The Simoonga Health Post sits just outside the Mosi-Oi-Tunya National Park, amidst a vast array of Zambian wildlife. Miriam Banda, a registered midwife, has worked at this Health Post for 4 years. During this time, her working conditions have changed dramatically – for the better.
When Miriam started working at the Simoonga facility, a major challenge she faced in her day-to-day work was a lack of space. There was one screening room, one lodging room for both male and female patients, and one room for the maternity ward. The limited space affected everything: patients didn’t have privacy, staff weren’t able to deal with emergencies effectively, and there was only one bed for delivering babies. The cramped quarters in the maternity ward were especially challenging. Without enough beds, if there was ever more than one mother delivering at a time, someone would have to give birth in another room—one that hadn’t been properly sterilized. In some instances, mothers were on the floor. These conditions could lead to newborn babies getting infections. “I remember one time there were 3 patients delivering. This was very difficult for me,” said Miriam.
Precious Chiweka, a community member who lives near the Simoonga Health Post, recounted her experience delivering a baby at the facility. She and another mother were both in labor: Precious was on the floor and the other woman was on the bed. They had to switch places depending on who was progressing faster in the delivery. Because of these conditions, many women preferred to deliver at home, in spite of the risks.
Partnering with On Call Africa changed everything. In 2023 and 2024, over a span of a year, On Call Africa worked with the Simoonga Health Post to upgrade the entire clinic, including the maternity ward, the pharmacy, waste management, staff housing, and the washroom facilities. During the renovation, the facility had to temporarily offer services from a tent, and that was difficult. But, as Miriam notes: “we were waiting for the wonderful clinic to be the way it is today.” In the meantime, On Call Africa formed and trained a community committee that would be in charge of the ongoing facility maintenance. After much anticipation, the upgraded facility was handed over the community in July of 2024.
The delivery room at the Simoonga Health post now has three beds
Now, the facility has a room for screening, another for testing, separate male and female lodging areas, and a safe space for keeping medications. Patients now have privacy, and they are no longer crowded into a small space. “There is enough room to see patients, and we see them fast,” Miriam said proudly. Mostly importantly, the maternity wing has been significantly expanded. Now there are 4 rooms: one for prenatal patients, one for delivery, one for postnatal patients, and one for family planning. The delivery room now has 3 beds (up from 1), and the entire maternity wing now has a total of 9 beds (up from 2). “Now if 3 patients come, I will be happily delivering them from the delivery room. It has made a very big impact on my life,” said Miriam about her new working conditions. “The community is also very happy with the changes,” she emphasized. “They have seen there is more privacy. We are seeing more patients than before.”
In addition to the facility upgrades, On Call Africa is working with the Simoonga Health Post to enhance their Community-Based Volunteer (CBV) program. Traveling to a health facility for care takes time and money: in many cases this is prohibitively costly. To address this obstacle, CBVs are community members that are trained to provide basic front-line and last mile health services directly in their communities. This local access is a game-changer for community health.
The Zambian Ministry of Health has been working to expand the role of CBVs across the country. Under the Ministry’s new strategy, CBVs are empowered to diagnose and treat some of the most common medical conditions and major drivers of mortality for children under the age of 5 such as upper respiratory tract infections and diarrhea.
Precious Chiweka, a Community-Based Volunteer for the Simoonga facility
The ambitious initiative involves training, supervising, and incentivizing CBVs, along with providing key supplies for these expanded areas of work. This is precisely what On Call Africa is doing with the Simoonga Health Post. Indeed, Precious Chiweka, the community member mentioned previously, is one of these CBVs who has been trained and elevated to treat a range of conditions in her community. Precious has found the experience so far to be extremely rewarding. She received 12 weeks of training, and has learned about many new health topics. “A lot of things are exciting for CBVs,” mentioned Precious. “Before the training, we didn’t know most of these things. After the training, we’ve been equipped with enough knowledge about the conditions and how to treat the patients.”
Precious is already noticing changes in the community: in one week alone, she treated 4 cases of upper respiratory tract infections. This is especially important because in the past, community members would have to travel to the facility to treat the infections. Often, they simply couldn’t afford to go, and the cases would worsen. Now, care is happening close to home and the facility is less crowded.
Simoonga is proud of all of these positive change. Nonetheless, they still face a great many challenges. Although they have a water tank dedicated for the facility, it is only 2,000 liters: most facilities need 5,000 or 10,000 liters to function well. As a result, the facility only has water for about 2 hours per day. This is very challenging for their work: it is hard to properly sanitize medical equipment for use between patients, and they are not always able to properly clean the delivery room. In addition, the facility is experiences power cuts for about 4 hours every day, affecting their ability to properly keep patient data records up to date on their digital system.
On Call Africa wants to help the Simoonga facility address these pending challenges, and keep bringing improved infrastructure, access, and health improvements to the community.
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