By: Regan Kelso
I woke up at 5:30 am on a mid-September Sunday morning, anxiously awaiting my 6am talk with Mark Mwenda, my fellow CHW Ambassador colleague. I sat up in bed, reached in thin dark air towards my nightstand, and blindly searched for my journal. I was excited about getting to know Mark. And, I wanted to write everything down so I would not forget any details. Also, I was excited to speak to someone from another country who had the same job. I hoped we could give each other a glimpse of what Community Health Work was like on opposite sides of the globe.
When Mark called, it was 4pm in Kiambu County, where he lives. It took several emails between Mark and me to decide the best time to arrange this call due to our 10-hour time difference. Mark, wise and ahead of his time, suggested that we use WhatsApp as the best way to communicate to avoid disconnection. Anticipating communication barriers, offering viable resources, and finding solutions to problems before they exist, demonstrated the qualities of a true Community Health Worker—quick thinking and resourceful.
Mark called on time, and when the video connected, we smiled at each other for a few seconds before breaking out into nervous laughter. It dawned on us that we applied “to do a thing,” and months later, here we were, random strangers, “doing the thing,” giving voice to CHW work. Five minutes into our call, I felt like I had known Mark for a long time. We were connected in service-to help the people in our community get the medical care they need.
Mark and I spent an hour and a half talking about the needs of our respective communities. Mark shared, “In Kenya, quality care costs money, and hospitals do not have enough medical staff to care for its patients. Pharmacies run out of medication, and families are forced to make choices between paying for food, clean water, or medication.”
I nodded in agreement when Mark talked about the high costs of healthcare. In San Bernardino, California, where I live, most of the families that I worked with in the NICU struggled to get prescribed formulas due to a national shortage. The over-the-counter formula is expensive. Some mothers did not have the privilege of breastfeeding.
One of the NICU mothers I worked with had to stop working because of her unexpected premature delivery. At the same time, she had an increase in her rent, kids home from school because of Covid, and not enough gas to drive around the county to find the formula her baby needed. How do you prioritize your baby’s needs when their survival depends on meeting all of their basic needs?
It would be a far stretch to say that America is exactly like Kenya when it comes to health disparities considering all of the western world’s resources. So, I won’t. But, when Mark talks about prioritizing which basic needs are most important, I understand completely.
There have been times when I’ve had to use rent money to buy groceries or gas, so I can get to work and pay rent. And, when my kids with asthma had flares, I had to choose between taking them to the ER or urgent care. The decision was based on how far the care provider was and how much gas I had to get home.
Even though free or low-cost statewide healthcare programs exist, they do not address health disparities and the social impacts of poverty effectively. In both the US and Kenya, some initiatives have just begun to employ CHWs in under-resourced communities to fill in the gaps. Affording healthcare is a privilege that not everyone has. And the lack of this privilege leads to early deaths in the communities where Mark and I live.
“Prevention is better than curing a disease,” Mark recites this phrase with confidence before telling me about more of his daily CHW interventions.
Mark provides health education to help families to prevent communicable diseases, like Covid-19 and Malaria. “Many families do not understand the importance of prevention,” Mark shares. So, building trusting relationships with people in the community allows Mark to teach patients how to protect themselves. And while he guides his community through procedures to “stay safe” during a global health crisis, he has had to enter homes without the proper PPE protection to keep himself safe.
Listening to Mark made me think about how much support CHW/V/P need when working on the frontline of public health, especially during a crisis. CHW/V/P fight to receive acknowledgment and support for the work that we do. As a collective, we know that our work improves the outcomes of patients in ways that are different from other providers. Interventions, like going into a person’s home while they are sick, lend human care and support to the person unable to access traditional healthcare.
Time passed quickly talking to my friend, Mark. The sunlight stretched out towards my nightstand to tell me that the morning was passing by. It was getting late for Mark. We ended our call with promises to connect often while we are in ambassadorship with each other.
After we hung up, I reflected on my talk with Mark. I wondered about the experiences of CHWs in other parts of the world. How are we all similar? How are we different? What do CHW/V/P face on the frontlines in Canada, Mexico, or other parts of Africa and the US? How are we connected? How do we begin calling out to each other?
By sharing stories, CHWs can learn from each other and improve the quality of care we give to communities in need. What I learned from talking to Mark is that being in service to our community connects, but what will sustain us as CHWs is linking together, calling each other and building connections across the globe so we can rely on each other for support.
 Community Health Worker (CHW), Volunteer, Promotor(a)