Silvie Mukundwa, a resident of Masoro sector, Rulindo District, Northern Province, saw her 4-year-old son suddenly develop many symptoms such as running nose, watery eyes, swollen eyelids and sneezing.

She dismissed it as an ‘ordinary’ cold, subjecting him to flu tablets with anticipation that the infection would go away overtime.

Ten days later, the flu tabs had not helped. The child instead developed more strange symptoms like red eyes and sensitivity to light, a high temperature peaking around 40°C, tiredness and irritability.

However, she started becoming desperate when aspects like dry cough, loss of appetite, tiny greyish-white spots in the mouth and throat, started showing.

It was not long before her older child started presenting similar symptoms, and, for once, Mukundwa bought into what her neighbours were saying; that her family was a bewitched.

However, their fate was helped by a community-based health worker (CBHW), during one of the periodic visits in homes. The volunteer told the family that the ailment could be measles and helped Mukundwa and her sick child get to a nearby health centre.

After weeks of treatment, the child recovered. Two years later, Mukundwa still describes the visit by the CBHW as heaven-sent.

Mukundwa was one of the mothers whose children received a measles vaccine during the Mother and Child Health Week – also known as MCH, a three-day countrywide event that ended last week – aimed at improving the welfare of children under 15, pregnant and and lactating women.

She says previous experience of the disease in her family has taught her to always be responsive to health campaigns like immunisation.

Activities during MCH week

Rutongo Hospital currently supervises 10 health centres that serve about 291 villages in Rulindo District.

According to Ismail Niyorurema, the monitoring and evaluation officer at the hospital, during the three days of the MCH week, not only measles vaccination was carried out, but vitamin A and deworming tablets were given out.

Screening for malnutrition and family planning related sensitisation was also done.

"Prior to the start of the week, we oriented about 662 CBHWs,  heads of health centres and 54 representatives of primary and secondary schools about the exercise, and these were not only crucial in mobilisation but also helped implement certain exercises,” he said.

Henry Murinzi, the MCH supervisor at the hospital, says the exercise was 75 per cent successful in the first two days.

Usual efforts

Rutongo Hospital, through 44 mobile sites and 662 CBHWs in its zone, ensures that malnutrition screening is done at village level at least once a month.

"For every case of malnutrition received, we have to find out whether the cause is poverty or poor nutrition knowledge. For the former, we partner with sector authorities to help the family get land to farm or a job so they can fight poverty, and for the latter, our health experts try to give as much proper nutrition counsel to the family of the victim,” Dr Salomon Sindayiheba, the facility’s clinical director, said.

The hospital currently has two tonnes of Sosoma (fortified supplementary food) in stock awaiting dispatch on request to villages affected by malnutrition.

As a result, malnutrition has been falling in the zone supervised by the hospital, seeing it fall from 0.09 per cent in May to about 0.05 per cent as of September. 

According to Sindayiheba, at least twice a month, a midwife, general medical doctor, and MCH supervisor, are sent out to coach health centre staff in line with baby delivery techniques, management of newborn, and use of certain delivery tools.

He added that as part of efforts to improve mother and child health, 48,650 mosquito nets were for instance given out in January alone.

Every month, an average of 500 people get free HIV screening at the hospital, and 16,000 women are currently under regular family planning use, courtesy of the hospital.

Challenges

Sindayiheba said some families do not have health insurance, so sometimes extending care to them becomes difficult.

"Even those who have it sometimes are unable to raise the 10 per cent portion mandated to them,” he said.

He added that some families resort to use of herbal medicine when one of their own, for instance, catches a disease like measles, only to bring them to hospital when the disease has advanced.

Sindayiheba concludes that most times women take the lead in fostering their health and that of children, and that men have limited participation.

"For instance, many times pregnant women come to hospital without their husband,” he said.