Village health workers treat malaria in Zimbabwe

Utseya, a village in Zimbabwe, is about 15 km from the rural hospital. The area is mountainous and rugged and roads are poor, making the village inaccessible by transport, even an ox-drawn cart.
JSI/WEI Photo Library Photo
Rebecca is a village health worker (VHW) in Utseya and is trained in malaria community case management. Her neighbor Rena is a community caregiver who is 58 and has diabetes and asthma. After Rena failed to appear at a monthly meeting for community health workers, Rebecca did not worry because it was the start of the farming season and many women were preparing the fields. Yet as Rena, who was suffering from the flu, worked the fields that afternoon, she felt unusually hot and sweaty. By the next morning she had worsened and was vomiting. Word was sent to Rebecca, who packed her malaria kit and rushed to Rena’s home, where neighbors had gathered and were whispering that something spiritual had attacked Rena.

“When I got to Rena,” said Rebecca, “She had difficulty talking. I decided to do a rapid diagnostic test for malaria. It was positive so I explained it to Rena and her husband, and gave her medicine and a referral note for the hospital.”

But Rena was so weak that she could not walk. Rebecca tried to hire a car but the owner asked for a lot of money. Rebecca called the village head and villagers to make a stretcher to carry Rena to the most accessible part of the road. Rebecca also asked them to contribute money for private transport to the hospital from the road head. The neighbors obliged and when Rena arrived at the rural hospital, she was referred to the district hospital, where she stayed for more than two weeks.

Reflecting on the incident, Rena’s husband is thankful that Rebecca helped his wife and was able to get the villagers to lend a hand. He spoke of his confusion before Rebecca explained his wife’s affliction. “The sudden change of my wife’s condition had me puzzled and I thought that she was bewitched,” John said. He added, “I now understand the value of having a community fund for emergency transport, and I will help convince villagers to contribute so that there is money for the next emergency.”

JSI, through the Maternal and Child Health Integrated Program (MCHIP), placed a particularly strong emphasis on building local capacity in the area of malaria community case management. During a 2013 outbreak, for example, MCHIP and the National Malaria Control Program supported community-level malaria sensitization and training for more than 500 community leaders. Throughout 2012-2014, MCHIP also trained VHWs like Rebecca in malaria community case management. Today, MOHCC data indicates that VHWs have increased coverage of early screening, diagnosis and treatment of uncomplicated malaria at community level and that this has likely averted excess morbidity and mortality due to malaria.

Now that community members have witnessed people with malaria being treated and cured, they consider VHWs to be local heroes.

Rebecca is glad that community members now value her work. “Since we began testing for malaria, people have gained more confidence in the work that I do and many call me to assist them when there is a health-related problem,” she said.

JSI was a partner on MCHIP, USAID’s flagship maternal and child health project between 2008-2014. Under subcontract to JHPIEGO, JSI led MCHIP implementation efforts in Zimbabwe.

Image: Rena's husband, Rebecca, and the MCHIP community officer