Jennifer Schechter, an activist, mother, and co-founder and CEO of Integrate Health shares impressions from a trip to Togo, West Africa and what it means for Universal Health Coverage. Originally posted on December 13, 2017 on Jennifer Schechter’s Medium.
Pernille Hoej suited up for the ride, wrapping a scarf around her face and pulling her helmet down. It was Harmattan, that season when a dry, dusty wind sweeps down from the Sahara toward the West African coast. From December to February, red dust carries in the air coating every surface, especially if you happen to be on the back of a motorcycle driving into it.
Hoej, Hope Through Health’s Program Director, and Emile Bobozi, Hope Through Health’s Clinical Mentor, were making the rounds, visiting clinics selected for Hope Through Health’s forthcoming expansion. Despite the thick layers of fabric that covered her nose and mouth, Hoej could smell bat excrement from a hundred yards away as she approached the first location.
She was completely horrified as she took the tour. Bat droppings coated almost every surface, the shelves in the pharmacy were bare, and the cramped confines of the space were almost unbearable. Hoej relayed all of this to me later with panic in her voice.
“It was awful,” she gasped.
I nodded, “That’s what most of the clinics looked like before we started this work.”
In fact, some locations were even worse. In addition to the bat infestations and cramped conditions, most clinics had no water or even electricity.
Contrast this with the clinic in Kpindi I visited last week, where Hope Through Health has been working for two years. Thanks to our partnership with some remarkable organizations, including the 30/30 Project, Construction for Change, and Water Charity, this clinic now has running water, solar panels, and wire mesh covering the roof vents to permit ventilation but keep bats out.
Since 2004, Hope Through Health has been working in Togo, a beautiful yet forgotten country, nestled between Benin and Ghana on the West African coast. The organization was born from a collaboration between local activists with HIV, who in spite of a death sentence diagnosis, refused to accept their fate and a committed team of Peace Corps Volunteers inspired by their resilience and resolve. Today, it has expanded to serve more than 40,000 people in rural northern Togo by deploying Community Health Workers who provide doorstep care and improving the quality of care at public clinics. In short, a recipe for universal health coverage, in some of the most neglected communities in the world.
Imagine, for a moment, being a patient in this situation. As a mother of two myself, this isn’t hard for me to do. You are already afraid that your child’s fever might be something serious, might be malaria. You consider the clinic, but as you approach the building the stench makes you gag. I would make the same decision that many of our patients previously did, to visit a traditional healer, to try an herbal remedy, to just close my eyes and pray.
Imagine for a moment what this does to your psyche. As a patient, these conditions erode agency. They leave mothers feeling powerless over the health of their children. I can only imagine how unbearable that must feel.
But this reality can change. I have seen it happen firsthand when quality healthcare is put within reach. Universal Health Coverage Day, celebrated annually on December 12, calls for all nations to provide for their citizens affordable, quality health care. At Hope Through Health, we have chosen to begin this pursuit for Universal Health Coverage in those communities and clinics where it seems most improbable, least likely. In doing so we are proving that even starting with the worst conditions, transformative change is possible, Universal Health Coverage is achievable.
If we can transform healthcare in the forgotten communities of rural northern Togo, then I believe Universal Health Coverage is within reach. And when something is achievable, we must make it a reality. As a mother and an activist, I can stop at no less.