Connecting Deou’s 28,000 Inhabitants to Medical Care
AMURT’s activities are spread within a radius of about 50 kilometers of the Sahel region, comprising more than 35 villages and a population of over 28,000 inhabitants. The Sahel is a particularly poor and environmentally damaged region of Africa south of the Sahara that became infamous in the 1970’s when almost 200,000 people died as a result of drought and famine.
The more remote villages have nothing resembling a medical center. Most people either have to walk or ride donkey carts up to 20 hours just to reach the nearest center. These clinics are around 50 kilometers away and are poorly equipped, often lacking doctors to care for patients. This distance is especially hard on pregnant women. In addition to the normal difficulties encountered during childbirth, they rarely receive medical checkups and are exposed to heightened risk of anemia and malaria.
Traditional Birth Attendants
Traditional Birth Attendants (TBAs) are women selected in each village within AMURT’s area of coverage in Deou. Their main duties are to bring the mothers to the nearest clinic for delivery, and to lead talks and encourage discussions about issues such as hygiene, family planning, the importance of prenatal care, HIV protection and screening, and the refusal of female genital mutilation. When needed, pregnant women receive iron pills, malaria medicine and general checkups. The TBAs were also trained to help women deliver when there is no possibility to access a government clinic, have become the link between the health authorities and the villages.
AMURT’s coordinator in Deou visits the TBAs on a monthly basis to supervise their work, provide them with medicine and sanitation supplies, and fill out a report about their activities. One hundred kilograms of millet are given to each TBA per year as an incentive for the important role they play in their community.
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| One of our trainers, Madame Oubda, takes time to answer questions after her class on breastfeeding. | Fanta, from Boulekessi Soum, was trained in 2005 and has established herself well in her community |
Components of the Program
- Basic and specialized training, equipment and supplies for TBAs.
- Literacy training TBA network
- Food assistance for TBAs: one 100 kg sack of millet annually at the time of grain shortages.
- Monthly follow-up and supervision for TBAs. Monitoring of instruments and refill of supplies. Data collection.
- S.M.I. Mobile Sante Maternel Infantil: weighing and check-ups of infants and pregnant and nursing mothers, health education for women in the villages, including audio/video.
- Mobile out-reach to the communities by health department team.
- Donkey cart ambulance to transport emergency cases to nearest clinic.
- Training and supervision of village health promoters.
Before the program started, virtually no women of the Bella tribe would come for pre-natal consultation or deliveries at the medical centers. With the efforts of the TBAs, these attitudes have started to change, and the Bella tribe no longer remain aloof from the health infrastructure of the country.
Fostering Leadership
The TBAs are earning much respect within their communities. Overcoming rigid cultural norms, they are now assuming positions of leadership; ones that have historically been unavailable to women in the past. The TBAs are also becoming respected advocates of maternal health. Their training has brought them to the frontline in raising awareness about concerns crucial to the welfare of women.
- The Peuhl AV at Ndiawe village gets help from visiting UK midwife Suniiti Crowther to understand how to better use the instruments in her midwife kit
- The AV from Bungelday gets read to practice oral resuscitation. The use of teaching aids (visuals and dolls to demonstrate/practice on) are particularly important when teaching the illiterate, who find it difficult to follow theoretical classes
Bissiri Clinic
Located near a large lake in Bissiri Village, Bazega Province, AMURT runs a primary health clinic. It serves an area with 5,000 inhabitants, who live between 15 and 25 km from the nearest health facility. The clinic employs two nurses and offers a low cost alternative to the community. It is especially busy during the rainy season, seeing up to 250 patients per day. Most people come to receive treatment for malaria, diarrhea, and infections. As many of the diseases are preventable, the clinic also offers patients guidance on best practices related to hygiene and sanitation.