“I get up at 5am every day, so that I can go to the garden and come back in time for when patients start arriving. I use my inSCALE phone to set the alarm.”
“There is a problem with network in our area, so I have to walk to a certain anthill 500m from my house to get reception.”
“From here I send my weekly reports. Before the phones, I had to bring all my paperwork and forms to the health centre to complete the reports. Sometimes, I wouldn’t find the coordinator there, so I had to go back home and come back another time. I prefer sending the reports on the phone because it’s fast and easy and it saves me time.”
“I use the calculator on my phone to work out my stock balances for the reports.”
“I use the Closed User Group to call my fellow VHTs. Sometimes I call them just to greet them, other times for advice, or to prepare the monthly meetings of our VHT association.”
“Sometimes, if I have a patient and I’m out of drugs, I call Bridget, my fellow VHT to check if she has stock.”
A few weeks back, Robert – the son of Yese Muzinguzi – was brought to me with pneumonia. I didn’t have any Amoxicilin, so I called Bridget to check if she had some in stock. Luckily, she did, so I referred them to her, and Robert was treated straight away and recovered.”
Yese Muzinguzi: “I am proud to have Stephen in our village. When our children get sick, the services are there.”
“I also use the phone when I’m treating patients. I use the RDT test timer and the respiratory timer.”
“But, sometimes, I use the phone just to relax. Like listening to the radio with my wife, Robinah…
…or I play a few games.”
“I use the solar lamp when I am attending to patients at night – you need light to examine them, to do the tests and to fill in the reports. With the solar charger, I can charge phones for other people – maybe two every day – and charge 300 per phone.”
“The inSCALE solar products inspired me to buy my own solar system – it’s bigger than the inSCALE one, it lights my house and charges my own and other people’s solar products. I thought, ‘why not buy my own system so that I can save and earn money’.”
“People in the community admire my phone – how it can send reports and be used as a timer. I like that they know it’s unique and not everyone can get one. It shows that I am privileged to have that phone.”
Sunday Robert: “The thing I admire the most about the phone is that when my children get sick, I can just call him and he’s here.”
“When I get a message that says ‘VHTs save lives’ or ‘thank you for treating children’, I feel very happy. When I send a report, the feedback says how many children I have treated. I like that, it encourages me that they Malaria Consortium know I have been working and treating, that the medicine we receive from them is at work and put to good use. That is important to me.”
Andama Godfrey is a VHT in Kadekuru 2 village in Masindi district. He teaches history at the local secondary school.
When not teaching or performing his duties as a VHT, Godfrey provides for his family through subsistence farming.
“My standing in the community has improved because of the village health club. VHTs from other villages see our improvements and invite us to share. I travelled to Mubende to help them set up their club there.”
“The village health club has helped our relationship with the local government; we now work closely together. They help us mobilise people, and always involve us in their activities. They supervise our work and inspect the health situation in our village.”
The VHTs keep a record of all the cases they see. “Before, I would treat at least ten malaria cases per month, now it’s much less than that. The reason is that people have been sensitised on prevention, such as clearing stagnant water and sleeping under nets.”
Godfrey examines his neighbour’s child, 1-year-old Adule Isaac.
Job aides have been designed and produced to assist the VHTs in keeping records and making correct diagnosis.
Rapid Diagnostic Test kits enable community level testing…
If the test is positive, and the condition is not severe, treatment is given at community level. If the test is negative, or the condition is severe, the VHT writes a referral note for the nearest health centre.
Test results are ready in just 15 minutes; every minute saved is vital when it concerns malaria in young children.
“The village health club has been a success. There was a positive response from the community from the beginning, and almost all of the households are members now. The benefits we see are that the overall health situation has really improved. Before, I could see as many as 20 patients a day. Now, there are days when I don’t see any at all. And people are seeking treatment earlier than they used to.”
“Before the ICCM training, there was a lot of delayed treatment. Really a lot! People would die.”
“Now people come for treatment very fast. There has been a big change in the community. Better sanitation and better health.”
“When I have drugs in stock, I have many patients come to my house – maybe 15 in a week are treated. Now, I have had no Coartem for four months, so people don’t come because they know the drugs are not there. Right now, I see maybe 1-2 patients in a week.”
“I collect the drugs on my bicycle from the nearest health centre, which is 10km way. Because the drugs are not always there, I call them first to check.”
“The relationship with my supervisor is good. She calls me when she has info or programmes, maybe once or twice per month. As the parish coordinator, I submit the quarterly reports to her and, together with the other parish coordinators, get feedback from her.”
“As a parish coordinator, I guide my fellow VHTs on their work, how to complete the registers and reports and discuss the way forward in how to treat children. They bring their challenges to me so I can communicate them to the supervisor. I try and offer them support and advice and feed back their comments to the supervisor.”
We get moral support and appreciation from our supervisors. And it feels good when treating a neighbour’s child, and that child improves and you get thanks. That feels good. And, sometimes, when my own children are sick, as a VHT I get attended to very fast at the health centre. It feels good to be recognised like that.
“There are many challenges, but I continue to serve, because during the ICCM training it was made clear that there would be no pay. I want to continue this work. In some places people don’t value and appreciate their VHTs. I would love to see them recognised for their services by local leaders and communities.”
The Kitaleesa Village Health Club was formed in January 2013 and has 35 members. “Our club is open to all – children, adults, young and old. Health concerns all categories of people,” Kemigisa Grace, facilitating VHT.
Every meeting opens with a run through of the agenda, followed by prayers and an address by the chairperson. Then a health subject, chosen at the previous meeting, is discussed. Discussions are led by the facilitating VHTs, guided by the inSCALE flip charts.
A ‘referee’ is appointed to make sure the discussion stays on topic. Following the health talks, the floor is open to other issues concerning the community.
The discussions are interactive and lively. “In a group discussion it can be funny and interesting. Things come out, people can say funny things and we laugh.”
“It’s better to learn in group, you get ideas from fellow members. Even us VHTs can learn new things.”
Today’s discussion topic is diarrhoea. “I’ve learnt that diarrhoea is deadly if not treated early,” Byenkya Vincent (2nd from left).
“I have learnt that you take the child straight to the VHT if it has signs of diarrhoea. There’s a picture in his book (flip chart) of a woman carrying a sick child,” Rosemary Kaserenye, Village Health Club Chairperson.
The Kitaleesa Village Health Club has an unusually high male membership. “It’s always been like that in our village. Health issues are also part of the men’s lives.”
Non-members are encouraged to attend meetings, and if they wish, become members by filling out the card, which means they can access services with any VHT and get attended to quicker at health facilities.
How many of you have changed your behaviour as a result of being in the club?
“Before this club I had no proper latrine. I learnt of the problems and the difficulties so I built a proper one,” Bamutura Antonia.
“The meetings have enabled the members to learn new things in every meeting. Before, many of them had mosquito nets that hadn’t even been unpacked. Now they use them,” Kaddu Christopher, facilitating VHT.
“I have changed so many people’s behaviour. I got someone to build a drying rack, and have encouraged hand washing,” Rosemary Kaserenye.
“The club has transformed my whole family, my children use all the modifications. So many people have stopped using the bushes, and use latrines instead.”
“The three main changes we have seen in our community as a result of the club are: 1) The death of children below 5 has reduced by maybe a third because before there would be delay or no treatment; 2) Parents now take their children for immunisation; and 3) Women go for ANC and deliver at health facilities.”
“My main motivation for being a VHT is to see the village change its direction with regards to health issues. In the past I would work alone, teaching and sensitising – now, the club promotes my skills as a VHT, and the members take responsibility for their own health,” Kemiisa Grace, facilitating VHT.
“The major change from before and after the club is that caregivers would delay seeing the VHT, by two days sometimes. But because of the education they have received in the club, they now come straight away.”
“Before the club, caregivers would come to me, I would treat them, and they would leave. With the club, they come to learn more, and it makes sensitising easier. It is easier to educate a group than an individual.”
“Our Area MP has pledged 100,000 shillings to our emergency fund. It is very motivating to have her attention, support and financial contribution from our MP; it makes us feel that maybe we could be a role model village health club that members from other, dormant clubs want to attend. Already, the club is so successful that it has attracted people from other villages to come for meetings. ”
“I know many mothers who have suffered because they didn’t have money for transport to the health facility. Now that the money is there, I feel happy and relieved.”
“My son, Joseph, was two years old when he got severe malaria. He was referred to the hospital for treatment, but we didn’t have enough money for transport. By the time we had raised enough his condition was so bad, and he died on the way there. The thought that stays with you is ‘If there had been money available for transport, he wouldn’t have died’.”
“The idea was inspired by the pictures in the flip book. We even went to sit under a tree, just like in the drawing, to do exactly what the flip book said.”
“People used to have a lot of delays getting treatment because they didn’t have money for transport. The child would get sick, convulse on the road; the mother would worry and stress and cry. So we set up the emergency fund to avoid this. If a member brings a sick child with a case that is too severe for the VHT, they can get a loan from the fund to pay for transport.”
“There is no longer misuse or waste of medicine. Right now I have 70 doses of Coartem at home; before I would run out all the time.”
“The most important thing that has come from the club is that all members have been educated on childhood diseases. It has cleared people’s doubts. Now, when the VHTs refer the more serious cases, there are no longer complaints that the VHT lacks skills.”
“Through the village health club, people have come to understand about prevention of childhood diseases.”