Spend a moment with the health team in a village in Obongi and experience what palliative care means in the fragile, rural setting. 

Village Health Teams (VHTs) are often the first responders to any health-related issue in the community and voluntarily serve to link community members to the healthcare workers. Some of these VHTs have become leaders and mentor other VHTs, and hence are called ‘VHT Mentors.’ VHTs and VHT Mentors can be found in every district of Uganda and are particularly important in rural and fragile settings.

Cairdeas is proud to have worked with our Ugandan partners to offer basic palliative care training and support of VHTs and VHT Mentors in both Obongi and Adjumani districts. (See a recent group photo to the left with VHTs and VHT Mentors in Dama Village with Cairdeas, taken during our Needs Assessment.) Below are two interviews from them, Silva Ayan and Betty Juru, both of Dama village in Obongi district, to help us better understand their day-to-day work. 

Silva Ayan leads the many VHTs in the Dama village area; he is active and quick on his feet as well as quick to smile. After introducing himself and the team, he was curious of our linguistic skills. Could we speak Swahili? Bari? Keliko? Arabic? Not a problem, he could translate them all. As a VHT Mentor, he visits and counsels patients and their families and works to liaise them to a health centre or other health service provider for further assistance. Note that Silva is pictured to the left, under the tree, on one of our Needs Assessment visits. 

He makes sure those ill and suffering get referred to see other doctors for investigations when they don’t get better. We visit them either every day or three times a week, he told me, when I asked about his interactions with patients with possible palliative care needs. Many patients visit the health centres only occasionally, he explained, and they forgot what they are supposed to do or even the date of their next check-up. Silva’s approach is quite holistic: “we pray so God can do his part in their lives … while we give them health education so they know how to control and manage their illness.”

Silva told me about one patient who has been suffering with Tuberculosis, living alone, and not getting any better. She wasn’t around her home the two days we visited Dama Village, but I asked Silva to tell me a little more about her. He shared more about her illness, and what struck me was the overwhelming care. One time, when she was very weak but needed to go to the health centre, he took her there on his bicycle. “We don’t want to leave someone suffering here,” Silva explained. “If there is no one here to take care of them, we will, as one of their own family.”

Betty Juru, a VHT in Dama village, hopes to be a nurse one day and loves working with families. (Families live in homes like this one, pictured to the left, whose walls double as a blackboard.) Betty first shared about one young lady, just a teenager, who recently received a positive HIV status and also just delivered her first baby. Betty explained the holistic needs of the young mother too – she has been left to raise this two-week old infant alone and is battling what sounds like depression. Simply going to the health centre or supporting ante-natal was not enough, Betty told me, but she went a step further to link her with other couples in the community who are living with HIV for support and counselling. 

When we chatted about other individuals with palliative care needs in her community, Betty mentioned another lady, a mama, who she would have loved for us to meet. Betty had worked quite closely with her, taking her to different health centres and coordinating medications to be delivered to her home, to treat her Hepatitis B infection. Just a week ago, they went to another health centre together for assistance, and unfortunately the lady died while at the centre. Betty said that she was glad that she could be there until the end – “I don’t fear the dying” – and helped coordinate an ambulance bring the mama back to their community for burial.

There are several other VHTs and VHT Mentors and many more conversations and stories to share. One of our programmes (in progress) is the Photovoice Pilot research, looking into the lived experiences of those living in fragile settings with serious, chronic illnesses. (Three VHT Mentors, to the left, act a drama on the consent part of the research, in preparation for their work with patients.) Be sure to subscribe to the Cairdeas Blog to receive updates on our work.