Simango

Simango

The Simango Rural Health Centre is located in Kazangula District, approximately 60km from Livingstone. The health centre serves 35 villages within its large catchment area, with a population of approximately 10,000 people.  The villages are largely populated with between 100-200 people and situated long distances from one another, and the health centre. Some villages are as far as 40km from the health centre, and the majority of the population have no means of transport.

Staff and facilities

Simango Rural Health Centre does not have any doctors working there, and the closest doctor is located at Zimba Hospital (which offers limited services), which is approximately 30km from Simango. Those with more serious conditions would need to make the 60km journey to Livingstone.

The centre currently has 4 medical staff situated in the facility, and two Community Health Assistants working in the community, and reporting into the health centre. The staff consist of 1 clinical officer, 2 nurses and 1 environmental health technician. Due to high demand for health services in this area, the government are opening a new health post in Chinkozya, 35km from the current health centre. This will be staffed by one nurse who will report into the Simango health centre.

Services

The centre offers antenatal services, vaccinations, family planning, diagnosis and referral services to hospitals.  The staff also do a lot of outreach work in the community to deliver vital health promotion around water and sanitation, contraception, hygiene and nutrition. The staff work closely with OCA CHWs to deliver monthly under 5 clinics in each village.

Challenges

Despite being well equipped by local standards they centre faces many challenges

  • The centre stocks very little medicine, and very few patients can afford to make the journey into Zimba or Livingstone to access medicine
  • There is very little access to water in the region, resulting in a very high prevalence of diarrhoea. The health centre have done a lot of work to map out where there is no access to water, and which communities would benefit most from access to water, but the government do not have the funds to install bore holes. They see this as the biggest barrier to health promotion in the area.

Most common ailments

  • Respiratory
  • Diarrhoea
  • Muscular Skeletal
  • Skin

Most important health promotion interventions identified by clinic

  • Immunisation
  • Contraception
  • Water and sanitation
  • Hygiene

Our role

On Call Africa worked with the RHC to identify remote communities within the centre’s catchment area, where patients were unable to access the RHC, let alone see a doctor. On Call Africa delivers treatment in these remote areas through our mobile health clinics, where we offer diagnosis and treatment free of charge through qualified overseas doctors. The doctors also deliver vital health education at clinics and within the communities to reduce the need for our services.

On Call Africa train Community Health Workers from within these communities to strengthen the existing health systems, ensuring that patients have access to medical advice, and can get referrals when needed. Our monthly clinics currently operate in Chinkozya, Mulamfu and Siluyasila.

Malamfu

Our clinic in Malamfu is delivered from a simple structure built by the community for On Call Africa clinics, situated in a central location in the village. The village has approximately 120 households and a population of 400+. The clinic also serves the 3 surrounding villages of a similar size, and people walk as far as 10km to access our services.

The village has one bore hole, situated 1km from the clinic, but this is dry during the dry season, and the surrounding communities do not have bore holes. The majority of the community collect water from the river for drinking, bathing and cooking. The health post chair, community health workers and headman all stated independently of one another that the community know they should boil the water before using, but very few people do this in practice, due to the cost and time required.

The village is 20km from Simango, and 6km from the nearest school. The common issues identified by CHWs were:

  • Diarrhoea
  • Back ache
  • Tooth ache
  • Coughing
  • Bilharzia

Biggest locally identified challenges

  • Lack of clean water
  • Poverty
  • Hunger

Siluyasila

Siluyasila is 10km from Simango RHC, and 5km from the nearest school. The village has a population of over 300 people and the clinic is held in the local church, which is the only communal building in the village. The village has 2 bore holes, one of which has water all year round, and the other is completely dry during dry season. The surrounding villages that commute to the clinic (from up to 10km away), do not have access to clean drinking water. There are limited toilet facilities in this village and there are no handwashing facilities where the toilets are located.

The common issues identified by CHW’s were:

  • Diarrhoea
  • Coughing

Biggest locally identified challenges

  • Lack of clean water
  • Poverty
  • Access to power
  • transport

Chinkozya

The village is located 35km from the Simango health centre, and has one of the highest rates of disease presentation of all of the villages in the catchment area, due to its high population. Due to the high level of demand the government have opted to open a new small health post to work under the Simang RHC. The centre will have one nurse located on site permanently. This site is opposite the local primary school and the community bore hole, and will open in December 2019. The Simango RHC have requested that we relocate to Malimba village 10km from Chinkozya, where the need will now be greater.