The water system helped us survive a second war

The personal experience of a VHT in fighting COVID-19 in West Nile

Martin Ngolobe
22 August 2022

There are two times Michael thought he would die; the first during the war in his homeland of South Sudan. 

Michael Duku is a 31-year-old refugee. In 2016 he and his family fled the fighting in South Sudan and moved to Uganda, settling in Mireyi Refugee Settlement in Ofua Sub County in Adjumani District, northern Uganda. Shortly after, Michael was elected by his community to serve as a village health team (VHT) member.

“We received training on health mobilization, disease prevention, treatment of children under five years, identification and referral of pregnant mothers, screening of children for malnutrition and sensitization of the community on sanitation and hygiene.”

Uganda adopted the VHT strategy in 2001 as a bridge in health service delivery between community and health facilities. The VHTs were established by the Ministry of Health to empower communities to take part in the decisions that affect their health; mobilize communities for health programmes, and strengthen the delivery of health services at household level. The VHTs are highly credited for promoting demand for and continued health service delivery especially in rural areas. 

Michael had served two years as a VHT when the coronavirus (COVID-19) pandemic hit Uganda in 2020. Michael faced his second war, this time in his country of refuge.

“The district health office summoned all the VHTs for training on COVID-19, I was terrified and thought these people wanted us to die!” Michael exclaims.

However, the training helped to dispel fears, while highlighting accurate information and underscoring the need for proper observance of preventive, protective and treatment measures.       

The training was conducted by UNICEF under the EU-IGAD COVID-19 Response programme. Funded by the European Union, managed by UNOPS, coordinated by IGAD and implemented by UNICEF, GIZ, IOM, TradeMark East Africa and UNOPS, the programme is mitigating the health and socioeconomic impact of COVID-19 across the IGAD sub-region. 

According to Robert Dragule-District Surveillance Focal person, the objective of the training was to equip VHTs with knowledge on COVID-19 and how to prevent its spread in the community, particularly as VHTs were critical in the fight against COVID-19 in the rural areas and continued health service delivery during the resultant nationwide lockdowns. In Mireyi Settlement alone, 10 VHTs were orientated on COVID-19 signs and symptoms, standard operating procedures, prevention messages, social mobilization, referral and follow up of patients on home-based care. 

“We were still scared, mostly because of the initial lack of and misinformation making rounds, but it was upon us to share the right information with the 6,400 people in Mireyi Village,” Michael reveals. 

After the training, the VHTs started conducting home visits, mobilizing the community using megaphones and holding weekly village COVID-19 task force meetings to share the challenges faced in the community, the number of people referred for testing, those followed up on home-based care. The team worked tirelessly to cover the 537 households. 

“In my village, only one person died from COVID-19 and that was because of late reporting (the family reported to the VHT about the sickness of the patient late). Because of the training and support supervision, we really did make a difference,”

Michael says.

Michael shared his experience with an old refugee lady who was coughing a lot, had fever, headache and no appetite for food. He made an assessment and referred her to the health centre for testing. He also communicated to the health centre which sent an ambulance to pick up the old lady. She tested negative for COVID-19 but was diagnosed with pneumonia, treated, and later discharged. The old woman and her family have never forgotten Michael, and that makes his voluntary work rewarding.  

UNICEF also set up a water system in the village, consisting of a pump house (where the sub immersible water pump was installed), overhead water tank, distribution lines and 13 tap-stands serving the entire settlement. 

Michael reports that the water system was critical in effective community mobilization and response around standard operating procedures particularly hand washing. The water systems continue to enhance community wellbeing, especially sanitation and hygiene. 

To enhance his work as a volunteer VHT, Michael requests for more support, particularly a bicycle for transport, a mega-phone for community awareness and mobilization, a raincoat and gumboots to ease movement during the rainy season, and a torch to support working at night as VHTs often respond to emergencies.  

While Michael still looks forward to returning home to South Sudan and serving his community there, he is content to be a changemaker among his fellow refugees in Adjumani. In his home country, Michael was a primary school teacher, but he now focuses on preaching health as a VHT and preaching the Word of God. 

“I am now better empowered and equipped to support my community to deal with any circumstance that threatens our lives, particularly disease outbreaks.”

Motorized water system
District meeting