Village volunteers sustain lifeline

When his community nominated him as a village health worker a year ago, 60-year-old Ap Chencho was intimidated by what he thought would be complex ailments and an intricate system of medication that he would never understand.

Today, Ap Chencho's greatest satisfaction comes from helping the 70 families in his community. Whatever the weather, he does his rounds to promote hygiene practices, and attends daily to people's health problems.

He has been trained to recognize and treat some minor health problems. He also maintains a stock of essential drugs and is able to deal with some eye infections, stomach problems, minor injuries, sores and other simple ailments, referring more serious problems to the basic health units or the hospital.

More important, he encourages fellow farmers to practise basic sanitation and to look after their personal hygiene. His biggest satisfaction came when he persuaded his neighbours to build a latrine in every home.

"We had to walk hours to the basic health unit for headache medicine," 63-year-old Gyem recalls. "Having a village health worker in the vicinity has been wonderful." Farmers around the country have understood that, through personal hygiene and sanitation, they can prevent diseases themselves.

The network of about 1,000 such trained workers represents a health lifeline to the rural communities. Some of them have served their communities for more than 10 or 15 years, and enjoy the important role.

As the programme continues to expand, such workers are becoming a visible presence around the country, whether it is at monthly out-reach clinics where they help monitor the growth of children or at the bedside of patients in their homes. Most of them are volunteers who receive very little or no incentives in cash or kind.

However, Bhutanese society finds its cohesion and strength largely in the values of Buddhism, which teaches that helping others is an act of compassion. Apart from the appreciation of both the community and the health system, the village health worker's contribution to the community is, therefore, a cause for deep spiritual gratification. This is viewed as a great reward.

UNICEF supports training of such workers and the strengthening of the programme which is an example of successful community participation.