On the front line of medical care in a vast drought zone

MOUSSORO, Chad, April 16, 2012—We were leaving Moussoro this morning for the long drive back to N’djamena, the capital city of Chad, but first I was keen to meet with the IRC medical staff who are at the forefront of providing crucial care throughout the vast Bahr el Gazal region. 

Every Monday at 7am, IRC field coordinator Dr. Martin Bubu meets with 12 nurses, 10 midwives and other staff to discuss their schedules for the coming week and any urgent issues they need to address. Afterwards, they all climb into IRC vehicles to make journeys of up to three hours to the 26 health centers scattered throughout the region.  

Before we went our separate ways, I talked with senior health manager Dr. Rondouba Firmin, nurse Elias Konodji and midwives Habiba Hassan and Linda Neloum. 

I asked them whether they have seen an increase in illnesses among mothers and children. “Food is a big concern here,” explained Habiba. “They don’t have enough to eat, despite the food provided by the World Food Program.”

Linda heads out with an IRC driver on her first assignment of the day. She and other IRC medical staff travel up to three hours to reach the remote health centers they support. (Photo: Sophia Jones-Mwangi/IRC)

With the IRC’s help, however, things are improving, Habiba added. “More and more people are coming to the health center, compared to before. This is partly to get food from WFP, but also because IRC is providing quality, and free, health care.” It helps that the network of community health workers keeps people informed of the services available to them, she stressed. 

On a logistical level, the IRC is trying to make it easier for people to access health services. “There is now an ambulance provided by the Ministry of Health but maintained by the IRC, so people can be referred to the hospital from the health centers, said Rondouba.  “We have also put in place a strategy using a horse and cart in the villages to transport people to all 26 health centers.”

I asked them how it would be if the IRC were not here. “It would be a catastrophe!” exclaimed Rondouba. “Unfortunately, the Ministry of Health is very weak. It doesn’t have enough capacity to cover the health of this community without outside help.… They have limited drugs and supplies, so they need a lot of support. If IRC were to leave quickly, it would be a disaster.” 

According to midwife Linda, the community is well aware of the shortcomings of local health services, “so now they rely on our services.” When people know the IRC will be visiting a health center, the news spreads. “One of people’s big concerns is that IRC will leave one day,” she said. 

Elias noted that nurses are seeing an increase in certain illnesses. “We are treating more cases of infection such as pneumonia,” he said. “This is because of lack of food, which compromises the immune system so children are predisposed to infection. 

Diarrhea, which leads to malnutrition, is also on the rise. The process is too often cyclical. “A baby comes to the health center, it is given therapeutic food and then recovers,” said Linda. “But sometimes the food that is for one baby is shared with the entire family or even sold, because the family is so poor. Then the same baby gets sick again.” 

Tomorrow, from N’djamena, I leave for Guera, a region also struck by drought. Unlike Bahr el Gazal, the IRC is not yet working there, although plans are underway to start an emergency nutrition response for children under five and for new and pregnant mothers.