Community Health Workers are helping to ensure people in remote regions of Somaliland have access to essential healthcare.
In the remote village of Fardaha in the Awdal region of Somaliland, Hamda recalls the moment she thought her dream of becoming a nurse was ruined, 'My family married me off when I was very young and there was nothing I could do about it and that was the end of my desire to further my studies and become a nurse. The early arrival of my baby boy was also another big hindrance to the last hope of becoming what I always wanted in life.'
But Hamda is enrolled on the Somaliland Programme’s Community Health Worker (CHW) training course which will give her the skills and training to become her community’s first point of contact when they need care.
Aged 19, Hamda has one child who she gave birth to when she was 17 without the assistance of a health worker, just the help given by a local woman in her village.
‘No one provides assistance to pregnant mothers and it is only the untrained traditional birth attendants who come out to help when mothers go on labour. Giving birth is the most dangerous, life-threatening thing for women in my village but most of the people do not feel for the mother, and they always think this horrendous journey is normal for a mother and something she must withstand. Sometimes, mothers die in labour, especially when the case becomes complicated, including my own sister. I have seen relatives, aunties and sisters in labour being carried on the back of a camel and donkey to a distance of three days walking and some of them did not come back alive after labour,’ Hamda says tearfully.
It’s this emotional connection with the women in her community that drove Hamda to reassess her situation and embark on a nine month programme to become a CHW and help pregnant women in her village.
In 2013, the village health committee and elders selected Hamda to go on the course and THET provided extra support to Hamda by allowing her to bring her baby along with her to the training at Burao Institute of Health Sciences.
The Community Health Workers training programme stretches across 40 of the hard to reach villages in Sahil and Awdal regions of Somaliland, in the Horn of Africa. Supported by DFID, the programme aims to create awareness about maternal, neonatal and child health in some of the most underserved communities in which these health workers will be the only trained point of contact for families in need of health care.
Hamda's love for her community inspired her to be part of the CHW training because she did not want to see other women in her village going through the same fate that her sister and many relatives went through. ‘Many women do not know about the existence of services in nearby health posts and referral health centres, and my hope is that I will be a source of this very vital information,’ said Hamda.
According to Amina Abdi, the CHW Lead Trainer, lack of access to health facilities, information and care has contributed to the increasing mortality of many pregnant mothers in many villages. Amina believes that these deaths are often preventable if the villages had well trained health workers. She noted that education levels in hard to reach areas are very low and many myths – especially about childbirth - dominate communities. ‘The old CHWs trained during the Siad Barre Regime have been supporting some of the communities voluntarily for more than three decades, while many other villages remained without any trained health worker,’ Amina noted.
After graduation, Hamda will return to her local community to provide essential front-line healthcare, helping to ensure safe births for dozens of women.