29th April, 2008
There has been debate surrounding the AMREF Katine Community Partnership Development Project Village Health Teams (VHT). The questions range from their expertise to the terms used to refer to them.
“Why are they called village doctors?”
“Why VHT and not community health workers like we have previously known them?”
“How do they diagnose, before giving treatment?”
All these were questions raised at the AMREF Katine Project stake holders meeting, held on April 3, 2008.
The village health doctors’ title has been controversial to say the least. It has been said that it may mislead the VHTs into thinking that they may have more technical expertise than they actually do or, that they may start assuming more medical roles than they are trained for. However, the fact is, that the title is based on a story title published a couple of months ago.
“This is not a term coined by the community or the project,” said Dr. Charles Luwaga, AMREF Katine’s project officer for health. “It was a creative name given to a story; it was symbolic if anything. It was just taken out of context”
VHTs don’t walk around assuming their village doctors because of the story that run, matter of fact, most of them are unaware of it.
Thirty eight- year-old Ebalu Moses who has been a VHT since 2001 has never even heard of the name. “If you were to use the title, people would assume you’re referring to herbalists or traditional healers rather than VHTs” he says
Part two. The reason VHTs are not referred to as community health workers, is the fact that AMREF believes very much in capacity building through the already existing structures. VHT is a structure that was developed by the Ugandan government. It was established under the Ministry of Health National policy.
“VHTs are the way to go in the decentralized health delivery system,” says Dr.Okadi, deputy district health officer, Soroti District. “They are in the policy of promotion and prevention of health care, most diseases are preventable and it is our role to empower communities to promote ways to prevent them.”
AMREF has been giving training to the VHTs; the most recent was the training on home based care of children illnesses.
“We invest and reinforce existing structures,” says Dr. Charles, we are giving training to the community itself for a more efficient and people driven service delivery.”
Initially, VHTs were broken into two groups. There were the mobilizers referred to then as VHTs and drug administers referred to as Community Medicine Distributors (CMDs). Nowadays, they are all just known as VHTs. They all receive training on diagnosis and treatment. However, there roles in both cases are limited to Malaria and diarrhea, which are some of the main ailments in Katine Sub County.
“The VHTs are not trained to conduct laboratory tests but simple clinical diagnosis” says Dr. Charles. As a government guideline, any fever cases for children beyond 2 months of age are treated as malaria. This is what the VHTs go by, since Katine is a malaria prone area.
According to a community survey conducted by the AMREF project in December 2007, malaria in children is a burden through out the year. Almost 8,000 cases, 63% of the total outpatient visited the three health centers in Katine between October 2006 and October 2007.
VHTs are only allowed to give first aid, or treat malaria and diarrhea through anti malaria tablets or oral rehydration salts for diarrhoea.
“Malaria is a huge problem that is being tackled by VHT; they are reducing the enormous pressure on the health centres. Many people who can not get to health centres due to the distance are also ensured of support. A single VHT supports 25 homes within his area of residence,” says Ekulu Emmanuel, a VHT parish coordinator, Ojom parish.
Twenty-three-year old Samuel Esagu is one of such. “I have been a VHT for the last 3 years; I walk around homes just to make sure that they have the necessary information. I also check on the hygienic sanitation practices and net use. If any one in the homes is unwell, I offer basic treatment or refer them to hospital.”
Nora Among, a mother of 2, from Obocoi Village, agrees, “VHTs help you quickly because they are so close by. Before, one would have to walk very far to get to the health centre or access medicine.”
| The Katine project is run in partnership with The Guardian, AMREF and Barclays. To find out how you can support the Katine project go to www.guardian.co.uk/katine/ |