Burundi is one of the poorest countries of the world, it ranks at place 187 from 191 countries in the world. People live mostly from subsistence farming, and health insurance is available to about 13 % of the population.
Why the focus of international donors is still very much targeting commutable diseases, like Malaria, HIV, or others, on the ground there is a surprising rise of chronic diseases, too. This project aims at easing the burden of the disease for the poorest parts of the population.
In a community needs assessment the following needs have been identified:
- need for qualified healthcare staff (knowledge and amount of staff, there is one doctor for 19.231 inhabitants)
- need of sensitization (large part of population is uneducated and does not know about the diseases and could instead blame their neighbors for using withchraft)
- need for treatment: availability of medicaments, medical treatment which is free or cheap, treatment / doctors close to the homes of people
- technical equipment
The project has already done a precursor district grant project in 2021. In the testing campaging around 750 people were tested for diabetes and hypertension: 7,1 % suffered from diabetes, and 19,3 % from hypertension. 90 % of these cases had been undiscovered before. The cervical cancer screening was done for 299 women, with 38 of them showing suscpicious lesions, that during follow up examinations were confirmed not to be cancer. A side diagnoses were 87 cases of sexually transmittable diseases.
The follow up project will be done through Global Grant, with a few modifications and geographical expansion. The following activities are planned:
- Signinig of MoA with health ministry, ministry of solidarity, and ministry of sports (already done)
- Opening event with all stakeholders: local administration, public health officials
- Sensitization campaign for the population, on markets, public places, in churches, through the radio, distribution of leaflets etc.
- Workshops about diagnosis and treatment of diabetes, hypertension and cervical cancer for staff of 16 community health centers and community hospitals, including information about family planning
- Technical equipment of the participating health care centers (blood pressure device, blood glucose meter, spatula and Lugol's liquid)
- Workshop for cervical examination (hysteroscopy) and treatment of early stages of cancer through cauterization for 3 doctors
- Technical equipment of clinic of Karuzi with gynaecological bed, hystroscope, electrocauterization device. Establishment of a medication depot (including medication for STDs).
- Mass testing campaign in all 16 community health centers where staff has been trained.
- Creation of patients' registrar to plan follow up treatment
- Doctor's rotation to remote health care centers to follow up on patients on a monthly basis (check parameters, hand out medicines)
- Transport of patients to services of more specialized medicine if needed
- Health insurance card will be issued to the 100 poorest families with members suffering from a chronic disease, others will be encouraged to buy it. This card pays for 85 % of the treatment costs, it does not include medicines
- 30 poorest households will participate in a business development training so they can make an income and will be able to buy the medication in the long run
- Data will be collected and shared with the ministry of health
All of these activities will be funded by the Global Grant. A large part are costs for the trainings (including transportation of participants, as there is almost no transport available in Burundi), another big part is the technical equipment of health centers and the creation of a medication depot. A local Rotarian, Dr. Ndayirukiye Jean Pierre, has been involved throughout the planning of this project. He is himself workin in an NGO for helping rural women medically, and cervical cancer is one of the issues close to his heart. He will also participate in trainings about this disease.