"Community mothers" and "health travelers" (Caminantes de la salud) are two of the groups of health promoters who visit Colombian neighborhoods to offer information, help eliminate mosquito breeding sites, answer questions, and detect possible cases of Zika virus infection for referral.
Barranquilla/Cúcuta, Colombia, March 14, 2016 (PAHO/WHO)- "It's beautiful work and we do it from the heart. We're not even earning pocket change, but it's wonderful because we work with families and while they learn from us, we learn from them," says Rosa Chona, a community mother in Cúcuta, located in the north of Colombia, one of 31 countries and territories affected by the virus in the Americas. She is one of a group of 12 women who periodically visit families in different neighborhoods in this municipality, offering information and advice on prevention, and answering questions about different health issues. Lately, Zika has become a hot topic and on their visits, the women work to confirm that the dwellings do not contain recipients that could serve as breeding sites for the mosquito that transmits Zika, as well as dengue and chikungunya.
On each visit, "we explain what to do to prevent mosquito breeding sites. We tell them how to prevent bites and invite them to fight these viruses not only in their homes, but also in the community," says María Eugenia Fernández Ruiz, another of the community mothers belonging to the Fami Torcoroma association, part of the Colombian Family Welfare Institute. Each woman is assigned 12 families to visit at least once a month. They also give talks on prevention in the neighborhoods and hold weekly meetings with pregnant women. "We talk to them a lot about Zika because several cases have been reported," says Fanny Anaya, another member of the Cúcuta group in the north of Colombia, which is one of the 31 countries and territories of the Americas affected by the virus.
The community mothers agree that the families they visit have many different concerns and that, since the women visit homes in their own neighborhoods, they share the same concerns. "Many fear being re-infected by the mosquito. They've already gone through dengue and chikungunya, and now it can give them Zika. And many women are pregnant, so we pass on information to encourage these mothers to go and get check-ups at health centers and take the necessary prevention measures so that their babies are born healthy," María Eugenia adds.
Every 15 days, the 12 women meet to discuss the issues they will be addressing in their neighborhood visits and talks. "We have very low-income families. Sometimes it's out of their hands because they don't have all the resources they need to solve their problems, but we point the way forward. As citizens, we try to help the rest of the community," Rosa explains. '
'Walk for Health' Promoters
The same thing is happening in many Colombian cities where community health workers visit homes in their neighborhoods to promote prevention, focusing on the breeding sites of the Aedes mosquito, which transmits dengue, chikungunya, and Zika. As health agents, they have also become key partners in detecting cases and referring them to health centers.
This is the case of the Walkers for Health, a group of 400 health promoters in Barranquilla. Each of them is assigned a number of houses to monitor in a particular neighborhood. "They do active case-finding, identifying pregnant women with Zika, connecting them with health centers, and continually searching for mosquito breeding sites," explains Alma Solano Sánchez, Health Secretary for the district of Barranquilla.
Every morning in the streets of Barranquilla, the travelers can be seen out in the heat knocking on doors, talking to neighbors, filling out interview forms, and helping clean out containers that could be mosquito breeding sites.
The Pan American Health Organization/World Health Organization (PAHO/WHO) recently carried out a mission with a multidisciplinary group of experts from several countries to support efforts to respond to the Zika virus outbreak in Colombia, where 47,771 people have been affected, including 8,890 pregnant women, according to data from the country's health authorities.
Zika is a mosquito-borne virus that is new to the Region. Since Brazil reported the first cases of local transmission in May 2015, the virus has spread to most of the Hemisphere, a situation made more serious by its possible association with cases of Guillain-Barré syndrome and microcephaly in newborns.
PAHO has developed a strategy to help countries mitigate the impact of Zika by strengthening their ability to detect the introduction and spread of the virus, reduce mosquito populations, guarantee the necessary health services, and communicate effectively with the public about risks and prevention measures.