Community health workers; the ‘unsung heroes’ of Covid-19

Every day, 45-year-old Augustin Kabanda visits homes in his village in Nyanza, Southern Province, checking on the health conditions of Covid-19 patients who are under home-based care. On a routine basis, he measures the patient’s temperature and oxygen levels to establish if their situation is critical or whether they are recovering from the virus. Sometimes, he takes blood samples and if a patient is in critical condition, he calls an ambulance to take him/her for advanced medical care. Kabanda, who also doubles as a village leader, is a member of a cohort of Community Health Workers (CHWs), a network of slightly over 58,500 people deployed across the country to deal with health challenges in their communities. “When we visit a Covid-19 patient, we collect their daily health information,” Kabanda said. The nature of their work means that they are highly exposed to the risk of contracting the virus, and at first, the idea of working with Covid-19 patients was quite frightening for most of them. Césarie Mukambayire, who has been serving as a community health worker since 2010, says that in addition to catering for Covid patients, they are also still executing their pre-Covid duties. Before the Covid-19 outbreak in Rwanda in March last year, the volunteer health workers were working with communities to, among other challenges, eliminating severe malaria, reduce child mortality and malnutrition “I feared to be infected with the virus,” Mukambayire, 49, said, adding that, just like her other colleagues, she overcame the fear. The battle against Covid-19 Efforts of community health workers in the fight against the pandemic have been remarkable, and they’ve been praised by some leaders as the “unsung heroes.” Currently, 95 per cent of the Covid-19 patients are placed under home-based care, with only a few who have severe symptoms admitted in hospitals. Before they are deployed to the forefront of fighting the spread of Covid-19, the community health workers are given basic training in health care. They are also equipped with protective gadgets. In addition to temperature and oxygen checks, they sensitise the quarantined patients on good feeding and observing the Covid-19 guidelines. For some like Kabanda who is a village leader, their helping hand extends beyond health care support. They’ve participated in mobilising the community to help needy patients with food. Yet, in the process of executing their duties, they are confronted with many challenges. They are neither facilitated with transport nor airtime to help keep in touch with their patients. For instance, Mukabayire runs a boutique in front of her home. Splitting her time between the shop, the only source of income she has, and unpaid full-time volunteer work is quite overwhelming. While she has a passion and love for serving her community, she also has a family to feed. “Often, I have to abandon my boutique to attend to patients in the community,” she stated. Should the number of health care workers be increased? Introduced in 1995, the country started with 12,000 community health workers before scaling up to 58,500, of whom 65 per cent are women. This was part of the country’s ambitious strategies to bridge the shortage of health care workers. Currently, each village in Rwanda has a minimum of three health care workers, and the outbreak of the pandemic has exerted extra pressure on them. This, according to experts, may call for a rethink of the number of health care workers deployed.

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Community health workers; the ‘unsung heroes’ of Covid-19