| Consuntivi Attività 2005 | ||
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International Development Organization
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Primary Health Care Project in Sololo, Moyale District, Project Report January-December 2005 |
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Background “Comitato Collaborazione Medica” (Medical Collaboration Committee) CCM
is a non-governmental organization of international development cooperation
founded in Moyale is a district in the northern part of Since 1982, CCM has been providing health care services in Sololo by supporting
the local Sololo missionary hospital. The activities of CCM during these
years were within the hospital. However, in the last few years the focus
of CCM intervention has shifted from support of the missionary hospital
to extending its services outside the hospital through the primary health
care project and supporting government - run dispensaries around the
areas of Obbu and Uran divisions. This was after an assessment conducted
by CCM in the area which indicated that a large population could not
access the health services provided at the hospital either due to the
distances involved or the inability by an individual to afford the cost
sharing fee charged by the hospital. It was therefore deemed appropriate
to establish a Primary Health Care project that would provide services in communities
that have no access to health services/facilities through provision
of mobile curative services as well as support to the government dispensaries
that are more accessible to a majority of the population due to the
affordable cost recovery fee charged in these facilities. The mobile
clinic services are reinforced by a community mass education initiative
that aims at raising awareness amongst the community on issues regarding
health and sanitation in order to promote good health practices. This
is complemented by a social welfare project that provides assistance
to poor families and students in the form of food rations, capital to
start income generation activities, restocking of livestock and scholarships
with funding from private donors. The assessment also indicated that water is a major problem within the
district and hence a major source of conflict. The recurrent droughts
experienced in Water and pasture being a major source of conflict between the Moyale community
and its neighbours, particularly communities living in Obbu and Uran
divisions of Moyale, CCM deemed it relevant to include water projects within its interventions. This involved the drilling
of a borehole and rehabilitation works in Amballo and Sololo town. CCM
has also in the past worked with the local Chiefs in creating awareness
on environmental management issues through its mass information activities
to ensure that the communities understand the need for proper management
of the pasture resources and advocate for traditional measures of pasture
conservation. This has helped reduce tension and conflict for the residents
of Obbu division who for many years had problems with the communities
in the neighbouring district while in search of water and pasture for
the livestock. However, the water points (boreholes) available are still not sufficient
for these communities compared to the livestock population. The management
of the pasture resources is also affected by this as there is often
overcrowding at the points where there are permanent water sources (boreholes).
There is therefore a need to have permanent sources of water in order
to reduce the possibility of conflict with the neighbouring communities.
This should however be coupled with community dialogue with the aim
of reconciliation as one community cannot exist in isolation and there
will always be a need for interaction between these communities in one
way or the other. Development of water resources to sustain the livelihoods
of the communities and prevent inter-tribal clashes in Moyale district
has therefore become an integral part if CCM’s strategy for support
of the area. In 2005, CCM was able to continue with its primary health care activities
through a project funded by SACCHI. This project aimed at improving
the welfare of the community through enhanced access to Primary Health
Care. The specific objectives of this project were: To provide outreach health
services through a mobile clinic To support government dispensaries
in the provision of curative primary health services To enhance the provision
of quality and safe health services by low cadres of health workers
through training To conduct mass information
activities on health Project Activities The project provides mobile clinical services for areas that are not endowed
with a health facility. Five mobile clinics were conducted in a month
where patients were visited by two nurses seconded by the public health
office in Sololo to CCM. Drugs were provided at no cost during the period
to the clinics in a bid to encourage people to seek health services.
The following graph represents the number of patients visited by the
mobile clinic during the project period:
In the month of January 2005, there were no mobile clinic activities due
to rampant insecurity that plagued the area in this period. This rendered
the roads insecure and inaccessible for any project activities to be
conducted. During the months of February – April 2005, the low morbidity
rates can be attributed to the rains experienced during that time, thus
most of the areas served by the mobile clinic could not be accessed,
particularly for Amballo and Walda dispensaries. In addition to this,
due to unfavourable security conditions in the months of May and June,
Amballo dispensary did not realize any morbidity returns. This was due
to the closure of the dispensary since all the people had left the area
in search of pasture and no one was utilizing the services. It is also
anticipated that once the morbidity reports of the centre are submitted,
the morbidity figures will be very low. The same problems of insecurity
and inaccessibility were realized in the months of September-December
2005. It is important to note that the mobile clinic did not operate
in some dispensaries in 2005 due to unfavourable security conditions
in Moyale.
The project vehicle Through this project the Amballo dispensary was rehabilitated in 2002 -
2003 and a residence unit constructed for the nurses working in the
dispensary to ensure that the dispensary is fully covered in terms of
staffing due to its remote location. The dispensary was furnished and
equipped through the project and the initial drug supply provided by
the Ministry of Health office in Moyale. The dispensary was expected
to be fully functional by the 17th January 2005, with the
Ministry of Health having identified and seconded a medical staff to
the dispensary. There was a delay in identifying and seconding of medical
staff to the dispensary. However, this was eventually done in April
2005.
The Amballo Dispensary
The accommodation unit for the Amballo Dispensary In the framework of this project, three government dispensaries around
Sololo namely Amballo, Damballa Fachana, Golole, Uran and Walda dispensaries were supported through the provision of drugs with
the staff being seconded by the government hence paid by the government.
These dispensaries being supported by the project are also the referral
centres for the mobile clinic patients whenever referral or follow up
treatment was necessary. The following graph represents the number of
patients visited at the dispensary during the project period:
Through the same project, trainings were conducted for community health
workers (CHW), traditional birth attendants (TBAs), village volunteers
and village health committees (VHCs) to ensure that the population of
Sololo receive quality basic health services and enhanced safe delivery
practices for the expectant mothers. A third phase training for 15CHWs,
16VHCs and 19TBAs was conducted in February 2005. Refresher training
was conducted in June 2005 for 14CHWs, 17VHCs and 19TBAs. A fresh batch
of trainees started their first phase training in September 2005 consisting
of 18VHCs, 20CHWs and 15TBAs. This was followed by second and third
phase trainings of 17CHWs, 13VHCs and 18TBAs, conducted in November
and December 2005 respectively. The figures of the trainees are varying
each month due to the stringent rules that must be observed during all
the trainings. I.e., if a trainee defaults from one phase, s(he) can
not be allowed to continue with the next and has to being the training
again. This is to ensure quality trainings and trainees graduate in
their respective fields. The pictures that follow depict two TBA training sessions being presented
to the community and the other two pictures are of graduates i.e. TBAs,
CHWs, and VHCs displaying their certificates.
(i) The VHCs who completed their training displaying their certificates.
(ii) CHWs displaying their certificates upon completion of their training.
(iii) Two practical TBA training sessions
(iv) The TBAs who completed the training displaying their certificates. These activities were complemented by regular mass information activities
on health related issues particularly HIV/AIDS through video shows and
public health education sessions. The video shows were conducted in
collaboration with the Public Health Office in Sololo where after every
show on health and sanitation related issues, the community received
a lecture from a Medical Worker on the subject relevant to the show
which was then followed by public discussions. Sixty video show sessions
were held during the project period and on average of 200-250 people
attended each session with the highest attendance being of four hundred
people. The Sololo community highly appreciate these sessions which
they say are quite edifying and enlightening especially for the youth
with regards to the deadly HIV/AIDS scourge which has also had its effect
on the community. UNICEF KCO( The project
was started in late 2004 after a delay of disbursement of funds from
UNICEF KCO. After the rains arrived, the project could not be continued
and this led to the revision of the activities. A letter was written
by CCM requesting re-channeling of funds to suit the identified needs.
According to the agreement, CCM agreed with UNICEF to use the project
funds to construct a water tank, two water troughs and rehabilitate
the pump in Amballo. The works contracted included:
Collaboration
with the counterparts and the community was positive, since the activities
undertaken were identified through a participatory approach and addressed
some of their crucial needs. The following
is a narrative of the activities that were completed mid last year,
2005.
1.
Construction of one water tank in Amballo Amballo has one functional
borehole installed with an electrical pump but does not have a water
tank where pumped water can be stored for use. The current method in
place for water storage is not very effective since it implies the sharing
of the commodity between animals and human beings. The construction
material was sourced by the contractor from Moyale town which is over
160km away. The tank was constructed using sand and cement. The water
tank was thus constructed to help tap the water that is made available
by the onset of the long rains. This construction was completed by the
end of July.
Picture 1: The new water
tank in Amballo.
2.
Construction of two water troughs in Amballo. The construction
of troughs was undertaken to address the supply of water to livestock.
The construction for these two troughs was done by the same contractor
and it was completed in the month of July.
Picture 2: The pipe that
comes from the community water tank; it leads to the two taps for the
troughs.
Picture 3: water trough number 1 during the construction
works.
Picture 4:
water trough number 2 during the construction works.
Picture 5: The two water troughs after completion of
the works. 3. Rehabilitation of the
hand pump in Amballo CCM procured
the hand-pump with private matching funds in 2001. When the construction
works began alongside the above mentioned works of the water tank and
the two water troughs, it was perceived that all these works would be
completed at the same time that is at the end of July. However, a blockage
in the water system of the borehole also made it impossible to successfully
complete this work. Fixing this new unexpected problem required sophisticated
machinery, not used for the other works by the contractor and not available
in Moyale district. A first attempt
to resolve the blockage entailed the construction of a pulley; five
pipes of considerable weight were then connected to a wench and forcefully
dropped into the borehole to try and unblock it. When this maneuver
failed, water was then poured into the hole to create pressure, after
which a metal pipe of considerable weight was plunged into the hole.
However several attempts of these maneuvers were again unsuccessful
and the contractor had to solicit the help of a specialist, who had
the necessary tools needed to facilitate the unblocking.
Unfortunately the blockage was not resolved since the efforts
that were made to clear it and make it functional resulted in the hand
pump breaking up and being rendered un-functional. Monitoring and Evaluation Monitoring and evaluation of the project was a continuous process. Monthly
activity reports were submitted by the Project Manager to the regional
office in Conclusion CCM has been able to maintain the same level of activities and make some
improvements on the infrastructure of health facilities within the project.
With this project the standards achieved by the previous projects have
been maintained even though some logistical problems were experienced
considering the remoteness of the area of operation and the general
poor state of the infrastructure. Though the project is not able to
meet the high demand of health services within the area due to poor
coverage in terms of facilities and health service providers, the Sololo
community appreciate the efforts of and services provided by CCM through
this project hence the need for continued support of this project. |
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| Consuntivi Attività 2005 | ||
Amballo and Walda are newly opened dispensaries. Due insecurity in the
area, the roads were inaccessible and impassable thus no morbidity returns
for the month of January 2005 in all the dispensaries. The poor attendance
during the month of April can be attributed to the rains experienced
during that period and inaccessibility of the health facilities as a
result. This was especially evident in Amballo, Walda and Sololo Outreach
services since the roads had been rendered impassable by the rains.
Low morbidity returns for September-December can be attributed to insecurity
and inaccessibility of the areas.
