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Local Health Emergency System: An approach that instils the spirit of solidarity and community service

Empower host communities and internally displaced persons, and help them stay alive through a sustainable local health emergency system.

Photo of sangwe clovis
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What problem does the idea help to solve and how does your solution work? (2,000 characters maximum)

Cameroon, a country in West and Central Africa is currently a host of refugees from Nigeria in the North due to the boko-haram insurgency and in the East from Central Africa Republic. The socio-political crisis in the North West and South West Regions have let to internal displacement of about 500,000persons. Most internally displaced persons and refugees usually find refuge in remote rural areas. Most remote rural areas in Cameroon generally have poor health access. Cameroon has a low physician density of only 1.3physician per 1000population, and as low as 2 physicians per 10,000population in some rural areas. Health access is further worsened by bad roads and lack of medical emergency system which delays time taken for a patient with a medical emergency to reach the hospital. Sudden rise in the total population in these areas will lead to increased health challenges stemming from over crowding. Over crowding has been found to be associated with raised disease burden, increase mortality rate and epidemic outbreaks. It is therefore a matter of urgency to help the community withstand, prevent and fight health consequences arising from the sudden population growth. Our solution is to empower both host communities and people on the move on basic health issues(like how to make water safe for drinking), train them on basic first aid and create a local first aid emergency system that will help them cater for themselves, contact nearest hospital and use well adapted local transportation means to rush patients to the hospital when need arises. This solution will not only help them stay alive, it will create solidarity and collaboration between people on the move and host Communities. This is because the local first aid system will depend on mutual support and willingness to help each other stay alive, to function effectively. The emergency system will be owned and run by host Communities and people on the move.

Geography of focus (500 characters)

Our area of focus is Douala VI subdivision in the Littoral Region of Cameroon. It is a host community to internally displaced persons because it shares borders with one of the regions in crisis. It has a population of about 40,000persons unevenly distributed in 47islands. The entire population is catered for by a lone hospital with 2 medical doctors. There is a big problem of inaccessibility because it takes hours on water to reach the hospital and commercial boats don't sail every day.

Building Bridges: What bridge does your idea build between people on the move and neighbors towards a shared future of stability and promise? (500 characters)

The project brings together people on the move and neighbors to fight for their survival as one community. It will empower them with unique skills and knowledge that will help them to work together under one umbrella (local first aid emergency system) to fight health effects of sudden rise in population density. It will therefore help people on the move to integrate faster and become a part of the community.

What human need is your idea solving for? (1,000 characters)

Our project is going to give hope to both the host community and people on the move. Instead of watching their love ones die helplessly, the local first aid system will help them make an effort not just as a family but as one community to help the victim/patient stay alive. The project will also help them prevent epidemic outbreaks which will have left the community in sorrow. The hope that this brings will boost confidence and solidarity among them, making them more prepared and willing to host and help even more people on the move. Lastly, people on the move will feel loved, interact more and will be more open and ready to restart life.

What will be different within the community of focus as a result of implementing your idea? (1,000 characters)

1) The Local emergency system will markly reduced the number of pre-hospital deaths that will have been made worse by overcrowding (overcrowding has serious health consequences). Our indicator will be to compare number of pre-hospital deaths every 6months. 2)The project will empower people on the move and neighbors to better prevent health consequences of over crowding including epidemics. We will reevaluate their knowledge and health behaviours every 6months and compare. 3)The emergency system requires full collaboration between people on the move and neighbors to function effectively. Since they all have a common problem which is pre-hospital deaths, it will promote solidarity and community service. Our indicator will be how fast people on the move integrate themselves in the community. 4) Neighbors will be more confident and empowered to host people on the move. The fear that comes with overcrowding will be completely subdued. Questionnaires will be used to evaluate neighborswill

What is the inspiration behind your idea? (1,000 characters)

I am a medical doctor practicing in the lone Hospital in Douala VI subdivision( Manoka District Hospital). I have watched many patients rushed in at near death and also received reports of pre-hospital deaths which occurred as a result of delays to get to the hospital. The last stroke on the camels back was a case of a 23 year old internally displaced pregnant lady that was rushed in with severe blood shortage following bleeding for 2days. The family did not bring her earlier because of no available commercial transport means, since they do not own a boat. I started asking myself, what if there was solidarity at the island where she is coming from? What if members of that community received training on basic first aid? What if they have a local first aid system to help them stay alive? It means that, basic first aid will have been offered and an emergency local transport means made available by the community. This was my motivation.

Describe the dynamics of the community in which the idea is to be implemented. (1,000 characters)

Douala VI subdivision is a remote area made up of 47 islands and only one Hospital with 2doctors to cater for a population of 42,000 persons with no existing medical emergency system. There is a very poor commercial transportation system making health access a nightmare. This was the state of this rural area prior to the anglophone crisis. Presently there are rising health challenges worsened by increasing number of internally displaced persons fleeing from the neighbouring South West region. Over crowding is not only increasing the work burden for the 2 physicians, it is posing a huge risk of rising health challenges, including the possibility of an epidemic.

How does your idea leverage and empower community strengths and assets to help create an environment for success? (1,000 characters)

1)Both people on the move and neighbors have one common challenge which is poor health access with a huge pre-hospital death rate. This is a big motivation for all to come together to seek a common solution for the good of all. 2)Every island is controlled by notables and everyone respects and accepts decisions from them. So our project makes use of this to ensure community sustainability. 3)Each island has several "meeting groups" that makes it easy to educate and pass on an information since members are usually peers or at least share common view about societal issues. This include the transporters group, Women's group etc. Our project makes use of this, to empower the community. 4) since they live on islands, they are bound by nature to collaborate and help each other since they have no where else to run to.

What other partners or stakeholders will work alongside you in implementing the idea, if any? (1,000 characters)

1) Our first partner is Manoka Health District 2)We will partner with existing social groups in every island. 3) public health experts and first aid trainers

What part of the displacement journey is your solution addressing

  • Arriving and settling at a destination community

Tell us how you'd describe the type of innovation you are proposing

  • Systems design: Solutions that target changing larger system

Idea Proposal Stage

  • Pilot: We have started to implement the idea as a whole with a first set of real users. The feasibility of an innovation is tested in a small-scale and real world application (i.e. 3-15% of the target population)

Group or Organization Name

Rural Doctors

Tell us more about your group or organization [or lived experience as a displaced person?] (1000 characters)

Rural Doctors is a non-profit organization with aim to beat preventable deaths in rural areas. We envisage a world where persons living in rural areas have an equal chance to stay healthy like those in urban areas. Our mission is to design and implement well tailored projects that will help to beat Preventable deaths in rural areas, especially among vulnerable persons (pregnant women, children less than 5years, the elderly, persons living with chronic diseases, refugees and internally displaced persons. This project perfectly blends with our goal to reduce preventable deaths among vulnerable persons. We are the right group for this project because of our community experience and the fact that most of our actors are doctors who have practiced in rural settings. I am the founder of Rural Doctors and at the same time a medical doctor working in the lone Hospital in this target community. So I have a mastery of the problem and what it entails.

Website URL:

Type of submitter

  • We are a registered Non-Profit Organization

Organization Headquarters: Country


Organization Headquarters: City / State



Join the conversation:

Photo of Uchenna Okafor

Hi sangwe clovis! Thanks for this insightful idea. You are right on point. Yes; it makes no sense to be waiting for the government while the local people are dying of treatable ailments. Nonetheless, I am appealing for special provision for disabled persons in this design. Thank you once again and best wishes.

Photo of NDEF Cameroon

Hello sangwe clovis, thank you for the great work being done in Manoka by responding to the needs of IDPs and host communities alike. We are living the consequences of the crisis in Bamenda everyday. Is it possible for you to request for an ambulance boat from the Ministry of Public Health as a stop-gap measure prior to the acquisition of first aid kits and training of volunteers to administer the help? Courage! Nkeng Pius

Photo of sangwe clovis

Thank you for your kind words. The lone Hospital (Manoka District Hospital) owns a speed boat but the greatest challenge has always been to get fuel for the boat as there is no funds allocated for that. As a consequence, my humble self as a medical doctor practicing there, use public commercial boats and sometimes fishing boats to gain access to islands because I can't afford the cost of fuelling the speed boat and motivating the pilot and co-pilot. How much more of people who have fled their homes, leaving everything behind including their source of lively hood.

Each of these Communities have a transport system such that everyday there is a "bonus fuel". If every transporter donates just 0.5l of the fuel everyday and is kept aside for emergencies, it will be quite a lot. Plus we prefer the community to own this project. That way, we are sure of it's sustainability. Even if the ministry accepts to provide fuel, it may not be willing to do that for longer than a certain period of time.

Thanks again.

Photo of Sevde Şengün

Hello sangwe clovis  thank you for sharing your idea and great to have you in the Challenge! The work you are currently doing and the project you are trying to develop is really precious.The challenge's idea phase will be closing on 17th August.Before its expired could you clarify what are the results of the project so far in your pilot phase? What are the insights so far? Also you can create a possible user( or you can choose a existing patient's story) and share with us
i.e. "journey map of displaced people from Cameroon " which is very important to integrate into this platform as you progress in the challenge!

I would suggest also to have a look at our challenge evaluation criteria again for last checking:

Photo of sangwe clovis

Thanks a million for your feedback. The first phase of our pilot work is aimed at evaluating acceptance of the problem and the solution by the communities involved to ensure sustainability. It will be considered a success if 80% of community representatives accept that there is a problem and at least 80% agrees to the solution. We chose 5communities out of 47islands in Douala VI, Cameroon for our pilot work. All notables (100%) accepted that there is a big problem of pre-hospital deaths and lack of collaboration among members of the community in times of medical emergency. Every family try to sort out their own problems. This gave us an idea of how difficult it will be for internally displaced persons to integrate and get help in such a community. 91.3% of Notables agreed that a local first aid system that will empower the community to act as one and help themselves will be a solution to the problem. 93.5% of women representatives accept both problem and solution. Our next target population are youth representatives. If at least 80% agrees with us, we will carry out a series of activities to instil the spirit of solidarity and explain the importance of unity in the proper functioning of the first aid system. Then we will train them on first aid , create a first aid system with them and evaluate output.

Before the project: Experience of an internally displaced person:

A pregnant lady fled from the South West Region of Cameroon with her husband and kids to seek refuge in Cap-Cameroon which is a remote island in Douala VI. Upon arrival, she had an inevitable abortion as consequence of the physical and emotional stress she went through. She bleed heavily and only got to the hospital 2days latter because the receiving community was never prepared or had a system that could help them to easily help people on the move. She arrived the hospital with severe blood shortage (anaemia) and in a near death state. Her family explained that their stay in Cap-Cameroon has been a very frustrating experience because it is always so difficult to get help. The recieving community on the other hand thinks that the government ought to help them to be able to help people on the move. So though the community is willing to help, they are just not empowered to do so.

A scenario we expect after project implementation:

A family flees from kumba into Cap-Cameroon. Upon arrival, their 15year old child had an asthmatic crisis but while fleeing he forgot his inhaler. Members of this Community saw a family in distress, notified their notables and innitiated the local first aid system. While some where carrying out the basic first aid, others were organizing for an emergency transportation and the hospital was also notified. Their son was rushed to the hospital and his life saved. Not only was their son's life preserved, they felt loved and cared for. As a result, they began to interact even more with members of this Community. Therefore helping the community to help them even more with other needs. Within a short time they became fully integrated as members of the community and were even taught basic first aid. Now they help the community to help others. The project indeed brought a lot of hope to the internally displaced family and built solidarity and confidence in the receiving Community. The community was therefore well empowered to help people on the move.

Any receiving community with poor health access need to be empowered to help themselves. Only then will they feel confident to help others. If they are taught to work like one community towards one goal, they will learn to collaborate more and help even strangers.

Photo of Udoka Inwang

Amazing work sangwe clovis 

Photo of sangwe clovis

Thank You