Last week, we brought you the first blog in our series about Global Brigades’ ongoing work in Ghana, despite the absence of volunteers. Part I focused on the struggle to bring clean water to Ekumfi District. But without brigades, how do remote communities access medical care?
Part II: When Health Care Stops Arriving
Health posts dot the landscape of Ekumfi District. The Ghanaian government has established a system of Community-Based Health Planning and Services (CHPS) centers, training and placing health care professionals in remote communities to provide medical care.
It’s a step in the right direction to attend to the country’s most underserved, but many people who need care remain out of reach. In Ekumfi, nine CHPS facilities and two health centers serve 55 communities. Community members in Ekumfi Abor need only walk 15 minutes to the CHPS in neighboring community Ekumfi Eyisam. But other communities, like Ekumfi Adansimaim, are still 45 minutes or more from their CHPS – a distance that can discourage people from seeking care.
As a result, Global Brigades mobile clinics continued to fill a need in communities that could not easily access a CHPS. When brigades to Ghana stopped, so did the medicine, personnel, and care that many people in Ekumfi had come to depend on. Mobile clinics became impossible to execute.
But common diseases like malaria and cholera continue whether or not someone can see a doctor.
Faced with this reality, Global Brigades Ghana had to devise another way to reach Ekumfi’s remotest communities with health care. Their solution: Community Health Volunteers.
Global Brigades Ghana now deploys trained Community Health Volunteers into communities to monitor community members’ health and provide basic services. If a Community Health Volunteer identifies a patient who needs treatment, he or she refers the patient to an Ekumfi Health Directorate community health post. These posts are smaller health centers located throughout the district, staffed by a nurse and sometimes a midwife. The new link between Community Health Volunteers and Ekumfi health posts ensures that a community member with an illness or injury does not go untreated.
As it did with Water Brigades, establishing a strong partnership proved crucial to the success of GB Ghana’s Community Health Volunteer initiative. In early 2015, the team signed an agreement with the Ekumfi District Health Directorate to facilitate training the Community Health Volunteers.
By February 2015, 26 volunteers across 8 communities had been trained. The Director of the Health Directorate, Ekumfi Health District’s Public Health Director, GB doctors and staff, and local district health center nurses all came together to lead the training.
“Animals do not need passports to roam in communities. They step on feces and [enter homes], transferring diseases back to families.”
Community Health Volunteers are not only addressing Ekumfi’s health care issues, they’re also stopping disease before it starts. Volunteers become a health resource for communities throughout the year, educating community members on health practices to reduce the occurrence of disease.
Recently, Community Health Volunteers have focused heavily on spreading awareness about the harm of open defecation. The practice remains a concern in rural communities, where farmers interact with domestic animals that wander freely around local villages.
“Animals don’t need passports to roam in communities,”says James Oppong, Water, Engineering, and Public Health Program Lead for Global Brigades Ghana. “They step on feces and [enter homes], transferring diseases back to families. Our target here is educating [community members to stop] open defecation.”
When it comes to educating Ekumfi’s community members, children are a particularly important audience. Young children are very susceptible to diarrheal diseases (like cholera), contracted via contaminated water and poor hygiene. Frequent intestinal infections can lead to malnutrition, growth stunting, and even death. Recurring diarrheal disease is so serious that the World Health Organization has named it the second leading cause of death among children under age 5. GB Ghana has supplemented its ongoing clean water efforts with children’s education sessions about the importance of handwashing with soap — especially after going to the bathroom and before eating.
Although Ghana avoided the Ebola outbreak that plagued nearby West African countries, the GB team is not taking chances in Ekumfi. Global Brigades Ghana is currently supporting the Ekumfi Health Directorate to organize cholera and Ebola educational campaigns across nine communities.
Ebola spread so quickly in neighboring countries in part because many people did not know how to identify the virus or prevent its transmission. These campaigns are employing 10 Health Directorate medical staff to visit communities with crucial disease prevention and management knowledge that might one day be life-saving. More than 1,000 people will receive these education sessions, and initial campaign visits have been well attended by community members of all ages.
Global Brigades Ghana now plans to provide motorcycles and bicycles to Community Health Volunteers and CHPS staff so they can access particularly hard-to-reach communities. GB Ghana has also partnered with Ghana’s Ministry of Health, which has promised to sponsor the Community Health Volunteers with training and equipment. The Global Brigades team continues to monitor and assess their new Community Health Volunteers, ensuring that they sustain impact in communities in the absence of Medical Brigades.
Continue to Part III: Adansimaim Gets a School