Canadian docs, Ugandan villagers
harmonize for kids' health
By Julian Rosenberg
Children
performing health skits in costumes, medical scales
hanging from trees � and people singing songs about
diarrhea. A bad dream after too long a shift on the
peds ward? Actually, it's pediatrician Dr Jenn Brenner's
idea of a nice break from the office. Dr Brenner, of
the Alberta Children's Hospital, is the Canadian Project
Coordinator of a joint effort between the Canadian Paediatric
Society (CPS) and Mbarara University of Science and
Technology (MUST) called the CPS-MUST Child Health Project,
Uganda.
It all started back in 2000 when
MUST approached the CPS and proposed they work together
on a community-based educational project aimed at the
health of local children from birth to five years of
age. The project has been up and running for a year.
Twenty-five Canadian doctors have all done tours of
duty of at least a month, and with the help of CPS volunteers,
the locally driven program is now improving child health
conditions in 60 villages, with a total population of
25,000, throughout southwestern Uganda. "This is a happy
story about Africa," says Dr Brenner, "and we'd like
to share it with Canadians."
With seven years of volunteer experience
with a medical school in rural southwestern Uganda,
Dr Brenner knows a lot about the joys and difficulties
of working in a country where one in five children die
before they turn five. "One of the most frustrating
things," she says, "is when kids come in so sick that
they often die within a day, from a preventable illness."
THREE-PRONGED
APPROACH
The project uses three strategies to create long-term
solutions. First, it emphasizes health promotion and
prevention. Second, putting the emphasis on a community-based
approach. Third and, according to Dr Brenner, most important,
is the goal of building the local skills needed to keep
the program going.
The role of Canadian doctors is
to provide consulting for the project and to train twelve
educators at MUST. Each of the 60 villages selects two
leaders; these 120 leaders are trained by the MUST educators
using materials provided by the CPS. The local leaders,
also called community-based healthcare facilitators,
are all parents (71% are mothers) and often have to
make long journeys to deliver health education. They
do all the day-to-day work on the ground, explains Dr
Brenner. They hold workshops to train other parents
about breastfeeding, sanitation, nutrition and family
planning, and train villagers in malaria prevention
by cutting down bushes and using bed-nets. To create
long-term health promotion, the healthcare facilitators
organize communal activities like building latrines
and planting co-op gardens for growing nutritional foods.
The key to the project's success,
according to Dr Brenner, is that it uses a bottom-up
approach to community-based learning. Essential to the
process are community action plans, where villages define
their own needs, priorities and solutions. One village
recognized that their children's health problems were
primarily created by poverty. The solution? The villagers
initiated a plan to start a pig farm and put the profits
into a healthcare fund.
The present phase of the project
is funded by the Canadian International Development
Agency (CIDA) and ends in January 2005. But Dr Brenner
foresees the project continuing in Mbarara, and hopefully
elsewhere. "The community-based approach to child health
has been very successful in Uganda," she says. "We're
hoping this model can be developed and used in other
countries."
CREATIVE
methods
The most successful project initiative has been the
hugely popular Child Health Days, which attract 500
to 1000 kids each time. Twice a year in each of six
parishes, children are dewormed, immunized, given vitamin
A and weighed on decorated scales that hang from tree
branches. But beyond practical matters, the days are
creative festivals for the kids, with children performing
skits about health issues, and parents singing songs
about boiling water to prevent diarrhea.
So what's the most rewarding part
of the work for Dr Brenner? "The enormous community
response to the program," she says without hesitation.
"People will walk 10km with three children and babies
strapped on their backs and fronts. Seeing that was
what kept me going. They face so many challenges, but
they're motivated, inventive and resourceful � they
keep going."
More info: contact the CPS at
613-526-9397 or [email protected]
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