Community Health Workers: Spokes of Change
Three years ago, Irene Gaundi was living with her parents in the Millennium Village of Bonsaaso, in Ghana. She had completed her last year of secondary school, moved home, and was helping her mother sell second hand clothes.
Each day, Irene and her mother walked along the rust-colored roads, beneath the hot sun, balancing clothes atop their heads. And each day, during their rounds, they stopped at the health clinic in the nearby village of Tontokrom where the staff made frequent purchases.
Irene, now 23, still comes to the Tontokrom clinic daily, but for a different reason.
Today, she is a nurse.
As a nurse, Irene dispenses drugs, takes vital signs, renders family planning services, and immunizes children. Her work saves lives and helps families – women and children especially – stay healthy, giving them a better chance to break free of the cycle whereby disease and poverty reinforce each other.
I heard about Irene’s accomplishment from Rosemary Boakye, 30, a Community Health Worker in Tontokrom, who helped the transition come about. I was visiting the Tontokrom clinic, where I interviewed Rosemary for a Millennium Promise campaign called Spokes of Change that will launch next week. The campaign will highlight the wide-ranging impacts Community Health Workers (CHWs) have on communities in rural Africa.
CHWs bring the services of a clinic directly to households. They monitor for malnutrition, malaria, diarrhea; provide pre- and post-natal care, and more. And as Irene’s story illustrates, a CHW’s impact on a community often goes beyond his or her role as a health service provider.
“Irene was not attending school,” Rosemary explained. “Each day, she and her mother stopped at the clinic. The staff would buy clothes, and we would also spend time talking with them.”
As time went on, Irene’s mother told Rosemary that she wanted Irene to further her education and become a nurse. “Because whenever she saw us,” Rosemary said, “she felt proud of us.”
In fact, Irene already had dreams of becoming a nurse. After finishing secondary school she applied to nursing school, but her application was denied.
“When I came here [selling clothes],” Irene told me, “they directed me. When they were dispensing drugs, I asked them the meaning of prescriptions, how to check vital signs. And I decided I would do my Practicals (nursing school exams) again.”
“We advised Irene that the mother wanted her to become a nurse, too,” Rosemary said. “We said she should be a good girl, and humble. She did exactly what we told her, and now she has become a nurse!”
Rosemary laughed, and said with pride: “The post she has is even more than ours!” In the Millennium Villages clinics, in Ghana, nurses supervise the Community Health Workers.
In Ghana, when someone finishes nursing school the government places them in a health clinic. The nurse chooses the top three regions where he or she would like to be placed, and the rest is typically in the hands of the government.
When Irene completed her training, her father informed Eric Akosah, Health Coordinator for the Bonsaaso Millennium Villages Site. Eric saw an opportunity for her to serve her own people, and to be a role model to other girls in the community. He worked closely with the District Director of Health to get Irene posted to the Millennium Villages clinic in Tontokrom.
Today, “When people from the community come here,” Rosemary said, “they give Irene due respect. They see her as a new person, a different person.”
When I put this to her, Irene, in her typical modest way, agreed. “Some [people in the community] now want to be like me,” she said. “So they have decided to go to nursing training school.”
As for Rosemary, she continues with her work, visiting households, wearing the bright pink dress that indicates she is a CHW. Though she is a health worker, her presence in a community also represents the importance of education, especially for girls. “Even at times,” she said, “the school children come to me and say ‘Madame, I will try and go to school and become like you.’”
How many others will follow, and are following, in Rosemary and Irene’s, footsteps, both in Ghana and across sub-Saharan Africa? Be sure to follow along with the new Spokes of Change website to find out.