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Community Health Worker: Not Only & not Least, a Shoulder to Cry on

In Dangamvura, Area 14, eastern Zimbabwe's Mutare city, Ngonidzashe Muyambo, 36, is known as more than a community health worker (CHW). ...

In Dangamvura, Area 14, eastern Zimbabwe's Mutare city, Ngonidzashe Muyambo, 36, is known as more than a community health worker (CHW). 

Rather, she's a listener and a lifter of burdens, community members say – on hand when close family members struggle to cope under the weight of a chronic patient's delicate daily needs.

She's also regarded as a role model for her own strength amid vulnerability. As a person with albinism in a country where prejudice is prevalent, and where one in three of her peers die of skin cancer before the age of 40, she's had her own challenges to contend with.

"I became a CHW because I love people, and like to listen to people, and assist them with their troubles," Muyambo recently told VaccinesWork.

Trained by Island Hospice and Healthcare, the Zimbabwean NGO that was established as Africa's first hospice, Muyambo specialises in care for home-based patients, supporting nurses and doctors working in local hospitals.

And with Zimbabwe confronting a rising exodus of health care professionals, her role is only growing in importance. Since February 2021, the country has lost more than 4,000 health workers to an accelerating brain drain, including more than 1,700 registered nurses.

Muyambo has never been motivated by the prospect of remuneration, of which there's very little. "I work with Island Hospice and Healthcare as a voluntary CHW," Muyambo said. "I only get transport allowances for the work to visit patients and compile statistics for the local clinics when we work on a certain project."

Community Health Worker: Not Only & not Least, a Shoulder to Cry on

After she discovered her ability to help and listen to others, people in her community began to consult her. She says she's glad to help. Though her daily work is about addressing pain, tears and disease, or comforting the sick in their final days, it is also sprinkled with smiles and tears of joy. 

"One of the most interesting things about my work is when I meet a patient who is very sick, and sometimes not even taking some medication," she said. "After speaking, regularly visiting and calling patients, and seeing them recovering and revived, it brings fulfilment into my life."

A conversation with Muyambo, edited for length and clarity, follows.

VW: Can you tell us about your life journey, including the challenges you have faced and how you overcame them?

NM: I work as a community health worker (CHW) and caregiver in my community. At times I meet patients, who are not open about what is affecting them, and it takes time for me to understand their lifestyle and problems, because I am supposed to deal emotionally with the patient. 

Some patients believe in consulting spiritual healers, and not in modern medicine, and this becomes a challenge. Sometimes, some patients expect us to bring financial help, food and medicines, but my core work is to give them emotional support during their sickness.

VW: Can you describe in detail the kind of work you do, and who are the people you serve?

NM: My work is to help the sick in my community, to lessen their pain and problems. We work with palliative care. These patients include those with high blood pressure, stroke, HIV and AIDS, cancer, and those who have defaulted their medication. Some of the disabled have cerebral palsy and depend on others for everything. 

Some family members don't even know how to handle them, or are confined in the home, afraid of the community reactions and stigma. We educate these people on how to accept and deal with such problems. I try my best to educate them about how to handle the disabled, taking them physiotherapy.

VW: How do you keep motivated?

NM: My training equipped me to handle patients in the community and effective communication. At times, you get patients who are not even communicating with their families, and we help them.

Also, I am motivated to help patients who are on home-based care, to serve the community to the best of my ability. My work as a CHW helps many people – sometimes people come to me seeking help for their home-based patients, asking how they can properly handle them.

Some people are noticing my work and talking about it in the area, and are proud of what I am doing in the community. Some [of the patients] may eventually die, but people still appreciate my work.

VW: What needs to change, on a policy or legislative level, to make your work and the life of your patients easier?

NM: What needs to be addressed in our communities that will transform our work is to make medication available for free, even at clinics. 

Sometimes, we meet patients who are desperate for financial help, food aid, accommodation, and they expect more from us – more than emotional and health support –and these people must be helped to change their lives. 

Some will not recover because of depression, leading to anxiety, and we lose precious lives. To change their lives, even the CHWs must get incentives, because we help the Ministry of Health. - VaccinesWork 

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