Midwife Betty Mwiinga, Community Health Assistant Moutress Zulu and two volunteers staff Manyana Rural Health Post, which is just over 40 kilometers from the main district hospital in Mazabuka District, Zambia. Betty and her team provide maternity services, family planning, tuberculosis screening, malaria diagnosis and treatment, and HIV counseling, testing and treatment services, in addition to community outreach.
They work hard to provide a full range of quality health services. But they weren’t ready for an outbreak of cholera.
During the last week of April, 2016, a cholera outbreak began in Betty’s district. With little training on how to manage patients with the disease, her team was worried.
“I would have run away,” Moutress remarked, when asked what she would have done if a cholera patient had shown up at their door.
Midwife Betty agreed. “If any cholera case came through, we would have ended up putting them outside the health post…for fear of contamination of the clinic.”
Thankfully, Jhpiego-trained mentors were already working with Betty’s health facility and 37 others in the area, under a capacity-building project led by Jhpiego and funded by the Centers for Disease Control and Prevention. The project aims to improve the competence of health providers like Betty and her team to provide key HIV-related clinical services.
In early May, just a few weeks into the cholera outbreak, these mentors pivoted and began working with Betty and her team to reinforce infection prevention and control measures and cholera preparedness. Even simple tasks like proper handwashing are critically important to preventing the spread of the disease in a facility and ensuring that care providers are safe.
When the mentors visited Manyana, they helped Betty and her team prepare by reviewing what fluids, drugs and protective clothing should be available in the health post to respond to a cholera case. The mentor team conducted a containment exercise, simulating how the staff could close a section of rooms to create an isolation ward for cholera patients while clients seeking other services used alternate entrances. The mentors emphasized protocols for communication with a nearby facility responsible for tracking the cholera outbreak, and ensured that Manyana would remain open if a cholera patient presented.
“We thought we were too far away from where patients were being admitted, yet we have fish mongers coming to sell fish from the river at our center every day,” Betty said, referencing the high potential for her facility to receive a cholera case. “Now we know that we can admit them and just close off one part of the health post to create an isolation room.”
Manyana Health Post is among 38 health institutions in Mazabuka District which benefit from Jhpiego’s on-site clinical mentorship, aimed at improving the competency of providers like Betty. Because of the program, mentors were quickly mobilized, reoriented to cholera preparedness and infection prevention, and deployed throughout the district. Jhpiego also provided supplies such as basins, sterile gloves and disinfectants to facilities to ensure infection prevention. After ten days of mentorship, all 38 health facilities were prepared to receive a cholera case.
“I am deeply humbled with this partnership we have with Jhpiego,” remarked the District Medical Office’s Dr. Stephen Shajanika. “You went a mile further, without any delays. A friend indeed, is a friend in deed, and that’s what Jhpiego has demonstrated thus far.”