health workers

 {Photo credit: Cindy Shiner/MSH}A mother waits for the nurse to vaccinate her baby during an immunization clinic at Phebe Hospital in central Liberia.Photo credit: Cindy Shiner/MSH

Stronger health systems are critical to preventing outbreaks from becoming epidemics. In fragile states, systems already weakened by conflict, disaster, or instability can crumble under the weight of an outbreak -- devastating access, availability, and quality of basic health for women and their families.

 {Photo credit: Diana Tumuhairwe/MSH}A multidrug-resistant TB patient from Kitgum, Uganda. He lost his job because of his illness.Photo credit: Diana Tumuhairwe/MSH

Health workers throughout the developing world provide vital services and improve the lives of the people they serve, and yet they are often invisible. These men and women conduct community outreach, provide key prevention messages in the community, and deliver clinical care, treatment, and follow-up. In Uganda, the US Agency for International Development (USAID) TRACK TB project, led by Management Sciences for Health (MSH), supports 52 community linkage facilitators to help increase tuberculosis (TB) case detection and treatment success rates.

As their name suggests, they serve as the link between the patient and the health facility. The facilitators receive a monthly allowance, mobile phones, paid airtime, and transportation reimbursement as they track treatment adherence of TB patients in and around Kampala, Uganda’s capital. The facilitators are critical to successful implementation of the World Health Organization’s DOTS (directly observed treatment short-course) strategy, which helps patients adhere to treatment.

World Health Worker Week (April 6-10, 2015) is an opportunity to mobilize communities, partners, and policymakers in support of health workers in your community and around the world. It is a time to celebrate, raise awareness, and renew commitments to health workers having the training, supplies and support they need to do their jobs safely and effectively.

Meet some of the health worker heroes among us!

Muhamed Mulongo, acting district health officer, Uganda

[Dr. Muhamed Mulongo] {Photo credit: Cindy Shiner/MSH}Dr. Muhamed MulongoPhoto credit: Cindy Shiner/MSH

Muhamed Mulongo decided when he was a boy to become a doctor after accompanying his sister to the hospital in the middle of the night during difficult labor. The baby died.

I said to myself, 'I should be a doctor I think'.

Now he is the only surgical doctor in the eastern Ugandan district of Bulambuli.

You work here only when you love your job.

You always have to improvise. You have no choice -- you have to save people in the process.

{Photo credit: Katy Doyle}Photo credit: Katy Doyle

Members of the global health community commemorated International Women’s Day (IWD) on March 8 by celebrating recent advances in women and girls’ health and indeed there was much to celebrate: maternal deaths have declined 45% worldwide, The Global Fund to Fight AIDS, Tuberculosis and Malaria has distributed over 450 million bed nets, and over 1 million babies have been born HIV-free thanks to the President’s Emergency Plan for AIDS Relief (PEPFAR); but there is still work to do.  What happens once the day is over? How do we turn that attention into action? How are these issues going to be addressed? After awareness is raised, we still need concerted global action every day of the year if we are to make truly sustainable, impactful improvements in the lives of women and girls’ around the world. Here are a few things I think we can do at the global, US and local level to keep the spirit of IWD alive:

Globally: Elevate women and girls in the Post-2015 Development Agenda

{Photo credit: Rui Pires}Photo credit: Rui Pires

{Photo: Dominic Chavez}Photo: Dominic Chavez

The key element of any health system is the people who run it. Nowhere is this more true than in countries in the midst of, or recovering from, conflict. Indirect or direct threats faced by health workers exacerbate a population’s challenges in seeking and receiving health care.

In conflict settings, health workers may be forced to flee to safe havens as refugees, internally displaced people, or leave the country as migrants—if they have the means to do so. Some of the most capable are absorbed into international agencies. Those who remain frequently have insufficient resources to perform their jobs and must carry on as best as they can under daunting circumstances.

This situation has worsened in recent years with a growing number of direct attacks on health workers in fragile states, such as those against polio vaccinators in Pakistan and Nigeria. These blatant violations of the Geneva Conventions inhibit an already difficult environment for the delivery of health services and the recovery or development of the health system.

{Photo: Mark Tuschman, Kenya}Photo: Mark Tuschman, Kenya

This post originally appeared as part of the Woman-Centered Universal Health Coverage Series, hosted by the Maternal Health Task Force (MHTF) and USAID|TRAction, which discusses the importance of utilizing a woman-centered agenda to operationalize universal health coverage. To contribute a post to MHTF's series, please contact Katie Millar.

Who is accountable for the young woman dying during childbirth in a hospital in Lusaka, Zambia? For the woman in a health center in Bugiri in Uganda? For the girl child in a rural home in Uttar Pradesh, India? In a shanty town in Tegucigalpa, Honduras? Who is accountable for the women and adolescent girls in a thousand places everywhere?

L to R: MSH staffer Niniola Soleye and her aunt, Dr. Ameyo Adadevoh

My aunt, Dr. Ameyo Adadevoh, identified and contained the first case of Ebola in Nigeria.  She paid with her life because the health system was not ready to deal with Ebola.  The system has since caught up, and is today a model for other countries.  But the loss of such a gifted doctor and family anchor is incalculable.

Ebola arrived in Nigeria at a time when doctors at all federal government hospitals were on a labor strike (my aunt worked in a private hospital).  After ongoing negotiations with the government failed to meet their demands, the doctors – desperate to see significant changes in the health system and seeking improved salaries, positions, and titles – reached their breaking point.  So they went on an indefinite strike.

Patrick Sawyer – the index case – left quarantine in Liberia and collapsed at the airport in Lagos, Nigeria.  He was trying to travel to a meeting of the Economic Community of West African States (ECOWAS) in Calabar, Nigeria.

"I thought I [would] go home with a dead child. I came carrying my child on my back. She was lifeless. Now my child is well and she is walking," said the mother of 5-year-old Ajak in South Sudan.

Ajak was ill with malaria, the number one cause of death in South Sudan.  Ajak and her mother had come from Nyeith village to Panthou Primary Health Care Center (PHCC) in Aweil South County, a facility supported by the MSH-led, USAID-funded Sudan Health Transformation Project (SHTP II). SHTP II focused on improving the diagnosis and treatment of malaria in that fragile state emerging from 35 years of conflict. Arriving in a coma, Ajak was admitted to the pediatric ward for further management and investigation.

The Panthou medical team immediately started Ajak on a quinine drip for a presumed malaria infection, which blood slides then confirmed. The following day Ajak remained in a coma, and her mother’s hopes for her child’s recovery were fading. In discussion with family members, Ajak's mother decided it was time to bring the sick child back home to their village.

{Photo credit: Warren Zelman. DRC}Photo credit: Warren Zelman. DRC

MSH's current newsletter (November/December 2013) features stories about the people on the frontlines improving health and saving lives: health workers.

A Note from Dr. Jonathan D. Quick

My MSH colleagues Mary O'Neil and Jonathan Jay blog about what we can learn from the Third Global Forum on Human Resources for Health, held this November in Recife, Brazil:

Recife Top Ten: Together Toward Health for All

 {Photo credit: MSH/Filmona Hailemichael}Dr. Florence Guillaume, Minister of Health of Haiti.Photo credit: MSH/Filmona Hailemichael

On June 7, Management Sciences for Health (MSH) and partners hosted Dr. Florence Guillaume, the Minister of Health of Haiti, and panelists for a Capitol Hill luncheon on community health workers in fragile states. The day before, MSH hosted Guillaume in Cambridge, MA, for a town-hall style event on improving maternal and child health. Revisit the two events through a "Storify" story of photos, text, and tweets.

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