On a given work day, Misra Yusuf might vaccinate a child against polio, inject a woman with a long-acting contraceptive, screen a man for tuberculosis, hang a bed net to protect a family from malaria and help dig a pit latrine. Over the past few years, she has administered some 10,000 coronavirus vaccines in her community in eastern Ethiopia. She has also spotted and snuffed out a measles outbreak.
She works far more than the 40 hours her contract requires of her each week. For her labor, the Ethiopian government pays her the equivalent of $90 a month.
“The payment is discouraging,” she said. “But I keep going because I value the work.”
Ms. Yusuf is one in a legion of more than three million community health workers globally and is one of a small minority that are actually paid anything at all. Eighty-six percent of community health workers in Africa are completely unpaid.
But now, spurred by frustrations that arose during the Covid pandemic and connected by digital technologies that have reached even remote areas, community health workers are organizing to fight for fair compensation. The movement stretches across developing countries and echoes the labor actions undertaken by female garment workers in many of those nations 40 years ago.
“Community health workers in some countries like Rwanda and Liberia are treating half of malaria cases, they’re doing huge feats of curative care, of promotive care, of preventive care — and yet the vast majority of community health workers around the world are not paid or supported,” said Madeleine Ballard, the chief executive of Community Health Impact Coalition, an advocacy group that is helping with organization and strategy. “This is a gender issue, it’s a public health issue and it’s a labor issue.”
The new pressure is starting to produce results. In Kenya, 100,000 female community health workers recently started to receive stipends — $25 a month, paid by the government — as a newly formalized group of health promoters. The win followed a campaign, coordinated on WhatsApp, in which women posted pictures on social media of themselves doing their jobs and used an app to learn strategies for lobbying politicians.
Margaret Odera, who formed the first WhatsApp group, said she relished her successes helping pregnant women in Nairobi, the Kenyan capital, shield their babies from H.I.V. But she was tired of a decade of being told that “only God can thank you” for the work.
“If you can pay a doctor for saving a life, you can pay me,” she said.
Touting cheap labor costs
For more than a billion people in low-income countries, community health workers deliver the main, and sometimes only, health care they receive over their lifetime. Health and aid organizations, such as the Bill & Melinda Gates Foundation; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and USAID, depend on the workers to carry out programs that often have multimillion-dollar budgets. Yet little or nothing in…
2023-09-21 04:00:30
Link from www.nytimes.com