Helping Health Workers Prepare for Crisis

I wanted to lift up the voice of my colleague, Emily Janoch, by sharing with you one of her recent blog posts. Thanks, Emily!

What do health workers in refugee camps see change when they get support? In Uganda they say, “It has helped a lot… people used to die so much in the communities but they were made aware of good health seeking behaviors which they adopted fast.” In Jordan, case workers say they’re getting more effective at their jobs. “The training made me make many changes on the way I work…”

In CARE’s work around the world, we know how to help health workers face crisis. 91% of health workers in Uganda working with CARE in refugee camps felt more prepared to deal with the influx of patients, even in cases where they are dealing with more than 20,000 new people arriving every month.

With Syria, Uganda, Bangladesh, and Ecuador all reporting cases of COVID19, we’re bracing for what happens when refugee camps get their first cases. We don’t have all the answers, but we know that supporting health care workers is possible even in the worst situations. It’s one of the best defenses we have. Supporting health workers means saving lives in the face of potential disaster.

In FY19, CARE had 92 projects supporting 3.8 million refugees and host communities directly, and 4.9 million indirectly. These projects operated in 19 countries and had a total operating budget of $132.5 million—a little over $15 per person reached.

What did we accomplish?

• Get people access to health care: In Jordan, 84% of refugee women had better access to, and case workers said they are better at their jobs. In Uganda, Refugees also say they are more satisfied with the health services available to them. 79% increase in women giving birth in facilities. In Chad, 19,990 people got access to better health care services, and 46% started washing their hands.
• Health workers feel supported: 91% of health workers in Uganda working with CARE in refugee campsfelt more prepared.
• GBV services are stronger: 61% of refugees in Uganda say the GBV services are reliable, and 77% of women feel that they can report cases of violence. In Somalia, 95% of people say the relationships within their families got better, and 91% said community relationships improved.
• Kids are healthier: In Bangladesh, children with malnutrition received treatment and support 927,993 times! Moreover, 22,631 children with severe malnutrition are enrolled in the 34 Therapeutic Programs Centers, and another 60,317 children with moderate acute malnutrition have been identified and referred to other centers for treatment.
• Help people access services other services: Health services aren’t the only need in a refugee setting. In Jordan, 100% of referrals to food and water services were successful, and helped refugees get the basic services they need. In Somalia, 95% of families said that the project made it easier for them to purchase food and to meet all of their family’s food needs.
• Get access to water: In Sudan, 293,300 people got access to clean water who did not have it before. 117,773 people got access to sanitation, which means they have healthier and safer communities. These are critical services to fight the spread of disease.

How did we get there?

• Remember refugees aren’t alone: poor people in local communities suffer too. Massive influxes of refugees can put pressure on local systems. CARE often reserves a percentage of its services for host community members so everyone can benefit and we don’t create additional tensions.
• Understand what women need: successful projects build from rapid gender assessments and a focus on obstacles women face to make sure that they can help women overcome those barriers.
• Support health staff skills: In Bangladesh, CARE was able to reach 15 times more people with quality CARE by supporting health care workers and other organizations than we would have been able to help ourselves—even when caseloads were around 14,000 a day. CARE has provided training to over 700 partner staff and volunteers from different NGOs and provided on-the-job coaching and training to ensure quality services.
• Support infrastructure: In Uganda, we organized training, equipment, and salaries for local health workers.
• Create space to address GBV: Most projects are setting up safe spaces and referral processes for women facing gender-based violence. This includes working with local leaders and gender volunteers as well as setting up up a case management system to help survivors seek support and referred survivors to local health services.
• Listen to feedback: Most of the projects set up feedback and complaints mechanisms to make sure that they were fixing problems as they came up, and communities were getting what they needed. In Somalia, one participant said, “CARE works in an open and transparent way. We trust them very much. They allow us to lead our development.”
• Use surge capacity, start up fast: In Somalia, the project rolled out activities 14 days after we got the approval from FFP because we could bring surge staff in from other projects.