22 November 2012

Rwanda: Life As a Community Health Worker

Gisagara — Not long ago, Therese Niyonsaba, 54, witnessed expectant mothers giving birth at home or by the roadside while thousands in her village failed to report to health centres or hospitals for treatment on time.

And, this, from time to time, took the lives of some of her friends and neighbours.

This harsh reality is one of the factors that inspired her to become a health volunteer eight years ago.

"Residents entrusted me with the duties after realising that I met all the requirements to be a health worker," says Niyonsaba, a widow and mother of four.

She lists integrity, honesty, and love for mankind, dedication and charisma as some of the qualities that a community health volunteer must have.

"We are not paid for these services," she insists; "But, I am pleased to be involved in the transformation of my community," she adds.

"It always pleases me to see how my services are helping members of the society to improve their health conditions".

Niyonsaba, who is the coordinator of all community health workers in her remote cell of Ruturo in Kibirizi Sector, says she does not regret her choice of becoming 'a servant of the community'.

Neither, she adds, does she complain of the demanding nature of her job.

"Sometimes, I have to stop my activities to concentrate on helping residents," she says.

"On a daily basis, I have to make sure that I have enough information about my neighbours: I have to know who is sick and who needs any form of assistance. And, that requires me to visit all the families under my supervision," she explains.

The health worker insists serving her community is the best thing she has always dreamt of doing.

"It is a difficult task because I have to balance it with my daily farming activities, which I rely on for survival," she acknowledges, before adding: "But, because I love my position as a volunteer, I always get enough time to educate society on health issues and help residents access the services they need."

Niyonsaba affirms that since the workers were elected, they have made a big impact in improving people's health and the access to health services.

"For instance, in my area, more women are embracing family planning methods, something essential to development," she says.

"Child mortality and maternal deaths have also drastically reduced in recent years," she adds.

And, this statement is somehow corroborated by a recent report by UNICEF which revealed that in just two decades, Rwanda has reduced by two thirds the number of children under the age of five who die annually from preventable causes.

And health figures also indicate that maternal deaths have been reduced by more than 50 percent within the same period.

"Community health volunteers are playing a vital role in educating members of the society," Niyonsaba says. Our efforts are crucial in building a healthier community, she observes."


A few years ago, the government introduced an initiative which would later facilitate the flow of information between health service providers and the community.

The donation of mobile phones to community health workers is seen as a measure which boosted the access to health services, especially in rural areas.

The exercise, which started about three years ago, saw thousands of mobile phones distributed to health workers across the country. And today, the initiative is credited to have contributed to saving many lives.

"The phones have contributed a lot in easing our tasks," Niyonsaba affirms.

As a community health worker, she notes that she has, on many occasions, answered calls from residents seeking for her help.

"It is either a sick child or an expectant mother who needs urgent care," she says.

"In such cases, I rush to the field, and when I consider the situation to be serious, I call in an ambulance to take the individual to the health centre, the ease of communication has saved many lives in my area", she says.

As a coordinator of all health workers at the cell level, Niyonsaba is the one entitled to call health centres and ambulances. And, that reveals how she must work hard and remain vigilant to avoid any risk.

"Sometimes I receive calls late at night and I have to get up to assist such individuals. Many times, I accompany expectant mothers to the health centre," she says with unmistakable pride.

But she insists it does not make her lose heart to keep up the work.

"When I was elected to this position, I expected to face challenges and I knew some would be difficult,. I knew it would require me to make sacrifices," she says.

"Challenges cannot stop me from this journey. They just give me courage".

And to conclude, she says: "When my work saves a life, it encourages me. When authorities recognise the impact of my efforts to the general community, it pleases me.

And, above all, when at the end of the day I realise that I have given someone a chance to live, I get the strength to carry on," she said proudly.

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