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Using Leadership Skills to Improve the Health of Those in Underprivileged Communities

Dr. Zyh Akumawah is a 2022 McCain Global Leader and is the founder and medical director of Easy Health, an organization aimed at improving the health outcomes of people trapped in conflict, hard to reach communities, and underprivileged communities through the utilization of telehealth. Her passion and drive are the hope of someday seeing universal health coverage across Africa, which she believes will happen through the use of growing technological advancements in digital health, which are invaluable to this effort.

I was raised in a small town in Cameroon called Bamenda. It is the capital of the North West region, which is one of the two English speaking regions in Cameroon. Many will say it’s a city or town, but I will like to refer to it as a semi urban area with the kindest people. Everything seemed to be stable until about six years ago when years of accumulated gruntles burst into a full blown sociopolitical crisis. A story that began as a one-day peaceful protest has dragged on as an unending war between separatist fighters and the Cameroonian military.

It is usually said that when two elephants fight, it is the grass that suffers. This is the reality of the people on the ground. The fighting has led to gross human rights violations. Hospitals, schools, homes and markets have been burnt down with many losing their primary and only source of income. Families have had to flee their homes to become internally displaced persons and refugees in neighboring Nigeria. The rates of rape have drastically increased with victims having zero access to any reproductive health services. Everyone knows at least one person who has been killed due to the conflict.

The intensity of the conflict is worse in rural communities as self-proclaimed “separatists fighters” see these as favorable grounds due to the difficult terrains and very bad roads.

Most rural communities in Cameroon already suffer from poor health infrastructure and limited medical personnel to cover every community. The growth of the conflict has therefore forced the few skilled medical personnel to flee these areas. Everyone just wants to live. This is not peculiar to the rural communities but also for the town of Bamenda.

Regions plagued by conflict have both emergency, as well as non-emergency health challenges. While the focus on  emergencies like gunshot wounds is appreciated, a majority of humanitarian relief agencies turn a blind eye to existing disease conditions that have been crippling the health system for years. It’s fair to say that in most conflict regions it is way better to have a gunshot wound than having malaria or hypertension. There is a general lack of trust among humanitarian institutions and some communities because of the likelihood of there being an agenda. On many occasions, most agencies fear being attacked. However, in my experience working in a conflict region for about five years, healthcare is one area where separate groups at loggerheads are able to compromise on.  There is no rule of law so power, therefore, shifts to people who have resources like food, weapons or healthcare. He who serves as a major stakeholder because of his involvement in the healthcare of the community can contribute to sway opinion that can help the peace process.

I have always believed that digital health is the solution that will help Africa achieve universal health coverage especially through mHealth and electronic health records (EHR). For a long time, most governments of low income countries  have been trying to solve the high doctor patient ratios by training and recruiting more doctors into the medical fields. Unfortunately, this has proven futile as a majority of young doctors quickly find their way to more advanced countries with better pay. They also prefer to work in bigger towns where their kids have access to better schools and amenities.  A survey carried out by the EasyHealth team showed that more than 80% of medical personnel detest working in rural communities, because they see the environment as unfit for them to have and raise families. With conflict came a great migration of the few skilled personnel from rural communities into the more urban areas. Conflict brought in great despair; lives were lost and all hope was gone. With the burning down of hospitals, patients must travel very long distances for care. Most times arriving in more complicated states and decreasing their chances of survival. Having all this in mind, EasyHealth sought a solution that will make use of existing medical doctors working in their desired locations while remotely consulting patients found in the most rural communities and conflict areas  of Cameroon. Patients in conflict zones are therefore able to be consulted remotely by medical doctors through a community health worker.

Community Health Workers (CHWs), are persons within the communities who are trusted by all stakeholders. This is because  the CHWs live within the community, can relate with the beneficiaries on many areas hence sharing some familiarity and trust within conflict areas. These CHWs already exist, whose opinions are highly valued and have gained community respect. They are therefore swaying the peace process in their own right. EasyHealth was founded to support these CHWs to provide quality healthcare at community. EasyHealth’s role is not only healthcare, but it empowers CHWs to be community leaders working towards building a community-based movement to foster peace.

Many will wonder why a CHW is needed. Firstly, CHWs are an integral part of the healthcare systems. CHWs are trusted community members who patients have been able to trust over time. CHWs also understand the local languages, making them resourceful in cases where patients only speak the local dialect in communities where the healthcare system has been fractured by escalating conflicts. Therefore, CHWs are a saving grace.

Unfortunately, they are not usually armed with sufficient health knowledge to make more robust health decisions. However, they are able to make basic assessments through continuous trainings. This is why CHWs are able to connect patients with doctors remotely and together, offer high quality medical services to rural patients in conflict zones at very affordable rates. While CHWs are presently unable to use more advanced digital health tools, mHealth and the use of electronic medical records are helping to advance care for patients in the world’s most neglected humanitarian crisis.

All of this would not be possible if the EasyHealth team did not believe that advancing healthcare in areas plagued by conflict could lead to community resilience and foster peace. The team has been able to move to the communities to carry out medical campaigns that have brought hope to the community. The fact that these people know that someone cares gives them hope for a better future and a reason why they forge ahead despite living amidst gunshots and blasts.

The McCain Institute has been a pivotal point in my career. I first came across the name Senator John McCain in 2008 when he was running against then Senator Barack Obama in one of the most popular American campaigns of all time. I was 14 and truly amazed when I came across a video where he defended Sen. Obama from a comment his supporter made. I remember asking to myself saying, “Who does this?” He may not have won the election, but he definitely won my heart. I could never have known how to describe it back then but that was a perfect example of a character-driven leader. As a person of principle in a world plagued by corruption, embezzlement and dishonesty, I choose to be a person driven by purpose and character. The McCain Global Leaders (MGL) program has encouraged me to re-evaluate my leadership trajectory to become a more inclusive and dynamic human.

During my time learning in the MGL program so far, I have been able to make clearer and better decisions for the organization. With my acquired knowledge on better understanding adaptive and technical challenges, evaluating my personal leadership style and getting opinions from other McCain Global Leaders about their views on world issues, I have been able to build confidence in my leadership, able to make better decisions and move towards leading the organization better. Through the program, I have been able to connect with other leaders and work to partner with them on various projects.

I can tell you, without a doubt, there are millions of people in conflict regions who lack very basic necessities and are finding life very difficult, both financially and emotionally. Most organizations lack resources to carry out the humanitarian work to hope to do. Volunteering time, finances or ideas can be of great help. Also, helping to share stories of work being done within networks creates awareness.

Being in a position where I am able to help my community and work towards solving major health issues with the bare minimum available resources is something I do not take for granted. I hope that the organization I have helped create will continue to save lives.

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DISCLAIMER: McCain Institute is a nonpartisan organization that is part of Arizona State University. The views expressed in this blog are solely those of the author and do not represent an opinion of the McCain Institute.

Dr. Zyh Akumawah
Publish Date
September 23, 2022