One Ambulance Can Go A Long Way
Dilla is a small town located in the Awdal region of Somaliland, west of Hargeisa. A 20-minute drive away, the closest hospital is in the city of Borama. Since May, the UK aid-funded SHINE Supply programme has been supporting Dilla Health Facility (HF) with an Essential Package of Health Services (EPHS), including ante-natal care (ANC), deliveries, referrals, medical supplies, family planning and outreach activities, as well as salary top-ups for 14 staff members. The Programme also built the capacity of the health workers to attend to the needs of mothers and children.
Safiya Dhinbil (see above) is the Team Leader of the facility. She has been working there for over 30 years and has seen a lot of change during this time. Safiya has been the Team Leader for 10 years now and enjoys the challenging yet rewarding work environment.
Safiya is delighted with the ambulance service that is being supported by the SHINE Supply. The Programme is supporting maintenance of the vehicle, fuel and a salary top-up for the driver. Keeping the ambulance operational used to be the biggest challenge faced by the facility as well as the community. Patients referred to Borama Regional Hospital would often have to endure the 3-hour trip to Borama by camel or donkey; a trip that takes a mere 20 minutes in a vehicle. In more serious cases, community members would collect money to send patients by taxi; a great example of community-driven action and support. However, this is often a time-consuming exercise when referral cases are often urgent. In the past, the community also supported the maintenance of the ambulance, including purchasing new tyres. However, the community is poor and this is not a consistent or reliable source of funding.
Now that the ambulance is operational, the largest challenge faced by the facility is staffing. Dilla HF has 14 staff members, including the watchman and cleaner, as well as the medical staff including qualified nurses, midwives, pharmacist, etc. Safiya pointed out that her staff “work long and stressful hours”.
The midwives are especially ill-equipped, with 3 midwives running a 24-hour service. However, this section was overseen by just two midwives until the introduction of the SHINE Supply, when the facility was able to employ a third midwife – Sahra.
Halima is the chief midwife. She has been working at the facility for over 6 years and is overjoyed that Sahra came to join her team. The facility oversees an average of 65 births per month. To offer a quality service, and to make sure that her colleagues are well-rested, Halima told us that 4 midwives would be ideal. “We are understaffed and overworked. The long shifts take a toll, but we have to provide this service for our community”, Sahra told us.
Despite the continued challenges, Safiya and her colleagues have seen significant improvements at Dilla HF since the introduction of the SHINE Supply in February 2019. All the health workers at the HC now receive top-up payments regularly. The essential supplies required to provide quality services to mothers and children are now available. The pharmasic is trained on how to manage drugs, provide up-to-date consumption data and also understand the type of supplies the facilities requires. In the past, supplies were given to the facility without inputs from the pharmacist and most of the drugs supplied had not included essential medicines.
SHINE Supply is supporting 18 health centres, 17 primary health unit and two hospitals in Awdal with EPHS and 86 health facilities across the whole of Somaliland over a period of two years.