Helping Children Survive in Democratic Republic of the Congo: A Family Tradition
"My mother taught me that I had to help others, because many children my age were dying."
Narcisse Naia Embeke, 41, comes from a small community in South Ubangi in northwestern Democratic Republic of the Congo (DRC). When he was young, a measles outbreak hit his village almost every year between October and March and in those months, he remembered, an average of eight children died every day.
Childhood death from the disease became so common that there was a saying, Narcisse remembered: "Until measles has passed, don't count your children."
Narcisse's father, Embeke Ngolenga, was a nurse who worked to implement primary care in DRC and was active in the effort to vaccinate children in their village against measles. Embeke said Ngolenga often woke up at 4 am to transport vaccines 50 to 100 kilometers to reach children in local villages, because local health centers did not have a way to keep vaccines cold. When he was young, Embeke once made this journey with his father. He saw that health centers needed refrigerators, children needed vaccines, and villages needed doctors. And from that point on, he said, he knew he wanted to work to fulfill these needs.
Embeke now works as the child health senior technical advisor for the Integrated Health Project (IHP), a five-year project funded by USAID and led by MSH that focuses on capacity building to improve reproductive, maternal, neonatal, and child health, among other health goals, in DRC. The project aims to improve accessibility, quality of health, knowledge and leadership, and works in four provinces and 78 of the country's 516 health zones. IHP trains and supervises health care providers and provides essential commodities and equipment, like fuel and refrigerators.
IHP uses a seven-step analysis to select the best intervention for a specific context and has also implemented Integrated Community Case Management (i-CCM), a program that dispatches trained and supervised community health workers to provide basic care for communities that have traditionally had limited access to health care.
In his role, Embeke is responsible for planning, organizing and implementing IHP's child health activities, and for monitoring results. He also provides guidance to ensure that these activities follow international and national guidelines and works on integrating child health services into existing health programs.
Embeke said he has seen a big change in accessibility, quality, knowledge and leadership when it comes to healthcare in his country. One of the biggest changes he has seen, he said, is improvement in the quality of training for doctors, nurses, and community health workers.
"In the past, it was classic training. You sat down in the classroom and they taught, like in high school," he explained. "And that changed to practical [hands-on] training."
Indeed, after IHP provided training to maternal care providers on a set of low-cost, high-impact activities, survey results showed dramatic changes: In October 2010, prior to IHP interventions, 44 percent of infants in 78 health zones were receiving essential newborn care; as of March 2015, that figure is at 86 percent. IHP data also show that the percentage of women in these health zones that delivered at a facility has risen to 89 percent, from 53 percent in 2010.
I-CCM, Embeke added, is saving the lives of many of the country's most vulnerable children who do not live close to health centers, because they can now receive treatment in their own villages. IHP estimates that the project as a whole has helped save the lives of more than 100,000 children.
And though DRC still has one of the highest under-five mortality rates in the world, this rate has gone down. DRC as a whole has the goal of saving 430,000 children under five by the end of 2015, and Embeke is hopeful that his country, with the help of programs like IHP, the DRC government, and other partners including UNICEF, World Bank, GAVI and the World Health Organization, will succeed in reaching it.
"We can reach this goal," he said. "If this work continues to accelerate, I think it's possible."
Embeke has two children, ages nine and four. It's unusual to have only two kids in DRC, he explained. Families are often large because of the expectation that some children may not reach adulthood. But Embeke is grateful, he says, that he can count on a healthy future for them.
"In the past, having two children in our country was crazy ... But now you can plan for [your children]," he said. "What it was like in the past and what it's like now are very different."