Local health knowledge is saving lives in Papua

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A community health worker checks for fast breathing in a child who may have pneumonia, Papua, Indonesia

When three community health workers took up their training in 2011 in the remote village of Yalelo, West Papua, Indonesia, they faced a difficult child health context. From 107 households in this village, 11 children had died between 2009 and 2011 from pneumonia or diarrhea.

The high prevalence of pneumonia in Yalelo can be related to the traditional houses of the village, with an open fireplace and limited ventilation. The causes of diarrhea are also easy to identify, as villagers and their children sometimes drink unboiled water and do not wash hands with soap before eating. The situation is made worse by the inability, or at times, reluctance, of families to seek treatment for sick children. Most children died at home. With the village location a three hour walk to the road and transport, other children who were taken to seek treatment died on the way.

“This kind of story happened not just once, but three times,” explains one of the community health workers, Arnos Asso. “It is traumatizing for us in Yalelo. Because of this, if our children get sick, we prefer to treat them here at our home.”

WV Indonesia is working together with the District Health Office and UNICEF to implement an Integrated Community Case Management (iCCM) program in the Papua context. The program is empowering community health workers to be able to provide early detection and treatment of pneumonia, diarrhea, and fever and emphasizing the needs of referral for cases which have danger signs or cannot be treated at community level. The advantage of training people like Arnos Asso is clear; local health workers understand their community context, customs and hesitations on children’s health, and what families are prepared to do to protect their children from further harm. Between October 2011 and June 2012, the three community health workers successfully managed 97 cases of pneumonia, pneumonia, diarrhea and fever.

“We are so glad and feel so lucky for having this new knowledge,” says Adin Lokobal, another of the three. “People come as soon as possible to bring us their sick children. No more sad stories here at the village of Yalelo.”