Since taking on the role of Associate Director of the Community Health Department just a few months ago, Ashma has taken the program by storm transforming the clinical follow-up program, helping get the WATSI program off the ground so that even our poorest patients can receive life-saving treatments from the tertiary care units in Nepalgunj and Kathmandu, and helping implement the mobile health technology platform that our community health workers now use to report their data. Through the numerous hours we have spent working with Ashma, she has become a close friend and a respected colleague.
Ashma has also quickly earned the trust of the community members. One Saturday when we accompanied her into a nearby village for the weekly community health meeting, one FCHV told us about a man in her ward who had HIV, TB, and asthma. The FCHV told us that the man’s health status had been deteriorating but he was not willing to go to the hospital because he had formally had a negative experience with clinicians during the course of one of his many visits to different medical centers. After the meeting, we went with Ashma and the FCHV to the man’s house, along the way passing families out in their fields preparing their rice patties in the heat of a Saturday afternoon. There, she spent well over an hour patiently discussing the situation with the family. The wife had literally carried her husband to all of his medical appointments throughout Nepal and India and just could not keep doing that while also raising their several young children. Ashma promised the family that she would personally see to it that the man got treated properly and only then would he agree to come. We then accompanied the man to the hospital where Ashma saw to it that he was received properly by the clinical team.
However, the story of the heroes of the community health program would not be complete without including the Community Health Worker Leaders and Female Community Health Volunteers. As we have had the chance to get to know the 9 CHWLs when they come to the hospital each week for trainings and to report data and the 92 FCHVs whenever we go out into the community, we have seen the dedication and kindness each woman brings to her position. While each woman has a different story for how she decided to become a CHW, every one of them brings a common desire to help their communities. The FCHVs are selected by their communities and are the true links between the population of Achham and all health services. These strong and wonderful women break down the barriers – geographic, cultural, and social – that the most vulnerable and marginalized Nepalis face in accessing care.
Ashma, the CHWLs, and the FCHVs are heroes.