MALAWI / CHILD SURVIVAL

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The Child Survival Call to Action that will bring together 700 leaders and global experts in Washington DC this week (14-15 June) seeks to identify "smart investments" to help end preventable child deaths. In Malawi, Health Surveillance Assistants (HSAs) linking villages with the health system have contributed to a significant drop in the country's child mortality rates. UNICEF
Description

STORY: MALAWI / CHILD SURVIVAL
TRT: 2.53
SOURCE: UNICEF
RESTRICTIONS: NONE
LANGUAGES: CHICHEWA / ENGLISH / NATS

DATELINE: 31 MAY 2012, MALAWI

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Shotlist

1. Close up, Blessings Makono
2. Wide shot, Blessings Makono at the village clinic with mother
3. Med shot, Makono talking to Mwanaisha Lubaini
4. SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"The reason I came to this village clinic today is because my child has a fever and is complaining of stomach pains. "
5. Tilt down, child's feet
6. SOUNDBITE (English) Blessings Makono, Health Surveillance Assistants (HSAs), Chimphanga village:
"I assist children with diseases like diarrhoea, pneumonia, eye infection, and some other minor diseases. When I find the child has a more complicated disease, I refer them to Khombedza health centre for further management."
7. Med shot, Makono giving instructions to Mwanaisha when to administer the other pills to her daughter
8. Med shot, Mwanaisha and her daughter, Awesha
9. Med shot, Makono giving medicine to a child patient with a spoon while she is sitting on her mother’s lap
10. SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"If it was not for this village clinic, my family and I would have to travel very long distances to get the proper healthcare needed. And getting to the next health centre would mean I would have to pay 600 Kwacha for each trip which we cannot afford."
11. Wide shot, Khombedza health centre, 18 kilometers away from Chimphanga Village clinic
12. Various shots, inside one of the waiting rooms at Khombedza health centre with a large queue of mothers with their children waiting to be seen
13. Med shot, waiting room of health centre
14. Close up, mother smiling while getting up with her child wrapped behind her back
15. Med shot, waiting room with a mother walking towards camera
16. SOUNDBITE (English) Blessings Makono, Health Surveillance Assistants (HSAs), Chimphanga village:
"When they come here for treatment they don’t pay anything because it is free of charge."
17. Wide shot, cyclist turning onto a dirt road that leads to Khombedza health centre
18. Med shot, Chimphanga village clinic with Makono, mothers and a father and son waiting their turn
19. SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"What I like about this village clinic as well is that unlike busy hospitals, here you get attended to very quickly because of the small number of patients."
20. Close up, Makono talking with a mother and child
21. SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"Mr. Makono has been a great help to my family. Last month I was here with another child of mine who got medicine and is now in very good health. I am very confident that my daughter which I brought today to the clinic will get well too with the medicine Mr. Makono gave."
22. Close up, measuring tape being put around a child’s arm
23. Med shot, Makono helping to hold a child’s head back while the mother gives her child the medicine

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Storyline

Thirty-two year old Blessings Makono has been up since 8 o’clock in the morning conducting a "village clinic" outside his wind-swept brick house in Chimphanga Village, Malawi. Already a small group of women are seated on the dusty floor, their babies tightly wrapped behind their backs with the traditional chitenje cloth.

Makono asks Mwanaisha Lubaini, a 29 year old mother of four, what is wrong with her child, noting down the information in the child’s health passport.

SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"The reason I came to this village clinic today is because my child has a fever and is complaining of stomach pains. "

Using the stopwatch on his mobile phone, he counts the child’s heart rate, then pulls her eyelids to reveal the inside lining. A pale lining, he later explains, means the child has anaemia. Awesha (age 4) is showing signs of malnutrition and, pressing his thumb into her feet, Makono checks for oedema.

SOUNDBITE (English) Blessings Makono, Health Surveillance Assistants (HSAs), Chimphanga village:
"I assist children with diseases like diarrhoea, pneumonia, eye infection, and some other minor diseases. When I find the child has a more complicated disease, I refer them to Khombedza health centre for further management."

Makono has diagnosed Awesha with malaria and immediately administers the first dose of an anti malarial drug. He also hands her mother, Lubaini, the other dose and additional medication to take home, with strict instructions to administer them at prescribed times. If nothing changes in three days, he says, the child should be brought back for further assessment.

Makono is one of two Health Surveillance Assistants (HSAs) in Chimphanga village. With his colleague, Makono holds a village clinic every day of the week using a medical kit supplied by UNICEF. The kit contains antibiotics, anti malarial tablets, oral rehydration salts, and zinc. In Malawi’s battle against common childhood diseases, HSAs have played a key role in bringing health care closer to the people.

SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"If it was not for this village clinic, my family and I would have to travel very long distances to get the proper healthcare needed. And getting to the next health centre would mean I would have to pay 600 Kwacha for each trip which we cannot afford."

Khombedza, the nearest health center, is 18 kilometres away from Chimphanga village. In a country where nearly half the population lives on less than a dollar a day, 600 kwacha (equivalent to around USD 2.40) is more than most poor households can afford.

SOUNDBITE (English) Blessings Makono, Health Surveillance Assistants (HSAs), Chimphanga village:
"When they come here for treatment they don’t pay anything because it is free of charge."

It would take Lubaini hours to walk to the health center and the sheer effort and time involved means parents are reluctant to seek medical help when their children fall sick. Makono’s village clinic ensures that treatment is only a few minutes’ walk away. And because Makono lives in the village, people can bring their sick children at any time.

SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"What I like about this village clinic as well is that unlike busy hospitals, here you get attended to very quickly because of the small number of patients."

Malawi currently has about 12,000 Health Surveillance Assistants (HSAs). These health workers are the vital link between the village and the health system.

SOUNDBITE (Chichewa) Mwanaisha Lubaini, 29 year old mother of four children:
"Mr. Makono has been a great help to my family. Last month I was here with another child of mine who got medicine and is now in very good health. I am very confident that my daughter which I brought today to the clinic will get well too with the medicine Mr. Makono gave."

Malawi’s HSA program has contributed to a significant drop in the country’s child mortality rates. The major childhood killers - malaria, diarrhoea, and pneumonia - are not only preventable but can be cured with the simple treatments that Makono administers at his village clinic.

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UNICEF
Subject Topical
Geographic Subject
MAMS Id
U120613d