back to the community

Over the years we've trained traditional birth attendants, community health workers, nutrition outreach volunteers, peer educators . . . all people whose role and qualification comes from being respected members of the community rather than from degrees earned in school. In a place with limited manpower, this cadre of informal, unpaid workers forms the backbone of primary health care. Fifteen years ago no one but our WHM predecessors (Dan Herron, Lori Borchert) seemed to be attempting much of this in Bundibugyo. We found our way to the Uganda Community-Based Health Care Association and bought their manuals, incorporating spiritual as well as physical lessons on health. Over time, though, our role has become less direct. Team mates such as Pamela and Stephanie and Pat worked more recently with these volunteers, and bigger programs such as UNICEF and the Belgian government put lots of money and effort into scaling up this kind of training and organization for the whole district.

But today John Clark launched a new wave of community health outreach. Thanks to contacts we made in the last year with a program called NuLife, we were able to send two of our great agriculture/ nutrition extension workers to be trained to teach village health workers about infant and young child feeding, particularly in the context of HIV/AIDS. This organization, funded by USAID and working in close partnership with the Uganda Ministry of Health, has developed a nice set of teaching aids to bring basic health and nutrition messages to the village level, and to teach dedicated village health team members to screen their population for malnutrition. Instead of waiting in the hospital for the kids to come to us, these village health team (VHT) members will actively search out those failing to thrive. This dovetails nicely with our other health-center and hospital based programs for moderate and severe malnutrition. And this prepares our district to receive the commercially prepared high- calorie food supplement which NuLife hopes to begin manufacturing. That is still a ways down the road, and as a medicinal food it will only be given to the most severely malnourished and those with AIDS, so again there is complementarity with our BBB local-production for moderately malnourished kids.

Over the last few months a good amount of aggressive advocacy was required to get our staff included in the trainings, and to try and hold together the various partners involved. But now I am enjoying the teamwork, dropping in to see our trainers drawing out the 20 VHT's in a participatory way, noting that a good number of those chosen for the training are HIV-positive people themselves taking an active role in their own care, thanking John who saw to all the details of transporting and feeding and informing and facilitating the people involved in this event. The training will go on all week and end with a community launching ceremony. We pray it puts information, inspiration, vision into the hands of the people.