I entered the O’Flanagan Theatre in RCSI and took a seat in the middle back amongst colleagues and international delegates. A photographer whooshed in and out of the crowd snapping as many pictures as possible before the big event. Excitement was in the air. When the room became full the inevitable tapping of the microphone led everybody to their seats, and there was a gradual decrease in noise. The fifth conference of the Irish Forum for Global Health was about to commence!
This conference, deemed ‘the most important IFGH event to date’, had a packed programme including the signing of the European ESTHER Alliance and many intensive workshops and would no doubt lead to personal journeys and provoking debates. From success stories and appalling statistics, to increasing capacity and addressing migration, there would undoubtedly be plenty of food for thought.
An informative, heart-wrenching speech by Dorothy Ngoma, executive director of the National Organization of Nurses and Midwives of Malawi, informed the audience on the challenges facing Malawi, a small country with a rapidly growing population and where 12 mothers die due to childbirth daily.
The majority of Malawians live in rural areas, while most of the skilled health workers live in cities. This poses a key challenge for a country that has trained only 10,000 nurses in the past 65 years Numbers of nurses may need to be quadrupled to sufficiently deal with such a challenge. On the bright side, Ms. Ngoma closed her speech with great stories of student campaigns, strategic plans and advocacy successes.
After a strong cup of coffee I moved on a session on Health worker motivation and task shifting chaired by Anne Mathew from Dublin City University.
Passionate and optimistic researcher Jennifer Weiss from Concern Worldwide presented her motivation model for community health workers in Rwanda. A ‘core group approach’ was used to complement the existing health care structure. Joint problem-solving was encouraged and sustainability maintained through representatives for village health workers termed ‘cell coordinators’.
Psychosocial support, working conditions, networking and on-the-job learning were mentioned as contributing to motivation and retention.
‘Self stigmatisation’, a term I had never heard before, came up at the presentation. This was described as s a hidden and serious challenge to capacity building for those living with HIV. This discussion re-emphasised the importance of disclosure and how it relates not only to HIV infected individuals but also to health workers. Simply practising empathy and understanding one’s capacity to help alleviate negative feelings can be a very strong motivational factor –perhaps the strongest of all.
Last but certainly not least, Professor Fr. Michael Kelly gave his thought-provoking annual Irish Aid lecture. This was my second time hearing him speak, and his sharp mind was as acute as ever. He certainly didn’t miss a thing, and was keen to face up to the ‘dodging of AIDS related issues’ and the realisation that the Global Fund is experiencing a decrease in contribution in a world that is experiencing a financial crisis.
He then asked whether we are making sufficient use of traditional healers who could be helped to respond to HIV and other issues. His question is highly relevant many African countries. For instance, in Zambia there are 40,000 traditional healers compared with 700 physicians for a population of 13.5 million.
Phew! I had absorbed so much information and felt overwhelmed. I could spend a whole week mulling over everything I had heard in just one day. All in all the day was a major success thanks to a diverse range of influential speakers and presentations addressing health worker related topics.
Reflecting on the day the term that comes into my head is balance – the balance between national development and poverty; between stability and migration of the workforce, and balancing the sensitive issue of getting money out quickly with the concern of corruption. One must even consider the balance between intervention and utilisation of already present resources.
Balance is key within any action. It prevents us from running ahead carelessly, and reminds us to pay attention to each step we take.
Richeal Nic an Ri