Village Health Works heals people and communities in Burundi

By Tom Spoth

Deo escaped the civil war in his native country of Burundi, but he couldn't leave it behind. He came to the United States and built a new life-learning English, finding work in nursing homes, and enrolling in graduate school. But still he was consumed by thoughts of death and despair back in Burundi, distraught because he didn't know whether his family was alive or dead.

“You feel so lonely even though everyone is really nice, you feel like you are a stranger even in public space,” Deo says of his years in the US. “I was carrying my tragedies like luggage all the time.”

While at the Harvard School of Public Health, Deo met Partners In Health co-founder Dr. Paul Farmer and became involved in PIH’s work. “It was such a great relief to get involved with PIH,” Deo says. “I felt at home here. It’s amazing how far Haiti is from Burundi, and yet how similar these two countries are in terms of misery. Finding a group of dedicated and talented people in the USA doing such great work in Haiti, a country with a history of tragedy like my own country, brought my dream back to life.” This dream of developing a free medical clinic in his native village turned into the birth of  Village Health Works (VHW), a 501(c)(3) charitable organization based in the US.

Deo and his family were forced to flee their home when Burundi’s civil war broke out in 1993. When he returned in 2005, Deo found that his home village had turned into “hell on earth.”  He describes seeing a picture of extreme poverty, hunger, disease, and misery. Children going naked and eating garbage. Women dying in childbirth. No clean water. With the complete devastation of health infrastructure, Burundians were being incarcerated because they could not afford medical care. Diseases such as tuberculosis, malaria and AIDS, went untreated, along with conditions well known in the West like chronic arthritis, cardiac disease, and diabetes.

In 2006, the World Bank rated Burundi the poorest country in the world. Life expectancy in the country is 39 years. More than 25 percent of children don’t attend primary school and 18 percent die before the age of 5.

People in Burundi are by and large uneducated, and many don’t even know when they were born, Deo says: “People here are preoccupied with how to survive each day… where they might get their next meal. They don’t celebrate birthdays or keep a calendar; they mark time by their own suffering. That’s the kind of life we are talking about in Burundi.” But Village Health Works is now providing health services and hope where there was none before.

	The future site of the VHW health clinic
	The VHW health clinic today

Deo returned to to his home village on Christmas Day, 2005, and encountered great skepticism about developing his dream here. The people were so embittered by years of oppression from their leaders, and indifference from the international community, that they had a hard time believing Deo was there to help. In time, he convinced the residents that he was for real. Once hope was restored, hard work soon followed. The community pitched in as best they could, gathering and hauling stones to build a health clinic, rebuilding roads, and injecting new life into the moribund village. Today, the VHW staff meets regularly with a “community committee” of 22 women and 5 men to discuss health issues and community participation.

“Without the help of the community, it would’ve been very difficult,” says Deo’s younger brother. “It’s theirs, it’s their clinic.”

Now 20, Deo's brother is following in his footsteps, having spent more than a year studying at Deerfield Academy in the US. and matriculating at Williams College this fall. He had a difficult childhood – he was often on the run with his parents because of the civil war – but he hopes to return to Burundi after school, perhaps to work on education initiatives. “I know education is important, that’s what we lack,” he asserts. But after a moment’s thought, he adds, “We lack a lot of things.”

Deo's brother says it took 90 minutes to walk to the nearest health clinic before Village Health Works was operational, and most people wouldn’t go anyway because they couldn’t afford to pay. Village Health Works provides medical care without charge, relying on donations to sustain itself and following the PIH model of providing a preferential option for the poor. “It’s going to involve a lot of fundraising events and begging for the poor,” Deo says.

The community and government of Burundi provided 26 acres as a site for the VHW clinic, and Burundi officials have visited the village and met with Deo several times. While the government is unable to provide financial assistance, it’s important to have the moral support, Deo says.

	A crowded waiting room at the VHW health clinic

Since opening in 2006, Village Health Works has welcomed two doctors, six nurses, 33 community health workers, and many volunteers into the fold. The outpatient clinic opened in late 2007, and served over 16,000 patients in its first eight months of operation. Deo, colleagues and friends are also working on bringing reliable supplies of food, water, and electricity to the village.

VHW has formed close bonds with Partners In Health’s Rwanda project, Inshuti Mu Buzima. IMB employees have come to VHW to offer technical support and training; PIH medical director Joia Mukherjee and PIH co-founder Paul Farmer have also visited the Burundi clinic. Workers from VHW have also traveled to IMB to see the PIH model in action. While PIH does provide assistance to VHW, all funding has been secured directly by Deo and his team.

Because the services and quality of care VHW provides are not available elsewhere in the country, people are flooding into the health clinic from far and wide looking for medical care. “It’s going to be very difficult in terms of how we can handle this huge operation [but] we are not going to turn people away,” Deo says.

	Deo's home village in Burundi was not always this peaceful

The impact of Village Health Works goes beyond treating the sick, Deo explains. “People ask me, ‘What is the most gratifying thing about this work?’” he says. “Burundi is a country where people have been living in fear of each other for more than a decade, many of them displaced by the war. We now have Hutus and Tutsis being brought together because of this project… they’re doing something constructive instead of something destructive. While the government and the international community talk about reconciliation, it’s hard to expect any positive outcomes when people who lost their homes get sick, and instead of getting medicine, they get detained; when parents can’t send their children to school. Now we have former enemies volunteering to work together to help build their clinic, and getting health care in the process.” Indeed, they know better than anyone else how important the VHW clinic is for them.
  
To donate to Village Health Works, visit http://villagehealthworks.org.

[posted August 2008]