Preliminary interviews and visits at Dassalami Soce

During VV, PCT’s became better acquainted with their site’s health challenges and infrastructures. The training team asked that we:

• Visit a health structure (health hut, health post, district de santé).
• Speak with at least one person who works at that structure and fill out the following information about that structure.
• Speak with at least one woman and one man in the community about health issues facing the community.
• Meet with at least one community health worker operating at the village level to talk about their activities.

During her service, Venchele worked with her community and Pharmaciens Sans Frontières to build a bigger and better equipped Case de Santé. As of now, the Case de Santé in Dassalami Soce is serving more than 1240 people; two nearby villages, Saroudia and Bouilimite, also come to get medical help there. In Senegal, the health system is organized as a hierarchy pyramid. Cases de Santé are at the very bottom of the pyramid; they are usually maintained by community volunteers, ASC’s, and Matrones. Cases de Santé report to a nearby Post de Santé, which is run by an ICP (Infermier/ère Chef de Poste). Health Posts report to the closest District de Santé.

The ASC (Agent de Santé Communautaire) at Dassalami Soce’s Case de Santé will also be my counter-part for the next two years. He speaks perfect French, so I was able to communicate with him from the start.

I initially asked him for the name of the District de Santé he report to (District de Santé de Soho). He then listed the names of the matrone and the health relais (or community volunteers) at my site.

The nearest Post de Santé is in Karang. During VV, I was able to go visit the Infermière Chef de Post there, and introduce myself to her.

In some circumstances, the Case de Santé can’t provide adequate health care to a patient, and must refer them to the Post de Santé. Most of the time, referrals occur if the Case de Santé doesn’t have the necessary technology or the means to treat difficult cases.

Patients who visit the Case de Santé must pay a sum of money to get treatment. Adults typically pay 2,000 CFA (about $4), whereas children pay 1,500 (about $3). There seems to be very little financial support from the government here. Pharmaciens Sans Frontières, has agreed to supplement the medical stock of the Case de Santé for the next two years, but it still needs to obtain medication from the Post de Santé. The ASC regularly sends money to the Post de Santé, which in turn supplies it with a regular influx of medication.

The Case de Santé is equipped to treat malaria (it is stocked with rapid malaria tests and ACT), diarrhea, respitory infections, cuts, ear infections, and skin infections. Soon, it will also receive a maternity ward with adequate sanitary measures and tools.

In addition to Pharmaciens Sans Frontières, a number of other NGO’s work in the area: World Vision, Child Fund, Jica, etc. They work on child nutrition, education, health, and hygiene.

I interviewed two community members, one female and one male, on major existing health problems in Dassalami Soce.

• The village Matrone told me that access to medicine and medical equipment were two major problems. She also said that the village tended to have water shortages, and that access to water was also difficult.

• The son of the Imam told me that water shortages, and access to water were major problems. He also said that, as of now, there is no reliable way to transport extremely ill individuals from Dassalami Soce to the Post de Santé in Karang. He thinks that the Case de Santé does not have enough medicine and medical equipment. Finally, he suggested that the Case de Santé’s lack of electricity is detrimental.

• The ASC was most concerned by lack of access to medicine, and by inadequate funds to buy them. He also thinks that the Case de Santé should have a reliably way to transport sick individuals from Dassalami Soce to the Post de Santé in Karang. He said that people in the community are poor, and can’t always pay the fees for treatment. Sometimes he defers pay, but he can only do this so often. Sometimes, people are never able to pay it back at all.