Tuesday, September 15, 2009

Village Health Team Follow-Up

Today Julius and I accompanied the Red Cross on their Nabitovu Village Health Team (VHT) follow-up. It was a really good process and, while the Red Cross volunteers conducting the follow-up (two of them) ended by saying that a refresher course was clearly in order, we felt quite proud of our Village Health Team, overall.

The volunteers who did follow-up today were the same two volunteers who trained the Nabitovu Village Health Team, about a month and a half ago. While much of the training focused on particular diseases, a lot of it also focused on household-level sanitation measures, which prevent disease and infection. Measures like having a large, well-built, two-tier dish drying rack (made out of branches) built outside over a whole dug filled with rocks – building the rack outside exposes drying plates to the sun, killing bacteria, and digging a hole underneath gives a place for water to leak down. Filling the hole with rocks prevents the earth from slowly washing away. Or, having an outside, walled-off bathing area with a path for the water to run away, so it doesn’t simply puddle and become a breeding ground for mosquitoes (aka malaria). Or having a latrine, with walls and a roof and a lid over the latrine hole, and a tippy-tap outside with soap for washing hands. (A tippy-tap is small ‘jerry-can’ - a rectangular plastic jug with a handle – strung up by a string so that you can tip it once and thin stream of water will pour out in order wash your hands. Some of the Village Health Team members even had tippy-taps strung so that you would press a branch on the ground with your foot, connected to the jerry-can, and the jerry-can would pour water as you pushed.)

So, we spent the day walking to one Village Health Team house after another. Mbasalaki Monica, the acting VHT chair, took us around the entire day, sacrificing time, lunch, and a huge quantity of energy for the cause. Some of the VHT members had model households, with huge, beautifully-built drying racks, excellent latrines and bathing houses, clean, mosquito-free compounds, well-dug trash pits with a branch-fence around, etc. Some of them were lacking here or there, though only one VHT member was lacking a latrine. He promised that he was just about to dig one, as the old one had filled up a few weeks before.

Surprisingly, not a single member seemed to feel that the follow-up was an invasion of their privacy, perhaps because the two Red Cross volunteers had been their teachers, or perhaps because the volunteers were excellent at both praising the good elements of a home while still lecturing on the bad. When a VHT member was missing a particular sanitation measure, the volunteers would note the absence, often chastise him or her lightly, and then explain once again why the measure is important to household health.

It was clear than many of the Village Health Team members had constructed or dug or set up various arrangements just before we came, in expectation of our visit. This showed another merit of follow-up; besides being a sort of refresher course, the visits actually prompted VHT members to take action on measures that they had been putting off for some time.

Of the 27 Village Health Team members, we got to 20 households, and Julius and I will return shortly to visit the last seven. The Red Cross volunteers told each household that they would return in two weeks – we expect that this will prompt many members to hurry about fixing the points in which they had been found lacking. The volunteers kept a record for each household, according them a check or a zero for each sanitation measure, so we shall see in a month’s time how the improvement has gone on.

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