Problem: What problem is this project trying to address?
Poverty levels in Burkina Faso are high with over 80% of the population surviving of subsistence farming. When Simon began working on access to health care, the monthly cost of antiretroviral medicines was more than ten times the monthly salary of an entry level civil servant. Of the 20,000 Burkinabe who needed ARVs, only 300 had access; for the rest, diagnosis was equivalent to a death sentence.
The health level of low income populations, particularly in rural areas is particularly low. Maternal and infant mortality remain high with over 16% of children dying before the age of five. Treatable maladies like malaria and diarrhea claim an unnecessary number of lives. While, each village is assigned to the closest basic health clinic in the region, these clinics are often not accessible and can be located up to 20km from the patient’s village.
Funding pours in from international donors to facilitate access to basic health care; however, national policies and prices are often not applied outside of major cities. For example, the subsidized price for birth by cesarean section is 9,000 cfa (about $18 USD); however, the staff at some health clinics charges mothers six times this amount and pockets the difference. With little access to information, citizens often don’t know the price of the health services and furthermore, they lack a mechanism or ability to negotiate the actual price. Generally receiving adequate and prompt health care requires a personal connection at the clinic. Disempowered, citizens often avoid the health clinics, preferring traditional healers, or they approach the clinic staff with the spirit of a beggar, not realizing that they have rights as a patient.
The lack of feedback mechanisms and controls in the system coupled with a fear to speak out as an individual against a more powerful force has created deep-seated frustration that when inflamed has detrimental consequences. For example, in 2011 in the city of Bobo, a woman died while giving birth in the hospital due to neglect from the nursing staff. Her furious relatives had no mechanism for recourse against the few individuals responsible. In their anger, they incited a mob which burned down the maternity ward.
Solution: What is the proposed solution? Please be specific!
Simon is building a volunteer citizen movement to advance patients’ rights and dignified health care in West Africa. In a context where the quality of health care is inconsistent and most patients feel too disempowered to ask for better health care, Simon allows all individuals to improve the local and national health care system. Simon utilizes complementary approaches to first demystify health care laws and policies and then engage diverse actors in claiming and ensuring essential health care.
Through this movement, Simon educates the public to first understand their health rights and the commitments that have been made by their government. He utilizes a variety of approaches to reach a wide audience across segments of society including creative poster campaigns and public conversations with the government in the form of published letters in prominent national newspapers. He hosts a series of roundtable discussions with various populations—students, women, unions, religious leaders, journalists, administrative officials, etc.—targeting his messaging to their perspective. After increasing awareness of how existing health policies affect their group, Simon mobilizes these populations to lobby the government for improved patients’ rights.
Simon mobilizes this newly educated public to take ownership of their health and ensure quality in local health clinics. He has created a new communication system for healthcare accountability that bypasses existing power structures. He is initiating and mobilizing community health watchdog committees to verify that patient treatment and care at all levels –from national hospitals to remote village clinics—is fair, of high quality and that national prices and policies are applied locally. These watchdog groups are formed of highly committed volunteers who deeply understand the value of this work. They confidentially report any grievances and situations of malpractice to Simon’s organization. The organization then consolidates and synthesizes these cases and presents them to higher levels of the national health department for correction.