Professional Documents
Culture Documents
This paper narrates how a volunteer activity – understood under subject areas of
international volunteering and national volunteering – impacts on a more effective
health delivery system in Darkhan district in Mongolia. It describes the current
health situation in Mongolia and how VSO’s volunteering programme addresses
problems on effective health delivery. The potential impact of local volunteers’
engagement to challenge traditional health system and behaviours has been
examined. Finally, some general research questions are suggested as a basis for
looking at concrete impact of volunteering and volunteers towards meeting MDGs.
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A paper written for the 5th ISTR Conference in Manila, Philippines by Marilou Pantua-
Juanito, Executive Director of VSO Bahaginan and Glenn Benablo, VSO volunteer working as
Health Management Adviser in Darkhan Health Department, Mongolia. VSO Bahaginan is a
member of VSO International Federation, a development charity that works to fight global
poverty and disadvantage through volunteering.
percentage of women patients at local health facilities and in
hospitals are receiving treatment as a direct result of this. (VSO
Mongolia CSP, May 2006)
A causal map analysis of the situation was done by VSO with the
Ministry of Health (VSO Mongolia Health Programme Area Plan
2006). As a result of this analysis, the health programme area will
address the following problem statement, “Poor quality of health
service delivery in Mongolia, with a focus on treatment rather than
prevention, negatively affects the health of the population”. The
main causes identified as leading to this problem include:
Since October 2005 doctors and nurses of the FGP have been
trained on how best to manage volunteers, with a formal training
workshop held in June 9-10, 2006. Particular training for the
community volunteers has focused on prevention rather than cure
as well as basic nursing skills and First Aid.
In May 2006, four staff from DHD and three FCHWs undertook a
study tour to the Philippines to further their understanding (in a very
practical way) of how local community volunteers are used in the
Philippine context. The study tour was clearly strategically planned,
with local organizations carefully considered on how appropriate
they would be in ensuring replicable learning. Glenn used a lot of his
knowledge of the area and tapped former colleagues to customise
the Darkhan team visit. As a result, the study tour was a huge
success. The learning from the Philippines very successfully argued
the case for mobilising and strengthening support to community
volunteers towards enabling them to undertake a vital role.
At two FGPs that were visited, discussions with staff highlighted how
successful this project has been in both valuing and refocusing the
work of the volunteers and thereby releasing time for the clinic
doctors and nurses. Both doctors and nurses reported that the work
of the FCHW now allows them to remain at the clinic for more hours
as the highly capable volunteers can often do community visits. Now
that the FCHWs have been supported around how to plan their work,
much less supervision is required on the part of the doctors and
nurses, as they know and are confident that the FCHWs will get on
with the priorities for the moment. The FCHWs are part of the
communities. They are aware of arrivals and departures, of people
who are sick or not living healthily. They are able to relay that
information to the clinics and use this knowledge to promote health-
seeking behaviour of the community people or, if necessary,
encourage them to visit the clinics instead of remaining at home or
going straight to the hospital.
Doctors in one FGP in particular spoke very highly of the FCHWs and
their real commitment to their current role. It was very much felt
that the doctors, nurses and FCHWs were a tight team who work
together, celebrate together and support each other. One FCHW
who was previously a housewife and has now taken on this
volunteering role (at the doctors’ recommendation) is currently
considering (and is being supported by the doctors) going to
medical school to become a doctor. This is a significant achievement
in Mongolia where the health system has historically been extremely
hierarchical.
Ways forward
The VSO volunteer will be continuing to work on this project with his
colleagues including
• Facilitating volunteer management training for doctors and
nurses at the FGPs
• Value formation and gender development training (i.e. looking
at the Mongolian context and analysing the team’s values
around local practices)
• Salesmanship and interpersonal relationship support and
training (e.g., how can the clinics and FCHWs promote
themselves and their work more
• Popular Education using Puppetry skills
• Roll out of this methodology nation wide. Already three
of DHD and VSO partners, the Chingeltei, Uvurkhangai
and Nalaikh Health Districts have travelled to Darkhan
to learn from their experiences. VSO volunteers were
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Gers are traditional round felt tents. They are quite roomy (about 4
metres across the middle), easy to heat with the wood stove in the centre,
and provide a comfortable, practical and attractive living space.
also placed in these areas to ensure proper replication of
this project
• Developing and managing small-scale health-related
businesses
• Conduct training sessions for local volunteers on:
• Basic Computer Training;
• Community approaches in the management of
common illnesses;
• Functional English Literacy Program; and
• Project expansion to include 3 soums
(municipalities) of Darkhan-Uul Aimag (province).
VSO will also continue to support this project and will focus on
providing opportunities for replication within Mongolia, particularly
in areas where there are capacity and resource constraints.
Discussions are underway around funding possibilities to support
this innovative and very exciting project.
References:
Glenn Benablo (2007), Local health initiatives in Mongolia: An article written for
WHO Mongolia Newsletter. Ulaanbaatar, Mongolia.
VSO Mongolia (2005), VSO Mongolia Health Programme Area Plan, unpublished
report to VSO.
VSO Mongolia Annual Review Report (2006), Case Study: Dharkhan Local Health
Volunteering, unpublished report to VSO.