We all know the saying: “to walk a mile in someone else’s shoes”, but have you ever imagined yourself walking a mile in a community health worker’s (CHW’s) shoes? 

If you can imagine it would look something like this: you are walking the dusty streets of your community. You have been walking for 5 km already with a heavy backpack filled with medical equipment, medication, educational tools, and if you are lucky some personal protective equipment (PPE). You find yourself knocking on the next house’s door – this might be a follow-up visit, medication drop off, or screening. In the midst of the COVID-19 pandemic, you don’t know what you will find and if the occupants of the home are infected or not. You find yourself anxious because you either don’t have enough PPE to protect yourself, or you have no PPE at all. 

Once the door is opened to you, you have to deal with the stigma associated with CHWs bringing COVID-19 into the community. Some people might send you away because of the belief that you will infect them, others might invite you inside because they desperately need the services or medications you offer. Before you leave, you will most certainly be asked if you can provide the house occupants with PPE, which unfortunately you can’t because you don’t have any. As you leave the house you are once again hit by the African heat and you find yourself continuing over rough terrain to the next house. 

CHWs are members of the community, chosen by the community or organizations with the goal of providing basic health care in their district. They are an extension of the primary health care system and due to the fact that they are chosen by the community for the community, they are trusted and therefore able to provide health care on a household level. [1] Community health workers are positioned to engage at the community level to ensure millions of lives are saved at a higher rate and lower cost when compared to facility-based care. [2]

To date, community health workers have been undervalued and underappreciated but due to the COVID-19 pandemic that is changing. CHWs are the cornerstone of COVID-19 response across the globe. These extraordinary people proactively search for patients, provide at-home or in-clinic health care services and education, and if necessary refer patients to appropriate facilities. [3]

In an article written on Bebe Bola, a community health worker in the Democratic Republic of the Congo, she said: “Since being in the midst of the COVID-19 pandemic, the work has become a little more difficult to do because we are in the field every day raising awareness, tracing contacts and going door to door without having enough equipment to protect ourselves. This exposes us to the pandemic because we meet people who do not present the symptoms, but after you learn that they were infected with COVID-19. We only have a few pieces of hydro-alcoholic gels and a small number of masks, but this is not enough. We need the protective materials to continue to do our service well.[4] This was Bebe’s response to the question: What has your work been like during the COVID-19 pandemic?

This statement made by Bebe Bola is powerful and informative at the same time. Her statement sheds light on the challenges the CHWs face every day, one of which is the lack of personal protective equipment (PPE). Lack of PPE isn’t a challenge for just Bebe Bola’s community but a global problem for thousands of community health workers. We can all agree that the responsibility lies with the PPE providers to equip and protect those serving their communities as CHWs with PPE. The reality is that PPE providers have many hurdles to overcome in order to provide their products to those who need them most. These challenges include but are not limited to logistics, funding, availability, etc. 

Stellenbosch Nanofiber Company identified these challenges and decided to create the Rethink Reusable Surgical Mask™ with the aim of reducing the hurdles for PPE providers and therefore reduce the challenges CHWs face with regards to PPE. We decided to focus on creating a removable and reusable face mask filter with nanofiber technology that can be used up to 10 times. Between uses, the filter can be disinfected with boiling hot water. The Rethink Reusable Surgical Mask meets the stringent European Standard EN 14683. 

The innovative design of the filter ensures high bacterial filtration efficiency, sustainability, and lower logistical costs. Bacterial filtration efficiency is greater than 98% as a result of the nanofiber technology, sustainability as a result of the filter being able to be used 10 times and disinfected with boiling hot water, and lowered logistical costs due to the fact that only 3 filters are needed per CHW per month in comparison to 30 single-use masks. To put reduced logistical costs in perspective, this means you will only need 1 shipping container filled with Rethink Reusable Surgical Masks instead of 8 containers filled with single-use masks. We are grateful for and appreciate everything the CHWs do to serve their communities and ultimately their countries which is why we believe these amazing people should not be put in the position where they need to stress about PPE. The Rethink Reusable Surgical Mask™ is our solution to the challenges CHWs face in terms of PPE. 

Resources

[1] KwaZulu-Natal – Department of Health. Community Health Workers. http://www.kznhealth.gov.za/chw.htm

[2] School of Public Health – University of Western Cape. Community Health Workers: What do we know about them? https://www.who.int/hrh/documents/community_health_workers.pdf

[3] Muso. Our Model: Proactive Care. https://www.musohealth.org/the-muso-model

[4] Covid-19 Action Fund for Africa. Stories from the Frontlines: Bebe Bola. https://cafafrica.org/2020/12/23/stories-from-the-frontlines-bebe-bola/