Improving Health Care for the Most Vulnerable… Every Child – the Right to Survive and Thrive

Rising before the crack of dawn, getting dressed, packing up the small children, getting the older ones fed and ready for school… standing on the roadside to catch a bus or walking out to the main road or a bigger community to catch a bus… this was the story of women, children, anyone for that matter residing in Santa Teresa who needed to visit a medical facility equipped with a laboratory and staff to give that service. This is if the weather is good… if it is not rainy season. In those times, an hour and a half travel make take as long as three hours or worst – not be possible at all.

But no more… the health center of Santa Teresa now has a medical laboratory and staff of its own.

Elena Sam, 34-year old and mother to her very first baby – a now 3month old baby boy recounts how difficult it was to get to a clinic where she could get her pre-natal medical lab tests completed. It was not until her very final visit before birth that she experienced the ease of just walking a few minutes to get to her village health center and receive medical laboratory services right there at home.

“It was so much easier for my last visit before giving birth. Being late in my pregnancy, it was so much better,” she said. She reported that she didn’t have to be concerned about riding on the rough road, the hassles of trying to meet a bus schedule with runs few and far between, nor being away from her village for the entire day. “I am happy other mothers won’t have to go through what I did,” she said.

Just down the road, 51-year-old Ansanciona Teul relishes the same. Mother of 5 children, she was accustomed to traveling the long bumpy dusty road or delaying travel because of bad weather or no money to pay for bus ride. Now with a diabetic condition and still her last child, a girl of 11 years old, she is happy to have a health center equipped with a medical laboratory. As she spoke to us in front of her wooden walls, thatched roof and earthen floor humble home, her husband looks on with a smile.

Just down the road, 51year-old Ansanciona Teul relishes the same. Mother of 5 children, she was accustomed to traveling the long bumpy dusty road or delaying travel because of bad weather or no money to pay for bus ride. Now with a diabetic condition and still her last child, a girl of 11 years old, she is happy to have a health center equipped with a medical laboratory. As she spoke to us in front of her wooden walls, thatched roof and earthen floor humble home, her husband looks on with a smile.

“I don’t have to worry about passing out because my sugar is high,” she said. “I can walk just down the road to get my sugar tested. I can do it every month now. I don’t have to get up at 2 in the morning to take a bus or not go to the clinic in San Antonio because I don’t have money to pay a bus.”

For UNICEF, our work is anchored on five important pillars. The first being every child’s right to grow up healthy and strong. Poverty, poor health, malnutrition, and inadequate care and nurturing practices prevent millions of children worldwide from surviving and thriving. In Belize, according to the MICS5 of 2015, we still report 18 out of every 1,000 babies dying at birth. No doubt this situation is owing to poor health and nutrition of the mother but also to the lack of proper pre-natal medical care.

While Santa Teresa always had a health center and serves an important catchment that includes a dozen villages, it did not have a laboratory equipped to conduct basic medical tests. With the funding from PROBITAS Foundation and the collaborative efforts of the Government of Belize/Ministry of Health and UNICEF work towards building the laboratory started in 2017 and culminated with the official ribbon cutting for the opening of the laboratory in June 2018.

The facility is staffed by a laboratory technician who has passion for his work. Aristo Cal has been coming to Santa Teresa for more than a year. At first without a lab present, his job was once a week to visit the village health center, take samples and travel back for about an hour and a half to his duty station in San Antonio Village to conduct the necessary tests and upload the results in the Belize Health Information System (BHIS). However, since Santa Teresa does not have access to the BHIS, he would have to travel back the next week taking the tests to the doctor and nurse in that village. Needless to say, the responsiveness for the health care of patients suffered. If the doctor suspected an emergency outcome, he would rely on a phone call from Cal to inform of the results. Still not an optimal situation.

With the successful conclusion of the laboratory, the patients are now able to receive full blood count testing, platelets and blood typing tests, chemistry testing, cholesterol and glucose tests, HIV, Dengue testings, urinalysis and parasitology medical checks. The facility also has its own solar electricity system with a backup diesel generator and water storage tank. All to ensure that service can be available despite any eventualities. Santa Teresa is not on the national electricity grid system and relies on wells and hand pumps for water. A few homes have small solar panel systems used for electricity.

With a broad smile, Cal said “I think my job chose me. I love what I do. I am most happy to know that people are receiving service and care. I do believe that the people in Santa Teresa will be healthier because they now have this service.”

The benefits realized in health care is not only experienced by Cal and his team of Ministry of Health professionals responsible for the management of the health services in southern Belize, but the lessons learned in Santa Teresa is having a transformative effect in the national planning for medical care in Belize. Ms. Lizette Bell – Director of Project, Policy and Planning in the Ministry informed that the normal planning for health did not include placing laboratories in health centers. She explained that while the project to improve laboratory infrastructure and equipment in the Southern

Regional Hospital in Dangriga, improvement of equipment in San Antonio, Toledo and the construction of the lab in Santa Teresa, Toledo fits like a glove into the national health strategy and is well aligned with the national development strategy for the country; it is also resulting in some revolutionary thinking and strategizing.

“The lab in Santa Teresa and the positive benefits it represents for our people who most need it is now letting us relook at our normal practice and reconsidering whether it is appropriate to identify laboratory services for health centers in

key and strategic communities,” said Ms. Bell.

She continued to explain that the uniqueness of the project lies not just in this feature but also in the capacity building medical laboratory professionals across the health system were able to receive.

“This has resulted in a truly positive impact on the quality of health care services. The entire network of human resources was trained resulting in a broader network of capable persons improving clinical surveillance, allowing for early identification of conditions, raising alerts and information for action,” she concluded.

The professional enthusiasm is shared by the chief technical strategist for health care in the country – the Chief Executive Officer Dr. Ramon Figueroa. He said, “Initially it was a surprise that a funder – PROBITAS – wanted to invest in infrastructure and equipment.” Quickly he added, “But we did not hesitate”. UNICEF has been a valuable partner over the years and with the presentation of PROBITAS, it was an opportunity.

The project fits into government’s strategic planning for the development of the health sector. It satisfies principally the efforts for primary preventative, inclusive and comprehensive coverage. The project allowed the Government to improve infrastructure and technology, especially for remote areas, while enhancing human capacity, motivating staff by presenting environment conducive to work, and overall improving quality of service. Next steps now include the

Ministry’s continued methodical improvement of infrastructure, upgrading facilities nationally, with the key being finding financing strategies that are compatible and sustainable.

With that in mind, Dr. Figueroa remarked, “The expansion of our collaboration with PROBITAS in the remote areas of Northern Belize is a logical investment with a partner willing to work with us to improve lab and imaging infrastructure.” He concluded with an expressed pleasure to take immediate advantage and build on the successes already realized.

His concluding words resound, “Investment in health and health education drives social change with benefits for economic and national development. Health is not an expenditure, but an investment.”

Driving for results for the most disadvantaged families, children and young people… #ForEveryChild… Towards the

Agenda 2030 - Sustainable Development Goal #3 - Good Health and Wellbeing for All