Empowering Communities to Treat Themselves Listen to the interview (Windows Media - 2 MB)

My name is Katie Haxall and I am the Child Survival and Health Programme Manager at the

IRC (International Rescue Committee.) We have a variety of programmes that range from Primary Healthcare and Reproductive Health (emergency obstetric care) to Child Survival Programmes- that is for community based treatment.

There are nearly no services available in the community where we are working and it is incredible to bring health services within the community to the population. The programme began last October (2005), and the support is from the Canadian International Development Agency, but we receive drugs to treat malaria from the Global Fund. We receive bed nets from UNICEF as well.

Q. What impresses you most about this programme?

One of the things I like best is that a lot of our (what we call ‘Community Distributors’- those arepeople who are trained to treat these three diseases in the community) – a lot of them are female and illiterate. They have been performing excellently; literacy hasn’t shown to be a problem at all. One of our ‘Star Distributors’ who is an illiterate woman had correctly assessed and treated a child for acute respiratory infection. It is just wonderful to see the treatment excel, and especially to see the empowerment of the community and specifically of women within the community.

During the dry season, the distributors will go to the clinic, pick up the drugs and keep them in metal boxes that they receive. Then mothers bring their sick children to the distributors and the children receive treatment. During the rainy season, the distributors receive a larger stock of the drugs to be able to cover them for the time that they cannot access a health center to replenish their stock.

Q. Working successfully with communities is not easy- how do you manage this?

These people working in the communities are selected by the communities themselves. IRC has several approaches to the community. First they go to the village chief and introduce the programme, the community gathers as a whole and we try to gather as many people as possible, and they choose people from the community whom they would like to be distributors. And we are careful about trying to encourage it to be as democratic a process as possible and emphasizing that these are people working for the community- they don’t receive payment. It is up to the communities to say that they do want the programme there, if they don’t we don’t do it there. We actually had a case where one community said they didn’t want the programme and so we didn’t do it, and then they saw it happen in other communities and they said “Please come and implement this programme here.”

Q. What are the signs that communities are accepting this programme?

I think that the communities are enthusiastic, there was a letter received from a neighboring community saying please come and bring this programme to us as well. I think people are enthusiastic, it’s really being embraced by the community and I think it has the potential to be expanded. I think it is very positive because in the past there was another non-profit organization which did a similar programme, but I don’t think it was very successful for a number of reasons- one of which being that they paid the distributors incentives and I think there were a lot of problems with the programme. So it has been good to be able to go back and have success and to be able to help the community recover not only from conflicts and complete lack of infrastructure and things of that sort, but also from their experience in the past. There seems to be a really positive experience with IRC in the field.

Q. So what did you do differently from the previous organization?

I think one of the biggest things was payment of incentives as well as training and supervisory systems. With this programme the point is that the distributors are available to treat children but it’s not a task that is supposed to take them away from their daily work or schedules too much. They see maybe ten children over the course of the month and it shouldn’t be something that is such an additional workload that it requires payment. It makes it so that the distributors are working for the community. And we have cases where, for example, community members, to thank them for the care that they are giving their children, will help them with their farming- and things of that nature.