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Field-based training of students in poor rural communities strengthens Universities in the Democratic Republic of Congo 

Students constituted in multidisciplinary groups had as objective to strengthen university. Indeed, participants came from the Nursing School of Lubumbashi (Institut Superieur des Techniques Medicales- ISTM Lubumbashi) and the University of Lubumbashi (UNILU), namely; School of Public Health, Faculty of Medicine, Veterinary Medicine and Pharmaceutical Sciences. During Easter holidays under the supervision of faculty of ISTM (1) and UNILU (4), the 40 students approached this activity in non-residential session including two days in Lubumbashi and 3 days in Lumata.

The prior training consisted of training about the One Health concept and the appropriation of One Health competencies. Negotiation exercises were organized and the attitude at "The Chameleon School" was desired for a satisfactory leadership. Also, One Health competencies were presented to trainees.

Then, training involved a short presentation on epidemiological surveillance concept and steps, which they should use when visiting different levels of the surveillance system. This allowed trainees to better understand, through challenges and opportunities, the surveillance of diseases and antimicrobial and pesticide resistance in Lubumbashi environment. For this, the practical illustration consisted of site visits likely to improve the understanding of the epidemiological surveillance concept and steps. Sites visited were;

  1. Mzee Laurent Desire Kabila Market in relation to conditions of sale of food products;
  2. Slaughterhouse and makeshift slaughterhouse: basically goat slaughter
  3. The Zoological Garden of Lubumbashi for a good illustration of Man-Animal-Environment interface
  4. Kenya's Health Area was selected because of the suboptimal socio-economic conditions in that commune. During these visits, further explanations of surveillance were given to trainees by heads of the four health centers and those of the Health Zone Office.

At Lumata, a brief presentation on the Ecohealth concept introduced trainees to semi-structured interviews, followed by the development of data collection tools. Subsequently, under the company of community relays, visits were organized for diagnosis of health issues in the Human-Animal-Environment interface in neighborhoods of Lumata. These were Lumata, Mubote, Kasangula and Nyasaland.

Health issues were identified and community interventions were planned. In humans, malaria, proximity between humans and animals, cases of typhoid fever, anemia in children, and unsanitary conditions were reported. In animals, there were cases of cough, diarrhea, scabies, tearing and stray animals. Malaria and proximity between humans and animals attracted the attention of participants.

The intervention consisted of (i) a Malaria Rapid Screening Test and (ii) a Brucellosis Serological Diagnostic Test. Trainees accompanied by community relays sensitized communities on change in behaviors with regard to the diagnosed health issues. The sensitization had a special emphasis on environmental hygiene to avoid mosquitoes, unsanitary conditions and other aspects that could lead to the debility of people at risk of malaria, not to mention the issue of promiscuity between man and animal. 

At Lumata, trainees set up a patient reception system at the SNCC Health Center under guidance of the facilitators and the head of the center.

A group of trainees with community relays intensified mobilisation and by mid-day the health center was organized for the intervention.

The reception service, after patients’ registration, directed children and adults for blood samples. The Rapid Malaria Screening Test was conducted locally. Blood taken for Brucellosis serological diagnostic test was sent for analysis to the Laboratory Department of Lubumbashi University Clinics.

Subsequently, for the sustainability of the action, results were given to the Reception Center for the delivery of results to patients. Results of the Rapid Malaria Screening Test were positive (54.6%, n = 219), negative (40.9%, n = 164) and unclassified (4.5%, n = 18). The Brucellosis serological diagnostic test showed some positive cases (3.0%, n = 12).

 While it is important that these health issues were identified, it is also of benefit to highlight that poverty is a major problem with a big portion of the population leaving on half a dollar per day. This aspect is important to consider while designing solutions, in addition to screening.

The constitution of multidisciplinary groups enabled students;

  • to use the One Health competencies to diagnose health issues
  • to better package awareness messages for behaviour change
  • to convince the community to go to the health center to conduct tests

On the part of the community,

  • Communities of Lumata got to understand that self-medication is a bad habit
  • Heads of Health Centers Lumata are now able to take on this approach reminiscent that the treatment of Malaria cases is based on the test for a diagnosis of certainty

For sustainability, it is necessary

  • Create a network that would allow all actors to exchange information on aspects that address the Human-Animal-Environment interface
  • Ensure, through community relays, awareness on ways and means to avoid an environment likely to promote the development of mosquitoes breeding sites
  • Set up a network to address issues of poverty and to provide an education in order to raise the socio-economic conditions of the communities

 

 

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