Envy and Inspiration

My work partner and I have big dreams for the health hut in Dassilami Soce.

Here's what it looks like so far:

This is an ongoing project that I inherited from my ancienne and colleges. We still need to paint it, install solar panels, and build a maternity ward. Those major projects are all in the works, since the plans are already submitted and Pharmaciens Sans Frontières has pledged to provide funding.

Ultimately, we aim to make the health hut an autonomous entity, run entirely by the villagers themselves. Medication and consultations costs should be minimal, matrones and ASC should receive a yearly compensation (monetary or otherwise) from the village, a committee should be formed to properly manage the health hut, and the health hut should be able to run its own recurring (such as "pesées"). We're still working on all of these criteria, and we definitely have our work cut out for us. 

Even once the major projects listed above are completed, I have a feeling that the life-giving breath of the health hut will still be missing. I've been visiting other health structures to see what they were doing right, how they were doing it, and if it's replicable in my village.  So far, I've been to two highly functioning health huts: the first is in a village called Pacala, which is way out in the sandy bush. I'm hoping to go back soon, but here are some pictures of the community nutrition room they have there: 

The ASC and health relays do a monthly baby growth monitoring here

Listed members of various village groups and associations 

How the community represents the village major landmarks and resources 

Demographic data for different age groups over time

These chart papers show how organized and motivated the health team is. Not only do they hold monthly activities of all kinds, they also track their progress over time to make sure that their work is having the desired effect. This data is proudly displayed on the walls of the health structures. 

It's clear that such sustained efforts and excellent results are due in part to strong community support. I was lucky to meet with several village leaders, who all said that all villagers are invested in improving overall community health. Every year, each head of household donates some amount of grain or equivalent sum of money to the health hut team and committee. This contribution helps motivate and encourage the health workers, who have only a small mandate as volunteers. The health hut and its activities are entirely self-sustained; in french, we'd call this "une case de santé autonomisée". This is a goal I'm working towards in Dassilami Soce. 

The second health hut is on an island named Djinack Bara, where my work partner Ben has worked in several different capacities.

One of the health hut patient room 

The ASC's roles and responsibilities 

Notice how clean and livable that patient room looks. The health post in Dassilami still needs a faire amount of work, but even now cleanliness is an issue. The ASC doesn't have basic cleaning materials, and doesn't have enough money to purchase them. The consulting room is rarely wiped down, and biological waste piles up until it is finally disposed of (improperly). 

The neatly hanging mosquito nets are another nice touch. Sometimes patients in Dassilami Soce have to stay overnight, but we've only just acquired new mosquito nets. They're not hung yet. 

I was also very impressed by the signed roles and responsibilities form. It's tacked on the wall next to the front door for all to see. The transparency appeals to me. The patrons know what the ASC's responsibilities are, and can set their expectations accordingly.  At Dassilami Soce, we've been having some trouble determining once and for all which treatment practices and medications are allowed at the health hut level. Villagers don't have a clear understanding of the ASC's areas of intervention and limitations. 

I'd love for the community of Dassilami Soce to show the same level of commitment in supporting its health team. They're only so much you (NGO, health worker, etc) can give a community--there has to be an equivalent amount of investment on its part as well. When people are valued and recognized for their work, they tend to go the extra mile.