Bakhtar Development Network

How a death of a young woman served as a lesson to others

CHW Name: Freshta
Related Health facility: Baghe-shamal Health Facility
Village: Gharaw shakh

Freshta is one of the CHWs of Gharaw shakh village located in Baghlan province. She was trained in basic health service delivery in 2007. She usually performs household visits to the community where she treats simple diseases, takes care of TB patients, discusses the danger signs of pregnancy, and provides basic family planning services. 

During the period Freshta was taking her lessons, Fatema one of her fellow villagers who was 14 years old got married. After about one year Fatema delivered a baby at home. Due to family restrictions she was not allowed to visit the health facility, and even was not permitted to do her TT vaccine. When Fereshta saw Fatema after she delivered her baby, she noticed that Freshta was not well, and decided to talk to her husband about taking her to the nearest clinic. The family members did not accept the words of Freshta and said that everything is very normal. Three days after delivery Fatema got bleeding and stiffness. She had two mother-in-laws, who both said that when Fatema delivered baby her home got fairy (the very common community believes in such cases). The baby also soon after delivery become black and got stiffness. All the neighbors suggested that she should go to mullah, and rejected the words of Freshta who constantly was saying that they should be taken to hospital. Her husband Ali Reza was a farmer and worked on their own land, he was listening to his family as well as to Freshta but could not make the decision how he could help his wife and the baby. On the fifth day from the birth the baby died, and the day after Fatema died as well.

Freshta felt guilty that she could not help her fellow villager in saving her life. On the condolence day Freshta decided to talk to all present women, who felt sorry for the death of the young Fatema. She told the women that Fatema did not die because of fairy coming to her house but this happened because she was not vaccinated against Tetanus. Her small age, lack of proper care during the pregnancy had already caused anemia, which contributed towards becoming weaker. Un-proper and unsafe delivery was the major contributor to her death.

As the health facility is located in more than two hours walk from the village where Freshta lives and not all women could afford to visit the clinic, on the next monthly meeting at the health facility Freshta asked for an immediate immunization outreach visit to her village. She herself collected the women of reproductive age at her own house where they received TT shots. Those who accepted to visit the clinic accompanied Fereshta (the CHW) and got vaccinated themselves as well as their youngsters at the clinic. Freshta and most of those women who knew Fatema persisted in delivering messages about safe pregnancy, danger signs during pregnancy and after delivery, benefits of immunization and other related subjects to those who still were not aware of how they could save lives of their beloved ones.

Detection and follow up of TB patients by a CHW

Location:  Jare Khoshk BHC
Name of CHW:  Juma Khan
Village: Qandahari

Juma Khan is a CHW of Qandahari village of Baghlane Jadid district related to the Jare Khoshk BHC. He has been working as CHW since 2005 delivering health services to the people of his village which make population140 families.  Juma Khan is an active CHW helping his people to have the best possible health services through conducting health education sessions (where he discusses hygiene condition, water sanitation, family planning, pregnancies, proper care taking, seasonal disease like ARI/diarrea), treating simple morbidities and referring the patients with severe and complicated disease to the Jare Khoshk Basic Health Center.

The role of Juma Khan as CHW in linking the community with HF has been predominant. During his work he has attracted the beliefs and interests of all his villagers towards himself and has enhanced community awareness on various health issues in the village.

Most of people safer from respiratory infections and cough in Qandari village. TB is one of the major health problems of the villagers. Since the village is quite far from the HF, people with the cough and respiratory symptoms often do not visit health facility and consider it simple disease that could be treated indoors. This has resulted in spread of the bacteria among the people and has become a major concern. The issue was so evident that Juma Khan decided to take an immediate action regarding the problem of his village.

In a meeting with the HF in-charge Juma Khan expressed his concern regarding patients with cough and spread of respiratory problems among the community in Qandahari village and asked for holding a training about TB and an awareness campaign in the village.

Based on the BHC staff request, BDN conducted a community DOTs training for CHWs and health shora members of Qandahari village and oriented them about important issues regarding TB. Upon the completion of the training, Juma Khan started tackling each patient separately who suffered from cough. According to the provided history of each patient Juma khan found 16 suspected TB patients in the village.

For better investigation he accompanied these patients to the health facility. After a proper sputum examination 4 TB positive cases were detected. The anti TB treatment started for all these patients in the health facility, and Juma khan was eager to help with following up the patients from his health post location.

Juma Khan was the first that followed Community DOTs system in his village and referred the suspected patients to the clinic which resulted in detection of 4 positive cases. His sincere determination to fight the communicable disease was highly appreciated by the clinic staff as well as by the community members.