Image for post
Image for post
A Rwandan mother carrying her baby on her back

Strengthening Primary Healthcare Systems to Prevent Childhood Mortality

By Sandra Isano, Global Health Corps

UHC Coalition
Dec 12, 2016 · 5 min read

Rosa, a Rwandan mother from Gakenke District, carries her one-year old daughter Mukeshimana on her back. She has wrapped her baby’s body in a colorful kitenge cloth, tightly tied around her. Rosa cannot see that the tiny angel she carries is sweating, but she knows that her baby has had a fever and a cough for almost a week.

Worried, Rosa is taking Mukeshimana to Kinihira Hospital. The mother ignores the discomfort of her feet in a pair of green bodaboda shoes as she wonders how the doctor will diagnose her daughter. She hopes for the best but is worried about what will happen next, worried about the unknown. Her left hand is carrying the secondhand bag she purchased from the market, while her right hand holds up a colorful umbrella to protect Mukeshimana from the aggressive sun rays in the afternoon sky.

Rosa can’t believe it was raining all morning and now the sun is burning like the fire in her kitchen. This rainy season has flooded her mind with anxiety. While the heavy rains are a blessing to her crops, mosquitos invade her community as if they are awakening from the cursed ground. The risk of malaria is high. Rosa imagines how the hospitals will be overwhelmed with patients in the coming weeks, and her worry grows.

When a functional primary healthcare system is in place, the prevention and control of local endemic diseases is possible, as is the quality treatment of those do become ill.

Two of the most inspirational but least understood terms in global health are “universal health coverage for all “and “primary healthcare”. These themes became core policy issues for the World Health Organization first with the explicit commitment to expanding primary healthcare for all in the Alma-Ata Declaration in 1978 and later with the 2000 Abuja Declaration of “Health for All”. Some developing countries are already taking a lead on developing integrated, comprehensive community health programs. For instance, Rwanda has a well-defined model of management of malaria and pneumonia. This signals that progress is possible, but there is immense unmet need.

I am privileged to be a part of this global human family, but it pains me that so many people are dying from preventable or treatable conditions. So many people are suffering because of our society’s lack of interest, compassion, and concern. The mortality rate of children in developing countries is a particularly saddening metric. In other countries, the deaths of the children that these statistics represent would have been avoided in most circumstances. With 24-hour access to hospitals and doctors in developed countries, children have the opportunity to have their illnesses treated in a timely manner, or even prevent them before they begin.

Unfortunately, in developing countries, many children die because there is simply no integrated curative and preventive interventions to address the immediate and underlying determinants of their health. No child is born to die! As a global health activist, I believe that we should reject the status quo and drive a change. I recognize that serious change in global health will only be achieved with the skills, time and passion of a diverse community of leaders committed to building equitable health systems.

Rosa’s child might not have died of malaria if there was a functional system in place to prevent and control local endemic diseases. Who knows? If there was an integrated referral pathway, Rosa’s child’s imminent death could have been prevented. Perhaps she would have lived to grow into a beautiful woman. Rosa’s daughter is just one example of millions of children who are dying of preventable diseases.

The end of this story — and the lives of the Rosa’s and the Mukeshimana’s of the world — will depend on the choices that we make as policymakers, as leaders and as members of the global human family.

It’s our responsibility to step up to the plate to establish functional primary healthcare systems with no disparities or inequalities. Doing this work is not just for health practitioners or Ministers of Health. It’s for anyone who cares about the wellbeing of our global human family and wants to make universal primary healthcare a reality.

As Margaret Mead said, “Never believe that a few caring people can’t change the world. For indeed, that’s all who ever have.” The end of this story — and the lives of the Rosa’s and the Mukeshimana’s of the world — will depend on the choices that we make as policymakers, as leaders, and as members of the global human family.

Sandra Isano is a 2016–2017 Global Health Corps fellow working with the Rwanda Zambia HIV Research Group as a Program Officer in Kigali, Rwanda. Sandra is the founder of the E-CARE Initiative, a digital platform for HIV patient follow-up. Sandra has a degree in pharmacy from the University of Kigali, and is committed to using her expertise to ensure health equity.

Crossing the Divide

Join the conversation bridging vertical delivery approaches…

UHC Coalition

Written by

1000+ organizations in 121 countries advocating for strong, equitable health systems that leave no one behind. → HealthForAll.org

Crossing the Divide

Join the conversation bridging vertical delivery approaches to health and primary health care.

UHC Coalition

Written by

1000+ organizations in 121 countries advocating for strong, equitable health systems that leave no one behind. → HealthForAll.org

Crossing the Divide

Join the conversation bridging vertical delivery approaches to health and primary health care.

Medium is an open platform where 170 million readers come to find insightful and dynamic thinking. Here, expert and undiscovered voices alike dive into the heart of any topic and bring new ideas to the surface. Learn more

Follow the writers, publications, and topics that matter to you, and you’ll see them on your homepage and in your inbox. Explore

If you have a story to tell, knowledge to share, or a perspective to offer — welcome home. It’s easy and free to post your thinking on any topic. Write on Medium

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store