Thoughts from the Last Mile Welcome to the VillageReach Blog

Category Archives: Notes from the Field

01.09 2018

At VillageReach, we often use numbers and data to understand how our work increases access to quality health care. Since our founding in 2000, our programs have reached more than 20 million people in sub-Saharan Africa – and that number continues to grow. But as we look at the progress we made in 2017, numbers only tell part of the story. The success of VillageReach is also reflected by our collaboration with partners, our dedicated staff and the generosity of our supporters. Their voices tell us why 2017 has been such a remarkable year:

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01.08 2018
Nous allons prendre les vaccins au dépôt du Bureau central de la Zone de santé situé par pirogue à ramer.

Depuis plus de 14 ans, nous allons prendre les vaccins au dépôt du Bureau central de la Zone de santé situé à 135 kilomètres d’ici par pirogue à ramer et le voyage dure 4 jours au moins.

Quand nous rentrons avec les intrants au niveau du centre de santé ici à Monzambi, on arrive très épuisés par le voyage qui exige beaucoup d’effort à fournir mais, malheureusement, on ne ramène en plus que des vaccins virés ou en voie de l’être à cause de l’interruption de la chaîne de froid puisque nous transportons ces intrants avec des boîtes isothermes dans lesquelles nous mettons les accumulateurs.

Cet appui de VillageReach nous permet de nous occuper aisément de nos malades, d’économiser nos énergies et d’améliorer nos stratégies de vaccination.

Une bonne chose nous est arrivée maintenant depuis le mois de juillet 2017: VillageReach appui régulièrement le transport des intrants de bonne qualité en bonne quantité et dans les bonnes conditions depuis l’antenne provinciale du Programme élargi de vaccination (PEV). Cet appui de VillageReach nous permet de nous occuper aisément de nos malades, d’économiser nos énergies et d’améliorer nos stratégies de vaccination.

Nous en sommes très reconnaissant et implorons à VillageReach de continuer à nous soutenir.

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02.03 2017

Version française

As someone who has dedicated his life to public health, I am thrilled to see Africa’s leaders making a bold commitment in support of immunization. The African Union endorsement of the  Addis Declaration on Immunization (ADI) demonstrates that vaccines, and the proper health systems to deliver them, play a significant role in the future of our continent.

Measles and many other diseases preventable by vaccination have a devastating potential. Even a few years ago, rural communities had a saying: to know how many children you have in your household, wait for the measles. Measles epidemics have decimated children in times past. This was the case of the Mankanza territory in the province of Equateur, located 220km from the provincial capital, Mbandaka, and accessible only by water. Many, many children were buried because the measles vaccine had not yet come to their communities until 1996. The few survivors can still recall the impact of these measles epidemics. Even with sub-optimal immunization coverage, once the vaccine came, no epidemics occurred.

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02.03 2017

English Version

Comme quelqu’un qui a consacré sa vie à la santé publique, je suis ravie que les dirigeants Africains se soient engagé ardemment à soutenir la vaccination. L’adhésion de l’Union Africaine à la Déclaration d’Addis-Abeba sur la vaccination démontre que les systèmes de santé adéquats pour la livraison des vaccins jouent un rôle important dans l’avenir de notre continent.

Les maladies évitables par la vaccination—tel que la rougeole—ont des conséquences catastrophiques. Il y a quelques années, les habitants de plusieurs communautés rurales en RDC disaient :« il faut attendre le passage de l’épidémie de rougeole pour savoir combien d’enfants tu as dans ton ménage ». Dans le passé, ces épidémies étaient responsables de la mort de nombreux enfants. Cela a été le cas du territoire de Mankanza dans la Province d’Equateur en RDC. Mankanza se situe à 220 km de Mbandaka (chef-lieu de la province) et est une zone totalement riveraine. Le vaccin contre la rougeole a été mis à disposition vers les année 1996. Dans les années précédentes, cette maladie aujourd’hui évitable a emporté des milliers d’enfants simplement parce qu’ils n’étaient pas vaccinés. Malgré la faible couverture vaccinale, à partir de l’introduction du vaccin contre la rougeole, aucune épidémie n’est survenue dans cette contrée, et les rares survivants peuvent encore témoigner à l’impact mortel de cette maladie dévastatrice.

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02.01 2017

Versão português

With the endorsement of the Addis Declaration on Immunisation, African leaders demonstrated their commitment to life-saving immunizations.  The Declaration names a number of components – ten, in fact – crucial to realizing the full benefits of immunization.  But there are many more pieces in the day-to-day work of getting vaccines to children.  These are the pieces I think about as I do my part in reaching global vaccine goals.

Depending on the day, I’m thinking about things like this:

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01.31 2017

English Version

Com a aprovação da Declaração de Adis Abeba sobre a Imunização, os líderes africanos manifestaram o seu compromisso para com as imunizações que salvam vidas. A Declaração indica várias componentes – de fato dez – que são decisivas para realizarem-se os plenos benefícios da imunização. Mas existem muitos mais elementos no trabalho quotidiano de fazer chegar as vacinas às crianças. Estes são os pedaços nos quais penso enquanto dou a minha contribuição para alcançar as metas para as vacinas a nível mundial.

Dependendo do dia, estou a pensar em coisas tais como as seguintes:

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01.06 2017
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Patuma and her family outside her home in Malawi. Patuma used CCPF to get information about her daughter’s Epistaxis.

I recently returned from a trip to Malawi where I had the opportunity to visit several families who have benefited from Chipatala Cha Pa Foni, or Health Center by Phone, a toll-free health hotline in Malawi that connects individuals directly with trained health workers who provide information, advice and referrals over the phone. One of those visits was with the Richards family who live in Kazondo Village in Balaka, a district in southern Malawi.

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11.23 2016

For the past month, I’ve been in Democratic Republic of Congo working to further establish and expand VillageReach’s presence in the country. I’ve also been preparing for a workshop to present the preliminary results of a supply chain modeling exercise that will help key stakeholders identify opportunities for improvement. In the process, I’ve been making the rounds to all our partners, and a key question about our work keeps coming up:

What is taking so long?!?

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11.16 2016

Having just returned from a visit to Malawi and Mozambique, I had the opportunity to meet with many health workers who contribute to and shape VillageReach’s work at the last mile. Most of them  work in incredibly rural and remote locations, challenged by many of the barriers we talk about most frequently at the last mile – lack of infrastructure, human resources, information, and access to medicines. One of the health workers that made an indelible impression on me was Mackson Khalawako. Mackson joined VillageReach in September 2008 as a Health Surveillance Assistant (HSA). In this role, he serves a population of around 1,000 from two villages: Bakili and Makande. In addition to the health surveillance assistant’s duties facilitating community clinics for vaccinations, growth monitoring and health education, Mackson also helped to implement and continues to run a village clinic for children under 5.

Mackson and his fellow HSA deliver vaccines and dother supplies for the village clinic
Mackson and his fellow HSA deliver vaccines and other supplies for the village clinic

VillageReach supports HSAs as part of the Kwitanda Community Health Project which aims to address healthcare through a community-led and managed approach, supporting health interventions that address the most critical needs of the community. I caught up with Mackson at the Bisani clinic for children under five, held in a small, two-room structure that was built brick-by-brick by the community members last year. Previously, the clinic had been conducted outside under a tree, not uncommon for village clinics in rural communities like Kwitanda. His performance has won the hearts of many people in his catchment area, and it’s easy to see why.

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11.15 2016

OpenLMIS, SELV, iSC. To most people these acronyms don’t mean much. To me, they tell a story of getting vaccines to the most remote communities in Mozambique. Sistema Electronico de Logstica de Vacinas (SELV) is the local name of a software used to record information about where vaccines need to go and how they are going to get there – an implementation of OpenLMIS, a logistics management information system (LMIS). As the Information Systems Officer at VillageReach, it’s my job to provide technical assistance and support for this critical software.  The BETA version of  OpenLMIS 3.0 was launched last week, representing a major milestone in the evolution of software that continues to demonstrate the import and impact of robust information systems at the last mile.

photo-3Over the last few weeks, my colleagues and I traveled to five provinces around Mozambique to talk about SELV. In some provinces like Cabo Delgado, SELV is an established tool. In others like Maputo City, SELV is brand new. VillageReach and the Ministry of Health are just beginning to expand the reach of SELV to all eleven provinces, so this trip provided me an opportunity to meet stakeholders, introduce myself as a resource, and find out how we can better support SELV within the immunization supply chain.

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Malawi healthcare worker