In Sierra Leone’s Ministry of Health, DANIEL SARA TURAY is a National Co-ordinator for Community Health Workers. Here he tells us about his desire to bring confidence and better leadership to the country's rural communities.
You have a busy job, but you also voluntarily run another organisation and play a part in the Freetown Cluster. Why?
That’s a good question! The short answer is I’m passionate about grassroots work. I founded the Center for Positive Attitude and Sustainable Development (CePAD) in 2006 because I wanted people at the grassroots to have a positive mindset when it comes to meeting their challenges. You see, in my country, when you talk to people in most communities, often they will say “the NGOs are not doing anything for us” or “the government is not doing anything for us”. Dependency is a big problem here – and it keeps people hostage. So I try to tell them that “it is you that determines your destiny and your development. You have to first take the lead as an individual and as a community”. I started CePAD to do training, sensitisation, lectures, develop jingles, songs and radio discussions on this subject. And then more recently, I met Adbein from the Freetown Cluster. I looked at what the Cluster was doing to end the culture of donor dependency, and I wanted to get involved. Really, wherever people recognise the fundamental importance of attitude, I will get involved.
Sierra Leone has faced two big crises in recent years: the Ebola outbreak and the mudslide. What have these things taught you about attitudes?
Well one thing that made the Ebola outbreak worse was that people persisted with traditions of touching those who were sick or who had died, and this spread the virus. They did this partly because they didn’t want to abandon their loved ones, and partly because they did not want to break with tradition. And so this physical contact persisted, despite the terrible implications. This attitude of clinging to tradition, and ignoring important health advice, was a key factor that led to the fast spread of the Ebola virus. And this exposed a big problem with the public health system in our country. There were attitudes that needed to change, and there were Community Health Workers who could help them change, but this Community Health Worker system was fragmented – they were not in every community, and they did not have the support they needed.
The Ebola outbreak therefore showed the need for an institution that could oversee and support CHWs [Community Health Workers] throughout the country. And that is why today we have the Community Health Programme, which I help oversee. Now, these people work at community level and perform three key functions: health education; basic healthcare services; and they are also agents of change. These are people who live in these communities, who know their people, and have the trust of them because they live with them. And so whatever they do, it stands to reason that people will co-operate and work with them. At present we are getting close to almost 13,000. The target is 15,000. So, so far so good.
And then what about the mudslide?
Well I think the recent mudslide is a good example of the success of this new structure, because after the mudslide, many people were expecting a Cholera outbreak. But because of the CHWs, there were local people whose voice was respected, and who educated people about basic hygiene practices, and so we did not experience a Cholera outbreak. We are really grateful and thankful to God and the CHWs for the impact they are creating. In the future, if there were to be an Ebola outbreak, it would not kill people as it did in the past. And so I think people are beginning to move away from negative cultural and traditional practices, as a result of what we have suffered in the past. The aftermath of the mudslide showed that people are beginning to adopt positive behaviours that will help them to be healthy. But Rome was not built in a day. Things are happening, just perhaps not as quickly as we might hope. But as long as people are taking steps forward, we will eventually get to our destination.
What do you advise to people who want to see this kind of attitude and behaviour change in their own community?
Well the first thing you have to do is to show to a community that their own attitude is fundamentally important. Attitude – by which I mean our views, opinions, ideas and perceptions – determines our actions and behaviour, and so there is nothing that you do that is not rooted in your attitude. So to change your community, you must first look within yourself: what are your ideas, views and perceptions about development, life or work? You need to identify and accept your negative attitudes. Once you have done this, then you need to be convicted to change them. You see Jake, in Sierra Leone the problem most of the time is there’s always a blame game – people throw spanners at each other because we don’t have acceptance or conviction of our own problems. People don’t accept that they might be architects of their own suffering. But our development is in our hands – it has to be championed by us.
You’re talking about change coming from within. So what support is needed from outside – from the international community?
Well a single finger cannot lift a stone. No matter what we can do ourselves, we will always need help from other people. I mean, this is human! It is natural. I always tell communities that it is not that you don’t need help from outside, but there are certain things that you will need help with. Once you recognise what those things are, then you ask for others to come to your aid. But if our attitude is negative, then no matter what the foreign aid is, it won’t have much impact. And so while roads, electricity and infrastructure are important, I believe in investing in the human person.
Finally, what are your hopes for the future of the Freetown Cluster?
Let me disclose to you one plan that I have, which I have started discussing with Adbein [from the Cluster]. Now, you might know we have a system of chiefdoms in Sierra Leone, and I am from a ruling house in Kalanthuba Chiefdom in the Northern Province. The people of my home chiefdom have requested that I put myself forward to be a Paramount Chief at some point. And I really want to do this, because I want to model the positive attitude that I talk about. But more than that, I recently wrote a development model for the said chiefdom. This model looks at every level of community leadership, and is designed to be applied in every community in this country. I want to work with the Cluster to use this model to train other chiefs and leaders on community leadership.
For example, in every village you have a village chief, you have a women’s leader and you have a youth leader. These three are key people. But when you ask them, often they cannot tell you their functions, their role and responsibilities, and they don’t really see leadership as an important responsibility. But they are supposed to be overseeing the general good of their community! And so the model I’ve come up with is to train these people to know their role and their responsibilities, and to be better leaders. So these are some of the things I want us as a Cluster to focus on together.
That sounds important and ambitious and exciting – I look forward to hearing how it all develops!
You know Jake each time you go to these villages you see a lot of poverty, and to me people should not just retire to fate, people should not just think poverty is destined for them. I want this to change. And I plan to make my chiefdom a model for the rest of this country. That is my determination. So all I ask of you guys is to have me in your prayers, and I will definitely continue to work with you so that we succeed in what we are doing.
Daniel's full job title is 'National Coordinator for the Multi-Stakeholders Collaborative in the Community Health Workers of Sierra Leone’s Ministry of Health'. Learn more about him and his work here, or contact him directly here.
And since this article was published, Daniel won this national award for his community engagement work.