KCPP six monthly narrative report - October 2007 to March ...image.guardian.co.uk/sys-files/Guardian/documents/... · inadequate teaching materials that are required to make the thematic

CASE STUDIES

Health

Community vaccinators support health workers in increase immunisation outreaches

One of the most pronounced challenges in Katine is the severe shortage of health workers. The main health centre IV that serves Soroti county has not had a doctor for over a year. Tiriri HC IV only has 20 health workers, ten staff members short of the minimum government recommendation. Ojom health centre II which is supposed to have a minimum of four health workers has had one person man the centre for over six months. Only Katine HC II, a missionary owned clinic has the recommended minimum number of staff. Considering the nationwide shortage of health workers where the doctor to patient ratio is 1: 6,000 and nurse to patient ratio is1:26,000, attracting medical staff to Katine is not an easy task.

Health centres should run community outreach activities according to government policy such as immunisation and health education but with such few and overstretched staff this is near to impossible. In August 2008, KCPP trained 15 community vaccinators to support health workers in bringing immunisation services nearer to the community. After training, they immunised children under five years against the eight childhood killer diseases under supervision at the health centre. There are now five community vaccinators assigned to each health centre. Their time is spent between visiting villages immunising children, with two days in a week spent doing the same at the clinics, reaching many more community members with critical health services.

Lucy Ariamo, the only health worker running Ojom health centre II says about the project: “I am glad they sent us vaccinators. They have simplified our work; we are now not overloaded like before. Before, you had to handle patients here but you also had to carry out community outreaches. It’s difficult working alone. And when drugs arrive the number of patients increases, yet I still have to carry out immunisation activities too. I wouldn’t have managed on my own. But now they [community vaccinator] can work on the immunisation side as I also handle other things.”

The in-charge at Katine Health Centre II, Kevin Omongin has the same view. He appreciates the work that the community vaccinators do. “Most of them are hard working; they really help us on the community outreaches and immunisation activities here [at the health centre],” he says, before adding. “They now know what to do and we send them out on their own.” The KCPP Project Assistant for Health, Alfred Okurut, says that the government’s Expanded Programme for Immunisation (EPI) is one of the main targets of the Ministry

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of Health to ensure that all children under five years are immunised to eradicate the eight killer diseases.

“It was necessary to train community vaccinators so that these services reach hard to reach areas,” he says the project trained 15 vaccinators for sustainable purposes. “The challenge with training many people is that when the project winds up, maintaining those people by the health centres is hard. We had to agree on the number to be trained.”

The community vaccinators themselves are excited about their work. Akiror Pamela from Oderai village in Olwelai Par ish is a c o m m u n i t y m e d i c i n e distributor trained as a community vaccinator.

She says: “the training gave me more skills in vaccination and I can help t h e c o m m u n i t y . Yo u imagine Oderai is very far from here [Tiriri health centre IV] when it comes to immunisation the number coming here is smal l because it’s far. The number of children immunised has been very small but since we have started carrying out outreaches the number will be big.”

Above photo: Akiror Pamela, a Community Vaccinator doing her work.

Education

Getting parents involved in their children’s education; making local teaching materials

Katine schools had a shortage of 26,0001 text books to enable teaching and learning; the project’s budget allowed for the provision of 6,000 textbooks to primary schools. As the project is focused on community participation for development, an idea emerged for parents in partnership with teachers to produce local teaching materials.

In September the KCPP through the education component organised a four-day course on training and development of local teaching and learning materials for primary schools.

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About 100 parents and 15 teachers were expected to take part in the excise. However over 150 parents and 20 teachers participated in the training, all fully committed to what they were doing.

The headteacher, Otim Onyang, of Ochuloi Primary School where the training took place was full of excitement observing parents and teacher preparing materials to be used in schools. He recalled the days when he had just completed his studies at the teachers training college.

“In those days, it was prestigious to be a teacher. Teachers loved their work and were highly motivated to teach. It was mandatory that a teacher had to prepare teaching aids before entering any class to teach.”

It was with a nostalgic tone that Otim expressed his gratitude to the parents and AMREF for organising such a mass gathering of parents to develop materials that would aid their teaching.

He was particularly happy that it was going to enable them to teach using the thematic curriculum better.

This was the second training of its kind. The first, where six schools participated, was organised in the first half of the year. In this second training seven schools participated.

In Katine teachers had inadequate teaching aids to use in teaching the children. Therefore the training was intended to supplement and address the challenges of inadequate teaching materials that are required to make the thematic curriculum

teaching and learning reality.

The fact that materials are locally sourced and made makes it an appealingly sustainable activity for the teachers, parents and children.

Photo: Figure cut out puzzles for teaching infants and painted play tyres all done by the parents

Since there is limited material developed for use while implementing the curriculum especially for infant classes, the materials developed are expected to ease the work


of teachers especially in crowded classes and make the learning process more interactive and participatory.

In addition, the development of the materials by parents enabled them get involved and interested in the learning of their children while at the same time developing their literacy and numeric skills that enhance their ability to monitor child progress in school.

WATSAN

Empowered VHTs bring change in their community

On May 22, 2008, Emmanuel Olege completed a village health teams (VHTs) training conducted by KCPP water and sanitation component alongside another 131 VHTs (49 women and 83 men.)

One of the objectives of the training was to equip VHTs with the necessary knowledge and skills on promotion of hygiene and sanitation. After that VHTs had to draw up strategies and action plans for improving hygiene and sanitation in their respective areas.

In the course of the training Emmanuel couldn’t stop contemplating on how he would put what he was learning into practice, to benefit his community and finally settled on sensitising his community through music, dance and drama.

Therefore on May 25, two days after the training, Emmanuel initiated a music dance and drama group. The group’s name was Kalela Sanitation Club.

Emmanuel, the founder and the chairperson of the group, said “the group started to educate communities about sanitation in particular and health in general. They moved around homes, markets and churches raising awareness to people on these issues.”

Since its inception, in less than three months, the group reached community members in two villages, performing in homes and also staging one in a market. They have so far been to four churches, performing to congregations.

“The church is the best way to reach many community members at the same time. So when we talk to the [church] leaders and they grant us permission we are always glad to reach those many people,” Emmanuel said.

He added that the group was planning to expand to wider areas to reach more people with their messages.


“During the training I realised that in our community we were backwards. That is why I decided at least to pass on sanitation and health messages to community members,” he says.

“Most of them picked up on what we were teaching them. Besides, each group member made sure that they had latrines, a drying rack and other things we are talking about at their home. This is a new development in our village,” he says.

Samuel Okiror, the group mobiliser concurred with his chairperson. He said: “It [the group formation] has already brought change in the communities evidenced by the number of latrines in the community. Members have latrines in their homes and this is a role model to other homes.”

The Kalela Sanitation Club has 30 members and still open for new membership. They have not limited themselves on sanitation but also to educating communities on reproductive health, HIV/AIDS and immunisation.

To sustain the group each member contributes Uganda Shillings 1,000 (less than US$1) and so far they have collected Ush 30,000, from the 30 members in the group.

On August 20, the group had a show in one of the homes in Kalela village in Olwelai parish. The short play was about sanitation, trying to change community attitudes.

In the play a couple is adamant about the sanitation sensitisation messages by a health team member.

The husband says they don’t need a latrine because they have a bush nearby, besides, the last time they had a latrine their son fell into the pit. Therefore they don’t believe they need one.

Photo: Emmanuel Olege in one of the plays in the community

At the end of the play, the local council leader informs the village authorities about the couple and they are arrested.


In another play, friends share the advantages of having a latrine, bathing shelter, a separate shelter for the animals, a drying rack for utensils, etc and they are happy with the new development at their homes.

Besides short plays, the group also sings songs, sensitising the audience about hygiene and sanitation and HIV/ADS. In one of their songs they hail AMREF for coming to Katine.

“We thank you AMREF for coming here, we were backwards but now we have been uplifted. Katine has been backwards for all these years but you have promoted education, sanitation and health and also promoted development,” part of the lyrics of the song.

AMREF is training and working with VHTs in Katine so that they can reduce the incidence of preventable illnesses. They are expected to improve hygiene standards of communities through awareness creation and positive practices.

Two other sanitation clubs have been formed using music dance and drama to sensitise their community about sanitation and hygiene. Meanwhile, parish chiefs from other parishes in Katine are also embarking on the plan to establish drama groups to sensitise community members in their areas.

Livelihoods

Group work; Members of Ojemorum Framers Group weeding their cassava demonstration garden.


“My name is Julius Moses Otim from Ojemorun village. I am 31 years old and married with 4 children. Before the project my family had at the most two meals a day. Because of unreliable weather, my family sometimes depended on the local market (Arapai) to acquire food. Sources of income were minimal to support the family in terms of food, medication and school fees. We are still struggling to cope from the insurgency that depleted our wealth in terms of livestock and we depend on the sale of family produce for income.

Since being part of a farmer’s group, I have diversified my family source of income through borrowing money from Ojemorun Savings and Loan Association (VSLA) where I joined as a member. I now deal with business in produce which I sell and get a profit which I use to pay for my son’s fees in a tailoring school, buying scholastics for other children in primary level, and other domestic obligations (medical care, buying food.) I have borrowed money three times from the group.

As the chair of the group I have been able to share experiences with other group members; and this has made me more focused and confident. I look forward to building an iron sheet-roofed house, educating my children up to university level, having livestock e.g. goats, cattle and enough food to have three meals a day in my family.

Other members of the group have been able to borrow money to carry out different income generating activities, especially women, which has motivated group members. More people are requesting to join their groups.

My group has 25 members and has so far accumulated UGX 126,000 (= £39) from monthly contributions of UGX 2000 per member. This money is lent out to interested members at an interest of 10% per month. The group received planting material for improved cassava (variety Akena) which they have planted in the demonstration garden. I hope this demonstration garden will facilitate my group to learn modern farming practices, and shall also provide a source of cuttings to the group members.

As Chairperson of the group, I lead and guide the rest of the group members especially in problem solving and mobilise group members to carry out group activities and lobbying.

If we are trained on savings and credit we would be able to accumulate our savings and buy a grinding machine that will generate income for our group. There is nothing that you can get freely, food has become very expensive and money has lost value. I am happy about the project and feel that with more knowledge on income generation, savings and credit, we will be a better community that will be able to educate our children, accumulate savings and improve on nutrition and income.

In the future, my group plans to save money to buy a grinding machine to help process produce and generate income for the group members, we would like to ensure each participating member’s household has enough food to afford three meals a day and have


excess for sale to generate household income, we want to open an account in the bank to safeguard our savings, lobby for more support from different stakeholders. I want to save money to educate my children at secondary, tertiary and university levels and finally improve on farming practices and produce enough food for household consumption and sell the surplus for income.

Community Empowerment

Empowerment through Information Sharing. Margaret Aniko a VHT and her radio talk show experience on radio Delta FM.

Margaret, 30 is a married woman with 3 children. When AMREF started running the radio programme in September this year, Margaret who is one of the 272 Village Health Teams (VHTs) in Katine Parish was identified as a suitable community member to participate in the radio programme because of being an active VHT and being able to communicate in Kumam - a local language popularly used in Katine Sub county in addition to Ateso. She feels proud of being part of this radio programme and she takes off time with her family to attend this weekly one hour radio talk show from 6-7pm. At this late hour Margaret cannot make it back to her village in Katine so she stays with her brother in-law in Soroti town.

Considering the wider coverage of the radio, Margaret’s health education messages reach out to many people in Katine and beyond compared to 25 households she reaches in her village as a VHT. During the radio talk shows, listeners from all over Katine and the other sub counties within Soroti District and ne i ghbo r i ng d i s t r i c t s (Katakwi, Kaberemaido, etc) normally call for clarifications and additional information and Margaret would confidently respond especially for those queries addressed to her. Even when out of the studio, people are more eager to ask her questions on a host of issues than before because she is now more exposed. She has become a local celebrity of sorts.


She believes that the radio programme has made her known to many people and also improved her communication abilities/skills because of the greater interaction the radio has exposes her to.

‘I feel I am more empowered and worthy of being valued with equal footing with my husband’ she says.

Margaret says that the VHT radio programme has done a lot to re—inforce VHT roles and responsibilities while also making communities understand their roles better. The challenge however is the lack of drugs which is limiting their effectiveness to reinforce health messages the radio programme has provided.

Photo: Aniko Margaret, A VHT who feels empowered through radio talk shows.


KCPP six monthly narrative report - October 2007 to March ...image.guardian.co.uk/sys-files/Guardian/documents/... · inadequate teaching materials that are required to make the thematic

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