HSA’s plight drives mother care group to action

WaCunanan Mkumbwa was excited by the prospect of serving people while earning an income when the government in 2020 deployed him to Mkamaumoza to work as a Health Surveillance Assistant (HSA).

But Mkumbwa has never had a house in the area since his deployment, a development he says is diminishing his excitement and negatively affecting his work.

HSA house under construction

Mkamaumoza is in Group Village Head (GVH) Daudi Thela in Traditional Authority Mthwalo in Mzimba District.

It is a remote area, deep into the vastness of the district, along the western foot of a mountain covered in a thick forest.

Mkumbwa and hundreds of other HSAs work involve, among others, providing health promotion, disease prevention and curative care, promoting community participation in health-care activities and providing surveillance of health problems in the community.

This, according to health authorities, means that HSAs must live within their area of work and always be available for community members.

Mkumbwa checking vaccines in the EPI refrigerator

Therefore, not expected to operate from Engutwini Trading Centre which is, after all, 24 kilometers away, Mkumbwa moves from one borrowed house to another in Mkamaumoza.

The situation, adds Mkumbwa, disturbs and troubles his wife and two children.

“For instance, at one time community leaders moved me into a house whose owner was in South Africa, working. I was booted out when he came back.

“Then they moved me into a house meant for teachers at Mkamaumoza Full Primary School, where I am currently staying. I am insecure for I know that some teacher would be deployed anytime and I would be booted out.

“Besides, the house leaks. I get busy moving property around when it is raining. The roof is shaky. It can be blown off anytime when heavy winds accompany rains,” said Mkumbwa.

However, Mkumbwa still has some hope as Kandazyewe Mother Care Group (MCG), with the support of chiefs and community members, is building a house for an HSA in Mkamaumoza.

The group is one of the 33 MCGs in Mzimba, established through the Health Systems Strengthening Program (HSSP) funded by GAVI through the Ministry of Health. Malawi Health Equity Network (MHEN) and several other stakeholders implement the program in nine districts.

HSSP trains and introduces MCGs as tools for improving child immunization coverage and advocates for improved health services provision.

Kandazyewe MCG Secretary, Wezzie Sanga, said the HSA house, which so far has all walls built and a roof done, will be ready by the end of this year.

“Mkumbwa’s situation is a big concern to us hence our resolve to build a permanent house for an HSA in this area. We were unable to finish by this time due to material constraints and other engagements.

“We realized that if an HSA has own house, which they can occupy anytime, it will be convenient. They will be stable and happy, have peace and concentrate on their work,” said Sanga.

The MCG, which has 30 members, operates from a makeshift under five clinic, where it works with Mkumbwa in administering vaccines to under five children in order to immunize them against tuberculosis, polio and measles, among other illnesses.

The group, which started in 2019, also advocated for a solar powered EPI refrigerator in which the group stores the vaccines they administer to children.

According to Sanga, child immunization coverage has improved in Mkamaumoza since their group began, more especially with the coming of the EPI refrigerator last year.

“Otherwise, on immunization day, the vaccines came from Engutwini on an ambulance or mmotorcycle, traveling 24 kilometers.

“It takes ten hours to walk this distance to and from. As a result, we started immunization late in the afternoon and most people gave up because of waiting for too long.

“Now that we keep the vaccines right here, we start early in the morning and can immunize over 100 children. Before the fridge came, we vaccinated less than 50,” Sanga said.

GVH Daudi Thela throws his full weight behind Kandazyewe MCG and the health improvement initiatives it brought, adding “he is personally urging fellow chiefs, church leaders and other community structures to support the group, more especially in improving child immunization coverage”.

Despite his housing challenges, Mkumbwa cherishes the strides he is making in his work with the support of the MCG, emphasizing that lack of a house remains his main worry now.

He adds the government should prioritize construction of HSA houses as is the case with workers of other ministries, departments and agencies.

In fact, Dr Prince Chirwa, former Director of Health and Social Services for Mzimba North District, late last year acknowledged the lack of housing is indeed a problem for hundreds of HSAs in Malawi.

As a result, according to Chirwa, some HSAs do not live in their areas of work, which is unexpected of and results into compromised health service delivery in those communities.

Chirwa added that, while the government is doing its own part to address the problem of housing faced by HSAs, it also banks on initiatives of community structures such as MCGs, who, in many areas, have built houses for HSAs on their own.

Therefore, Chirwa asked duty bearers such as Members of Parliament and several others to assist MCGs whenever they come to them seeking for help of any construction materials.

Chirwa had spoken during an interface meeting for MCGs and duty bearers held by MHEN in Mzuzu in December 2022.

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