Provide healthcare to remote displaced communities

1.0 Background

The socio-political crisis in the North West and South West regions of Cameroon has since 2018 deteriorated into a humanitarian crisis with devastating effects on the healthcare system in the regions. Vulnerable communities in these regions experience attacks on healthcare ranging from the forceful confiscation of medical supplies to the death of medical personnel. This has caused health personnel to desert their health facilities and/or communities for safety leaving the resident population in vulnerable communities to endure the menace of violence, injury and communicable diseases. 

GlobalGiving has presented Reach Out Cameroon with a crowdfunding platform where amazing donors have been able to provide donations to provide relief for the deplorable healthcare services provided in conflict-affected communities through government-assigned community health workers (CHWs) in Ekondo-Titi health district and mobile clinic (MC) in Buea health district. These CHWs are providing primary health care services (PHCs) and referral services to the people of the most vulnerable communities in need. For this period of reporting, the vulnerable host communities selected from these health districts were Kitta and Tole.

2.0 Objectives 2.1 Project Goal

To support two (2) CHWs in Kitta and a Mobile Clinic in Tole to provide free primary healthcare services to those in need and perform surveillance on diseases prone to outbreaks in Kitta and Tole.

2.2 Specific Project Objectives

• Treatment of acute respiratory tract infections.
• Treatment of uncomplicated malaria.
• Screening and treatment of malnutrition in children without complications.
• Treatment of skin infections without complications.
• Provision of Vitamin A and Albendazole to children.
• Distribution of perinatal multivitamins to pregnant women and lactating mothers.
• Distribution of aqua tabs.
• Referral of complicated cases for proper case management.
• Referral of pregnant women to higher health facilities for ANC.
• Referral of SAM cases to higher health facilities for proper case management.
• Health Sensitization of community members on prevailing health problems.
• Identification, referral and follow-up of unvaccinated cases.
• Weekly reporting of activities.
• Surveillance for measle outbreak.

3.0 Results. 

The results for the period July 2021 - September 2021 are summarized and tabulated in the attached report below.

 4.0 Challenges

1. Insecurity

Frequent gun-shots, violence, armed military raids, lockdowns, and death have left host communities with the option of retreating to the bushes for refuge. This has greatly reduced their access to health care services provided by the CHW and vice versa.

1. Stock-out malaria RDT from Drug Fund

The Drug fund has been the supplier of drugs and medical supplies used in this project at relatively subsidized prices. Recently the drug fund has experienced a stock-out of mRDTs and Artesunate/amodiaquine for over 3 months. Other suppliers provide these supplies at a 110% increase of the price offered by the drug fund. This situation was managed by the Management of the implementing organization, Reach Out who authorized the disbursement of funds to procure these supplies at a considerable price.

• Remote_Communities_Health_promotion_project__July__September_2021_report.pdf (PDF)
  

Remote Communities Health Promotion Project Report for June 2021

The socio-political crisis in the North-West and South-West regions has affected the availability of healthcare services and personnel in Nalende and Kitta communities. The insecurity in the communities propelled by two conflicting parties has limited the movement of the civilians and reduced the motivation of both the patients and Community Healthcare Workers (CHWs) to seek or supply healthcare services due to fear for their lives. The frequent military raids in the community have caused both the patients and CHWs to flee into the bushes.  The above reasons have caused the majority of the population including patients and CHWs to seek refuge in the bushes and other distant communities such as Mudemba. However, certain healthcare activities were executed within the month of June 2021 and the following results were obtained;

1. Health Care Service Provision

• 77 patients (33 males and 44 females) were received by the CHWs requesting solutions to their health problems. The majority of patients received were children <5 years old (54), 14 patients between the ages of 5-17 years and 9 patients in the 18-59 years age group
• 60 patients (24 males and 36 females) were suspected of malaria out of which 34 patients (13 males and 21 females) benefited from diagnosis with the Rapid Diagnosis Test. Of these patients, 32 (12 males and 20 females) tested positive all being children from 0-4years old. Due to drug shortages, only 19 persons (2 males and 17 females) were provided with antimalarial treatment (Artesunate/Amodiaquine) and 1 little girl was referred to the Ekondo-Titi District Hospital for presenting a case of complicated malaria.
• 68 children (34 males and 34 females) between the ages of 0 - 4 years were provided with Vitamin A supplementation and Albendazole 400mg (deworming therapy).
•  12 pregnant women were provided with maternal delivery kits.
• 466 indigenes (213 male and 253 female) were reached out with community sensitization by the CHWs. The majority of indigenous beneficiaries of the sensitization campaigns were 438 adolescents between the ages of 5- 17years   (143 males and 295 females), followed by 136 beneficiaries (61 males and 75 females) from the adult group and 12 (9 males and 3 females) beneficiaries were children between the ages of 0 - 4years.
• 300 beneficiaries (145 males and 155 females) were educated on handwashing, 309 beneficiaries (157 males and 152 females) on water purification /preservation and 206 beneficiaries (114 males and 92 females) were educated on diarrhoea prevention.
• 300 beneficiaries (150 males and 150 females) were educated on waste disposal, 239 participants (102 males and 137 females) on the use of proper latrine use and 215 (105 males and 110 females) were educated on LLNS.
• 190 (86 males and 104 females) participants were educated on A.R.I prevention and 53 females were educated on menstrual hygiene.

1. Health Education and Sensitization

1. Nutrition

1. 63 children (32 males and 31 females) between the ages of 0 - 5 years were screened for malnutrition with 0 MAM cases and 0 SAM.
2. 22 females were targeted within the community consisting of pregnant women, lactating mothers and caregivers of children between the ages of 0 - 23 months. These women were sensitized on appropriate young infant child feeding.

The challenges encountered during this phase of the project were;

• Stock-out of Artesunate/Amodiaquine from the Drug Fund; The antimalarial employed for the treatment of malaria in this project ran out of stock with the drug fund. Not all the patients who tested positive to malaria with RDT were provided with treatment.
• Difficulty in Transportation of Drugs; Due to the high rate of insecurity along the Kumba Ekondo-Titi axis, transportation of drugs was done by sea which is expensive and there are other risks associated with it.
• Restricted Communication with CHWs; Communication between the PM, Field nurse and CHWs is hindered by the poor network in the communities which have worsened with the crisis and power outage in the whole community.
• The retreat of patients to the bushes; The insecurity caused by the Non-State Armed Groups, and frequent military raids have forced patients and CHWs to prioritize staying alive in the bushes over living healthy and providing healthcare services in the community.

 The following recommendations will address the above challenges

• The project team recommends that other funds should be sourced to procure Artemether/Lumefantrine. This drug is an effective alternative to Artesunate/Amodiaquine in the treatment of malaria and is more costly.
•  The stock of drugs delivered to the field nurse be increased to last for a duration of at least 3 months. This will make transportation which is dangerous less frequent.
•  Protective gear (i.e., plastic rain boots, raincoats and torch helmets) be provided for the CHWs to ease their movement into the bushes to provide healthcare services.

The communities of Nalende and Kitto extend their gratitude to all those who generously provided Reach Out with resources to bring them health and wellness. The Reach Out team continues to count on your selfless donations to replicate these results in other communities. See attached some pictures from the field. Thank you.