My 1st month with CHAI in Eswatini
I’m writing for the first time a blog to share my experience in Eswatini (previously Swaziland). A couple of years ago I could not locate it on a map, now I’m living and working in Eswatini 🙂
DISCLAIMER: What is written below reflects solely my opinions and does not engage any other person or any organization mentioned.
Why am I in Eswatini?
Back in January I applied for a PULSE international assignment in the framework of the FANTASTIC volunteering opportunity offered by GSK . Around April I had confirmation of the assignment: Project, NGO and the country. I could not have been happier: to work on vaccines supply chain and procurement with CHAI (Clinton Health Access Initiative) in Eswatini.
Before starting my journey to Southern Africa, I had one of the remarkable moments in my working life at GSK: ‘PULSE Orientation’. Three days at GSK House in London, with more than 50 volunteers from different countries, different departments, different experiences and skills, different ages, but all having the same will to make a change or to be the change. In addition to meeting all 2018 volunteers and some NGOs, we met talented and inspiring people who shared moving stories and outstanding achievements. I felt truly proud to be part of such community and went out of the training grateful, inspired and full of hope. The 3 days were masterly prepared by the PULSE team (see pic). So thanks to all PULSE team members with my admiration for Clement D. and Ahsiya M. To be complete on the reason why I’m here, my thanks go to Stephen C. my manager who accepted that I apply and to Carys C. who inspired me through her assignment in DRC. Do not hesitate to open this link PULSE & Global Volunteering Impact Report for more info on the impact of this program on public health.
A few words on CHAI
The 17th July I discovered a young committed team, IT & onboarding program waiting for me. Julia B. (Access team manager & PULSE supervisor at CHAI) has prepared a detailed schedule for the week and 2 days after she introduced me to the EPI Manager in MoH and to the WHO EPI focal person (see pic) withwhom I will be working closely. WHO, EPI central and regional teams were having a joint meeting on EPI performance.
The mission of CHAI is ‘to save lives and to reduce the burden of disease in low- and middle-income countries while strengthening the capabilities of governments and the private sector in those countries to create and sustain high-quality health systems that can succeed without our assistance’. I completely adhere to this approach that sounds for me like this one ‘teach a man to fish instead of giving him a fish every day then he can feed himself for a lifetime’. I learned as well that CHAI teams have accomplished many significant achievements in the different countries where they operate, however they remain humble and silent about their successes.
Here are some recent examples of the projects where CHAI were involved or have led: https://www.youtube.com/watch?v=hK4n5_LkqzU&feature=youtu.be This video* was made by the Dutch Postcode lottery about the MaxART Program in Eswatini and shown at the AIDS 2018 conference last week of July in Amsterdam. In this AIDS conference, a new price deal has been announced for viral load test. This key test for HIV infected people has historically cost $15-20 per test in Eswatini and now it will be available on an optimum platform (Hologic Panther) for $12 a test. In addition, hepatitis B and C (HBV and HCV), as well as tests for human papilloma virus (HPV), the leading cause of cervical cancer, will be including the $12 price. This price also includes all service and maintenance, eliminating the need for additional budget to support the platforms. More info can be found here on NPR article. In Eswatini, CHAI provides support around 4 main areas: affordable access to health commodities, sustainable health financing to attain universal health coverage, malaria elimination and exploration of new HIV prevention efforts. Vaccines are part of affordable access to health commodities.
*DISCLAIMER: CHAI was not involved in the production of this video and we only saw it in its (near) final stage.
More words on my assignment
I will be supporting the MoH Expanded Program on Immunization (EPI) team in addressing the goal of reducing morbidity and mortality due to vaccine preventable diseases amongst children less than five years and to meet global targets for vaccine coverage and implementation. The MoH teams are doing a remarkable work to improve public health, I may extend on that in another blog, and the EPI team plays a key role in prevention unfortunately the resources do not much their ambition. The main projects I’m busy supporting at are:
- Human Papilloma Virus (HPV) vaccine introduction to immunize girls against cervical cancer. HPV infection is considered a “necessary cause” of cervical cancer thus reducing HPV infection is critical for reducing cervical cancer. Cervical cancer is the leading cancer amongst women aged 15 – 44 years in Eswatini. The introduction planned initially in 2017 has suffered from procrastination due to lack of funding. Now that Eswatini government will benefit from UNICEF prices to procure vaccines this will reduce the budget for launch and long term implementation.
- Measles Rubella (MR) follow up immunization campaign planned in 2019: in Eswatini efforts to eliminate measles and rubella the country need to run a campaign to reach all children before 5 years. My role will be to assist in macro and microplanning of the campaign including assessment and preparedness of vaccination sites.
- Hepatitis B vaccination at birth: My role is to review the current recommendations, and determine the considerations for the EPI program. Present considerations and recommendations to EPI Program Manager, including quantification and financial needs.
Eswatini: first impressions
When I got the assignment I googled ‘Swaziland’, what I found was not reassuring: a small landlocked country with one of the highest HIV infection rates and lowest life expectancy! When I talked to people who visited the country I heard nicer things: beautiful, hilly, peaceful country, very good for hiking and very close to Kruger park (about 100Km). This location is a key asset that makes tourists spend one or more nights when heading to or coming back from KNP.
When I arrived to Eswatini via South-Africa borders, I felt a kind of peace and calm. Gorgeous landscapes and roads/highways are in an excellent shape. The country population is young and you see this immediately. More than 40% are below 20 and I will write more about the Swati young generation in a blog. People here are very friendly, very polite with some kind of self-respect or acute sense of ownership and hygiene values. I will not extend on the natural beauty of the country but I’d like to share what for me seemed different or specific to Eswatini. For that I prepared a patchwork portraying a snippet of daily life. I used the phone so be indulgent if you find the quality poor 🙂 .
In Mbabane, the capital of Eswatini Kingdom, from left to right: the station square which is the busiest place in the city with the public transportation, travelers and fruit sellers. The huge green park available for the public with a big yard equipped for children activities (there are 2 if not more). There is in the country, not only in Mbabane, areas available for people to picnic (no shop around!). You find as well spread in the city public toilets, I tried one it was clean and well managed. Loaded avocado trees are seen very often in Mbabane gardens.