A Race Against Rainy Season

This past month, KCHP and the district of Saraya's PEV (Programme Elargi de Vaccination)/EPV (Enlarged Programme of Vaccination) mobile team reached the distant villages of Fouroumbou, Khossanto, Sabodalla, Mamakhono, Diakhaling, Diégoung, Khobokhoto, Dialakhotoba and Bransan.

EPV mobile team member weighs an infant in the village of Dialakhotoba.

These villages were chosen in anticipation of l'hivernage (rainy season), during which they will become inaccessible as heavy rains flood the meandering, red dirt paths which connect these remote villages to the main road through the district of Saraya.

Case de Santé/Community health hut in the village of Bransan.

A young boy peers through the brush on an overgrown bush path.

Posted by Emily

Tuberculosis Training for CHWs

KCHP hosted a Tuberculosis training day attended by 16 community health workers (CHWs).CHWs serve as liaisons between formal healthcare structures and rural communities and are essential components of rural health education and promotion.

The training aimed to teach CHWs how to recognize possible cases of TB within their communities and the steps to follow when a case is suspected.

TB remains a major cause of illness and death worldwide, especially in Africa and Asia, killing almost 2 million people each year. In the district of Saraya, cases of TB often go untreated. In most villages, health education is limited to weekly community radio programming. The signs and symptoms of Tuberculosis— a cough that manifests for more than 15 days, fatigue, fever, night sweats, chills, loss of appetite, etc.— are unknown to the community. Many who suffer from these symptoms will never seek consultation and testing at one of the seven district health posts or the health center in the district of Saraya.

While TB is contagious, it is not very easy to catch. However, in compounds where family members sleep under the same mosquito nets, share meals from the same bowl and drinks from the same cup, the potential for the disease to spread increases. The bacteria which causes Tuberculosis, called Mycobacterium, spreads from person to person through microscopic droplets released into the air when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits or even laughs.

The most common strain of TB in the area can be cured by taking a combination of medications over a period of about six months. A major problem in Saraya is that many TB patients become “perdus de vue,” meaning that they are “lost from sight” and do not return to the health center to complete their course of therapy. Treatment is only available at the district health center in Saraya, which can take hours to get to by foot or by bicycle and is often totally inaccessible during the rainy season, when bush paths and wooden bridges are often ravaged by torrential rains.

CHWs were trained to host causeries (informal community discussions) about Tuberculosis to help educate the members of their communities. Ways to encourage those who exhibit the signs of TB to seek consultation were also thoroughly discussed, followed by ways to encourage TB patients to complete their course of treatment by making weekly “home visits” and aiding them in finding transportation to the district health center.

Posted by Emily

Pandemic Diseases

A PCV marks nets before distribution takes place, Saraya

The Universal Coverage Campaign of LLINs (long-lasting insecticide nets) conducted by Peace Corps in partnership with the Health District of Saraya and its management team in the Health District of Saraya was a great success and a very important event. While Kendeya is planning with the Health District and the local PCV a survey to assess the long-term benefits of Universal Coverage, the methodology adopted for the Campaign received strong appreciation from international agencies and national government institutions. Kendeya, who took part into the implementation of the second cycle of the Campaign, held between the month of January and February 2010, is now involved in the documentation and reporting of the result of the Campaign, in order to disseminate information about the modality of distribution and enabling future replication of the successful malaria prevention strategy.

Distribution in the village of Sountounkoloung

In order to assure that malaria mortality and morbidity can be effectively reduced, mosquito nets need to be distributed regularly, due to migration and the dynamic nature of the local population, as well as because of the deterioration of nets. For this reason PC, the Health District and Kendeya are already planning another Universal Coverage Campaign. Kendeya has already been involved in organisational meetings and, with the local PCV, is developing a training session for the community health workers who are going to have an active role in the delivery of the nets.

Kendeya also assisted in the submission of a grant application to conduct a HIV/AIDS programme in the Saraya district. The funding was approved and the programme will be fully implemented in the coming year. The main objectives of the project are the intensification and the optimisation of the distribution of condoms in the Health District, the conduction of regular educational interventions in local villages, as well as the creation of a follow up strategy for individuals that have resulted positive to the HIV/AIDS test.

Midwife Fatou Kan prepares HIV/AIDS tests, while project manager Annarita Imbucci distributes T-shirts to community members that helped the organisation of the free HIV/AIDS testing, Balori

Posted by Annarita

Outreach Visits

During the month of April 2010 Kendeya visited neighbouring villages of Dioulfundou, Bembou and Badioula situated in the zone of Saraya for the regular vaccination programme EPV (Enlarged Programme of Vaccination). It was the first time that the organisation conducted the EPV in these villages, as usually it visits further away communities with the mobile team. Two matrons, Dado and Diaba Danfakha, and the community health worker Mady Kanouté, constituted the vaccination team, and KCHP project manager Annarita Imbucci supported the activities. The villages visited had been previously informed of the vaccination team’s arrival, as the Health Centre attempts to visit villages on the same date of each month. For this reason, most of the mothers were already in place and ready to have their babies vaccinated. When the baby was not present the localmatrons went to the household and invited the mothers to come to the vaccination point. The villages’ matrons receive regular training from the Health District and, with their participation, they efficiently supported the work of the vaccination team. Knowing the number, names and parents of each new born, they were able to both assist the gathering of the mothers and take care of the babies during vaccinations with a maternal and caring touch that soothed the babies during injections. In total 35 of the 41 children to vaccinate in the three villages were seen in a single morning: 16 in Bembou, 11 in Badioula and 8 in Dioulfundou

Project manager Annarita Imbucci recently visited the women in Dalafing, to follow the project aimed at developing a community garden that has been implemented in the neighbouring community. Fences now surround two allotments of about 20 meters square each. Unfortunately, due to the current dry season it is not possible to plant any species of seeds, as the shortage of water reaches serious conditions in this period of the year. Communities are forced to choose between utilising the water for either dinking and washing themselves or to water their gardens. However, the women of Dalafing were enthusiastic to show to Kendeya their progress and commitment to the project, and feel they are ready to start growing different varieties of vegetables as soon as the season will be more favourable.

Posted By Annarita

Fundraising

Image on Kendeya greeting card

Since the month of December 2009, Kendeya has been working to establish a fundraising network in Italy, by promoting its activities as well as those of the Saraya Health District. Thanks to the sensibility and generosity of friends and family, Kendeya has been able to plan future projects for the coming season. The fundraising has been primarily constituted of selling greeting cards, the image of which conveys the sharing approach of the organisation. A charity market held at the Scuola Media Statale Esopo, Roma, allowed Kendeya to raise a considerable amount of money that will serve the creation of a internet point for the community of Saraya. The additional funds will be used to incorporate an internet café in a room that currently holds regular meetings organised by the Health District. Frequently, the attendees of such meetings travel from far away over very difficult terrain in order to participate in the meetings which can last for a considerable part of a day. The Health Centre is always an excellent host, providing participants with a meat-based meal and cold refreshments (both very uncommon luxuries in the area). However, despite the Health Centre’s best efforts to make participants feel looked after, the conditions of the meeting room, which can become unbearable hot and uncomfortable, can seriously affect the development of meetings. With the funds raised at the Esopo, Kendeya is planning to entirely restructure the room, remaking the electricity system, the floor, the roof, the wall as well as the back board and the projection board. With a subvention provided by the Peace Corps, 5 computers and an air conditioning system are already available, and a second air conditioning system will be provided by the Health Centre. Finally, with Kendeya financial and management support, the room will be made more respondent to the necessities of the District and the community of Saraya, providing the population with their first internet café.

Health Centre Meeting room

Posted by Annarita

March EPV

As every month, Kendeya supports Saraya Health District to carry out the periodic vaccinations for the EPV (Enlarged Programme of Vaccination).

This month we went with the mobile vaccination team to the village of Diakhaling (above) and the village of Diegoung (below).

Posted by Annarita

Universal Coverage

Since December 2009 Kendeya participated into the organisation of the distribution of mosquito nets implemented by the Peace Corps Volunteers (PCV) of the region of Kedougou, which took place during the months of January and February. The aim was to have ‘Universal Coverage’ in the Health District of Saraya, which in essence is the provision of ‘Long-Lasting Impregnated Net’ (LLIN) for all sleeping sites in every village within the region. With the involvement of community volunteers, 20 villages received the nets during the January cycle, with a total of 6000 LLINs distributed.

The LLINs are an efficient tool in the realm of malaria prevention, providing better protection than the old Insecticide-Treated Nets (ITNs). They are efficacious for up to 5 years and do not need to be re-treated after being washed. The usage of a LLIN does not only assure the safety of the individual that sleeps under it, but also has positive health benefits for the whole community. By impeding the transmission of the malaria parasite from human to mosquito and vice-versa, the parasite is unable to accomplish its entire life-cycle and gradually disappears from the zone. In addition the insecticide of the nets kills the anopheles a few minutes after contact, thereby reducing the population of infected mosquitoes in the area. This is, however, only possible through Universal Coverage, as otherwise infected mosquitoes may be diverted towards individuals that do not sleep under a LLIN. Without Universal Coverage only a percentage of the population are protected and it will not be possible to eliminate the disease from the region. Free Universal Coverage of LLINs is part of the WHO/GMP (Global Malaria Programme) resolution for the eradication of malaria burden and the region of Kedougou represents an important Senegalese target for malaria prevention programmes.

The distribution adopted an innovative methodology: a census was conducted that allowed the team to be informed in advance on the required number of LLINs needed for each village. Before distributing the nets, a couserie took place for the dual purpose of showing villagers how to correctly use the nets and inform them on the symptoms of malaria, as well as on the importance of seeking early medication treatment in case of contraction. A fundamental part of the prevention programme was a demonstration of how to prepare Neem Lotion, a natural mosquito repellent that is made by locally available ingredients.

Every year the distribution will be repeated in order to assure that the Universal Coverage is fully accomplished. The next stage is a study on the impact that LLINs have on malaria rates in the region, which will start after the next rainy season.

Peace Corps Volunteer Chris Brown and Saraya's radio director Moussa Danfakha show villagers the use of a mosquito net, Saraya.

Peace Corps Volunteer Chris Brown cuts up the soap for the Neem Lotion, Saraya

The chef du quartier tries the lotion on himself, Saraya

Steps of the distribution

Posted by Annarita

HIV/AIDS Depistage

Kendeya started its new activities for 2010 with a HIV/AIDS depistage in the village of Balori, a now regular destination for KCHP. Music gradually gathered the community together, and when people of all ages and occupations were present, a theatre sketch organised by the drama group of the community radio Giggi Sembe, took place. Through a dramatic and entertaining performance villagers were informed of some of the main causes and consequences of HIV/AIDS. Alongside this outdoor theatrical presentation, inside the local school Dr Sy, the HIV/AIDS social worker of the district of Saraya, provided more in-depth and confidential consultation to villagers, and midwife Fatou Kan, carried out the testing. The community reaffirmed its commitment and interest by participating enthusiastically at the event. Overall, the depistage was deemed a success, as KCHP was able to test 60% of the population of Balori for HIV/AIDS.

The community begins to gather as music is played

Radio director Moussa Danfakha entertains the community

The Imam and the chef du village, enjoying the drama performance

Posted by Annarita

Mother-to-child transmission

From the 18th to the 30th of December, KCHP and a team of midwives and nurses from the health district of Saraya traveled to 17 villages to conduct prenatal consultations. The team was able to reach over 100 pregnant women as a part of the PTME (Prévention - Transmission - Mère - Enfant) program. This initiative seeks to prevent mother-to-child transmission (MTCT) of HIV, which can occur during pregnancy, labor and delivery, or breastfeeding. As a part of this program, HIV/AIDS testing was provided in order to inform women of their HIV/AIDS status, and, if necessary, commence antiretroviral treatment (ART) as well as schedule periodic follow up visits.

During villages' visits, the health district team also conducted general medical checkups for the population and administered monthly PEV vaccinations (Programme Élargi de Vaccination) to children under one year old.

Women in the village of Bambadji waiting to be seen by the midwife for their prenatal consultations.

Saraya's lab assistant Gouda Diaby (right) is ready to administer a blood test.

Posted by Annarita

Community Health Workers learn to diagnose and treat Onchocerciasis

The KCHP sponsored a community health worker training on Onchocerciasis, commonly known as river blindness, for 20 Agents de Santé Communautaire (ASCs) working the zone of Khossanto.

What is Onchocerciasis?

Onchocerciasis, also known as river blindness, is the world's second leading infectious cause of blindness and is endemic in the region surrounding Saraya. The small black flies that transmits the disease thrive along the beds of the nearby Gambia and Falémé Rivers. The fly’s noxious bite injects parasites into the victims skin which cause intense itching and irritation of the skin. The greatest danger lies in that if not properly treated, infection can result in irreversible blindness.

In remote villages where formal healthcare is often inaccessible, ASCs hold a considerably high degree of responsibility and are well respected in their communities. In the case of Onchocerciasis, ASCs are relied upon to distribute and administer the annual treatment of Ivermectin, a drug used to fight the progression of the disease. In order to halt the spread of the disease in many endemic areas, every person in every community—with few exceptions, e.g., children under five years and pregnant women do not receive treatment—is treated annually with a single dose of the drug Ivermectin.

In the district of Saraya, government funding for the Onchocerciasis program was severely cut this year, and as a result, treatment coverage rates fell to as low as 60%. As a result, ACS

training was not well funded or organized, resulting in problems during community treatments, including the improper dosages of children, which can have serious side effects.

In order to ensure that this coming year would see successful and thorough coverage, ASCs were invited to participate in KCHP's supplemental training day. The day commenced with an introduction to the disease, including a discussion of the symptoms and dangers of the disease. A lively discussion in both French and Malinké ensued. More experienced ASCs were encouraged to come to the front of the classroom to answer questions raised by newer ASCs, as seen in the above photo.

The day culminated in a delicious meal shared by the ACS's and KCHP staff.