Guest blogger, Charles Oberg, MD, MPH, is Professor Emeritus in the Division of Global Pediatrics and the School of Public Health at the University of Minnesota. He is also a practicing pediatrician at Hennepin Health (formerly Hennepin County Medical Center).
This spring, Dr. Oberg spent four weeks in Nkololo, Tanzania volunteering for WellShare International. During this time, he worked in the local hospital and introduced tablet technology to villages. The “Together for Health” project will provide better communication and prevention tools to villages and hospital staff using tablet computers.
WellShare’s community health workers engage with villagers and serve as liaisons between community members and health providers. Funded by Health eVillages, the tablets offer health education for local people, and disease prevention materials and communication opportunities for community health workers and hospital staff. This blog post is an excerpt from Dr. Oberg’s July 25 presentation about his trip.
I arrived in Tanzania after months of preparation. Yet, I was still surprised by what I experienced. The trip from the airport to Nkololo took us about five hours. It was a different world with very beautiful landscapes — from Mount Kilimanjaro to the beauty of the Serengeti plateau.
While in Tanzania, I spent roughly a third of my time in Songambele Hospital where I worked with the three doctors there. Although the hospital has limited resources, they maximize what they have and do tremendous work. In Tanzania, the doctors are trained in both medicine and surgery and are really exceptional healthcare providers. I was joined by Dr. Judith Kerpelman an obstetrician from Rochester, New York, who was an incredible addition to the team and an invaluable resource to the Tanzanian physicians. Her daughter, Marina Scalise, accompanied her on the trip. Marina is a recent graduate from the University of Delaware with a degree in Disability Studies. She volunteered both in the hospital and assisted the Tanzania WellShare International team.
During rounds on my first day, I was overwhelmed by the amount of preventable disease I saw. I wasn’t expecting the level of illness to be as great as it was. Many people travel long distances to reach Songambele Hospital, often on the back of a bicycle. Being a pediatrician, I saw many preventable conditions in children, mostly malnutrition, pneumonia, malaria and sickle cell anemia, which are quite common in the region. Despite the level of illness, I saw many lives saved during the short time I was there.
In the village, the WellShare International team met with community health workers and local villagers in Bariadi district to learn about the community’s health concerns and introduce the tablets. Everywhere we went, the Tanzanians would greet us in song. It was a delight to sing along and to be joyous with the villagers. We did a lot of singing; we sang when we met and we sang when we said goodbye. Every village we visited has been part of a WellShare program called “Survive and Thrive” for young mothers. This program provides peer support, health education and a unique business model providing economic security to families.
I found it important to listen to the concerns of the community before introducing the tablets, to better understand the ways communities intended to utilize the technology. In particular, I listened to the women. Women have a voice and they need to be heard. Many of them expressed concerns about high blood pressure during pregnancy, malaria, anemia, transportation and communication with a healthcare provider. I enjoyed working with the strong community of women in the village, the WellShare team and the volunteers.
The new tablets will provide better education and communication for the village. When we introduced the tablets in the village and previewed the health education videos, everyone in the community would show up to watch and learn. Since transportation from the village and hospital can take more than two hours, the tablets will be very important to learn prevention methods and understand serious symptoms early.
It’s very clear from a prevention point of view, that if we can get people to the appropriate level of care sooner, then the overall health of the community is going to improve. By training community health workers on how to use the tablets and understand danger signs of common but potentially life-threatening conditions, they can communicate to health providers about problems villagers are experiencing before health deteriorates. The tablets are also a tool to improve basic healthcare information not only to the villages but the clinical health providers in the district health clinics and the doctors in the hospitals.
Building on the work of current health systems and providers, community health workers can communicate about health concerns efficiently. This is vital to improve health and ultimately lead to increased stability of a community. I thank WellShare and the amazing people I met during my time in Tanzania for all the meaningful work they have done. The people I met were incredibly gracious, and I look forward to another visit.
Photos courtesy of Dr. Chuck Oberg & Dr. Judy Kerpelman