It is designed in a way to secure healthy condition for the people resident in the selected sites and the students come into contact and become familiar with the communities they will work for after the completion of their education. Two sites were chosen (one urban and one of agropastorlist) so that the students understand the pattern of the diseases in different geographical locations.
It was started with Daraymacane village (agropastorlist) because of its accessibility and manageable population to attain better health and better quality of life for all those who are living in Daraymacane.
The objective was if this succeeded it could be replicated to other parts of Borama district, to the region and finally to whole country.
The second site of Sheikh Osman section of Borama town was started in the academic year 2011-2012.
The community of these sites were involved to assume responsibilities in defining their needs, identifying priorities, mobilizing their local resources and organizing themselves through a series of simple activities aimed at meeting the essential needs of the individual, families and the community. These activities will be implemented by
Involving all social groups in the community sites
Educating the community and building awareness
Bringing about constructive development by consensus
Promoting self-help and self-reliance
Promoting bottom-up community based approach to integrate socioeconomic development and promotion of health lifestyles through increased family income, self-care and provision of basic needs.
Patient in Daraymacaane referring to Hospital
All these activities are focused on producing a direct impact to improve the life and the health status of the community sites. The development of the community is categorized through:
Activities that can be accomplished by the community with little or no support from outside
Activities that can be carried out jointly by College of Health Sciences and the community without further intervention from outside
Activities that need outside involvement.
In order to carry successful activities, the community and students work together. Each party carries out certain tasks in promoting the life of the community. For the community a committee (Village community development) is formed composed of representatives from the different quarters of the community sites. This committee acts as a liaison between the community and College of Health Sciences. The community development committee is trained in methodology of learning by doing, skills in leadership, self-management and self –financing.
Each student is assigned to 2 families, which he or she will follow during his studies. The student has to observe the importance of confidentiality. Within the families, each student follows up children and mothers noting their growth and development and assesses the health status of other members of the family. The student keeps records of the members of the family (income, pulse, BP, heart sounds, weight and height). The student also observes and notes the environment and social characteristic of the family, relationships among members of the family and the effects of the extended family on health and disease.
The students also carry out the following activities:
Students identify the health abnormalities of the community sites and then study them as a problem.
Students are introduced to the methods of assessing health problems in the community (including data collecting, analysis and interpretation) and decide on priorities and intervention on the basis of specific orientation community diagnosis. The students identifying other problems within the community in collaboration with committees from the community, decide on priorities and look solutions for the problems they identify with the community committees.
The students study the role of the community’s socioeconomic and other factors in order to prevent development of diseases.
Students study the relationship between environment and host.
Team work is enhanced so that students could learn much from other members of the team.
The community committee and the students identify together the education and socioeconomic problems facing the community, prioritize the problems, classify according to who will be assigned to solve them, time frame and targets in managing the problems. Those targets must be clear, simple and realistic to motivate the community. College of Health Science students guide the community committee development and the community in the feasibility of solving different problems taking into consideration community needs, extent of the problem among families and impact of people’s quality of life.
Baseline surveys were carried out before the start of the community activities to get database for actions, plans and evaluation of the activities. It highlighted the actual problems and needs of the community and indicated ways to solve it. Baseline survey included:
household surveys were was conducted on house to house basis in order to obtain information about the families (family members, their age, sex, major income resources of the family, number of children, vaccination of the children, prevalence of chronic diseases and disabilities within the family).
Baseline community survey on the availability of facilities, safe drinking water, sanitation and hygiene, environment, nutrition, literacy and skills etc.
Surveys on vital indicators of health status such as crude death rate, infant mortality rate, maternity mortality rate etc
The community was also assessed for its response towards the development activities, its level of participation, acceptance and ownership of the activities and sustainability of the development projects.
While emphasizing the preventive and promotive aspects of health care of the community the essential curative services was carried out also. The overall focus was on communicable diseases, common nutritional disorders and environmental health and hygiene, with a special attention to the conditions constituting the major elements of the burden of disease: reproductive health care, treatment and control of basic infectious diseases (upper respiratory tract infection and tuberculosis), control of epidemic diseases (especially malaria), immunization. Information, health education and communication about health and nutrition are strengthened.
Activities students implement in community sites are aimed at:
Promotion of the health of the community (through health education which focused on the sanitation, water, lifestyle “Kat eating and smoking” and nutrition..
Treating those who are sick.(diseases process intervention)
Carrying out preventive measures such as vaccination of children who are less than 5 yrs of age
And schooling for the children.
Community activities achievement:
communities put their trust in the project and are actively participate
Early presentation to the health services
The sanitation of the Village improved dramatically with the disposal of solid wastes in front of their homes decreased and villagers began to burn or bury them.
Complete vaccination coverage of all children under five years of age are regularly given to the new born babies (no outbreak of measles for the last years even though it happened in the surroundings of Daraymacane and Borama city.
Preventive medicine is being recognized as an important aspect of health status
Students have already contacted the communities they will work with after the completion of their education. Following the patients from their early manifestation of the diseases to the tertiary stage (students treat the patients at site. Those who need further investigations and treatments were taken to the teaching hospitals of College of Health Science. Students assigned to the family follow up the patient in the hospital).
Inter-sectorial development including the schooling and upgrading of agricultural production through interventions from the faculty of agriculture which did not exist before College of Health Science engagement with community has been materialized. The Amoud university medical students were instrumental in recruiting students, hiring teacher, equipping the school and rehabilitating it.
Other Community services
Mental Health Activities
Amoud University College of health sciences has been involved in a number of community-based programs intended to provide basic health care to the communities and develop a good learning environment for its students. Mental health illnesses are prevalent in Borama with no mental health services. To find a solution and follow the guidelines of WHO mental Health policy for the underdeveloped countries College of Health Science started a mental Health services and integrated into the community based programs College of Health Science was already involved. It is the first community-based mental health service in Somaliland. The aim was to establish a comprehensive and sustainable community based mental health care in which a large number of patients requiring mental health care could have the opportunity to be treated. It has two components namely the community mental health services and the psychosocial intervention for chronically mentally ill.
The aim was:
To improve access to quality mental health services at community level at the health care facilities in Borama district.
To advance de-stigmatization of mental disorders through intensified advocacy campaign and health promotion activities.
To develop learning environment for the students.
Because of this project, a large number of patients suffering mental illness for a long time have been cured and re-integrated back to their normal life. The entire burden of the mentally ill is left to the family. This is costly in terms of money and manpower to the family in particular and to the whole society in general.
Stigma of mental disorders through advocacy campaign was also reduced. Families have started to bring their patients at an early stage instead of going to the traditional healers. The integration of mental health services into primary program is very helpful and tangible. This proved that community mental health service is the best way to reach out the outnumbered mentally ill clients in Somaliland and needs to be replicated to the other parts of the country. It tends to be cheaper for patients to get mental health care and follow up in a country where mental health facilities either is in a bad shape or not existing in most of the towns. The community program reached patients that would have never come to clinical care like chained people, people who could not afford any service. This offers good source of education for medical and nursing students in the country.
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