The Sunday Mail
Senior Health Reporter
OFTEN, they put their lives at risk and use the most rudimentary personal protective equipment (PPE), if at all, to assist those in distress.
From HIV/Aids to cancer and now coronavirus — community/village health workers (CHWs) are key conduits in the provision of health services.
The Ministry of Health and Child Care and other stakeholders have moved to train these community cadres and empower them with the right information on Covid-19, as the country battles a spike in cases.
“How communities are responding to Covid-19 in urban settings is different from rural areas,” said Regina Gireda, a CHW from Marondera, who spoke to The Sunday Mail shortly after receiving training in Kadoma recently.
“Many people in rural settings still think Covid-19 is a disease for the elite only and change of lifestyle has been a nightmare for us in the village. Before training, I had many things I did not understand such as symptoms of Covid-19 and how we were supposed to relate in communities.
“Now I have a better understanding of what is required of us as village health workers and this includes ensuring that returnees coming to our communities go through the necessary processes before we welcome them back.”
Gireda is one of at least 200 village and community health workers who have received training in Covid-19 management under Africa CDC’s Partnership to Accelerate Covid-19 Testing in Africa (PACT) initiative.
The PACT initiative seeks to mobilise experts, community workers, supplies and other resources to test, trace and treat Covid-19 cases in a timely manner to minimise the impact of the pandemic on the African continent.
This is expected to help prevent transmission and deaths, as well as minimise the social and economic harm associated with Covid-19.
Epidemiology and Disease Control Director in the Ministry of Health and Child Care Dr Portia Manangazira said the training was necessitated by the need to involve communities more in the pandemic response.
“As part of the Covid-19 response, we have been anxious to ensure that we just do not end up producing messages and sending them as some of them do not reach all aspects of the communities, particularly those hard to reach.
“When people are tested whether the results come out positive or negative, they have to go back to communities and this is why we have to make sure that they are ready,” said Dr Manangazira.
She said while the Government has been releasing returnees who would have been in quarantine, communities had not been prepared to receive these individuals.
“We are discharging people from quarantine facilities and sending them home, and we discharge people from isolation facilities having been treated for Covid-19 and send them to communities. Sometimes we say you are not sick enough for hospitalisation, do home isolation and that’s in the community,” Dr Manangazira said.
“So my issue was, can we make these communities Covid-19 ready even as we get information from them that we do not usually get from health institutions. Also, make sure that there is some capacity and resilience built within these communities.”
Covid-19 is not the only disease ravaging communities — HIV/Aids management is still a big issue even though talking about it has become difficult as the novel virus hogs all the limelight.
National Aids Council chief executive Dr Bernard Madzima said CHWs have come in to cover the gap that has been left by the usual programme managers.
“Covid-19 has presented challenges to HIV programmes because most of them actually happen in communities and it involves people gathering,” said Dr Madzima.
“Our clients have to go to health facilities to access medications and treatment. So the various forms of lockdowns, fear of travelling and the issue of health centres being considered hotspots for Covid-19 — have become a cause for concern. These factors might mean our clients not being able to access treatment.”
Dr Madzima said they are now heavily dependent on CHWs, who sometimes collect anti-retroviral drugs on behalf of their clients to ensure that default cases are minimised.
However, while CHWs have played an integral part in HIV/Aids response and now Covid-19, remuneration has been a major issue, with most getting paid after three months despite their contribution to health service delivery.
Some CHWs get US$14 per month while others get US$45 after every three months. Executive director for Community Working Group on Health, Itai Rusike, said the number of CHWs has decreased over the years due to lack of support.
Rusike said some, particularly during this period, are not willing to expose themselves to the coronavirus as they do not have adequate PPEs to execute their duties.
He said village and community health workers are a key link between health providers and communities, particularly in low resourced countries such as Zimbabwe where health professionals are a scarce resource.
“Despite the vital functions, the number of community health workers and their role has diminished over the past two decades in Zimbabwe due to lack of incentives, supporting resources and protective equipment,” he said.
“Village health workers are often undersupplied with PPE and because of the coronavirus fear, they are extra worried about their own safety.
“It is important that as a country we acknowledge the important role they play hence the need to support them with stipends that are regularly paid, tools of the trade such as uniforms and bicycles, as well as PPE during this period of Covid-19.”