Beyond the End of the Road: Providing Health Services To Marginalized Rural Populations
By: Olusimbo Ige, MD,MS,MPH,
Executive Director, Global Health Unit, Global Ministries
When Jean Shailunga of the Democratic Republic of Congo (DRC) contracted cholera, he was more fortunate than many of his neighbors in the rural community of the North Katanga Province. The change-maker for Shailunga was the 16-day cholera treatment he received at a Kizanga United Methodist health center. Health facilities in North Katanga are few and far between and often not equipped with medicines and supplies.
For global health efforts to succeed, several factors must work together. Without the health center where Shailunga received treatment, committed doctors and nurses, lifesaving medicine, critical supplies and more operating together, his experience might have been quite different. Without assistance, unaffordable prices mean that many patients will simply go without treatment. To assist low-resource communities, the Global Health Unit of Global Ministries supports access to essential medicines and health services in rural communities around the world. Our support comes in many forms.
Transportation difficulties in rural areas makes access to services very challenging. In Central Congo the Dingele Methodist Health Center is the only health facility serving a population of 8,450 people living in 13 villages. One of the patients who shared her story is Marie. Marie had been pregnant 3 times, carried all 3 pregnancies to term but none of the babies was born alive, they had all been delivered at home. When she became pregnant again, her husband discouraged her from attending the clinic again. Walking to the clinic 7 miles away was not worth the trouble he said. A trained community health worker however offered to walk with her to the clinic for prenatal services. By the end of her eighth month when she fell into preterm labor the doctor and his team were ready to intervene. Mother and baby survived. A volunteer network of Community Health Advocates (CHA) trained to visit their pregnant neighbors can make a difference in health care choices. They provide the community with health education and care, encouraging the women to visit the clinic regularly and to have their babies delivered by trained midwives at the clinic.
Since 1960, planes and pilots have been a vital component of the outreach of the United Methodist Church in Africa. The long distances and poor infrastructure found in the DRC often make air travel an essential part of getting medical staff, to the places where they need to help. The United Methodist Church in the Congo is blessed with a dynamic team of Congolese pilots who today provide the same level of quality air service as their Western missionary pilot predecessors did in decades past. With three airplanes in operation patients in critical conditions are flown to higher treatment centers. Gaston Ntambo, the piolot of the wings of morning says “People can walk 60 to 100 miles to get to a hospital in the DR Congo. People that we fly are people who have tried everything. They use the traditional medicine, they have tried the local medicine man, there are no clinics nearby—so basically, they have one chance to survive. They are in their last stage of life when we get called in.”“The most difficult thing we face in Congo is not flying in bad weather or flying onto difficult air strips. It is making that choice of flying in the wrong direction first and knowing that somebody is dying behind us. Sometimes I am afraid to go fetch fuel when they call me for a medical flight. We do the best we can to plan for it.”
Nigeria is one of the four countries accountable for nearly 50% of global malaria deaths. With a population of about 170 million people, many rural and hard to reach villages are left out of national malaria control efforts. The Rural Health Program the United Methodist Church of Nigeria focuses on these remote and forgotten places. It responds to the needs of communities tucked away in the nooks of the Sandstone Mountains of North Eastern Nigeria, along the banks of the Upper Benue River, and stretching across Federated States of Bauchi, Gombe, Taraba and Adamawa States. In these communities, pregnant women and children under five receive long lasting insecticidal nets (LLIN) and malaria diagnosis and treatment through mobile clinic operations supported by Global Ministries.
For mothers in San Juan, maternal and child health services are not always readily available. Rosario is one of the women who attended her prenatal consults at the Global ministries supported ODIM clinic. Nearing the end of her pregnancy, Rosario developed urinary tract infection and went into early labor. The staff at the center started her on treatment and accompanied her to the nearest national hospital for an emergency caesarean section. This is a 90 to 120 minute journey by mechanical rickshaw, boat and truck. Thankfully, Rosario returned to San Juan with her son, Joni. The Community Health Workers from ODIM supported her at home to care for her premature child and regular visits to the infant welfare clinic. Six months down the road everyone was excited to see Joni’s weight and length normalize. “Now that Joni has reached a healthy size, we are confident that he will continue to thrive” says Holly Burkoski, Community Health & Education Program Manager. This program has reached over 2000 indigenous women and their children through Mamá y yo, saludable (Healthy Mommy and Me) project.
In Liberia, the John Dean Town Clinic is the only health facility serving the remote John Dean Town community in Grand Bassa County, Liberia. The once-dilapidated clinic, with no water, electricity, or trained staff, received a new lease on life. Until recently, most care, including that for pregnant women, newly delivered mothers, and babies, was provided by traditional birth attendants with limited skills. This often led to negative outcomes for mothers and babies. Now, with support from Global Ministries, the John Dean Town Clinic has the capacity to provide community health education, delivery services, immunizations, family planning services, and treatment for common childhood illnesses. The clinic has hired a new nurse midwife, built a well with water piped to the clinic, and established a regular supply of medicines. The resident nurse/midwife also helps train Community Health Volunteers to serve the community and encourage mothers to have their babies at the health center. Now pregnant women are brought in hammocks by “runners,” who travel one hour by foot in order to save mothers in labor. Innovative solutions with community participation like this are critical components in the fight to stave off maternal deaths in remote areas.
The Global Health Unit supports more than 300 mission hospitals and clinics in sub-Saharan Africa, Latin America and Asia. There are many things in life that we can choose, but the place where we are born is not one of them. No one should suffer ill health or die prematurely because they were born in the “wrong place.” Our work in Global Health is to ensure that every child in every place has the opportunity for the abundant life and abundant health promised by God. We recognize that in all countries—whether of low, middle, or high income—rural dwellers often experience significant health disparities compared to the general population. The geographic isolation, lower socio-economic status, higher rates of health risk behaviors, and limited job opportunities leads to poor overall health and higher rates or illness when compared to urban populations. This is worsened by the limited access to health care services. Global ministries works with a global network of faith based organizations providing funding, information, and technical assistance to improve the health and healthcare in rural communities.
Church is more than a place to go; it is putting beliefs into action to transform lives. One-way United Methodists are innovating what it means to be church is through a variety of health initiatives. Our goal is to reach 1 million children with lifesaving interventions by 2020. Work has already begun to actualize this promise.
The General Board of Global Ministries (Global Ministries), the global mission agency of The United Methodist Church, connects 13 million United Methodists in 120 countries—through people, projects, and partnerships. Together we are alleviating suffering, promoting justice, freedom, and peace. The United Methodist Committee on Relief (UMCOR) and Global Health Unit (GHU), are both ministries of the General Board of Global Ministries. To achieve Global Ministries’ vision of abundant health for all, the GHU supports efforts to protect children and disadvantaged adults from preventable causes of death and disease in economically vulnerable communities.
Global Ministries is a member of the Georgia Global Health Alliance.