oh yeah..

I guess I should blog about what I do all day, why I am here.

Like I've said before, I am an intern for the health program of an international NGO. Our department is pretty small, we are just 6 people currently. There is the program coordinator (an expatriate also), the health manager (an Ivorian doctor who studied public health in Japan), 3 assistant health managers (also Ivorians), and then me, the stagiaire.

We currently have 2 major grants. The first grant is for a health systems strengthening project: re-equipping rural health centers, supporting them with essential medicines, training health staff and health management teams (i.e. community members who are responsible for managing the health center's finances), building pumps and water towers.

The second grant is part of a large multi-country grant for implementing community case management (CCM) for malaria, pneumonia, and diarrhea. These are the top three killers of children under 5 in developing countries (not counting neonatal deaths in the first four weeks from infection or prematurity complications). There is good research that suggests that a lot of these deaths can be avoided if care for these illnesses is made accessible at the community level. In West Africa, for example, about half the population lives in a rural area, the majority of who live further than 5km from a health post. So when a child is sick, its often not very reasonable for the mother (who is also responsible for most if not all of the household duties) to take her child to a health center. So the idea behind CCM is to train local women and men (who are often illiterate and have little education) to identify these illnesses and provide treatment (antibiotics, zinc, rehydration salts, and malaria combination therapy). If it sounds radical to you, then you aren't alone because many governments and local doctors are initially very skeptical too. It took our management staff 4+ months of meetings with the Ministry of Health and the medical community to get their support for a pilot project of CCM in Côte d’Ivoire.

Both of these projects are being implemented in central Côte d’Ivoire, in the former "confidence zone". In 2002, rebel forces from the northern part of Côte d’Ivoire launched a coup d'etat, using Bouaké (2nd largest city, located in central part of the country) as their base. Many people in the surrounding districts fled, including essentially all the government and health workers. The confidence zone was established by the UN mission to separate the government controlled south from the rebel held north. As you can imagine, basic social services in this area greatly deteriorated. So that's where we're working!

To keep this manageable (for you to read and me to write) I'm going to break this into a few posts. Here are a few links if you'd like to read more about pneumonia (short article from NYTimes) and the conflict in Côte d’Ivoire.