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Post by: Latifah Kiribedda

I have pondered this question for a while. In doing Global Health work, I have seen or heard various scenarios that I believe contribute to taking us off the trail to achieving global health equity. These scenarios most frequently occur in the rural and hard-to-reach areas. For example, I have encountered de-motivated health workers who don’t show up at the health centers until late afternoon, corrupt leaders who misappropriate funds intended for service delivery, and children not washing their hands before eating a meal. Several times, I have found some local government offices closed on a usual business day. Those of you who serve people in the rural villages in Africa can imagine what I am talking about.

As a young African woman who has spent the past four and a half years in the U.S, I have developed a different mindset on the way I view and value life. I have lived a life of privilege where I didn’t have to worry about access to water, good roads, electricity, internet, food, role models, information and many other indulgences that many times we do not even pause to think about. When I worked, I was guaranteed a pay-check every two weeks. On the other hand, a de-motivated health worker I met in a rural village in Kamwenge district shared her struggles with me and indeed I was humbled: At the health center III where she works as a nurse, she does not have gloves, drugs, and other critical medical supplies that she needs to save lives. She sees over 200 patients and delivers at least 10 babies per day; she is a public servant who earns modestly and has gone without pay for the past two months. Her child is suffering from frequent episodes of epilepsy; currently, she is worried that the government may re-locate her to another district since health workers are being re-shuffled to serve other hard-to-reach areas. She needs to stay closer to her child who needs her care and suffers discrimination because of his condition. Sometimes, she does not show up at the health center because she needs to sell vegetables to raise income to support her family. Additionally, she feels so stressed at work and occasionally yells at the patients who do not comply with the procedures.

How do I even begin to influence this nurse to think differently – prioritizing her patients, having good customer service, showing up to the health center every morning yet she is fighting her own battle within a broken health system? I understand that part of the solution is to initiate institutional change by providing enabling frameworks such as timely and good pay for health workers, access to medical supplies, and recruitment of more health workers. The critical need for this institutional change is why I am an advocate for Global Health Equity, and most importantly a Global Health Corps Fellow. I have HOPE because I have seen and lived in a different world where this is possible – so why not Africa? I BELIEVE we can reverse the paradigm. However, in the mean time, we need to think about more tangible ways to motivate our partners like this nurse, to think differently and ardently serve the Global Health Equity movement even as we work within a broken system that is hopefully being reformed for the better!