It was a shocking experience when Jean Bosco Nkundakozera’s grandson started shivering due to fever one Saturday of June, 2021.

Nkundakozera, 74-year-old from Muko sector, Musanze district in the Northern province does not remember the exact date, but says it was the worst evening ever.

It all started at 5PM when his grandson developed high body temperature. The grandfather soaked a cloth and started placing it on the head and chest of the child to cool temperature.

Towards wee hours, the child’s condition deteriorated and Nkundakozera started saying prayers of all kinds, with much worries.

He recalled that there was in his neighborhood, a volunteer who is always ready to intervene, at any time of the day; a community health worker.

He grabbed his phone, called and explained to the health worker, the condition of his grandson.

In the following 15 minutes, the health worker was knocking on the door with his first aid kit. Nkundakozera opened the door and ushered him to grandson’s bedroom.                                                                                                                                                                                                                                               

 “The first thing he asked me was why I called late when the child was sick since early evening, but the answer was straight; I thought I could manage alone with that piece of cloth soaked in water,” Nkundakozera confessed.

“He opened the first aid kit to diagnose and within a couple of minutes, he had confirmed that it was Malaria.”

After the diagnosis and results indicating that the high body temperatures resulted from Malaria infections, Nkundakozera said that the child was given Coartem drugs and advised to eat balanced diet for quick recovery. According to Nkundakozera, the work of community health workers is without precedence.

"Wasn’t the community health worker available, I could be compelled to walk my grandson 15 kilometer to Muko health centre, which is most tiresome at my age,” he said.

“They (health workers) are always available, when we need them. They walk long distances to give health advice and service.”

The Community health worker program began in 1995 with a network of 12,000 volunteers. They are three per village including a Maternal Health Animator (Animatrice de Sante ́ Maternelle), one male and female respectively called Binôme.

They are trained in preventing, diagnosing and treating Malaria and to solve other primary health issues of concern.

This is on top of giving health advice to the community.

According to the Ministry of Health, Community Health Workers have currently increased to 45,000 people.

They are important people behind the reduction of Malaria incidence in partnership with government and non-government organizations including Pro-Femmes Twese Hamwe (PFTH) through the Global Fund/CCM.

Pro-Femmes Twese Hamwe (PFTH) is an umbrella organization working for the advancement of women, peace, and development in Rwanda while the Global Fund is an international financing and partnership organization that aims to attract, leverage and invest additional resources to end three epidemics namely Malaria, HIV and Tuberculosis.

In this partnership, Pro-Femmes Twese Hamwe has been conducting a campaign to give more training and skills to residents and Community Health Workers about Malaria causes, prevention and treatment.

“We were trained to prevent malaria and to treat it. The disease is caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes, thus the call to always sleep under treated mosquito nets,” Jean Uzabakiriho, a health worker in Rwahi sector, Gakenke district, Northern Province said.

According to the Rwanda Biomedical Center (RBC), the combination of treated mosquito nets, prevention campaigns, indoor residual spraying and preventive interventions has seen Rwanda slash malaria cases by 71% between 2016 and 2021.

Malaria cases increased to 2.5 million in 2020 from 1.8 million cases two years earlier.

However, the number dropped more to 1.4 million cases since the second half of 2020 onward.

 “Malaria has reduced, but it is still around, the good thing is that we have been trained now to understand that it is preventable,” Nkundakozera said.

In the meantime, his grandson recovered and he is contributing to the wellbeing of his family.