Lifesaving Services Reach Tanzania's Most Remote Corners

Every morning, as the first light of dawn touches the sky, a new day composes its melody for Prisca Mkungwa. Her morning unfolds like a sheet of music, each ritual a carefully placed note in the symphony of her routine. She gently sips her morning tea, contemplatively gazing out the window, assessing the day’s weather. Grounded by these moments, Prisca heads to the Mapogoro dispensary in a remote village within Chunya district, Mbeya Region, southwest Tanzania, ready to take charge with dedication and care.

Upon arrival, Prisca is greeted by a queue of patients, mainly women and children, some of whom have traveled overnight from distant places to arrive in time for treatment.

“This health center serves people from 10 sub-villages, which are 20 to 50 kilometers away,” explains Prisca. “I attend to patients with various illnesses and refer those requiring further medical attention to the Chunya District Referral Hospital. I also provide other services, including routine immunizations, maternal health care for pregnant women, and screening children for malnutrition."

After seeing all the patients, Prisca takes her packed medical bag and slings a polio cold box over her shoulders, a smile lighting up her face. Her thoughts briefly drift back to her days at Mbeya Medical College, where she graduated and first met those tools with the curiosity of a rookie. Those fond memories quickly fade as she embarks on a journey to provide integrated outreach health services to communities away from the dispensary.

Accompanied by Patrick Naimu, a community health worker, Prisca navigates through dense forests and harsh terrain—sometimes even crossing flooded rivers aboard a motorbike—all driven by the passion to bring vital healthcare services to families in hard-to-reach areas. Today's "adventure" is no different. The time for a flashback might be over, but the knowledge and skills forged during college days remain intact.

In Masiano, a sub-village 20 kilometers from the dispensary, Prisca is welcomed warmly by the local community. Her visit is more than a valuable opportunity to access healthcare; it symbolizes hope. Her medical bag, containing various vaccines, vitamin A supplements, deworming tablets, educational materials, and much more, is crucial for the well-being of the children and families she serves.

"I prioritize emergency cases," explains Prisca. "Then I educate mothers about vaccination, exclusive breastfeeding, antenatal and postnatal care, basic home hygiene, and the importance of good nutrition to avoid stunting in children. Thereafter, I administer routine immunizations, including COVID-19 shots, weigh and screen children for malnutrition, and provide prenatal services."

The Petro family is first in line. The mother, Juliana, waits patiently with concern and hope for her three children. They missed a measles-rubella vaccination campaign, making it crucial to seize the opportunity to catch up with the immunization schedule.

 "I brought my children for vaccination because I know the vaccines will protect them from diseases," says Ms. Petro

The Masiano sub-village became the epicenter of the measles outbreak in November 2022 which quickly spread to the neighboring areas. Around 37 cases were confirmed in Chunya District, 21 of which originated from Masiano.

"The impact of the COVID-19 pandemic on the health sector and challenges of reaching every child in the district with vaccines contributed to the measles outbreak," said Blasio Kabwebwe, District Immunization Officer for the Chunya District. "We conducted mass immunizations, and the disease was controlled after four months.”

Like many other countries in the world, the COVID-19 pandemic strained Tanzania's health systems. However, primary healthcare remains a top priority for the Government. UNICEF, with support from the Gavi Alliance, procures vaccines and collaborates with the Ministry of Health to strengthen immunization and integrated health services across the country, increasing access to quality healthcare, especially in hard-to-reach communities.

The day nears its end for Prisca, but before leaving to return home, she makes time to interact with the people of her community, particularly the women. She listens to their concerns and provides advice beyond their immediate healthcare needs.

"We need support with transport and medical supplies to take services to all communities," says Prisca. "Out of the 10 sub-villages of Mapogoro village, we have only reached four."

Exhausted yet filled with a sense of fulfillment, Prisca brings the symphony of her day to a close with a final, sweeping gesture. She has become more than a health worker; she is a champion of life in the community she serves.

"It is a calling to do this kind of work," says Prisca, reflecting on the harsh realities she experiences in the remote setting.  "But, when I see the smiles of mothers amidst all challenges, their gratitude keeps me going."