community health toolkit

COMMUNITYHEALTHTOOLKIT

The Ebola Community Action Platform has been funded by the American people through the US Agency for International Development (USAID)

MOH

This toolkit was made possible with support from the American people

through the U.S. Agency for International Development (USAID). The contents

are the responsibility of Mercy Corps and do not necessarily reflect the

opinions of USAID or the U.S. Government.

ECAP II Community Health Toolkit : Liberia A 3

This is a simple guide to help Community Health

Committees (CHCs) do health awareness in their

communities. It uses approved information from

the Ministry of Health and partners about some

common health issues and diseases.

This book is a tool to support disease prevention in

the community. It should not be used for diagnosis.

If you are worried about your health, it is very

important that you go to the clinic for help. In case

of any questions on the content of the book, CHC

members should seek guidance from the Officer in

Charge (OIC) at the nearby clinic.

The book has been made possible with the

support of the American people through USAID

and Mercy Corps as part of the Ebola Community

Action Platform (ECAP 2). Special thanks go to

the Health Promotion Division of the Ministry of

Health, Population Services International, John

Hopkins University, UNICEF and IOM for their

valued contributions and for allowing us to use their

approved messages and illustrations.

It has been produced by Laura Keenan, Grace

Merekaje and Brittney Norton from Mercy Corps.

Additional illustrations have been provided by

Frank Dwuye with design support from Andrea

Henning Design.

Introduction

ECAP II Community Health Toolkit : Liberia A 4

STAYING HEALTHYUsing the Clinic 5

Vaccines 6

Handwashing 7

Safe Drinking Water 8

Eating Well and Taking Exercise 10

PREVENTING DISEASEMalaria 11

Ebola 13

Lassa Fever 16

Measles 18

Tuberculosis (TB) 19

Running Stomach 20

High Blood Pressure 22

Diabetes (sugar sickness) 23

TREATING DIFFERENT INJURIESAnimal Bites 25

First Aid 26

BIG BELLY BUSINESSTaking Care of Big Belly 27

Bad Signs 30

Delivery at a Clinic or Hospital 30

After Baby is Born 32

Feeding Baby 33

ROLE OF THE COMMUNITY HEALTH COMMITTEEWhat to do in an Emergency 35

Our Action Plan 35

Support Services and Contacts 41

INDEX

ECAP II Community Health Toolkit : Staying Healthy A 5

Using the ClinicRemember, use the clinic when you are sick or need a check-up!

Your health center is ready to serve you.

Health centers, clinics, and hospitals are the safest place to go for medical services.

The Ministry of Health is making sure all health centers, clinics, and hospitals are giving safe services.

STAYING HEALTHY


VaccinesDifferent vaccines are given to children under 1 year old and big belly at all clinics and hospitals.

The vaccines help give our children a healthy start in life. They save lives, and protect from plenty sicknesses like:

A Polio (crippling)

A TB (cough with blood)

A Measles (spot-spot on the skin)

A Pneumonia (deep cold on the side and chest)

A Tetanus (neonatal tetanus)

A Yellow fever

A Whooping cough

They also give 1 vaccine to big belly women and women that can born to protect against tetanus (stiffness/jerking).

Take your baby to the clinic for vaccines 5 times before they reach 1 year old.


HandwashingWashing hands can prevent plenty sickness like:

A Ebola

A Running stomach

A Typhoid

What are the important times for washing hands?

A Before preparing food

A Before eating food

A After using the latrine or after coming from the bush

A After changing baby diaper or cleaning up a child who has used the toilet


Safe Drinking WaterClean water is needed for good health. Water needs to stay clean at home, and it also needs to stay clean where it is collected. Dirty water causes many different sicknesses!

There are some things you can do to protect your water supply:

A Cover wells to keep out dirt and rubbish

A Build your latrine at least 30 meters away and down from your water source

A Teach your children to use the latrine and not to urinate or pupu near your water source

A Bury pupu far away from your home and water source if you do not have latrine

A Build a platform around your well to keep the area from becoming too muddy

A Keep animals, washing and farming activities away from where you get your water

Keeping water safe at homeIn addition, you make sure your drinking water is safe at home when you:

A Use WaterGuard

A Always use clean buckets and jerry cans to collect water and keep them covered

A Always use a cup with a handle to take water from the bucket or jerry can

Always keep your water source covered!


BUILD YOUR LATRINE AWAY AND DOWN FROM YOUR WATER SOURCE

BUILD A PLATFORM AROUND YOUR WELL TO KEEP IT FROM GETTING DIRTY

COVER WELLS TO KEEP OUT DIRT AND RUBBISH

BURY PUPU FAR AWAY FROM YOUR HOME IF YOU DO NOT HAVE A LATRINE


Eating Well and Taking Exercise Eating well and taking exercise can protect the body against different different sicknesses and help you live a longer life.

Some ways to protect against dangerous sicknesses like high blood pressure, heart disease and diabetes (Sugar Sickness) are to:

A Take exercises often (aim for 30 minutes each day)

A Eat healthy foods, including fruit and vegetables with your daily meal

A Avoid smoking

A Drink less alcohol (liquor)

A Avoid taking too much salt and sugar

A Visit the clinic regularly for checkups, especially if someone in your family has had a health condition like diabetes or high blood pressure

Eat a good diet with plenty fruit and vegetables to stay healthy and live long.

ECAP II Community Health Toolkit : Preventing Disease A 11

MalariaWhat is Malaria? Malaria is a disease caused by a mosquito bite. Mosquitos breed in stagnant water and tall grass around the house.

Young children and big belly woman are in the most danger from Malaria.

The Signs A High Fever

A Shaking

A Sweating

A Headache

A Vomiting

A Diarrhea

Preventing MalariaYou should sleep under a treated mosquito net every night to protect you and your family against mosquito bites.

Drain stagnant water in your community.

Keep the area around your house clean without too much grass.

In case of any fever, go quick-quick to the nearest clinic.

Preventing malaria in big bellyEveryone should use the net, but it is especially important for big belly women and children under 5 years old. Malaria is very dangerous for them because it can cause death of the baby and big belly, or make the baby come before time.

In a big belly, she might not know she has malaria because she does not feel sick. The only way to check is by a test that is done at the clinic or hospital.

It is very important for big belly women to go for at least 4 big belly visits. At the visits she will be given medicine and a net to protect against malaria.

PREVENTING DISEASE


Sleep under the net everywhere and every night to protect you and your family from mosquito bites.


EbolaWhat is Ebola? Ebola is a dangerous sickness that is spread through the body fluids of a person who is sick or who has died from Ebola.

Remember, early treatment helps people to survive. Don’t wait! If anyone has the signs and symptoms of Ebola, they must call 4455 quick-quick and tell the community leader.

Signs of EbolaKnow the signs and symptoms of Ebola.

A Fever that starts quick-quick

A Weakness

A Headache

A Body pain

A Sore throat

A Vomiting

A Running stomach

A Rash

A Red eyes and /or bleeding from the nose or mouth


Preventing EbolaKeeping Ebola out of Liberia is everybody’s business. You can protect yourself, your family and your community.

You can protect yourself by washing your hands often with soap and clean water.

You can protect yourself when you keep a distance from sick people, their personal things or their blood, vomit, pupu, pee-pee, sweat or spit. Do not touch them or their things! Call 4455 for help and tell your community leader.

You also protect yourself when you do not touch, bathe or bury anyone who is sick or who has died from Ebola.

Remember, early treatment helps people to survive. Don’t wait. If anyone has the signs and symptoms of Ebola, they must call 4455 quick-quick and tell the community leader.

Remember, we should not let down our guard. These preventive measures can protect us against many dangerous sicknesses. Protect yourself, your family and your community!


Lassa FeverWhat is Lassa Fever?Lassa fever is a sickness which is among us and has killed plenty people. You can catch this sickness from rats that play in your food and drinking water.

It can also be spread through contact with people who are sick with the disease or their body fluids.

Signs of Lassa FeverThe signs and symptoms of Lassa Fever are high fever, pain in the chest, back and stomach, cough, vomiting and running stomach. If you see any of these signs and symptoms you should tell your community leaders or gCHVs to report to the clinic quick-quick.

Lassa Fever is serious, especially for big belly women!

Preventing Lassa Fever It is important to keep our homes and our communities clean to protect against rats that carry the virus!

A Always keep your surroundings clean to keep rats away

A Dispose of garbage correctly and away from the home

A Cover your food and drinking water good good to stop rats from playing in your food and water

A Do not dry food in open places where rats can reach

Do not eat rats because you can get the sickness by coming in contact with the blood, pee-pee or pu-pu from the rats.

If you see people with the signs of Lassa Fever, do not touch them, call 4455, and tell your community leaders or gCHVs to tell the health people.

Dispose of garbage safely and away from the home to protect against rats.


Kill all rats at home and keep your home free from rats.

A Kill rats using traps or rat medicine and never touch rats with your bare hands! Do not leave the bodies of dead rats on the streets or near houses.

A Use a shovel, stick or plastic to bury the dead rat deep in the ground far from houses and any place that you can get drinking water.

A Use chlorine water or clorox to clean the area where the rat died. Kill all rats at home and keep your home free from rats. Follow these six steps to dispose of rat.

How to Properly Dispose of Rats to Prevent Lassa Fever


MeaslesWhat is Measles?Measles is very easy to spread. Measles is a sickness that can be spread through the air from coughing and sneezing from some one who gets the measles.

Measles can cause blindness and even death if not treated soon.

Signs of MeaslesMeasles is a sickness that can put small small bump on the child’s skin, make the child’s skin hot and the eyes red.

Preventing MeaslesIf the child has signs of measles, keep the child away from the other children to stop the sickness from spreading.

All children should take the measles vaccine at the clinic before one year old to protect them against measles.

Child can also take measles vaccine during the measles campaigns.

The vaccine is free and safe.

Make sure you child gets the Measles vaccine before they are one year old!


Tuberculosis (TB) (cough with blood)What is TB?Tuberculosis (TB) is a dangerous sickness in Liberia that mainly affects the lungs. It is spread through the air by a person who is sick with the disease.

When TB is not treated properly, it can be very serious and is often deadly.

Treatment from the health clinic can cure most people with TB. However this treatment must begin soon after the person has been diagnosed with the disease.

If you think someone in your family or community may have TB, it is very important that they go to the clinic to get tested.

Signs of TB A Coughing with or without blood for 3 weeks or more

A Chest pain

A Weight loss

A Weakness

A Fever and night sweats

A Do not want to eat much

Treating TBPeople with TB must get medicines from the clinic. This medicine can save their life and stop them from spreading the disease.

It is very important that they finish the treatment. It is very dangerous to stop taking the pills even when the patient feels better.

If you have TB, the health worker at the clinic will tell you how to take the medicine and for how long.

This treatment is free of charge in government clinics.

If a person has TB, it is very important that they finish the medicines that are given to them at the

clinic. These medicines are free of charge.


Running StomachWhat is Running Stomach?Running stomach is caused by poor hygiene, which allows germs to enter a person’s stomach. It is harmful, but can be prevented.

Signs of Running StomachRunning stomach is where you pass watery or loose pu-pu. Some people may also have other symptoms like:

A stomach pains

A sickness and vomiting

A headache

A not wanting to eat

Loss of water in your pu-pu can also cause dehydration, which can be very serious if it is not treated quick-quick.

Preventing Running StomachAll water that people drink should be treated with WaterGuard.

The use of latrine for pu-pu and pee-pee can help stop you from getting running stomach. Pu-pu outside is very bad for health. Don’t let children play in areas where animals go pu-pu!

Remember, washing hands prevents plenty sicknesses!Wash hands well with soap and clean water after going or touching pu-pu and before touching or preparing food or feeding children.

Treating Running StomachWhen a person has running stomach it is important to give clean water and Oral Rehydration Salts (ORS), which you can get from the pharmacy and some stores. If there is no ORS, drink coconut water.

When a child has running stomach, give ORS or give tay-tay water and then take the child to the nearest clinic.

In case of running stomach more than 3 times a day, take the person to the nearest clinic.

Put clean drinking water in the big mineral water bottle and empty the pack of ORS in the bottle. Shake well before drinking.


1. Fill a 5-gallon container with water

3. Shake the container to mix WaterGuard with the water

2. Pour one capful of WaterGuard into the water

5. After 30 minutes, it is safe to drink!

4. Wait 30 minutes

0

30 minutes later

How to Use WaterGuard


High Blood PressureWhat is high blood pressure?High blood pressure is dangerous because it makes the heart work too hard. This increase risks of serious problems like heart disease, stroke and brain damage.

Risk factors for high blood pressure include old age, eating plenty salt, smoking, alcohol, lack of regular exercise and being overweight (too fat).

Signs of high blood pressureHigh blood pressure is dangerous because most people do not have symptoms until it gets very bad. It is important to have regular check ups.

Some people with severe high blood pressure have nosebleeds, headaches, dizziness, fatigue, fast heartbeat or blurred vision.

How to prevent high blood pressure? A Avoid drinking too much alcohol (liquor)

A Don’t smoke

A Eat plenty fruit and vegetables

A Eat less salt and sweet things

A Take exercise often (aim for 30 minutes a day)

A Go for regular check ups at the hospital / clinic to do your blood pressure


Diabetes (sugar sickness)What is Diabetes?Diabetes is a sickness that causes the body’s blood sugar level to be too high.

If untreated, diabetes can cause serious health problems like heart disease, blindness and kidney failure.

There are two types of diabetes:Type 1 diabetes mostly affects young people under the age of 30.

Type 2 diabetes mostly affects older people and the risks of getting the disease increase as we age.

Signs of Diabetes A Fatigue (tiredness)

A Frequent thirst

A Frequent urination, especially at night

A Plenty eating

A Weight loss

A Blurred vision

A Poor wound (sore) healing

The exact cause of diabetes is unknown but there are certain lifestyles (risk factors) that could increase your chances of getting the sickness. These include:

A Having a close family member with diabetes

A Obesity (being overweight / too fat)

A High blood pressure

A Smoking

A Excessive alcohol (liquor) drinking

How to Prevent Diabetes A Avoid smoking

A Drink less alcohol (liquor)

A Take exercises regularly (aim for 30 minutes a day)

A Eat a healthy diet (eat fruits and vegetables with your daily meal) and manage your weight

A Go to the clinic for checkups. As you get older, it is a good idea to check your blood pressure and sugar levels regularly

You should visit the clinic quick if you have the symptoms of diabetes, such as feeling thirsty, passing urine more often than usual, and feeling tired all the time.


Taking exercise 30 minutes a day can help prevent diabetes and other sicknesses.

ECAP II Community Health Toolkit : Treating Injuries A 25

Animal BitesAnimal bites and scratches can cause bad sickness. In Liberia, some animals carry Rabies which can be very serious and deadly to humans.

Rabies is a very serious disease transmitted by a bite or scratch from a sick dog, cat, bat or monkey.

Don’t go near and don’t touch stray dogs and cats or wild animals, even ones that look friendly.

In case of bite of scratch from a dog or from a wild animal, do not wait! Wash the wound with soap and clean water and go quick-quick to the closest clinic or hospital.

TREATING DIFFERENT INJURIES

Stay away from stray dogs and wild animals!

ECAP II Community Health Toolkit : Treating Injuries A 26

First AidMany adults and children get wounds or cuts from accidents and injuries. A wound or cut may look small, but it is very important to take care of it so that it does not become infected.

First aid means giving help to a person who is hurt or has a wound.

How to treat cuts and wounds: A Clean the wound well with soap and clean water

A Remove objects that you can see clearly and rinse well

A Dry the wound gently with a clean cloth

A Apply iodine or antibiotic cream to the wound if you have it

A Apply a clean cloth and secure it firmly in place with a bandage

A Keep the wound and bandage dry

A Change the bandage as often as necessary to keep the wound clean

This is first aid treatment If the area around the wound becomes red and swollen or if the wound does not begin to heal, it may be infected. Go to the clinic for treatment!

Make sure you clean the wound well with clean water so that it will not get infected.

ECAP II Community Health Toolkit : Big Belly Business A 27

Taking Care of Big Belly Big Belly VisitsAs soon as a woman is big belly she should visit the big belly clinic. Big belly women should go for big belly visits at least 4 times. These check-ups are important to learn about her health and how the baby is growing.

A At the first visit, she will receive a big belly card. She should carry the card to all her big belly visits

A At the clinic, health workers will give her vaccine to protect against tetanus (stiffness), worm medicine and iron tablets to make her and her baby strong

A They will also give her medicines and a net to prevent malaria

Staying HealthyTo stay healthy and strong and to help the baby grow, big belly should try to eat many different kinds of colourful foods. A good diet should include:

A Body building food (meat, fish, eggs, beans, benny seeds, peanuts)

A Energy food (rice, plantain, eddoes, cassava, palm oil, potatoes)

A Protective food (pepper, banana, green leaves, pawpaw, orange, lemon)

She should also eat 1 extra bowl of food or snacks each day to help her and her baby get strong.

Big belly women should not take coffee, tea and sugary drinks since these drinks are not good for the baby.

Get plenty rest (at least 1 hour during the day and 6-8 hours at night).

Take light exercise every day (such as walking).

Avoid hard work such as carrying heavy things. Drink plenty clean water every day. Take daily baths. Washing often will help prevent against plenty sicknesses.

BIG BELLY BUSINESS


Women, go to the big belly clinic as soon as you know you are big belly and at least 4 times for check-up.


Big belly woman, make sure you stay healthy, rest, stay clean and eat well to keep you and your unborn baby strong.


Bad SignsBig belly women should seek care from a clinic quick-quick for any bad signs. Bad signs in big belly women can cause her or her baby to be hurt and can even cause death.

Bad signs can include:

A Bleeding from vagina / private parts

A Continuous vomiting or dizziness / fainting

A Bad belly pain

A Fever

A Swollen feet, hands or face

A Baby stops moving or doesn’t move so much

A Severe headache

A Blurred vision

A Fits (shaking)

A Fast or difficult breathing

If she has any bad signs, do not wait! Go to the clinic quick-quick for check-up.

Delivery at a Clinic or HospitalBig belly should deliver their baby at a clinic or hospital!

The clinic is the safest place to deliver your baby. At the clinic:

A Big belly will be assisted by trained health workers

A There can be quick-quick action if there is too much bleeding or if the labour is too difficult

It is a good idea for big belly woman and her partner to have a plan so that they are ready to go the clinic for delivery when ready. Having a plan is good for normal delivery but is very important if there is an emergency. This plan should help them to:

A Set aside money for transportation to the clinic or hospital

A Prepare a bag with clothes and supplies that she can take with her

A Know who will go with the big belly woman to the clinic or the waiting room and who will stay home with any other children

If a big belly is not able to deliver at a clinic or hospital, she should get there as soon as possible, at least before one day after delivery.

It is free to receive this care!


Have a plan in place to help big belly women get to the clinic in time. The clinic is the safest place to deliver your baby!


After Baby is BornQuick-quick after delivery, baby ma should hold the baby skin-to-skin. This keeps the baby warm and breathing well.

Give tay-tay as soon as the baby is born to make it healthy and strong. Make sure to give the yellow tay-tay water to the baby. The yellow tay-tay water is full of vitamins to make the baby strong.

If baby ma did not deliver the baby at the clinic she should go there within 24 hours of the baby being born. She should also go one week after delivery and again within 6 weeks. During these visits health workers will check the health of the mother and the baby and give the baby important vaccines.

A new baby ma should go to the clinic quick-quick if there are any danger signs for the mother or the newborn baby.

Danger signs for new baby ma include:

A Heavy bleeding

A Severe pain

A Fainting

A Weakness

A Fever

A Bad smell near private parts

A Bad headache

A Trouble seeing clearly or breathing

A A hot, red or painful lump in breast and fever

A Swelling in face and hands

Danger signs for newborns include:

A Trouble feeding

A The naval area is red or swelling

A Decreased activity

A Very hot or cold temperature

A Difficulty breathing

A Jerking

A Rash or bumps on the skin or discolored skin

A Eyes are red, swollen or lots of discharge

Take your baby quick to the clinic as soon as they get sick!


Feeding BabyGiving your baby food of any kind or liquids other than taytay water before the baby is 6 months old can be bad for the baby’s belly and make the baby sick.

Give only tay tay water to the baby for the 6 months, nothing else to drink or eat, for it to grow strong, healthy and clever.

Remember to:

A Wash your hands before feeding your baby

A Use a clean cup, plate and spoon to feed your baby

A Do NOT use feeding bottles. They are difficult to clean

A Give your baby small small bites at a time. Be patient when feeding your baby

A Take your baby to the clinic if they refuse the taytay or if they are not eating

A Do not feed your baby pepper!

Baby ma, give only tay tay water to the baby for the first 6 months, nothing else to drink or eat, for it to

grow strong, healthy and clever.

ECAP II Community Health Toolkit : Role of the CHC A 34

What can the Community Health Committee do to help people stay healthy?The CHC has a very important role to play to help everybody in the community stay healthy and strong. You are the health ambassadors for your community!

Here are some ideas for things you can do in the community to protect people’s health:

A Lead clean-up campaigns so that the community can be clean and tidy. Keeping the community clean from dirt and garbage can protect against many different diseases!

A Get rid of stink water. Stink water can be a breeding ground for the mosquitos that bring malaria.

A Do awareness on how people can stay healthy. You can do this in many different ways. Some examples are community meetings, dramas or door to door campaigns, but there are many other things you can do to get people involved!

A Keep latrines and water sources clean and safe. You can also share this information with the community people.

A Go to CHDC meetings monthly and give health reports for your community.

A Promote vaccines in your community and ensure baby ma and baby pa are up to date with their vaccine cards.

A Fix roads for motorbikes /ambulances so that they can get to the community if there is an emergency.

A Meet with community leaders to identify areas for handwashing, safe drinking water, and toilets.

A Be a role model for handwashing, safe drinking water and having a safe place for pu-pu in your community.

ROLE OF THE COMMUNITY HEALTH COMMITTEE


What to do in an EmergencyEmergency plansIt is a good idea to develop a plan to transport people from the community to the clinic or hospital if there is an emergency. This plan may include:

A Negotiating reasonable fees from community transport providers for services in case there is an emergency

A Brushing road sides or fixing drainage or bridges to ensure access for cars or motorbikes

A Collection of funds through Susu, Village Savings and Loan Association (VSLA) , or other means to assist poorer families

A Community awareness on how to access ambulance services

Remember, if there is an outbreak of a disease in the community it is very important that we stop its spread so that we can protect ourselves, our families and our community! If anyone has the signs of Ebola or other dangerous sicknesses, do not wait! Call 4455 and tell your community leader and the health people.

If you are worried about your health, go to the clinic. The clinic is the safest place to go when you are sick.

Our Action PlanCreate an Action Plan! Sometimes our challenges seem to big, so we don’t even try to solve them. With good planning and by taking small small steps, we can solve them together! The steps we need to take to solve our challenges are to:

1. Identify our challenges- What challenges do wehave in this community?

2. Make a vision- What do we want to see in ourcommunity?

3. Determine Action Steps- What steps do we needto take to reach our goal?

4. Locate Resources- What resources do we need toreach our goal?

5. Community Leadership- Who is going to ensurethat the steps are taken?


THESE ARE THE CHALLENGES WE FACE. TOGETHER WE CAN SOLVE THEM.

What challenges do we have in our community?

What do we want to see in our community?

What actions can we take to get there?

What resources do we need to solve this challenge?

Who is responsible?






Who is responsible?


Support Services and Contacts 4455Suspected Ebola case

Pastor

Imam

TTM

CHV / CHW

CHC members

Community radio station

School

This toolkit was made possible with support from the American people

through the U.S. Agency for International Development (USAID). The contents

are the responsibility of Mercy Corps and do not necessarily reflect the

opinions of USAID or the U.S. Government.

MOH

community health toolkit

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