Field Notes: Getting the word out in Zambia

Group CHV Training Mpika, Zambia

By Lindsey Pollaczek, Senior Program Director

MPIKA, Zambia — Last week we completed the first training for community health volunteers here in Mpika, northern Zambia, our first step toward establishing a nationwide fistula treatment network in the country.

Applying lessons learned in running our Action on Fistula program in Kenya for the past three years, a key part of our strategy here is to work with local groups to engage Zambian communities around fistula, which includes educating people about the condition, explaining that it can be repaired with surgery, and identifying women in need of treatment.

When asked at the very beginning if anyone knew of a woman living with fistula in her community, only one volunteer raised her hand. By the end of the training, they were able to identify an estimated 8-10 women with fistula from their communities.

Grassroots beginnings

My colleague Bwalya Chomba, our locally based program manager, and I led training for a dynamic group of women (and a few intrepid men!) selected to represent nine rural health centers located in the districts of Mpika and Shiwang’andu here in the Muchinga Province. The volunteers all came to the training with a good background in health education—on topics including safe motherhood, family planning, malaria prevention, and nutrition counseling—but none had ever received specific information about fistula.

When asked at the very beginning if anyone knew of a woman living with fistula in her community, only one volunteer raised her hand. By the end of the training, after the volunteers gained a better understanding of what fistula is and how it can be treated, they were able to identify an estimated 8-10 women with fistula from their communities.

Newly trained community health volunteers in Zambia

Newly trained community health volunteers prepare to return to their villages and start spreading the word about fistula treatment in Zambia.

A plan of action

On Friday, the community health volunteers took turns presenting their action plans for when they return to their villages over the next few months. These plans covered a whole range of community engagement strategies—briefing the chiefs and village headman and getting their support to mobilize in the community, training members of the neighborhood health village committees, educating religious leaders and women’s groups, utilizing the market leaders to spread their messages—farther—and making use of International Women’s Day on March 8 as a platform to amplify their message that fistula is treatable and preventable.

They all went home with educational banners, T-shirts, and a roll full of posters and flyers that were in both English and Bemba, the local language. They were all so excited to have these materials to facilitate their work.

Seeing clearly

To end the meeting, a vote of thanks was given and the woman who was selected to share said it wasn’t sufficient just to say a vote of thanks, but they wanted to sing and dance a vote of thanks to show their appreciation for Fistula Foundation and for the training. Bwalya translated the Bemba for me—Ilinso lyali limo, ilinso nomba nakula yaba yabili amenso yaba yabili, translated:

I only had one eye but now I have two eyes and am able to see clearly.

They couldn’t see the whole picture about fistula at first, but now they do, and they have the resources they need to be successful and to help women in need.

It was a great first training in Zambia and with this level of enthusiasm and support there is a great deal to be excited about as we roll out the program!

Lindsey Pollaczek is Fistula Foundation’s Senior Program Director. Since 2014, she has directed the foundation’s work in Kenya through Action on Fistula, coordinating delivery of the fistula surgery training program and managing development of the Fistula Treatment Network and outreach programs, which have resulted in successful treatment of more than 2,200 women to date.

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