The ability to see a doctor, nurse, or other trained health provider when we need to is hugely important. We may not think about it much when we are healthy, but sometimes, a visit with a health provider could mean the difference between life or death.
Unfortunately, millions of people in rural areas and low-income communities live far away from their nearest hospital, clinic, or health center, and don’t have adequate transportation or resources to reach them during an emergency. In fact, about half of the world’s population cannot access health care when they need it.
Consider those living in areas affected by natural disasters, emergencies, or armed conflict. Frontline health workers typically live in or near the communities they serve. If a community is affected by drought, the health workers are affected too. If ongoing conflict causes people to flee their homes and communities, doctors and nurses will likely flee with their families as well (if they can). Those left behind may have no one to provide them medical care or to help them stay healthy.
CARE trains, works with and relies on frontline health workers (FHWs) to deliver health services every day in a variety of low-resource settings. These include doctors, nurses and other health workers with varying degrees of formal and informal training. We know that their jobs are difficult, even in the best circumstances. Now imagine what life is like as a FHW in an area affected by crisis or armed conflict.
Let us introduce you to some of the people doing this work:
Mary is a midwife working in the Imvepi refugee settlement in Uganda. She has a three-year-old son.
Uganda has become one of the largest refugee hosting countries in the world. At the height of the crisis, more than 3,000-7,000 people from South Sudan would arrive every day in the search of refuge. Of the 1.2 million refugees in Uganda, 900,000 are South Sudanese and 86% are women and children in real danger of sexual and physical violence, with many reporting incidents of violence on their journey. Imvepi refugee settlement hosts more than 110,000 refugees.
CARE has established five centers in Imvepi where refugee women and girls can seek assistance and sexual violence survivors can be provided with psychosocial support and health services. Mary works in one of these centers.
She has a busy schedule. At the women’s center, she identifies pregnant refugees who need maternal health services, screens for possible complications, and advises them on antenatal care. She refers any serious medical cases to nearby health clinics and balances a large case load. “Usually in a day I see around 80-100 people, many of them are pregnant mothers,” she explained. “I make sure to highlight the importance of hospital deliveries, as most of them have never seen a doctor before. But it is challenging.”
Because of the scale of Imvepi (about 150 square kilometers), Mary also makes home visits. She provides education on different topics – from family planning to gender-based violence to malnutrition and HIV.
“[Intimate partner violence] is a reoccurring problem in many families. I mostly hear of cases where food shortages lead to physical violence. Many families decide to sell the food rations they receive, ending up with little to no food left for themselves and extreme tensions at home.” Mary said. “I screen such women to see if they are in need of immediate help or referrals.”
Khawla is also a midwife, providing family planning services in Aleppo, Syria. She lives with her husband and children.
Conflict has been ongoing in Syria for over seven years, and civilians are bearing the brunt of the suffering, destruction, and disregard for human life. An estimated 13.5 million people require humanitarian assistance, including 4.9 million trapped in besieged and hard-to-reach areas, where they are exposed to grave protection threats.
Working through partners, CARE supports 10 primary healthcare centers and 10 mobile clinics in northern Syria to provide vulnerable Syrian households with access to sexual and reproductive health and primary health education and services.
Khawla’s home and the health center often do not have electricity. She spends most of her time talking to women about their reproductive health and contraception. While most of Khawla’s work happens during daylight hours at the health center, sometimes she gets emergency calls from women late at night. “This is what scares me – having to go out during evening or night hours due to the security and conflict conditions in Syria,” Khalwa explains. The nearest hospital is 15 kilometers away.
Mary, Khawla, and other frontline health workers make personal sacrifices every day to deliver life-saving health care and emergency assistance to those in need under difficult circumstances. They experience and witness incredible suffering and choose to run towards the need when many would run away.
At CARE, we want to say thank you to all health heroes, wherever you are. We appreciate you, and your commitment to helping others.
Meet more of CARE’s frontline health heroes in our World Humanitarian Day publication: A Day in the Life of Seven Aid Workers.