Author: Kathy Griffith

Health access and coverage: an issue of justice

Posted on | by Kathy Griffith

The United Methodist Church’s Abundant Health Initiative is committed to reaching a million and more children with life-saving interventions, a goal set for the 2016-2020 quadrennium. This commitment is only possible through increasing health access and coverage for many thousands of community members within the reach of United Methodist congregations, health facilities and services. Reaching the most marginalized with healthcare is an issue of justice.

Access to health services is not always simple1

In Nepal, a woman has access to a prenatal exam conducted with care and respect early in her pregnancy. PHOTO: UNITED MISSION TO NEPAL 

In Liberia, Mardea was carried for two hours in a hammock, during labor, to deliver her baby at Camphor clinic. In Central Congo, the construction crew at Dingele Maternity Center rushed a woman in labor with complications to the hospital in their truck. In Jalingo, Nigeria, the taxi union has been contracted to transport women with obstetric emergencies to UMC health facilities. In Nicaragua’s autonomous regions, a horse or motorboat are on standby.

But there are so many other places around the world where physical access to health care simply isn’t possible. Tragically, women and children die for lack of transport – a bus, a bicycle, a motorbike, a truck – or the money to pay for the service, the confidence or permission to take it, or, finally, the limitations of staff and services available on arrival at a health clinic.

Affordability is at the heart of the matter for many families. Payment for consultation fees or medicines brings about hardship. They must use rent money, miss meals, walk instead of ride, go into debt or lose a day’s income.

For Bhawana, affordability meant a walk of several hours with her husband and mother-in-law in the hills of Western Nepal. She had gone into labor and needed to reach her clinic as quickly as possible. On arrival, the examining nurse found complications that she was not equipped to help with and immediately referred the family to the district hospital. How would they pay for the transport and hospital fees?

It seemed an impossible and life-threatening situation until they realized they qualified, on the spot, for an interest-free loan from a fund created for such emergencies. This fund was initiated through a Global Health grant and, after discussion and agreement, received equal and ongoing contributions from the community and local government.

Health coverage and health access go hand in hand

Health coverage is the actual delivery and receipt of services, but many people are unwilling to seek services near their home because of the attitudes of health workers. True health coverage is access to health care providers themsleves and to quality care offered with dignity in clean facilities. Many women from lower social classes or those simply lacking resources have given birth in poorly equipped and staffed facilities without basic infrastrature, like water or a decent delivery bed, because of years of neglect.

Justice for these women has been realized through the UMC-supported revitalization of their health facilities to provide maternal, newborn and child health care, among other essential serives. Delivery rooms are equipped and medications are available. Health care workers in UMC health facilities are trainied to provide care with dignity, regardless of the indivudal’s background. In Ghana, pregnant women and patients prefer to travel for miles to access the Methodist Health Facilities: “We prefer to come to the Methodist clinic” they say “because God is there.” God is there through the compassion, love and the quality care they receive.

In the United States, there has been great fear linked to the COVID-19 pandemic – fear of infection and fear of passing infection to one’s unborn child. COVID-19 has had a devastating effect on the African American community, in particular.2 According to The National Institute for Health Care Management Foundation, Black people are dying from COVID-19 at a rate 2.4 times higher than white people. This is due to higher rates of pre-existing health conditions, over-representation in frontline and essential worker jobs, unequal access to quality health care and insurance coverage and the greater likelihood of living in hyper-segregated neighborhoods. Systemic injustices impact minority communities in many detrimental ways, including the compromised heath of women and children.

A call for education

Residents of the communities surrounding the Dingele Health Center celebrate fresh, safe and potable water from their new well. PHOTO: CENTRAL CONGO HEALTH BOARD

Sometimes, even when quality services exist and people have access to them, they still might not be utilized. People may not be aware that they have treatable conditions because their illnesses have become “normal” or have a spiritual or contextual diagnosis. Annual bouts of malaria can just be part of life and HIV may be pronounced a spiritual malady or punishment. People may not realize how their avoidance of health care impacts others, like untreated tuberculosis and sexually transmitted infections, undiagnosed Ebola or COVID-19, hidden depression, alcoholism or anxiety. This calls for strengthening health education and the accompaniment of those with such conditions.

Some years ago, in Zambia, a young woman attending HIV awareness meetings conducted by a Global Ministries partner suddenly stood up and called for the group’s attention. She started by saying “I now know the witches who took my two daughters. Their names are HIV and AIDS!” She had never wanted to learn about the virus before because she had believed it was bewitchment. At the meeting, her mind and direction completely changed, and she went for testing and treatment. She now gives other women the testimony of her life – how she lost two daughters who were born HIV-positive because of her lack of knowledge, but that she now has a beautiful HIV-negative son.

Everyone deserves the best health care

Advocacy and funding for other foundational parts of our lives are also essential to personal, family and community health. For example, safe housing, clean drinking water, affordable fresh food, equal education and employment opportunities, affordable childcare and physical security improve the overall health of families and communities. Global Ministries has funded wells and latrines, small and large nutrition and agricultural projects, scholarships and livelihoods – all to address these underlying needs.

At the heart of The United Methodist Church’s Abundant Health Initiative is the desire to bring the best possible health services with the best possible outcomes to communities, and especially to women and children. Although beneficiaries are counted, the goal is not primarily reaching higher numbers. What’s important is offering quality health care with dignity and compassion, mostly to people who have been marginalized. Reaching them is an issue of Christian care and justice. We long for you to join us through your prayers, giving and by care for your community and the world.

Kathy Griffith is the Global Health team lead and program manager for Maternal, Newborn and Child Health.

1https://www.who.int/bulletin/volumes/91/8/13-125450/en/
2https://www.nihcm.org/categories/systemic-racism-is-a-public-health-crisis

Partnerships in health produce peace of mind

Posted on | by Kathy Griffith

The Abundant Health Initiative of The United Methodist Church supports mothers and children through teaching about pregnancy and child care, making improved services more accessible and available, and encouraging community participation. Confidence in this partnership leads to trust, empowerment and peace of mind. In communities from Nepal to Congo, where pregnant women’s and small children’s lives are at risk from everyday problems, let alone COVID-19, this connection is life-changing.

Finding local nutritious food

A partner in Nepal, the Nutrition Promotion and Consultancy Service, has implemented a childhood nutrition program in a difficult-to-reach mountainous area. They share practical information with the community through special events that bring women together to dance, sing, compete and learn about health. As a result, mothers are bringing their very small children for growth monitoring and nutritional assistance and breastfeeding their newborns longer, and supportive home visits are taking place. The field team gives food and cooking demonstrations to mothers’ groups in order to introduce local, affordable and nutritious variations into traditional recipes. After 12 months, most families are eating more balanced meals and community opinion leaders are discouraging the ever popular “junk food.”

Health services, healthy home

In rural Central Congo, women are taking advantage of the open doors of the health facility and ownership of new health knowledge. They understand the benefit of multiple prenatal visits, consent to tests, and request malaria-prevention medication and mosquito nets, which are no longer taboo. Services have been made more practical and helpful through mobile clinics and visits from Community Health Worker visits to screen children, village by village, for malnutrition. Kitchen and community gardens have been introduced, and some have had an opportunity to raise chickens. One of the most welcome interventions has been the drilling of two village wells. No more long walks for dirty water. Peace.

Community commitment

The health system in the autonomous region of Tashba Pri in Nicaragua relies heavily on community health workers. A partner, Accion Medica Cristiana (Christian Medical Action), works with community leaders and members to keep health data, particularly about pregnant women and children. They not only address health needs but also promote health through household water treatment, vegetable growing and the installation of smokeless stoves.

Empowerment

In Liberia, the nurse in charge of the clinic at Camphor assumed her post with very little midwifery experience. The community could easily have lost trust in the clinic’s capacity to provide care. Fortunately, the Abundant Health Initiative’s program officer began to mentor her. The nurse’s self-confidence grew, transforming her relationships with coworkers and patients. She became a better leader and manager. “I have learned to be patient and calm,” she said, and the work goes on. We celebrate her in the year of the nurse and midwife!

Unfortunately, COVID-19 has reduced attendance at many of these vital services. Health workers and community leaders continue to urge pregnant women and young children to seek treatment, deliver their babies at health facilities and breastfeed for as long as possible. They also teach and practice the new set of precautions that has come with the pandemic, not to spread panic, but to bring confidence and safety.  

As knowledge, respect and autonomy increase through health partnerships in these countries and more around the world, we pray for continued peace of mind for mothers and children.  

To support the work of Abundant Health, give to Advance #3021770.

No longer a generation of anguish but a generation of hope

Posted on | by Kathy Griffith

Ending the AIDS pandemic is a collective responsibility. It is a life-saving ministry and movement in which the church plays a vital part. There are eight projects under the Abundant Health banner that have leading roles in reaching young people who are least aware, most at risk, and perhaps most afraid of stigma. 

United Methodist Health Board section marches in the parade, World AIDS Day 2019, Kitwe, Zambia. Photo: Courtesy Zambia UM Health Board

The United Methodist Church’s Health Board in Zambia joined local partners in Kitwe, and the rest of the world, to organize and commemorate World AIDS Day 2019 in December. It was themed “Communities making a difference, pressing toward ending AIDS.” 

The celebration began with a candlelight service, helping participants remember people lost to AIDS and to have renewed hope for life. The district commissioner, Binwell Mpundu, gave an inspiring message. He said, “We are no longer a generation of anguish but a generation of hope. A hope that by 2030, Zambia will have zero new HIV infections.” He declared the goal attainable with collective action from all stakeholders. 

United Methodists taking part in World AIDS Day activities in Kitwe, Zambia, started off their participation with a candlelight service of remembrance for those who lost their lives to AIDS. Photo: Courtesy Zambia UM Health Board

The day was filled with activity for the people of Kitwe – aerobics, a march, a fun run and tug-of-war, but also with HIV education, counseling and testing, and condom distribution. Everyone was called upon to participate in the fight against AIDS; everyone can offer a hand to stop it. The general public was encouraged to go for testing, refer others for testing, take preventive measures and take antiretroviral medication consistently. 

The church is part of the wider community. It can make a significant difference in this life-saving campaign. The health board actively works with the Zambian Ministry of Health and other organizations in the mining city of Kitwe to spread information to prevent HIV, improve access to testing and treatment, and to work against stigma. It recently trained 74 young people as Peer Educators. They are starting to reach out to their friends at school, college and university, establishing clubs and communicating through drama, song and radio, urging everyone to know their status and to treat each other with dignity. The health board is the only organization there reaching out to adolescents. 

Project manager, Mrs. Phiri, describes Zambia Health Board HIV and AIDS projects to the district commissioner and other delegates at the World AIDS Day 2019 commemoration in Kitwe. Photo: Courtesy Zambia UM Health Board

The Zambia UMC Health Board is part of a national campaign to pursue UNAIDS’ 90–90–90 target. The objective for this campaign is: 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status access treatment and 90% of people on treatment have suppressed viral loads. In 2019, the health board launched the U=U campaign: The Undetectable virus is Untransmittable. 

As the Zambia Health Board, we are proud of being part of this noble cause and making contributions to Zambia’s vision of ending new AIDS infections by 2030. 

Betty Tshala, Health Office/Board Coordinator 

Kathy Griffith is the program manager for Maternal, Newborn and Child Health, Global Ministries. This article was adapted from a report by Betty Tshala, who serves as the Health Office/Board Coordinator, Zambia UMC Health Board, and as a UMC missionary with the Mujila Falls Project in Zambia.