Continuation: The Farthest Reaches of Our Impact Evaluation

This post is a continuation of the last update on our blog, a trip report by George Muwowo, program manager of the Riders for Health evaluation. For more information about Stanford’s work in Zambia, please visit our website.

CONTINUED: On the second day of our trip to Itezhi-Tezhi district, our team ventured to two health facilities, Kaanzwa and Ngoma, both were accessible only by poorly maintained roads.

A typical road in the Itezhi-Tezhi flood plain, cut-off by running water. Davis Albohm

A typical road in the Itezhi-Tezhi flood plain, cut-off by flowing water. Davis Albohm

Ngoma, although well stocked with medical supplies, is located inside the Kafue National Park and patronage is limited to a small population comprising Wildlife Police camp staff and their families. Mambwe Ng’oma, the Stanford Data Collection Officer working in this area, collected data at this center at the beginning of the study but had a difficult time traveling there because park regulations restrict access due to large and dangerous game such as lions and elephants.

Next we visited other distant health facilities. Unbelievably, because of the vast distances, we spent more time on the road than at the actual health facilities. This gave us an opportunity to understand the distances and obstacles our DCOs face. Even with a vehicle we could not reach the two furthest health centers: Nansenga and Mbila. The roads are poor and the vehicle basically can only run at 30 km per hour for most of the journey. We however managed to reach seven health centers in four days.

More about the dusty roads in Itezhi-Tezhi, these have a fine deposit of alluvial soils from flood waters in the low lying areas. But higher ground is not spared by the dusty conditions. A slight movement of  our vehicle’s wheels raises a lot of dust particles. A large number of health centers are located in the flood plains which are seasonally inundated and for most part of the year are impassable by vehicle. The grasslands are devoid of woody vegetation, dominated by grass and bush fires in the dry season are common. Due to flooding the district tends to have seasonal routes as well, created by vehicles during the dry season. There are no standard roads and they are difficult to map, because they shift to a large extent after every rainy season. Only housing infrastructure is permanent and is built on higher ground within the flood plains.

An EHT providing health education at an Itezhi-Tezhi health center. Davis Albohm

An EHT providing health education at an Itezhi-Tezhi health center. Davis Albohm

We kept wondering how these settlements received their supplies of food, medicines, clothing, etc. We got the same response from everyone; that supplies are stocked prior to the rains starting, which could be in November, earlier or later. The rains stop in March or April, but the plains remain impassable until somewhere May or June. On average, for six months in a year residents are cut off from the rest of the district.

You can never run out of amazing surprises in Itezhi-Tezhi district. While there is no gas station operating as a business entity we had to plan ahead of each day to ensure we had enough diesel to take us into the field. The only gas station in town belongs to the electricity supply company (ZESCO) for its private use, but has extended this facility to the community. It operates at unreliable hours, which again ensures that our work remains unpredictable in Itezhi-Tezhi!

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