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Protecting Zambia's most vulnerable
Aug 18, 2007 By: Susan O'Neill(Originally published May 8, 2006)
ZAMBIA -- Dozens of young women sit huddled together on the wooden benches placed under the shelter of the thatched roof, their babies wrapped in fabric slings, nestled snug against their backs.
They have walked with their newborns and toddlers from the community of Chilubula to hear Charles Katongo deliver an animated lecture about the importance of sleeping under mosquito nets. He is the chairman of the Chilubula Health Centre, located in Zambia’s northern province. Mr. Katongo speaks passionately and quizzes the women on preventing malaria, the leading cause of death in Zambia, particularly in rural areas like this. It is estimated that only 40 per cent of Zambians use mosquito nets to prevent malaria.
Children under the age of five are especially vulnerable to the disease, as is the case with pneumonia and diarrhea, which is why the management of childhood illnesses has become a priority for Co-operative Assistance and Relief Everywhere (CARE) International.
“These are the diseases which can easily be prevented,” says Martha Mwendafilumba, manager of CARE’s Moyo Wa Bana project, which aims to reduce childhood mortality rates attributable to malaria, diarrhea and acute respiratory infections.
Moyo Wa Bana is a Nyanja phrase that can be loosely translated to mean ‘healthy lives for children.’ The seven-year-old project targets the 225,000 children under the age of five who live in Zambia’s Lusaka, Ndola and Kasama districts through what is called the Integrated Management of Childhood Illnesses (IMCI) at both the clinic and community levels, Ms. Mwendafilumba says. The program is funded solely by the Canadian International Development Agency (CIDA).
“More and more mothers are becoming more knowledgeable on the three targeted diseases we are looking at,” she says, adding that means childhood illnesses are being diagnosed and treated at a much earlier stage.
In communities throughout the three districts where Moyo Wa Bana is running, volunteers serve as Child Health Promoters, raising awareness about the symptoms of the diseases and the ways to prevent childhood illnesses. The volunteers also set up growth-monitoring stations, and more than 440 semi-permanent weighing shelters have been constructed in Ndola and Kasama.
“They look at whether the child is growing and gaining weight, whether the child is well,” Ms. Mwendafilumba says. “They also check their vaccination records and provide vitamin A supplements.”
In Lusaka, the 100-plus weighing stations are often located under big trees like the one outside the Church of the Nazarene in Matero.
Bridget Kabsuwe brings her son Gift Jr. to be weighed at the station every month. He is three years old and weighs 14 kilograms.
“He is fine,” says the 32-year-old mother of four as she sits with her son in her lap, the white powder of his vitamin A pill still fresh on his lips.
Inside, nurse Irene Nyirenda administers vaccinations for polio, measles and diphtheria.
“It’s always busy,” she says of the station, which she visits once a month.
The community volunteers are also able to educate parents and to counsel them on matters such as proper nutrition.
“If you don’t teach a mother how to look after a child, even with the supplements, the problem will reoccur,” Ms. Nyirenda says.
The stations also alleviate congestion in the government-run health clinics. Clinics such as the one in the Kanyama Compound, a densely populated shantytown located west of Lusaka, also play an important role in the Moyo Wa Bana project. More than 129,000 people live in the slums of Kanyama.
“At the moment we are the only health centre on the western side of Lusaka,” says Alice Mainza, a nurse who runs the Kanyama Clinic, a facility where many of the nurses and health workers have been trained in the IMCI.
A special child health station has been created to ensure ill children are treated holistically.
The clinic also serves as a growth monitoring point. There are 13 in Kanyama, with as many as 400 children attending each session.
Beauty Maluti, the head nurse at Location Urban Clinic in Kasama, reports that IMCI has also had a huge impact on the quality of care provided to children there since it was implemented in 2002. Before that, many conditions would go untreated in children, she says.
“Normally, when a mother comes in she will present what is worrying her the most,” Ms. Maluti said. “So some conditions, which were not very pressing, would be ignored.”
Now, 18 of the clinic’s 20 nurses are trained in IMCI.
“Last year we saw more than 5,000 children. But according to reports from the community, there were only 70 deaths (of children under five),” she said, adding that the 70 deaths were caused by malaria.
Prior to the implementation of the Moyo Wa Bana project, the death rate of children under five was 28 per cent in the district. Now it has been reduced to less than five per cent, she said.
CARE came to Zambia in 1992 at the invitation of the Zambian government. Initially, its activities focused on emergency relief and on interventions to mitigate the extreme poverty in urban areas. CARE’s programming has since shifted to focus on long-term sustainable community-based development projects such as Moyo Wa Bana.
Ms. Mwendafilumba notes the project falls in line with the Zambian Ministry of Health’s plan to provide quality service as close as possible to the family.
“This whole strategy is moving the delivery of health services and the availability,” says Steve Power, CARE’s assistant country director in Zambia. “The poorer people are, the less likely they are to go to a clinic. They don’t have the bus fare. People will only go at the point at which it is too late.”
