourselves.

‘’On my part, I farm groundnut, corn and beans during the raining season. Sometime last year, my last baby almost died. She took ill and none of us knew what the problem was. It was after we gave her some herbs to no avail that someone advised us to take her to the Primary Health-Care facility which is about meters away from here that she was administered some medication.

‘’She was placed under injection for a few weeks and thereafter, she got herself back’’, Yunusa said.

The story of 20-year-old Mrs Ruth Paul is not very different from that of Yunusa who was also dislodged from ancestral home in Gwoza Local Government Area of Borno state.

Mrs Paul who lost her 2-year old daughter to high fever moved to WASSA IDPs camp in 2018 following attack by the insurgents where she was living with her family.

She said, ‘’When my daughter took ill, we didn’t know what the issue was from the beginning. She refused to eat for two days. She became frail and weak. I was helpless until one of my neighbour here advised me to take her to Waru Primary Health care facility around here. On reaching there, they could not attend to her because the crowd there was much. I moved to kabusa, it was the same story and finally to Apo where she later died, Ruth said.

Geoffery Tufur, leader of WASSA IDPs said, the former Speaker of the House of Representatives, Yakubu Dogara, had in 2016 constructed a mobile clinic, Vantage Mobile Clinic, with the aim of providing quick and affordable healthcare in the camp.

He however disclosed that the clinic stop functioning as a result of persistent issues that could not be fixed. ‘’It was a great relief for us when the clinic was functioning because issues like childbirth, malaria and other immediate health issues were handled. The case is however different not because we have to walk a very long distance to the clinic around here.

‘’Sometimes, we resort to traditional care, using herbs where the need arise’’, Tufur said.

Like WASSA several other IDPs scattered across the country are going through similar plight. For instance, at the IDPs camp at Otese located along Makurdi-Laafia federal highway in Benue State, the moment visitors drive into the camp, the women rush in their numbers and cluster the vehicle awaiting possible gifts or relief materials.

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Unfortunately for them, government, donors and non-governmental organizations have left them to their fate.

According to the 25-year-old, Mbasen Ulam, she lost her eight months old pregnancy after she was rushed to the hospital unconscious with a dead baby in her womb.

Mrs Ulam told this reporter that the hardships and trauma she underwent in the camp were responsible for her miscarriage.

“My problem is that the time I was living together with my husband here, I was pregnant and it was time for me give birth, but I couldn’t and I don’t know what was the problem. But when it was exactly 8 months, I began to experience blood coming out of me regularly. Then I told him to take me to the hospital and he took me there. The Doctor said the child died. I don’t know what happened because I was unconscious when they took me, and I can only hear the story of how I was revived’’, she said.

Power of community health workers in caring for IDPs

Gaps in health systems are coming into stark relief Particularly vulnerable are those in the IDPs, underserved and low-resource communities who experience fragmented access to health care.

The World Health Organization, WHO, has identified community health workers, or CHWs, as a key resource to providing basic health services for underserved areas, as well as health education.

Trained and supported health workers are extensions of both their communities and the health systems. More than 70% of these health workers are women, a much larger share of the workforce than other sectors.

They are well-positioned to deliver patient-centered, personalized, and efficient care for the underserved, improving health outcomes, and economic development of their communities.

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They support patients to navigate barriers to care including but beyond pharmaco-therapies, including transportation, food security, and lifestyle modifications. They are often equipped with digital information and tools such as mobile electrocardiogram.

These models may be more relevant than ever as COVID-19 will force us to innovate and extend services beyond clinical walls.

According to Dr Theresa Agbolahor, a neurologist at Gwagwada specialist hospital HWs have a critical role to play in the prevention, detection, and response to immediate health needs..

She said; ‘’they must be well trained, supervised, equipped, protected, and compensated. For example, they can ensure their patients and community members practice critical behaviors to prevent infection, including hand-washing and maintaining a clean environment’’.

Dr Agbolahor who spoke exclusively with the Daily Times further stressed the need for government and partners to support CHWs by equipping them with skills, and tools — such as digital blood pressure machines and glucometers to use during their in-home visits and community settings.

What NPHCDA is doing

The Executive Director (ED) of National Primary Healthcare Development Agency (NPHCDA), Dr Faisal Shuaib, said the agency has initiated Community Health Influencers and Promoters of Health Services, CHIPS, an innovation he said was design to scale up and harmonise different community health programmes.

The NPHCDA boss who spoke during an exclusive interview with the Daily Times was reacting to what the agency is doing to ensure that community’s health workers are trained and equipped in communities to handle emergency cases.

He said, ‘’we are also introducing new things that can improve community health programme.

These workers are women that have at least elementary school education who will be selected in their wards. We are looking at having 10 women per ward that will be trained for six months to treat simple conditions, like a child who gets injured after playing football can get first aid treatment.

‘’If a child has diarrhoea, this kind of women will teach the parent or guardian how to do Oral Rehydration Solution and then give ORS to the parent. If a woman delivers a baby, they will encourage her to go for routine immunisation. They will also encourage pregnant women to visit health facilities for antenatal activities to prevent maternal and child mortality in such communities.

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Since they have been visiting health facilities for antenatal, when the time for delivery comes it will be easy for them to go to the health centre. They will also promote hygiene, encourage environmental sanitation.

‘’Community health workers make huge difference in health outcome. The reason why it has not been in existence in the past is because people say it is too expensive. But is it more expensive than the number of women who die in our communities? This is also to encourage women who like to give health talks in communities. Some of them are retired nurses, while some are young people, if they are trained, they see it as an honour to go from one house to another talking to their community members, encouraging them and they may do it for nothing’’.