Soap Becomes a Lifeline
Before the outbreak of the Covid-19 pandemic, 23-year old Naima Abdulle, a trained Female Health Worker, had been supporting and guiding distressed mothers on matters of child care through the UK aid-funded SHINE Supply programme. Naima would also conduct training herself, advising caregivers on how to perform house-to-house follow ups to detect malnutrition and on appropriate infant and young child feeding practices.
Naima spends much of her time moving from shelter to shelter along the paths that criss-cross Wadajir internally displaced persons (IDPs) settlement in Mogadishu. The families who open their doors to her know her well. She has been visiting them every two weeks since she began as a community health worker in April 2020. She is one of the CHW trained to go door-to-door in the densely populated camps, sharing information about health and hygiene, looking out for signs of illness, and acting as a bridge between refugee communities and health facilities.
However, with the outbreak of COVID-19, the responsibilities of Female Health Workers adapted to respond to the pandemic. Despite movement restrictions, lockdown and physical distancing, Naima, along with other Female Health Workers initiated ways to promote healthy behaviours, help families prevent malnutrition and disease, and treat children with life-threatening health conditions.
Despite the increased risk of COVID-19, the commitment displayed by Naima and her fellow Female Health Workers did not abate. These hard-working women and men continue to be the people communities rely on to receive health information, commodities and services. As well as encouraging preventative measures, the Female Health Workers were trained by the SHINE Supply team on how to identify symptoms associated with COVID-19 so they are able to refer people for testing.
Currently Naima visits the 150 households in her assigned block every week. She explains to families how they can protect themselves from COVID-19 and what some of the common symptoms of the virus are. For those she identifies as having symptoms, she counsels them to get tested for COVID-19 at a health centre and explains the support they can receive at isolation and treatment facilities. “The people in the community like the health and hygiene messages I give them, and they have started practicing hand washing which they say has helped them prevent many diseases. They also appreciate the soaps and the hand washing containers that IMC supports them with”, says Naima
“People tell us that they are afraid. They have heard how dangerous the disease is and also that many people around the world are dying. We explain to people that if you have symptoms and you are afraid and do not treat it on time, it can affect your whole family as well as the people in your surroundings”, says Naima.
Like most of the Female Health Workers, Naima has faced a number of challenges while conducting awareness-raising sessions, including having to demystify beliefs and address misconceptions among the community members concerning the outbreak of COVID-19. “The biggest challenge we are facing is convincing people to get tested. The volunteers help us to reach the community and discuss with them the necessity of getting tested and how to prevent further spread of the disease”, says Naima.
“Initially, the IDPs thought if anybody expresses that they have some COVID-like symptoms, people might discriminate them, they might be shamed and named in the society”, explains Abdikani Ali Bashi, a Social Behaviour Change Officer, who supports Naima and other community health workers in their activities.
The trust that Naima and other community health workers have built with the families they visit has been critical since the first case of COVID-19 was detected in Mogadishu. They have been able to counter rumours circulating in the camps with accurate information and practical advice. This has also led to increased utilisation of essential health services offered in IMC-supported health facilities. Improved hand-washing practices have not only saved many lives from infectious disease, but also led to fewer cases of COVID-19.
Building trust also means working with respected figures in the community such as Suldaan (community leaders) and Imams (religious leaders) who can pass on important health messages.
“What the volunteers teach us, we tell the same to the people, and we have come to see the importance of washing hands with soap to prevent Corona, and now also we have fewer cases of stomach issues because of washing our hands”, says Osman Muhammed Salim, an Imam who uses the microphone attached to his mosque to broadcast information about the coronavirus.
“If the community health workers were not doing the work they are doing, we would not have known where to go when we are ill. We would have faced a lot of problems with diseases, even with Coronavirus. So raising awareness on the importance of hygiene is very important”, adds Osman.
Nevertheless, this has not been easy – most community health workers rely on group trainings, home-to-home visits, and close, personal interactions in the communities they serve. Lack of personal protective equipment and increased risk of contracting the virus have kept some community health workers at home, leaving them with the option of reaching out to the families by phone instead of physical interaction.
Naima intends to part of the active team on dedicated change agents to continue being a channel of helpful information that improves the health and nutrition status of her community members.
To find out how the SHINE Supply programme has been adapting to serve the Somali people, watch our video, here: