Bill & Melinda Gates Foundation

Call of Duty: On the Front Lines of the Battle Against Malaria

April 25, 2014

We were on a routine visit to the Got Matar health clinic in Bondo, Kenya. I was a part of a team from the United States Agency for International Development’s (USAID) flagship Maternal and Child Health Integrated Program (MCHIP), visiting to check in on the clinic and the work that health providers there were doing to combat malaria in pregnancy.

As I said, it was a routine visit. At least until Francisca enlisted us.

Francisca Aluoch is a community health worker supported by MCHIP. Like many health workers, Francisca often provides care for mothers living in rural communities, far away from a health center like Got Matar.

As the team and I drove up to the health clinic, Francisca was inside on her cell phone, calling Catherine, a patient who had failed to attend her antenatal clinic visit the previous day. Francisca was concerned that the one-hour walk to the clinic—a walk Francisca herself knew well from the four months of home visits she had already performed—had deterred this mother from attending her antenatal visit.

“She is quite advanced in her pregnancy and can no longer walk for long distances,” Francisca explained to me as she tried to get in touch with the mother. Little did we know that we were about to become a part of the life-saving work that health workers like Francisca do everyday.

Unable to reach Catherine by phone, Francisca made the quick decision to travel to Catherine’s house. Her method of transportation? The team and I.

She requested—kindly, but with urgency—that the team drive her to the patient’s home, explaining that if Catherine did not receive lifesaving antimalarial drugs, she may endanger her life and that of her unborn child.

Half an hour later, we returned to the clinic with Catherine Akinyi, the pregnant mother, in tow. Catherine confirmed to the nurse on duty that she was too tired to walk to the clinic. She is pregnant with her fourth child and this is the only pregnancy for which she has attended clinic.

“I did not believe in attending [an] antenatal clinic. Due to my cultural beliefs, I preferred to go to traditional birth attendants. This is what kept me away from hospitals,” Catherine told us as we drove her from her rural community to the health clinic. She told us that she had already lost two pregnancies because of malaria.

Indeed, antenatal clinic visits are critical in malaria prevention and control, and contribute to the eventual elimination of malaria country-wide. During these visits, pregnant mothers receive intermittent preventative treatment to combat the possibility of malaria. The mothers are also given a mosquito net before and after delivery and receive health talks on malaria prevention and control for themselves and their families.

 “With my second miscarriage, I bled so much that they had to hospitalize me for a week,” Catherine confided to me. “That is why I decided to come for [the] antenatal clinic with this pregnancy.”

Francisca can relate to this herself. Her own 2-month-old son died of malaria in her arms. She has never forgotten the pain of the loss, but balances it with the joy of a new life saved.

“My greatest joy is when I see a mother whom I have been monitoring throughout pregnancy safely deliver a healthy baby,” Francisca told me proudly. “That is what keeps me going.”

It was lucky timing, but even more so Francisca’s passionate, heroic decision-making that saved Catherine’s life, and I was honored to be a part of it.

My team and I could not stay to monitor Catherine all the way through her final weeks to a healthy delivery, but her odds are better than they would otherwise have been. Between the strategic care provided during antenatal clinic visits, the antimalarial tools needed to stay healthy, and the watchful eye of Francisca, Catherine is in good hands.

While we drove to the clinic expecting a routine check-in with the project, we drove away with so much pride in community health workers like Francisca, who are impacting lives every day, and going the extra mile—or, often, the extra many miles—to ensure that every mother and baby receives the care they deserve.

Catherine Njeri is a Communications Officer with Jhpiego, which leads USAID’s MCHIP project.

 
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