Imagine you are a pregnant woman in need of medical care. Your nearest health centre is many miles away on dusty or muddy tracks. You don’t have a car and there are no buses. There is no-one to look after your toddler either, so you have to carry her on your back.
Now imagine that your young child is very sick, with a high fever that is getting worse through the night. It is 2am and you are extremely anxious. Again, you have no transport to get you to your ‘local’ clinic 10 miles away and the only way you can do it is to set off in the dark, on foot.
This is the reality for hundreds of thousands of people in the Democratic Republic of the Congo (DRC). For patients to get access to health services, they often have to walk for many hours. This is not the only problem. Poverty leads to poor nutrition and bad sanitary conditions, leaving people – especially the very young and the very old – vulnerable to disease.
Decades of conflict and a lack of government investment have made it hard for people in the DRC to access basic healthcare. The distances, cost of transport, lack of health infrastructure, bad roads, burden of disease, poverty and poor nutrition combine to create a toxic mix that results in one of the highest child and maternal mortality rates in the world.
Epidemics have spread unchecked and treatment of deadly diseases has been neglected. Lack of investment in the healthcare system results in an absence of infrastructure and properly trained medical staff throughout the country. While medical needs are enormous, people, and especially the poorest, are left struggling to find even the most basic level of healthcare.
But there is hope on the horizon for some of the DRC’s population … SD Congo with the support of SDIA and many other donors[i], has developed a system called the Community Health Centre model, or CSCOM for short. Local participation is key, and the system combines investment in quality health infrastructure with health services management by Community Health Committees as well as Government investment in staffing.
It also provides a health financing option, through the creation of Health Mutual Associations controlled at the local level, that can help offset the cost of emergency and routine health services. With the support of SDIA and our donors, SD Congo is able to operate six community health centres and hospitals in the DRC, serving a population of more than one million people.
Susila Dharma and you: how our donors are helping us meet Sustainable Development Goal 3
The United Nations Sustainable Development Goals or SDGs were established as a global ‘plan of action for people, planet and prosperity’ by representatives of the 193 United Nations Member States meeting at the UN Headquarters in New York in September 2015.
The Susila Dharma network and its partners are helping to meet several Sustainable Development Goals in the DRC (you can see a list here), through the establishment and operation of CSCOMs, in particular SDG 3. Here’s how we are meeting the targets.
Sustainable Development Goal 3 – Ensuring healthy lives and promote well-being for all at all ages
- 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births. With the support of SDIA and other donors, SD Congo currently operates six CSCOMs and hospitals in under-served communities in Kinshasa and Central Kongo provinces. These centres, serving a population of more than a million people, focus on pre-natal, ante-natal, maternity and health services for children under 5. The latest health centre, the Mother-Child Hospital Centre of Kwilu Ngongo, is specifically designed to provide women in the community of 52,000 access to high quality pre-natal, obstetrical and ante-natal care, effectively contributing to a reduction in child and maternal mortality.
- 3.2 By 2030, end preventable deaths of new-borns and children under 5 years of age: By closely following the mother during pregnancy, ensuring she has access to vitamins and micro-nutrients, and having at hand the capacity for surgical interventions like cesarean sections, SD Congo health centres are providing the best chances to both mothers and newborns. Centres provide vaccinations and pre-school health follow-ups during the first 5 years of life.
- 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases: One of the keys to the elimination of epidemics like HIV/AIDS, tuberculosis and malaria are public education, treatment and screening measures. All our SD health centres practice mandatory testing of pregnant women for HIV/AIDS and malaria treatment and prevention strategies. By detecting the presence of HIV/AIDS infection during pregnancy, measures can be taken to reduce the risk of transmission of the virus from mother to child. As an extension of SD Congo’s health service provision in communities, with the support of SDIA, the Blond Trust and the Buchan International Fund, we have piloted community clean water projects that are effective ways to prevent cases of water-borne and communicable diseases, which are a common source of infant and child illness and mortality.
- 3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including family planning, information and education: Lack of access to sexual and reproductive health services, including family planning, can lead to frequent and at-risk pregnancies because mothers don’t have the chance to recover their strength before they become pregnant again. All SD Congo health centres provide family planning education and services as a means of promoting long-term improvements in maternal health.
- 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all: Through training and technical support that SD Congo provides to the creation of locally managed Health Mutual Associations (HMA), we give families in the DRC the possibility to save every month for eventual health care needs. The HMAs are democratically organised organisations that represent the members: they provide a voice for members in determining what kinds of services they value most and where the quality of services and medicines need to be improved.
- 3.12 Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries. With your support, SD Congo is also playing two other key roles: that of training and supervising health professionals that work in its centres, as well as that of advocacy with the government to provide a basic level of health coverage to the country’s most vulnerable. By providing on-going training for the health professionals working in our centres, they are more motivated to give their best to the patients. They have all the equipment and tools to do their job properly, so they feel a sense of pride to be working for Susila Dharma and the community. SD Congo representatives are also present in government meetings to continuously advocate with the Ministry of Health and share data that indicates where and for whom services are most needed.
- 3.13 Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks: By treating people, gathering health data and analysing local health trends, CSCOMs are important contributors to national health information systems that can help detect and respond to potential epidemics before they get out of control.
If you feel moved to support this work, you can donate here.
[i] Donor organisations that have contributed to the development of the CSCOM model include SDIA, the Buchan International Fund, Blond Trust, SD Canada, SD Britain, SD France, SD Germany, BMZ, SD USA, MSF and the Guerrand Hermes Foundation for Peace, all working together to help meet the Sustainable Development Goals in the Democratic Republic of Congo (DRC).