Volunteers on Bicycles Bring Health Care to Rural Senegal
GAMBEY, Senegal — Sillymane Ba pedals his rickety bicycle down a rocky, bumpy, red dirt road with a large bag slung over his shoulder. He is heading from the local health centre to his village of Gambey, one of Senegal’s poorest rural areas.
Sillymane Ba, a farmer by trade, is a member of Senegal’s community health worker program run by the Senegalese Ministry of Health and supported by UNFPA, the United Nations Population Fund. The program attempts to bridge the gap in health services between Senegal’s rural and urban areas.
In his bag Mr. Ba carries vitamins, basic medicines and contraceptives, which he will show the villagers how to use when he arrives. He will then answer their questions on family planning, pregnancy and the prevention of sexually transmitted infections. When he has finished, he will put away his black bag, prop his bicycle against his hut, and return to work as a farmer in the fields alongside them.
Senegal is one of the 50 poorest countries in the world. Twenty percent of its population lives on less than one dollar a day, with much of this poverty concentrated in the country’s underdeveloped rural areas. In the region where Mr. Ba lives, only 5 percent of the population has access to clean water. Fewer than one in five girls go to school.
Medical facilities in these underdeveloped areas are a far cry from those available among the high-rises of Dakar, the nation’s capital. Providing services poses a great logistical challenge, which is why the government and UNFPA adopted this community-based approach. By recruiting members of rural communities to serve as health conduits, the program enables villagers, who may never have the chance to see a doctor, to bring health services home with them.
Participants, like Mr. Ba, are trained to explain sexual and reproductive health issues, and are then provide with with the simple tools of their trade: a bicycle for transportation and a bag containing contraceptives, educational materials and basic over-the-counter medicines.
Roughly 201 million women in low-income countries would use safe, effective contraceptive methods if they were available. Help UNFPA increase access to contraception.
“Our goal is to bring the greatest possible level of reproductive health services to all,” says Dr. Suzanne Maiga-Konate, UNFPA Representative for Senegal. "These volunteers come directly from the populations they serve. Sensitive questions that people would never ask an outsider, they will ask of them. And if we can reach these people, we can raise the health status of this country.”
The volunteers are trained to pay special attention to the state of pregnant women in the village. They refer the women to the local health centers for three pre-natal checkups and do all they can to ensure that the women reach the centre to give birth with a skilled attendant.
Transporting a woman in labor can be difficult and expensive in this remote part of the country. To help remedy the situation, UNFPA has begun providing the villages with 'community health funds', usually around $50. The fund assists the community to pool resources for use in times of urgent need—such as when a woman experiencing complications during labor desperately needs to reach a district hospital. The villagers themselves work out the details of how to replenish the fund, usually by small monthly donations.