April 27, 2020
By Wade Zamechek, Village Health Works
Village Health Works has enjoyed a strong partnership with PWRDF for many years through the All Mothers and Children Count program, so when PWRDF allocated $60,000 of its COVID-19 response to VHW, health care professionals and Community Health Workers knew they could count on a caring approach.
VHW has been preparing since mid-March to confront COVID-19 infections – hoping for the best, while preparing for the worst. With limited pre-positioned resources, it has developed a strategy based on effective containment through protecting patients, health workers, the members of its community, and treating who it can treat. Moving quickly, it was able to secure the ingredients to produce hand sanitizer, which is being distributed widely on campus. Thanks to the work of our procurement team, VHW already has 124,000 gloves and 5,200 N95 respirators. It also implemented changes to its clinic, seeing only 80 patients per day (instead of numbers that could reach 180), spacing prenatal visits throughout the week to about 25 per day, and setting up tents to promote physical distancing – complete with hand washing stations. Dr. Aime Nzambimana, a physician at our clinic overseeing our hygienic response said, “Now everywhere people are washing their hands, wearing masks and, what we call, physical distancing. We are together but we must be physically distant”
One colourful solution to protecting both community members and staff is crafting facemasks from the local kitenge cloth. These facemasks are part of an effort to ensure that personal protective equipment (PPE) is available to help protect all staff (and as a reminder to refrain from touching one’s face), while helping to reserve the more limited amounts of medical-grade masks for the front-line health workers. This increase in demand has meant that the sewing cooperative VHW sponsors has had to add additional staff. Gaudence, a longstanding sewing cooperative member, says “It’s a lot of work, but it’s important work, we are preventing the spread of this virus, not only for our protection but for the people around us.” The sewing collective is making more than 100 masks a day and distributing them to community members.
VHW’s strong involvement with its community includes traditional music and dancing for the youth in our catchment area, helping them connect with their history and keeping traditions alive. These well-attended and popular activities are another victim of the new physical distancing requirements. “Unfortunately we had to stop our music and dance activities, it feels impossible to get all those children to keep their distance from each other” says Fabrice Nkurunziza, one of the leaders of our Community Engagement Team. “Every time I see one of the kids, they ask, ‘Why did you cancel it? When will we start again?’ … It’s very sad. They tell me that all these rehearsals help them focus more, it makes them feel good…but they are keeping their hope strong.”
While actively preparing for the immediate future, VHW is continuing its work to build a 150-bed teaching hospital (scheduled to be completed in 2021) recognizing that the critical infrastructure needed for a hospital can prove critical in the kind of crisis that results from a pandemic – in particular, the ability to deliver oxygen as essential treatment to a large number of patients. When completed, the hospital will provide greater support for the entire health system, allowing a more effective response to situations such as the ongoing spread of COVID-19. Greater space and more trained staff will allow VHW to better respond to unexpected developments, as will additional testing capabilities and the availability of isolation wards.
VHW’s Medical Director, Dr. Tarek Meguid, emphasizes the importance of an overall health system as a goal to building the hospital: “There is a huge portion of the population without access to high quality healthcare, and their situation does not improve as it otherwise could. Building this hospital is a meaningful contribution towards strengthening the health system, and to finally providing high quality healthcare to people who need it desperately. Every delay means more suffering for the people who need these services, and do not have it.”
This pandemic is also an important reminder that this new anxiety faced by residents of the U.S., Canada and Europe is what the people of Burundi feel all or most of the time. This is not unlike the fear a Burundian mother would have every time her child comes down with a fever. For comparison, over half of Burundi’s population contracted malaria last year with conservative mortality estimates of between 3,000 and 5,000 for each of the last three years. And that is malaria alone. That does not consider diarrheal illness, respiratory illness, childbirth, hypertension, diabetes, stroke, epilepsy, cancer, motor vehicle accidents and all the other things for which care is woefully inadequate. If anything positive can come out of this, VHW hopes for a more visceral understanding of what this feels like for too many in the world even on “normal” days – and a heightened sense of social solidarity.
Preparing for both the immediate future and the long term, VHW is bringing health and hope to Burundi. Asked if there was anything she’d like to say to her friends in North America, Sandrine says, “Don’t be afraid, don’t focus on this virus too much, when we are afraid the immune system gets weaker.” Her colleague Peter added, “We hear it’s bad over there, in all the world people are dying. But you know this will pass. …. We empathize. We feel with them. We support you from afar.”
Wade Zamechek is the Director of Development for Village Health Works.