“Solidarity in Sovereignty in Africa” is a call to action for the global community to stand with African nations by respecting and upholding their sovereignty – while recognizing that international assistance remains essential to enable low-income countries to invest the resources needed to close equity gaps and eradicate poverty. To be effective, this support must champion Africa-led priorities, decision-making, and solutions, respond to local needs and contexts, and recognize African leadership as central to shared global progress. In the fourth edition of our Black History Month series, we had the honour of speaking with Dygrace Lukwesa, a community health worker in Zambia that we also interviewed last year for our report Strong Health Systems Start on the Frontlines: How Community Health Workers Power the Fight Against Nutrition.
My name is Dygrace Lukwesa, and I became a community health worker (CHW) in 2018. I live and work in Zambia, specifically in the Nchelenge district, Luapula province. As a CHW, a lot of my work consists of doing health promotion, disease prevention, and providing access to primary health care.
We get trained in almost all departments within health facilities to deliver primary health care – from registering a patient to performing deliveries under the supervision of a midwife! But I would say that 80% of our work is done in the communities themselves, where we oversee local health posts or through house visits. I go from door-to-door to share information, perform tests, prescribe treatment for minor cases of malaria and urinary tract infections (UTI) and provide medication – essentially, providing frontline health services.
For example, I’m trained specifically in HIV counseling and testing, but also do malnutrition and malaria prevention, diagnostics and treatment. I also collect data and report it. When a situation demands further management, I refer the patient to a health facility and encourage them to seek care. If they need a little extra help, I escort them to the facility, and make sure they are taken in charge.
A practical example of this is my own situation! My contract was funded by USAID and was terminated last January, a year ago. Things have never been the same since. Though I still work a few days a week, I have to shift my attention to other activities that will help my family and I get by. I can’t work like I did when I was getting paid.
Beyond CHWs, other health personnel have been affected, and the survival of our communities as well. Because CHWs can’t manage cases within the communities anymore, and because there isn’t a permanent presence from CHWs at the local health post, the bigger health facilities become congested. The staff can’t keep up, despite the government’s efforts to employ more people. And because the government can’t provide many slots, it becomes very competitive to find a paid position even as a professionally trained CHW.
Of course, I would really appreciate being on the payroll someday. It would be motivating to get some support for my work!
But that’s not why I became a CHW. I was inspired by a nurse I met when I was hospitalized, because of the way she treated me. She was looking forward to seeing me well again. I was working as a secretary at the time, after having completed training in computer programs. But I was so touched by the way she treated me, helped me out, and wished me well up until I got better, that I decided to become a health worker as well.
The same facility offered the chance to train as a community health worker. The arrangement was that they would recommend your application on the condition that you came back to the same community to work after graduation. And I loved it that way. So I went to school!
Thinking that I can now help restore someone’s health, and that I’ve done it several times makes me happy. Helping them recover makes me happy. And knowing that I can inspire them like that nurse inspired me is what gives me the strength to go on whether I’m getting paid or not.
It’s a way of collaborating with other independent countries to work together on the same goal – in our case, building a strong health system for all. We can offer each other the support that we need, and learn from each other. We might be doing similar work, but we face different challenges, or we sort them out differently. Exchanging our knowledge and collaborating would improve our work, and motivate us all.
READ ON: solidarity to meet the moment: a conversation with Rosemary Mburu
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