Over the years, Medical Missionaries has seen many patients at St. Joseph Clinic who have had to walk for two to four or more hours from their homes to get to the Clinic.  In some cases, the patients have required only simple first aid or treatment for a headache or stomach ache.  That got us to thinking of ways that at least some patients might be served closer to home.  We met with community leaders in four of Thomassique's outlying villages (Dahlegrand, Bouloume, Baranque, and Savane Platte) to talk about how a health center might help to improve health conditions in their villages.  They were unanimous in their enthusiasm for the idea. 

 

The community leaders agreed to appoint a Community Health Committee in each village and to identify and contribute space for a Health Center.  The Committee's job is to oversee the Center, promote it among the residents of the village, and encourage villagers to take advantage of the many services they envisioned the Center providing.

 

Medical Missionaries obtained financial support for this program from the Gerard Foundation.  That support allowed us to establish a Community Health Center (CHC) in each of the four outlying villages.  The Centers are simple facilities consisting of two or three rooms equipped with a desk, exam table, a cabinet for medicines and supplies, and extra chairs for the patients.

 

 

 

The Community Health Committees nominated respected individuals from their villages who might be trained to become Community Health Workers (CHWs).  The final selection of the CHW candidates was made by the medical staff at the Clinic.  The CHW candidates received one week of training at the Partners In Health facility in Hinche, the provincial capital.  They received at least three weeks of additional training at St. Joseph Clinic, working with the doctors and nurses, rotating through all the departments of the Clinic. On completion of their training program, the CHWs were provided with cell phones to facilitate daily communication with the doctors at the Clinic. They meet as a group quarterly for additional training and to share experiences.

 

 

In each village, the CHC is seen as the "go-to" place for wellness programs and health problems.  The CHWs hold regular education sessions to promote good hygiene and illness prevention. They promote the use of home-based water purification systems and sell co-fortified salt to combat lymphatic filariasis and delayed brain development.  They provide first aid as needed.  They refer seriously ill patients to the Clinic and arrange transportation, if needed.  They help arrange and support mobile clinics each month, when a doctor visits the village to see ill patients.  Having the CHWs in these villages allowed us to respond quickly to the onset of the cholera outbreak.  The CHWs were able to get ill people started on oral rehydration solution and arrange for the seriously ill to get treatment at the Cholera Treatment Center or a hospital.

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