I come from a village in the Adaklu District in the Volta Region. I work in the Hospitality and Tourism sector and I am a trained youth leader participating in the Youth Leaders for
Health program which comprises 26 trained Youth Leaders across Ghana, Tanzania and Sierra Leone advocating for health systems
strengthening and increased domestic resource allocation to end malaria in Africa.

Presentation and use of hand sanitizer to a lady at Adidome, Central Tongu District

COVID-19 is here with us amidst all other health issues, including malaria which still remains an issue of national, regional and global concern. Various preventive measures and public advocacy by media, youth groups, NGOs and others are in the right direction. However, the expected results can only be achieved if everyone makes it a point to follow preventive measures strictly. In my role as a youth advocate, I have mobilized a group of 15 young people across communities in the Volta region and we routinely sensitise, inform, and educate community members. So far, we have interacted with 520 people over two weeks in the Kpetoe, Adaklu, Keta, Adidome, Anyarko, Hohoe, Sogakope and Ho communities through visits to homes, chop bars, small shops etc. We have conversations on the severity of the impacts of COVID-19 and the importance of  safety protocols.

Each day, it becomes even clearer that behavioural change in the midst of COVID-19 is unpredictable, unsustainable and difficult. Examples:

• There are people who constantly ensure they keep to the safety and hygiene protocols whilst some remain unconcerned.
• Some people use mosquito nets to prevent malaria and others refuse to.
• Some are reluctant to visit health facilities when they feel ill due to the fear of COVID-19.
• There are already signs of stigma in some communities so that people wearing face masks are regarded as having COVID-19 or as strangers in the community.
• Some people pick and choose from the various safety measures, based on what works best for them rather than their safety.
• Some people wear face masks but do not practice social distancing etc.
• In other areas, many people out of religious beliefs think that they cannot be infected by the virus and therefore see no reason for practicing various preventive measures.

Nevertheless, I believe sustained commitment is key.

The safety of a neighbour is our shared responsibility.

Let’s encourage our communities to carry on with preventive measures. As said by Dr. Peter Bujari, of Tanzania, ‘’Never say you know or have too little to make a difference’’.

My thanks to WACI Health, Results UK, Health Promotion Tanzania-HDT, Hope for Future Generations –Ghana and CISMAT – SL for their support.

Email: delight.siameh@gmail.com

COVID-19: USING MY VOICE AS A HEALTH ADVOCATE; EVERYDAY IS DIFFERENT

Author: Lucky Soglo

(Youth Leader for Health, Ghana)

 I am a trained youth leader for health and advocate regularly for increased domestic resources for enhanced malaria responses and health system strengthening. At a recent meeting in Addis Ababa, (Fig 1) we advocated through the Ghana Embassy and African Union for more political commitments towards malaria responses.

2:30am GMT mid-week and I can barely sleep.

I have been awake for the past hour and a half, thinking about global health. I have lost sleep over the COVID-19 pandemic and its devastating impact on other public health issues, especially malaria.

Fig 1: Youth leaders for Health Ghana, led by Dr. Anie (seated far right) meeting with Ghana Ambassador to Ethiopia (Her Excellency Amma Twum-Amoah seated in the middle), January 2020

I brace myself for the day ahead especially now that I mostly work from home.  I have decided to spend the entire month of April getting to know what it is like to be a health worker during these times. This means I will be paying visits to various health centers in the Sekondi-Takoradi district within the Western Region of Ghana.

I step out of the house at 8:00am without getting enough sleep.

As I walk past my neighbors, I realize everyone has got a face mask on, from the market trader to the flashy banker. Wonderful. Messaging and advocacy is working here, an area where the number of COVID-19 cases is increasing steadily. Who would take a risk and do otherwise?

My first stop is at the out patients section of the Effia Nkwanta Regional Hospital, this facility serves as the referral center for the Western Region of Ghana. I meet up with the senior nursing officer on duty. She says to me

 “As hospitals fill up and more and more people get infected daily, medical staffs have to endure long hours, intensifying conditions and the looming fear of contracting the virus themselves”.

Another nurse tells me “Rev Lucky, it’s not been easy at all, some of us, our own family members are scared to have interactions with us, our husbands are very careful when they are around us”.

You can clearly see the struggle these workers go through each day but at the same time you sense commitment and passion as they add their efforts to a national response.

The Senior Nursing Officer tells me, she will do this over and over again, given the chance. Admirable.

I respond to these comments by urging the nurse and doctor to consider malaria interventions concurrent with COVID-19 because immune systems weakened by untreated malaria will struggle more with COVID-19.

Community leaders and chiefs are key stakeholders in our fight against malaria, and so I end my visit at the hospital and decide to do a follow up visit to the traditional leader, the Chief of Apremdo, a community in the Western Region that has recorded high cases of malaria in recent years. We had met earlier in March.

As we navigate through issues regarding malaria, it’s hard not to talk about the impact of COVID-19. At the end of the encounter, I realize the head way I have made, as he sets up a meeting with the malaria focal person in the region. We talk about linkages between COVID-19, malaria and malnutrition and how as he talks to the community he should emphasize good sanitation, hygiene and proper nutrition, and so on to build wellbeing and resilience in these COVID-19 times. He assures me of complying.

It’s around 4:30pm, it’s late and I say goodbye. I feel a sense of satisfaction knowing that I can count on this traditional leader as an ally in health advocacy,  community mobilization and engagement.

I glance at my watch and its 4:45pm and I head home.

Not all days are the same though with this level of success.

A week ago, when I met the Head of the Public Health Division for the region to discuss strategies to address malaria, I was informed the Public Health Unit had suspended all malaria interventions and all attention was focused on COVID-19.

Sadly this is not just a Ghana thing; it’s the current tune the entire world is singing.

In all my interaction I ensure I adhere to all the safety protocols as I ensure social distancing and also I make sure I have my nose mask on, as much as it very uncomfortable sometimes, it’s important to lead by example.

As my COVID-19 journey progresses, I am learning to act like an advocate but think like a virus….what does this mean;

• Diseases ignore borders. Borders separating countries are meaningless to diseases. While there is the urgent need to act locally there is the danger of failing globally. My voice should cross borders.
• Distractions are an opportunity to lose sight of real danger and that is what COVID-19 is teaching me. As political dis-engagements and diplomatic spats continue the virus wreaks havoc everywhere. Every minute spent on arguing and blaming is a minute wasted on finding solutions. I will try to be focused at all times.
• Nothing makes a virus happier than misinformation. Confusing and inconsistent information has characterized this pandemic.  Facts, clarity and consistency of information should drive my work.

I am likely to lose more sleep in my work as a youth leader for health but I am encouraged by allies, influencers and motivators I meet along my journey including the support from Hope for Future Generations.

I will continue to follow up on visits and actions agreed.

I know what it is like to lose hope, so in my life as a health advocate, I aspire to be that thread of hope for someone else.

BE THE CHANGE YOU WISH TO SEE, I am doing my part, I hope you do too!

My name is Jennifer El-Duah.

I am a Youth Leader for Health and currently work as a Lab scientist.  My journey over the last 6 months has given me remarkable experience on how advocacy can change in the arena of a public health threat.

I live in the Bono Region of Ghana in the Sunyani Municipality.  It is 4:50 am and already the distinct Muslim call to prayer can be heard in the distance. And so every day begins. Usually, the rest of the day simply unravels from there.  A quiet prayer, making a list of all the things that need to be done that day, grooming and then you’re out the door-heading to work. Also, one cannot resist the temptation to read news updates from the various outlets. “COVID-19 cases rise”, “Global death toll up”, “Patients tested positive on the run”, “Health workers need PPEs”. This is more than enough to raise anxiety and cause some despair.

All community conversations now dwell on COVID-19. We know from the Ebola outbreak in West Africa that a sudden increased demand on fragile health systems can lead to substantial increases in morbidity and mortality from other diseases, including malaria. Now with community spread in Ghana and the similarities between symptoms of COVID-19 and malaria, are people comfortable enough to report to the hospital when ill?

These days, I am inclined to stay in bed for just a few more minutes, dreading the thought of having to ride in a taxi to work. What if someone coughs and doesn’t cover their mouth? What if I touch the very surface that an infected person touched? Who ensures that people wear their masks? Are masks really preventive? There is also the mental effort for me to remember not to touch my face.

My region, Bono region, is one of the few which have not recorded any case of COVID-19. However, this is not something one must be happy about. Complacency is simply a recipe for disaster. As if a disaster is not already happening.  Despite the ban on school, church and public or social gatherings, you still find people chatting and laughing away. We have a long way to go.

After a very uncomfortable taxi cab ride to work, I am faced with yet another hurdle, getting through work while observing all safety protocols.  Truth is, I love what I do.  I walk toward the entrance to work, nodding cheerily to colleagues and careful to stand a safe distance from anyone I stop to chat with. Ordinarily, a hardy handshake would suffice. Then when I make it to the entrance and onward to my department, my work day finally begins. “Jennifer, don’t forget to wear your nose mask” my supervisor usually says. This is a welcome reminder, not that I need it. With my mask firmly fixed on and in my protective apparel, I start to work. While concentrating on what I am doing, I must not rub that itch in my eye.  It takes a second for the itch to crop up and another second for the involuntary response to rub. That’s a mental battle. Did I forget to mention washing my hands at least 10 times while at work?

All day I think of how to advocate for improved health under these conditions.  Can I talk about malaria as well as COVID-19 at the same time? Will people listen?

Finally, it’s 5pm, and I clock out. A girl must eat. I make another taxi trip to the market so I can restock my supplies.  A thought comes to my mind. As wonderful as it is to see so many hand washing stations around, what happens when everyone has to turn the tap with their hands? Are people taught the right way to wash their hands? We must be careful not to turn these stations into coronavirus breeding centers.

Then I find out the price of lime and ginger has shot up. Madam market woman, why? “Lime and ginger mix is very good for fighting coronavirus so people are really buying. They are in high demand”. The less said about that, the better.  The price of tissue paper has also shot up simply because there are hand washing stations everywhere and people need to dry their hands. The good thing is that market vendors are spread apart. You have to walk long distances to get what you want, but it’s worth it.

I get home exhausted, wash my hands and get to cooking and preparing for the next day.  A small voice in my head keeps repeating “these are not ordinary times.”  I am usually glad when I am home. That is where I feel safe and gather my thoughts to face the next day. I cherish the days that I don’t have to go to work. I relish staying indoors and trying some new recipes or reading a few chapters of a good book.

We risk losing the art of socializing. Our culture is based on gathering, touching, embracing, consoling and sharing. Will all that go away? I look forward to the day when wearing masks is not routine and you can give one another a warm hug. I cannot wait for the day we can congregate once again at a place of worship, or attend a flamboyant wedding. Indeed, COVID-19 has even affected the way I dress! I no longer wear watches or bracelets. They get in the way of hand washing.

I also look forward to when I can speak up for better strategies against malaria when I am certain that I have the attention of my audience. Undeniably, the coronavirus has affected everyone’s life.

It laughs in the face of social inequality. This is a fight for all races and gender.  “If everyone is moving forward together, then success takes care of itself” Henry Ford. Certainly, there is great wisdom in this.

By: Jennifer El-Duah

Twenty-five African Youth Leaders passionate about health and healthcare systems have called on African leaders and policymakers to be committed to ending the malaria epidemic and achieving universal health coverage (UHC).

The young advocates, drawn from three African countries: Ghana, Sierra Leone and Tanzania under the Youth Leaders for Health (YL4H) Programme made this call when they presented a statement to the Deputy Chairperson African Union Commission, Ambassador Kwesi Quartey in Addis Ababa, Ethiopia.

In the same vein, the youth leaders also expressed their readiness to advocate for policy change at key national, regional and global advocacy moments for better health outcomes.

“As youth leaders, we pledge our ongoing support as partners and stakeholders in achieving health priorities within our own countries and across Africa. We support political and resource commitments to combat and eliminate diseases such as HIV, Tuberculosis and Malaria that have continued to plague our continent disproportionately,” the statement from the youth leaders read.

Dr. Sylvia Anie, Technical Adviser to the initiative commented, “Africa is home to 93% of the world’s malaria burden. It is time for renewed and enhanced political, private sector and community response.”
Youth Leaders for Health is a joint initiative by WACI Health, Hope for Future Generations (Ghana), Health Promotion Tanzania-HDT, CISMAT- SL and RESULTS UK with support from Comic Relief and in partnership with Malaria No More UK.

The young advocates are in Addis Ababa for a five- day training programme on advocacy. They are bound to influence decision-makers during a range of pivotal moments such as national elections, the Commonwealth Heads of Government Meeting and World Malaria Day towards ending the malaria epidemic, achieve Universal Health Coverage (UHC) and create lasting impact.

In his response, Ambassador Kwesi Quartey commended the Youth Leaders for Health and the implementing partners for their efforts which is aligned with the African Union’s Agenda 2063 (The blueprint and master plan for transforming Africa into the global powerhouse of the future).

He pledged the African Union’s support for the programme, granting permission for a banner to be mounted by the youth leaders at the AU Headquarters, to remind African leaders on the need to strengthen the health systems in their respective countries.

Ambassador Kwesi Quartey also promised to deliver the statement to the African Leaders at the upcoming Summit of the African Union in Addis Ababa.

“Advocacy is about collective action and utilizing the right opportunities to push for action. We are glad the Deputy Chairperson of the African Union committed to conveying the message from the Youth Leaders for Health during the African Union Summit,” said Farhan Yusuf, one of the advocates from Tanzania.
Augustine Kumah, a youth leader from Ghana also said:

“Africa has over the years recorded high malaria morbidity and mortality. It’s time for us the youth to change that narrative. We need not keep our voices to ourselves but speak up to ensure a better health system to achieve a continent free of Malaria.”

For her part, the Executive Director of WACI Health, Rosemary Mburu, noted that changing the trajectory of malaria will demand high-level political leadership in Africa.

Miss Rita Lodonu, the project lead from Hope for Future Generations (Ghana) was of the view that the statement would be a reminder to stakeholders and policy-makers to recommit to the Sustainable Development Goals (SDGs) as a whole.