Last week, we had an opportunity to sit down and chat with the recent awardee of the Best Volunteer on the FCHV Day from the Bharta PunyaDevi Health Post, SukuMaya Thing. Below entails snippets from the conversations with the oldest Female Community Health Volunteer of ward number 8 of Kailash Rural Municipality, Makwanpur.
Life of SukuMaya Thing, a Female Community Health Volunteer
Some 33 years ago, mothers from the community of then Bharta VDC gathered to assign selected married women with kids under the Female Community Health Volunteer (FCHV) program. The chosen women, non-paid community health bodies, would be a bridge between families and communities to peripheral health facilities but not as service providers.
SukuMaya was one of the mothers from the community who got selected as a female community health volunteer. The mothers from her community appointed her since she was someone they felt would be the right person for the program.
A housewife with no educational background or work experience, SukuMaya got referred by other mothers from her community for the role of an FCHV. Now nearing sixty, she was only twenty-three at that time.
SukuMaya Thing, age 56, has been serving as a Female Community Health Volunteer for thirty-three years. She lives in ward number 8 of Kailash Rural Municipality and volunteers in the same area representing the Bharta Punya Devi Health Post.
Once she got assigned the role of an FCHV, SukuMaya received a twelve days training followed by six days and later of three to four days. To date, she has attended numerous training about respiration, nutrition, checking pneumonia and more. And those trainings have provided her with knowledge and skills in understanding health issues related to mothers and children.
The volunteering of SukuMaya entails finding out the number of pregnant women and mothers in designated areas and what they are struggling with or need help with relevancy to their and their child’s health. She also raises awareness among the women in the community regarding the vaccines, medicines and nutritious food the mothers and children should take.
“A mother needs access to proper food during pregnancy. So, I tell everything I can about proper food based on what I learnt at the training and because it is my responsibility,” Suku Maya gives a reality check. “But it is up to them to change their mindset, which is quite difficult, speaking from my experiences.”
FCHVs get training about the nutritious food the mothers need to intake. They have relevant knowledge, so following their suggestions would greatly benefit the ones at the receiving end. Thus, Suku Maya, as an FCHV, is adamant about raising awareness of the value of proper food and sanitation.
But, the cases of malnourished children in the area are upsetting. SukuMaya is uncertain whether it is because the parents do not know or do not have time or ignore to manage the locally produced food. Since junk food, which is available easily, tastes good, children seem to like it more. So they cry and ask for it. And parents buy them for their kids to make them stop nagging.
FCHVs of the Kailash Rural Municipality sit for a meeting each month, where Suku Maya also submits a report on the work and activities she did that month.
FCHVs in the community create awareness regarding the illnesses the children are prone to and their symptoms and preventive measures. Moreover, they inform the women in the community regarding the importance and ways of maintaining sanitation at home.
At first, given her lack of experience, SukuMaya was indecisive about the program. She did not think it was for her, but she persisted. “It was a learning experience for me. I would ask Health Post Incharges about things I was unsure about or if I needed some guidance navigating my duties. Eventually, I discovered self-confidence and continued channelling it.” She reflects on the initial phase of the volunteer program.
SukuMaya believed that she needed to put in the work for progress. During her volunteering journey, people told her good and bad things. But she focused on the bright side. “If it weren’t for my work, even the good words would not have come my way,” SukuMaya adds honestly. The negative comments came from people with a poor understanding of things around which FCHVs like SukuMaya create awareness.
Mothers in the community would object when she would remind them of vaccinations because they did not want unnecessary hurt to their children. But Suku Maya, who has a zen aura, knew that getting pissed at them was not the way to deal with such a situation. She carried on her job of informing the mothers on the importance of vaccination to prevent diseases in children. In most cases, she succeeded in convincing but still, some people hide behind their ignorance.
While things are unimaginably different now, it did not happen overnight. The changes we see today took a lot of time to become what it is.
Her family were not on board with her decision to become a volunteer. So, she neither stayed with her in-laws nor her parents. Their thought process did not match hers. Her parents were too old school and would not let her go anywhere. She used to be with her parents and in-laws during the festivals. “The festivities obligations did not let me have comfortable choices on that front. But, apart from those times, they would think I was roaming around the village aimlessly. They did not understand what I was doing or tried to understand, for that matter.” SukuMaya shares her struggle with her family.
The training SukuMaya attended after being selected as an FCHV changed her perspective. She felt everything she learnt at the training should be put to use. Once she visited the mothers and children in the community, she started becoming affectionate towards them.
She was a mother herself and had seen many mothers go through several obstacles from pre-pregnancy to postpartum. As someone with knowledge, SukuMaya felt the urge to share them with the mothers in the communities.
“It would have been easier if I had some educational background.” SukuMaya contemplates. She could not even write her name then, but now she can do her and others. She learned everything by being in the shoes of a volunteer, not reading textbooks.
While SukuMaya did choose to volunteer, someone who works on a grassroots level deserves some form of compensation or incentive beyond the allowance of 1200 Nrs. a month.
Coordination of FCHV and SDA
SDA health staff sit during the FCHVs meeting. SDA also provides snacks along with transportation support at the monthly FCHVs meeting. The FCHVs and SDA Health team discuss possible issues that they plan on discussing at the Mothers Group Meeting at different wards of Kailash Rural Municipality.
SDA, via its Health Project, conducts different programs that focus on Sexual and Reproductive Health and Rights (SRHR). The FCHVs are one of the target groups of such programs because, through them, SDA can further one of its main objectives of knowledge multiplication. They attend programs in Literacy Home, Kalikatar and gain information and pass it on to other women and mothers from the communities at the meetings that follow in later days. FCHVs, one of the significant components, amplify the knowledge about sexual and reproductive health and rights in and around their communities.
SukuMaya trusts that SDA has supported FCHVs in various aspects. The help ranges from mitigating malnutrition one step at a time to providing NewBorn Support Bucket/Package and more. The latter has contributed significantly to increasing the number of pregnant women delivering babies at health posts and coming for Antenatal care (ANC) four times.
Many risk factors are associated with delivering a child at home. And those risks are lower when the delivery happens at a health post instead of a house. SDA’s provision of NewBorn Support Bucket to women who deliver at a Health Post after four ANC to reduce the number of delivery cases at home has worked wonders thus far. Now, women from the communities complete the ANC visit and deliver at the health post. Moreover, the health posts provide the women who give birth to the child there with 2800 Nrs and clothes for the baby for three years.
There have been cases of her getting phone calls the morning after someone gives birth at home. Someone in labour called me to get her in the middle of the road once.” SukuMaya adds with a smile. “I somehow, with the help of locals, got her to the health post, and she gave birth soon enough.”
Since FCHVs have been in the communities for years, women around the area are aware of the ANC visits and come for it themselves. The number has increased over time. While not implemented yet, there has been an update since a month ago in the required number of ANC visits, which is 8.
“One in three women is probably unaware,” Suku Maya makes an assumption based on what she has seen in the communities.
Community-level health posts do not have the facility of sonography, also known as video X-rays. SukuMaya wishes to have that facility so that the women do not have to go to Hetauda just for that. Most women do not go to Hetauda due to financial problems, poor road conditions and lack of adequate transport vehicles.
SukuMaya, who hosts Mothers Group Meeting each month, feels that the local government has handed over more responsibilities to the FCHVs. However, the duties have outweighed the perks or benefits. “We have tried to get the message of us deserving more benefits, but it is up to them to take that into consideration and work on it.” Suku Maya subtly speaks about the way government offices in Nepal function.
In retrospect, SukuMaya did not want to be a volunteer. Albeit, once she started volunteering, it demanded more of her. She learnt that the knowledge and skills she gained are life-saving. After becoming capacitated, she saw her potential in helping vulnerable people. Since then, she has not looked back.
After volunteering for all these years, SukuMaya confidently says that she can face the small things that come as obstacles to mothers and children.
“I want to see children in the community access nutritious food to the point where it becomes normalised and replaces junk food.” SukuMaya expresses her hope.