“What are we going to do?”
This was the question everyone was asking. It was May 2020, and testing had found another 42 cases of COVID-19 in Zamfara State, northern Nigeria.
I’m a health promotion supervisor with Médecins Sans Frontières / Doctors Without Borders (MSF) in Anka, a local government area in Zamfara State.
We didn’t have any positive cases in Anka, yet. But we know the community – it’s rural, we have high levels of insecurity and poverty, literacy levels are low. We have people who have fled violent attacks and are now living in overcrowded camps. If the virus came to Anka, we knew it could cause a lot of damage.
Everyone was panicked. So, what did we do?
No time to lose
I’ve worked in the health promotion team since 2017. Our team works with the local community, giving health education and building links with MSF’s services so that people are empowered to look after their own health.
The biggest health issue families face here normally is malnutrition. Then during the rainy season, malaria is at its peak. Plus, there’s also insecurity, with villages being attacked and people having to escape to camps, where contagious diseases like measles, cholera and diarrhoea can spread easily.
We decided we would not allow a coronavirus outbreak to happen here. We made a plan. We did not wait until we got a confirmed case. We didn't wait for it to get to that stage. We started earlier. We started on time.
We began with mass awareness-raising.
We went to every part of the community with our car, talking to people, showing them the symptoms and how to prevent coronavirus, the causes. If they saw any suspected cases, what they should do. The preventive measures.
We trekked by foot. We went around the camps for people displaced by the attacks; we went around the local villages, in the market square, every nook and cranny.
If people did not have the answers about coronavirus, we give them the full information. Then we moved to the next group. And the next one. In addition, the next one.
But we didn’t stop there. We knew we need to do more for the preventative measures to really impact. Especially in the areas where the security situation is so bad our teams can’t work there.
When they faced challenges in the community, when they had questions, they came back to us
So we mapped out all the community leaders across Anka town and the wider area. We called the social groups, the religious leaders, the traditional leaders. We explained: this is what is happening. We don't want it to come to the community here.
The leaders are the ones who came up with the next part of the plan.
Bit by bit, we invited them to our office for a training about the coronavirus. We were careful. Always observing social distance. Not overcrowding the place.
After training, we gave them each a flipchart. This flipchart has graphics and key facts to help them talk about the coronavirus. It’s a tool we use a lot when we’re doing our health promotion activities for other diseases.
And then the leaders went back, and began gathering their people and doing their own trainings and health promotion activities. For example, in some of our communities women and men don’t mix socially, so the community leaders trained women to go from compound to compound, raising awareness among other women in their homes.
We couldn’t have achieved this without a strong relationship with the people who live here
COVID is a new virus, so the information we had kept evolving. Every two weeks we had a feedback meeting or a refresher training for the leaders. When they faced challenges in the community, when they had questions, they came back to us.
It wasn’t just about awareness. We’ve been educating people about reusable masks. In our churches, in our mosques, in market squares, MSF has installed hand-washing points and guidance about social distancing.
Nearly one year on since the first COVID cases in Zamfara, and our state has been hit by a second wave. The problem isn’t solved, but all I can say is that, with our strategy in place, we still don’t have any active cases here in Anka. People here are aware of the virus, and how they need to act.
We are not here to work for ourselves. We work for them
We couldn’t have achieved this without a strong relationship with the people who live here. Because the local leaders are the ones who came up with large parts of the plan, they have actively involved themselves, working hand in hand with MSF to prevent this coronavirus from spreading into the community.
As a health promoter, I see the great impact of this connection every day, and really feel that this is what yields success. We are not here to work for ourselves. We work for them.