The scene: a crowd gathers in a remote mountain village, one which is often unreachable by motor vehicle, but which today is visited via helicopter by medical staff from a U.S. Marine Expeditionary Force, along with local health staff. The village—a community in Hauteo sub-district, Ainaro district—is located in one of the world’s newest, smallest and most isolated countries: Timor-Leste (East Timor).
Among the crowd is a mother with two young children, one of whom is two-years-old but unable to walk because of a deformed leg. She has brought her children for medical consultations, but the local health workers say that neither child has received any vaccinations because the father refuses, having heard stories of children who became sick from them.
Two of the visitors go to talk with the children’s father. One is burly and tanned, a large man by Timorese standards; the other is slim, of average height, with a sporty mustache. The two men do not have the manner of medical professionals and, in fact, are not—they are drivers for the foreign assistance project that works with the Ministry of Health to strengthen immunization services and coverage. The drivers, Antonio and Jose, finally convince the father to allow the children to be vaccinated, and the vaccinations are given.
This is not an unusual intervention by drivers from the Imunizasaun Proteje Labarik (Immunization Protects Children, or IPL) project. Over the project’s two years of operation, all seven project drivers have received training and encouragement to develop their skills and to participate. In addition to their driving and vehicle maintenance responsibilities, they have become active, contributing members of the field-based technical teams.
Particularly during integrated outreach and child health activities, the drivers mobilize people to bring their children, screen child health booklets to see which children have vaccinations due, help weigh children, and assist local health volunteers with such tasks as recording vital data. They also counsel individual mothers and fathers on such topics as vaccination, breastfeeding, nutrition and handwashing, and—along with professional health workers and trained community volunteers—give health education talks and answer questions.
They support a project initiative in which local volunteers and leaders keep a list of all of the community’s infants and their vaccination status, so that any child who falls behind will be noted and visited. Drivers participate in supportive supervision visits to community health centers, in particular, advising the local health staff about proper recording and reporting of vaccinations. Some drivers also serve as “masters of ceremony” for orientations that IPL provides for local leaders. They often take photos of program activities.
How were IPL’s seven drivers transformed from their traditional roles—as drivers who dozed or chatted while the technical work was going on—to active members of the technical teams, whose contributions are highly praised and appreciated by both technical health staff and community members? The idea in Timor-Leste seems to have germinated in the head of the IPL project director, a Bangladeshi doctor who had worked for an NGO in Bangladesh that gave its drivers additional duties.
There was no grand plan in Timor. Although the drivers received formal training from the USAID mission on taking photos and making videos, they picked up most of their new skills and abilities by observing in the field and learning from technical staff on the job. Over time, the drivers were given more responsibilities and grew more confident, while the technical staff became increasingly appreciative of their contributions.
Today, as the project is entering its final six months, the seven drivers have learned computer skills and are lobbying for English classes. They participate actively in IPL’s monthly staff meetings, first contributing to the technical team’s reports and later reporting on vehicle (traditional driver) issues. Some have begun submitting their expense forms via email. These drivers feel like respected members of the project team, and at home they report playing a much more active role in the care of their own children, and have become advocates for immunization among their neighbors and relatives.
It may be premature to say that providing opportunities for support staff such as drivers to enhance their capabilities and contributions should be done routinely in development projects, but it is fair to say that it should at least be considered. What can be said confidently about IPL’s experience is that it has been a win-win-win situation. The drivers’ expanded horizons have benefited the drivers themselves, their technical colleagues, and the project as a whole, as well as the communities and children where IPL works.
**This article was originally published on May 28, 2013 on MCHIP’s blog