With poor road conditions, the Kafue River is the most direct and reliable way to reach the Ngabwe District, a collection of isolated homesteads separated by forests, marshlands, rivers, and streams in Zambia’s Central Province. Due to its terrain, mosquito borne illnesses, like malaria, pose a serious health threat to the small-scale farming and fishing communities that call this area home—the Ngabwe District reported 240 malaria cases per 1,000 people in 2020.
The medicine and supplies that are necessary to treat malaria effectively have a difficult journey to reach the remote health facilities in Ngabwe that provide care to its communities.
Kandadu crosses the Kafue River by canoe to get essential malaria medicines to Ngabwe health center. Photo Credit: PMI Impact Malaria Zambia.
Kandadu Chibosha is a provincial pharmacist who works in Ngabwe as part of an integrated Outreach, Training, and Supportive Supervision (OTSS+) team. With the support of the U.S. President’s Malaria Initiative (PMI) Impact Malaria project to Zambia’s Provincial Health Office (PHO) pharmacy unit, pharmacists like Kandadu participated in OTSS+ visits to health facilities from March to June 2021. During the visits, Kandadu helped health care workers and pharmacy staff in the management of malaria commodity stocks at the health facility. He also spot-checked drug availability and delivered essential medicines and supplies.
To reach the Chilwa Islands and Ngabwe rural health centers, located on an island on the Kafue River, Kandadu parked his vehicle on one side of the Kafue. Using a pontoon and then a canoe, he crossed the river and made his way through neighboring swamps. After safely crossing, he walked for another hour on the last stretch to the remote health centers.
It’s an arduous and potentially hazardous journey, but it’s worth the effort as Kandadu says, “My passion is to see that every facility has drugs available for all diseases; therefore, the fear of crossing the river on the canoe to reach the two facilities does not apply. What applies is arriving safely, taking the safety precautions on the canoe and delivering the malaria commodities and other essential drugs to the most difficult to reach facilities.”
The OTSS+ visits build the skills of health workers and pharmacy staff to manage stock and maintain required levels of essential malaria supplies and drugs, complementing the U.S. Agency for International Development (USAID) and PMI supported Global Health Supply Chain-Procurement and Supply Management (GHSC-PSM) project, which provides commodity procurement, supply, and systems strengthening. The investments are paying off.
As Kandadu notes, “Before the introduction of commodity logistic supply chain in Zambia, it used to be very difficult to support availability of essential drugs at facilities that are far-fetched all year round. I enjoy seeing patients receive the right treatment with the correct diagnosis.”
Through PMI Impact Malaria and other global PMI projects such as GHSC-PSM, health care workers like Kandadu in Zambia help to ensure consistent malaria care can be provided to those who may be the hardest to reach.
PMI Impact Malaria is funded and technically assisted by the U.S. President's Malaria Initiative (PMI) and is led by Population Services International (PSI) in partnership with Jhpiego, Medical Care Development International (MCDI), and the Malaria Elimination Institute (MEI) at UCSF.
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