Village Health Teams support patients to overcome COVID-19 stigma in communities

"It was worse when he went to the borehole to fetch water. Everyone would run away."

Lucy Akello
COVID-19, COVID19, Uganda, stigma, patients, UNICEF partners, CUAMM
25 April 2022

In May 2021, Uganda experienced the second wave of COVID-19 pandemic with an average of 1,407 new cases reported countrywide. This challenge was exacerbated by the scarcity of oxygen supply. 

The family of Wilson Kizito Ochen, a resident of Otalabar East village, Atunga Parish, Abim Sub County in Abim District, was one of those that were caught up in the scramble for oxygen.  During that time, Ochen’s wife, Vicky Acheng, was unwell for two weeks. She complained of chest pain, pain in the ribs and kidneys and had to be taken to Abim Hospital for further medical investigation.  

At the hospital, Acheng and other patients were tested for COVID-19 and she was declared positive with the virus.

“I was scared. It is the worst feeling ever and I wondered how my children would struggle to survive without me if I died of COVID-19,”

Acheng said.

Acheng’s five children aged between 4 and 18 years and husband were also tested, and they all turned out positive for COVID-19.

 “My world was shattered! I could not stand the thought of losing my entire family, to remain alone in this world,” Ochen exclaimed.

While the two elder children were admitted to the hospital with their mother, Ochen returned home with his three younger children who were treated and monitored under the Home-Based Isolation and Care (HBI & C) management. 

The HBI & C policy was formulated by the Ministry of Health to support treatment of asymptomatic or patients with mild COVID-19 signs at home rather than in health facilities. The approach was also critical in decongesting the health care system that was constrained by the fast-growing numbers of COVID-19 admissions.

Under Home Based Isolation and Care, a positive COVID-19 patient is mandated to stay at home and the required care services are provided within the confines of their homes by a caregiver who may be a family member, a friend, or a Village Health Team (VHT) member while cooperating with the advice and support from the trained health workers.

While at home, Ochen’s family was supported by Sidy Akello, a VHT who visited the home to counsel and support families isolating at home. Akello is a beneficiary of the UNICEF-supported trainings in home-based isolation and care delivered by Doctors With Africa – CUAMM. Through the training, VHTs were equipped with knowledge and skills on how to identify suspected COVID-19 patients, referring clients to health facilities for testing and managing COVID-19 cases at home.

Equipped with the necessary knowledge, Akello was able to provide guidance on isolation ensuring the family members were housed in separate rooms as well as provide advice on meals and feeding. 

Ochen commended Akello for supporting him during the ordeal.

“She checked on the sick children regularly and even prepared some fruits including oranges, lemons, green vegetables for them until they got well,”

he said appreciatively.

Overcoming COVID-19 stigma

Being among the first cases of COVID-19 in their village, Ochen’s family did not escape the stigma and rejection from extended family, relatives, and other community members. “Even when the family was declared COVID-19 free in June 2021, the community kept away from us for another 3 months without being accepted to get closer at any public place, especially at the borehole,” Ochen noted with sadness.

The stigma was also experience by the Akello, the VHT. The community members did not want to relate with her for fear of contracting COVID-19. 

“It was not easy especially when the community rejected Ochen and family, no one including his relatives wanted to come close even just to inquire at a distance how his family was fairing. It was worse when he went to the borehole to fetch water. Everyone would run away and would not want to get close to him. The entire village feared me too and no one wanted to relate with me as a VHT in that village for as long as I continued supporting the family,”

Akello narrated.

“I approach the stigma from a positive perspective. For others to be safe, it was reasonable for them to stay away from those affected with and exposed to COVID-19 (including me). I was able to understand why the community treated me that way simply because the disease is deadly. The trainings by UNICEF and CUAMM I attended as a VHT regarding health management strategies, more so on the HBC helped me to overcome stigma,” she continued. 

Close to a year later, Ochen and his family have put the ordeal behind them. 

“From this experience, I leant that first and foremost, courage is key when faced with such a situation, taking advice from health workers is equally important – this helped me and my family to go through the situation. Continue to protect yourself and loved ones, when tested positive, take care, and maintain Standard Operating Procedures (SOPs). Keep faith in God. We are back to our usual life now though not easy. We had to sell the few assets we had (goats and chicken) to be able to manage the time of the sickness. Our two children completed their primary leaving examinations last year, and now joined secondary school. We are challenged with raising their fees since we strained the few assets we had to manage the family health condition.”

With support from UNICEF, CUAMM trained 125 VHTs from five hotspots in Abim District and over 1,125 VHTs across the Karamoja sub-region on Home Based Care through their health systems strengthening project. VHTs have been key players in supporting health facilities in the fight against COVID-19 and addressing other health challenges at the grass roots of their respective villages and communities.