By Wallace Mawire ,Harare A Community Health Clubs (CHC) initiative which is being implemented by Zimbabwe Ahead, a non-profit health and development organisation in the country’s urban and rural set-ups is helping to impart much needed awareness and education on sanitation issues to communities who have just recently emerged from a 2008-2009 devastating cholera epidemic.
The 2008 – 2009 Zimbabwean cholera outbreak is an ongoing cholera epidemic in Zimbabwe that began in August 2008, swept across the country and spread to Botswana,Mozambique,South Africa and Zambia. By 10 January 2010 there had been 98,741 reported cases and 4,293 deaths making it the deadliest African cholera outbreak in the last 15 years.(I suggest you use statistics as of June 2009, when the Zimbabwe government officially declared the end of the outbreak). The Zimbabwean government declared the outbreak a national emergency and requested international aid.
According to Regis Matimati, Programme Manager for Zimbabwe Ahead, Community Health Clubs are the way to go in public health interventions as they are about investing in social capital and consequently communities take responsibility over their own health as the concept empowers and capacitates them into health seeking mode.
Matimati says that Zimbabwe Ahead started operations in Zimbabwe in 1994 in Makoni district piloting the methodology of using community health clubs to empower communities with knowledge and awareness covering water, sanitation and health issues. The organization has since gone regional forming, Africa-Ahead based in South Africa.
A community health club is usually constituted by 75 to 100 people and membership is on a voluntary basis and not compulsory. In Zimbabwe, the clubs, according to Matimati are helping to incalculate community common-unity, realising social capital, ownership and responsibility over community development. Matimati says that they encourage community self reliance and self supply particularly around water and sanitation infrastructure.
Successful initiatives are being implemented at Chiredzi rural district council wards 11, 19, 20 and 29. Matimati says that 246 self supply toilets have been constructed by the local community after 3 months of community health clubs participatory health and hygiene education training.
Matimati says that communities need to realise that their health is their responsibility. They can and should do something about it themselves other than waiting for central or local authorities to clean up after them. He adds that a visit to the cemetery has never shown a tombstone written RIP-City Council or government. He says that it is the people who die so complaining, demanding and paying for a service does not take away the need to re-look at the services and do a bit more about it when things are not running normally or people die complaining.
Matimati says that in Makoni district, Manicaland club communities regroup and galvanise efforts in the face of a health or other developmental threat, self reliance resulting in high water, sanitation and health coverage.
He says that in Mutare city as old as many urban communities in Zimbabwe in Sakubva communities warded cholera through the involvement of 37 community health clubs. This involved massive clean ups that spread to non-club areas as the other residents organised themselves emulating the club location to clean up.
The local city council in Mutare is reported to have been relieved as money was not enough for effective waste management and it took the time to recapitalise on waste management.
According to Matimati, community health clubs are community driven, owned and sustained. They need training of community based and school based facilitators who steer the programme. They need community management committees and training for sustainability. They also involve very low cost tool kits and picture codes for training session delivery as well as a membership card for structured participation.
Asked on the humanitarian impact of community health clubs, Matimati said: “They have un-paralled community capacity building and provide home grown solutions to local challenges as people constructively dialogue over issues.”
Their emphasis is on local social capital and timely interventions due to high community organisational levels. They are also reported to have an increased sense of social responsibility as community assesses, identifies and prioritises own social issues for correction.
Zimbabwe Ahead also notes that community health clubs are the entry point to sustainable water and sanitation development by the people, with the people for the people. Matimati notes that they involve very little investment results in a very big impact and ownership and responsibility. He adds that knowledge is power and spurs people to act for common good.
The cost of initiating community health clubs is calculated at US$2 per beneficiary per annum and the project has a critical path of 8 months, according to Matimati. The concept has been successfully implemented in South Africa’s Kwazulu Natal province, Sri Lanka, Uganda, Sierra-Leonne.