Tuesday, May 27, 2014

In the Tracks of Community Workers

A journey to post-delivery care

"It's crucial that I have a close relationship to the parents to be able to not only inform but also to give way to behavioural change", says Bora Nhran, ECCA in Pou Chhorb village, Mondulkiri
© UNICEF Cambodia/2014/Victoria Enstrom


MONDULKIRI, Cambodia, 14 May 2014 - In the small village of Pou Chhorb, on a ridge in Mondulkiri, laughter from scores of children playing and music from a wedding is in the air. In this village there is a new Community Pre-school where eleven children attend for one hour every day and almost all the households in the village have a toilet or are on their way to building one. Bora Nhran is one person who is very cheerful about these developments in her village. She works as an ECCA, Early Childhood Care Assistant, and is an important person in her community where her role is to deliver information on early childhood care to the community.

Today Bora is walking around the village talking to families about the importance of hygiene, sanitation and going to school. Part of her role is also to help her community get access to services such as birth registration, vaccines and antenatal care and delivery at the health centre. She first pays a visit to a house on stilts where ten people live and two sisters are home breastfeeding their babies. “Bora tells us about hygiene, sanitation and looking after the kids. She also taught us about exclusive breastfeeding. Before we never knew about exclusive breastfeeding!  Me and my sister now both got prenatal visits, checkups and delivered (our babies) at the health center because of Bora.”

Bora also visits a household of eleven people who live in two small houses made of sparsely placed planks. Phea Phon is with Lisa, her three year old daughter, busily boiling water on a burning fire. “Since my mother stays at home and it is really close to the Community Pre-school, my daughter can go there every day. She has attended for six months. The ECCA informed me about the importance of sending my daughter to the school so I decided to. She really likes it because there she can sing songs and read the alphabet and learn how to count”, says Phea.

Phim Krek with Theara Rottana, 6 months, in Pou Chhorb village, Mondulkiri.
© UNICEF Cambodia/2014/Victoria Enstrom
There is one ECCA in each of the three villages in the commune of Dak Dam. They were recruited by their respective communes and trained on early childhood development as part of a pilot project initiated by the Ministry of Interior and UNICEF in three rural communes in Cambodia.

The pilot project was launched in 2012 due to a low level of literacy and high infant mortality rate in rural Cambodia. Real progress has already been made. “I could never get any information about social services in any other way than from the ECCA since I don’t have a TV or Radio. So the ECCA is essential for me. I gave birth at home and had never visited the health centre”, says Phea.

Terch Psang, standing outside a house in her village in Mondulkiri province, has just informed a mother of five about the importance of clean drinking water and good hygene.
© UNICEF Cambodia/2014/Victoria Enstrom
 Terch Phsang who is 25 years old is another ECCA in this commune. She was recommended by the commune to apply for the role as she is one of the few adults in the village who can read and write, a skill which is needed to fill out the village registration book. In a house made of palm leaves she is talking to a Ren Cliv, a mother of five daughters, about the importance of clean drinking water and good hygiene. The dark one room house is filled with children and neighbouring families. “I have informed this family three times before and they have changed. They are now drinking boiled water and the house looks cleaner”, says Terch and points to a bucket of water in the corner which is now only used for washing. “The ECCA taught us about hand washing with soap prior to meals and after defecation”, the mother Ren Cliv says.

The commune chief of Dak Dam, Vanny Som, is hugely supportive of the work of the ECCAs since they have a holistic life-cycle approach and are living in the villages which makes their work sustainable and less fragmented than some other community volunteer models. Bora thinks there are many benefits of having one community worker in every village. “It is crucial that I have a close relationship to the parents to be able to not only inform but also to give way to actual behavioural change”, she says.

As the people of Dak Dam belong to the ethnic minority group Bunong, whose livelihood is dependent upon growing rice and cassava as well as clearing land, many children follow their parents to the fields and do not have access to social services. The Early Childhood Care Assistants are making a real difference in these communities.

By Victoria Enström

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