On Monday morning, an IRC colleague and I drove to the Sengekoro PHU in Nimikoro Chiefdom.  It’s approximately a forty-five minute drive from our base in Koidu Town, down the highway with its broken concrete, past the mounds of sand and gravel of the diamond mines and then down a gutted dirt road that winds through thick, green bush.  The Sengekoro PHU is a humble four room building, and its staff currently serve 1,152 people in eight surrounding villages.  In previous years it served 4,064 people in 18 villages, but a new PHU has opened up nearby and the catchment area has been divided between them. 

In Sengekoro I meet Mabinty Samawaty, the Mother and Child Health (MCH) Aide.  Mabinty is assisted by Sahr H. Simbo, the volunteer vaccinator who administers vaccines to children under five and their mothers.  Mabinty also oversees 15 Community Based Distributors (CBDs), also volunteers, who monitor children under five in their communities for pneumonia, malaria (“fever” or “warm bodi”) and diarrhea (“ron belle”), three of the main causes of death in children under five.  When sick children are identified, the CBDs provide first line treatment and monitor the child’s progress.  If the child’s condition worsens, the CBD makes sure the mother takes the child to the PHU for further treatment.     

According to the MCH in-charge and new mothers I talk to in surrounding communities, the use of CBDs has improved child health in the Sengekoro PHU’s catchment area, as well as in the catchment areas of the 19 other PHUs with similar programs.  Previously, many mothers found it difficult to carry their children to the PHUs for treatment; most communities lack vehicle transport so mothers may have to walk for an hour or more down rough roads to access a health facility.  The CBDs provide free care in the communities themselves.  IRC has worked with these communities to select, train and support the CBDs, and last year the National Ministry of Health and Sanitation chose the program to scale up throughout the country.