Community effort brings access to health care

Since the Kyafukuma Rural Health Clinic (RHC) in northwestern Zambia closed its doors in 2000 after the old building collapsed, villagers have had to make do with a cramped inadequate clinic. "The place is too small, there is no ventilation, patients can't sit and you can't screen privately. Deliveries have been suspended because there is no space - we are referring all expectant mothers to traditional birth attendants," Lydia Mushiya, a midwife at the makeshift health centre, told IRIN. The clinic, originally provided by World Vision, the international relief NGO, offers few health facilities and residents are often forced to trek some 25 km across the Zambian border into neighbouring Democratic Republic of Congo in search of medical treatment. Now, growing frustration over the lack of satisfactory medical care has led to a community-driven initiative that promises improved access to health care. After years of waiting for the reopening of the RHC, a joint project by the state-sponsored Zambia Social Investment Fund (Zamsif) and local people is expected to hasten completion of a new RHC, including the construction and rehabilitation of quarters for five staff members. The project will also provide an admission block and 11 ventilated improved pit latrines, medical equipment and furniture, electrification and a borehole. The total cost of the project is estimated at Kwacha 490 million (about US $100,000). Zamsif has already made available US $85,000, while the community will contribute around US $15,000 in form of labour and locally available material like bricks, crushed stone and timber. The Zamsif regional facilitator and the district team are supervising the project. "The whole process is very democratic because we can decide what is very urgent. We had applied for both staff houses and a clinic but, as a community, we decided the clinic must come first," said project implementation committee vice chairperson Dinas Kamfwa. Once the project is completed, the residents expect to benefit from improved access to curative and primary health services, and extended health care through the use of trained community health workers.