15 years of APOC - World Health Organization

15 years of APOC
By Maimouna Diop-Ly
Stories from the field ADB
Close view of CDTI activities in the field
My visit to some villages in the Esse District of Cameroon
in April 2011, (my first firsthand experience of oncho
control activities on the ground) gave me a lot of food for
thought, especially as regards the concept of volunteerism
in developing countries, and also the selflessness of health
workers.
The involvement of pensioners in CDTI activities was quite
remarkable. A good number of pensioners from the city had
decided to return to their villages after several years living
in urban settings, with a different and more modern lifestyle.
Re-integration into village life, in the tropical forest with its
lush, peaceful and restful vegetation appeared to have been
easy, and must have facilitated the involvement of these
pensioners in community activities such as the fight against
onchocerciasis. These volunteer pensioners (CDDs and
ordinary members of the community) are examples of a
new generation of volunteers. Since these pensioners
already have their personal income this reduces, to an extent,
the problem of incentives, especially monetary incentives.
However, this begs the question: what is the ideal age for a
CDD? Is it better to recruit young people, often unemployed
and unskilled, and more likely to leave the village at the first
opportunity to work elsewhere, but who have the advantage
of being more fit, given the distances that sometimes have
to be covered to do community work. Or, older people, such
as pensioners, who are more readily available, with less
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constraints and expectations about incentives, but who may
find it more difficult physically if there are long distances to
be covered to conduct sensitization activities. Luckily, the
communities themselves solve this dilemma since they
choose their CDDs themselves.
I was greatly impressed by the commitment and passion of
a CDD; a pensioner in one of the villages that I visited.
During our conversation he talked passionately about his
commitment to serve his community and his desire to come
back to his roots and enjoy the benefits of a peaceful life,
and his wish not only to help his community but also to
belong (to it again). This is an opportunity that the APOC
programme should look into and develop as a channel for
advocacy and sensitization.
I also noticed the difficult conditions under which the health
staff were working; in this area there was just one nurse for
each health post. Difficulties included the very environment
in which they were working, travelling in the area along
narrow paths that are probably impossible to cross during
the rainy seasons. The search for quality in the delivery of
services, despite the many challenges, to better respond to
the needs of the community in the fight against
onchocerciasis, as well as the desire to provide other support
to communities are clear testimonies of a dedication that
nowadays is not always found among medical personnel in
urban areas.
As staff of a partner organization
(the African Development Bank -
ADB) of the programme, this field
experience gave me a clearer insight
into the difficulties and sociological
realities of oncho control activities
on the ground. The ADB supports
and funds national and regional
poverty reduction strategies and
strives to reduce or solve the
problems of human development in
general, and the CDTI fits aptly into
this framework.
Dr Maimouna Diop-Ly is Principal Health
Analyst at the African Development Bank
African Programme for Onchocerciasis Control