During the first module (the Kobi) of the Community Empowerment Program (CEP), participants learn the importance of taking care of their health. For many communities, one of the largest barriers to receiving good health care is access to services. Rural, agriculturally productive areas can be far from the nearest city, and sometimes far from the nearest road. However, today, many villages are home to Community Health Centers, bringing basic care to these difficult-to-reach areas.

In Taibatou, a village in The Gambia, there is a Community Health Center which also serves as a health hub for neighboring villages. This Taibatou health center was established through a grant with the World Bank as a Community Driven Development Project, seeking to empower communities to manage grassroots health projects. Omar Ceesay, a trained Community Health nurse who learned how to treat basic health issues at the government-supported School of Community Health in Mansakonko, manages the center. People from Taibatou and neighboring communities come to him with a wide variety of issues. Recently, he has treated patients complaining of abdominal pain, eye infections, urinary tract infections, and pneumonia.

The center contains basic medical equipment – machines for measuring blood pressure, antimalarial drugs, antibiotics, and supplies necessary for delivering children. Omar delivers many of the children born in the area, but stresses the importance of pre-natal check-ups. If a pregnancy appears more complicated than Omar’s limited equipment and basic training can cover, he refers them to the Regional health center in Basse Santa Su. Identifying any problems in advance is critical so that patients, many of whom need to rely on donkey carts to take them to the Regional Center, can be treated in time.

Omar Ceesay estimates that the biggest health problems for his area are malaria, pneumonia, and diarrhea. As a Community Health nurse, Omar’s role goes beyond treating people who are already sick. He now works closely with the local Community Management Committee (CMC), a group of 17 community members established during the CEP to lead local development activities during the program and beyond.  Together, Omar and the CMC work to share information that can help people prevent these and other illnesses. Improving personal hygiene, regular hand washing, breast feeding infants, and strategies for avoiding STIs, are shared with community members at regular meetings. Every week, they also help him keep the Health center clean and perform free maintenance on the building if needed.

Omar estimates that he has treated about 800 people from Taibatou and neighboring communities in the last year. Though he can only refer patients to other health centers in the event of major illness, his ability to treat common illnesses has improved both community health and the communities understanding of health, decentralizing care and giving people a sense of ownership over their own well-being.

Interview by Dawda Jallow, Tostan supervisor in The Gambia