Locko Francis is an electrician based in Ouenze, Brazzaville, Republic of Congo. Like millions of people in his country, the news of the COVID-19 pandemic affecting and also leading to the death of millions of people across the World did not auger well with him. “The news of COVID-19 created a lot of uncertainty and fear in my community. We did not have information about it and there was a lot of false information going around that only drove people into panic mode. My family was scared. I was scared.”
He continued, “Fortunately, I did not have any cases in my family. Some officials from the Department of Health approached me to be part of the Community Health Workers (CHWs). I agreed because I needed my neighbours and friends to have facts and not just act on hearsay”
Moukolo Marceline, a housewife and mother of four, listened to her fellow CHW as he narrated his experience. She seemed in deep thought and intervened, “He is right. We needed to do something as the number of cases reported was increasing.” She smiles, “I was arrested for not wearing a mask before I understood what was going on. We did not have any information, only the community grapevine which just worked to spread fear and not to inform. I am glad I am part of the CHWs and Red Cross equipped us with the knowledge and skills to do community mobilization and engagement in Ouenze and neighbouring regions.”
As COVID-19 has overwhelmed communities in the country, CHWs have played a pivotal role in the response by educating communities on disease prevention measures like hand-washing and use of personal PPE, identifying and reporting disease symptoms, and monitoring contacts and suspected cases. With many health facilities stretched thin, CHWs have simultaneously been at the forefront of continuing to deliver essential health services to communities. They are a force against fighting disease outbreaks and creating awareness that helps improve overall health outcomes of entire communities.
“Red Cross coming to the ground was very important because before an agent from the Ministry of Health would use a megaphone which was not efficient in reaching out to many people. The other challenge is the number of CHWs is still not sufficient. The Republic of Congo has over 5.7 million people according to the World Bank, some of whom are in remote areas. Having many more CHWs spread out across the country will ensure constant and accurate information is being disseminated especially now that we are pushing for people to be vaccinated” Locko, who is quite vocal and passionate about his work added.
Mangani Aruolol, the CHW trainer with Red Cross explained how they went about selecting the CHWs. “When we received the grants, we went to the districts and selected people in the community who are vocal and have some sort of influence. We trained over 700 CHWs, with 17 supervisors. In a day, one CHW was supposed to visit 25 homes, assuming each home has about 5 people, the target was about 100 which they managed to achieve.”
“In the beginning, we faced several challenges. One, the CHWs were not motivated. Logistics was also not easy as we did not have the resources for that. We were not prepared for such a pandemic that destabilized our everyday lives in ways we have not experienced before. When we received the grants, we were able to make great strides and even compensate the CHWs for the amazing work they are doing”.
Dr. Boteya Lambert, Head of Health and Social Action Office Red Cross remarked, “As Mangani says the grants were a lifesaver but we still need more resources especially to purchase vehicles to ease our logistics nightmare. We managed to reach 35 out of 52 districts. Data collection is done manually and we would need to buy data collection electronic gadgets for the CHWs to aid them to gather data and send it to us in real-time. Lastly, we want to be prepared to address other public health issues like malaria, measles among others and not just Covid-19.”
The role the CHWs are playing in Republic of Congo, especially in encouraging community participation by focusing on the health systems in low and middle-income countries is of great importance. They complement Government efforts in intervention. The CHWs, trained and guided by Ministry of Health officials, are currently focusing on vaccination especially post-vaccination with focus on the after-effects of the various vaccines and what care is needed while fighting the false information being spread about the vaccines. If another pandemic was to happen, the Republic of Congo has a ready army of over 700 CHWs empowered to fight and with the potential to attract more subject to the availability of resources.