Scaling Up: Expanding Community Health Worker Programs for Refugees and Internally Displaced Persons in the Bururi Province, Burundi, East Africa

Presenter: Alex Goodell, Biology

Burundi, a small and often-forgotten country in East Africa, lies directly south of Rwanda. Though poorly covered in the media, Burundi suffered a similar conflict as its northern border, with ethnic-driven violence plaguing the nation for 13 years. When the conflict officially ended in 2006, Burundi was ranked as the poorest country in the world. Its health statistics are equally low. According to the WHO, one in five children die before their fifth birthday, half of those driven by malaria. Only 200 doctors serve the population of 8 million and most of the poor have no access to healthcare. In some areas, days of walking are required to reach the closest physician. Additionally, hundreds of thousands became refugees or internally displaced persons during the conflict and have little access to resources. In this setting, the use of “Community Health Workers” (CHWs) is appropriate. Village Health Works, a small clinic in the rural Bururi province, has implemented a small CHW program similar to Partners in Health. Over a six-month period in 2009 and 2010, data was collected on 10000 patients regarding their medical status, location, and demographic information at VHW. Additionally, GPS data was collected on the location of the CHWs. This presentation looks at the history of CHW programs worldwide and analyzes the health metrics of the area surrounding VHW. It then makes a series of suggestions on how VHW could better serve its patients with CHWs, specifically focusing on refugees and internally displaced persons.