30-year-old Scovia is soft-spoken and rather shy. With a medicine bag in one hand and an illustration aide in another, she walks with determination and a sense of urgency. Scovia is a CHW in eastern Uganda’s Sironko district serving 127 households. Many people fondly call her musawo (health worker) before adding her clan’s name, as a sign of respect. Scovia lives atop of a steep hill—part of the district lies in Mount Elgon National Park. Due to the steepness of the terrain and the access challenges it poses, it is sometimes difficult to extend health services to some households. It gets worse in the rainy season, but this has not demoralized Scovia. No wonder the village chairperson speaks highly of her and what she does.
“There are rampant cases of malaria lately, so we are grateful to have CHWs like Scovia to treat our children,” Grandma Rose remarks. She adds: “Recently, when my grandchildren—the twins—were sick, I took them to her, and she tested and found that they had malaria. She treated them to recovery and did not charge me any money for the medicine. Her services are good, and she cares.”
Grandma Rose is not the only one who sings Scovia’s praises. Half a kilometer down the hill, a mother tells us that since the onset of the COVID pandemic, she has become more reliant on her because of proximity—unlike the distant public health facilities, which are often out-of-stock of essential medicines. This is partly what inspired Scovia into this work.
“I decided to become a CHW to help the people in my community because I realized that they are deprived. We do not have a proper road, which makes it hard if someone has to be rushed to the hospital in the night,” narrates Scovia.
The nearest health facility is just about three kilometers away, but because of the terrain, access is difficult. That is why for many parents, having a CHW within reach—a neighbor—is not just important, but lifesaving. The restrictive measures to curb the spread of COVID exacerbated the situation and created unintended consequences. Some patients are afraid to go to health facilities for fear of contracting COVID, while others simply have no means of transport.
CHWs like Scovia are bridging the gap by providing basic services at the community level and creating linkages to health facilities. “CHWs have been trained on basic care and are helping to provide treatments for U5s for diseases like diarrhea, malaria and pneumonia. We are grateful to our partner Living Goods who trained them using a phone and an app that helps to derive a diagnosis and conclusion on the medicine to give a child below five,” explains Charles Muduku, the Sironko District Health Educator.
A mother of five herself, Scovia has used the knowledge gained from doing this work not only to help others, but her family as well. “Using skills from the trainings we receive, I’m now able to treat my own children. We don’t have to spend a lot of money buying medicine when they fall ill.”