Women's health is priceless

Louvain Coopération is also active in Burundi to improve access to healthcare through community health insurance schemes. This year, a brand new initiative is taking shape, with a particular focus on women's health and women's representation within the mutual health organisations.

In Burundi, the problem of access to healthcare is particularly alarming. Almost 90% of the population has no social protection in terms of health. The hardest hit are the rural population and workers in the informal sector, who are exposed to insurmountable expenses in the event of illness.

Louvain Coopération and the Mutualités Libres are working to improve access to healthcare for these populations, with a particular focus on women. "According to custom, women are responsible for the health of the family, and of the children in particular", explains Dr Jeanine Kamana, technical assistant in health for Louvain Coopération in Burundi. "If a woman understands the importance of joining a mutual health insurance scheme, she will involve her whole family in the process! What's more, women are far too often absent from the decision-making bodies of mutual health insurance schemes, because priority is given to men. We want to encourage women to play a greater role, because this is a matter that concerns them directly."

The mutual health insurance schemes that we support in Burundi give affiliated women access to all pregnancy-related care. But until now, more serious illnesses such as cervical or breast cancer were not covered. This is about to change. "Many women die in ignorance. They are treated by healers when they could be treated more quickly and effectively if they were diagnosed early enough. It's vital that they are made aware of the existence of these diseases and how to recognise them," insists Dr Jeanine.

To inform women, Louvain Coopération organises awareness-raising sessions in the communities, in conjunction with the mutual health organisations. They learn how to protect themselves against sexually transmitted diseases, but also how to recognise the first signs of infection or cancer of the cervix or breast. "We are putting maximum effort into prevention because, in principle, treatment for women screened positive for cervical cancer is not reimbursed by mutual insurance companies, unfortunately we don't have the means to do so. But if the disease is detected at an early stage, and the lesions are still precancerous, we have set aside sufficient funds for treatment. If the cancer is too advanced, the patient will have to be transferred to a hospital in Bujumbura and the costs will be borne by her. That's another reason why it's so important to invest in prevention! "

This work on sex-specific diseases in Burundi is a pilot project, "if we manage to prove its importance and positive impacts on women's health, then we hope to get more funding to reach more women!"

In December, Hélène, Manon and Gwendolyn, three medical students at UCLouvain, completed a placement in Cambodia at one of our partner hospitals. One of them reflects on this human and medical experience.

"My name is Hélène, and I'm in my sixth year of medicine at UCLouvain. As part of our final year placements, we had the opportunity to go abroad to discover a different culture and healthcare system. I did my placement in the paediatrics department of a public hospital in Kampong Cham, Cambodia. There were several things that stood out during those six weeks. First of all, the notion of sterility is not the same as it is here: we're used to a lot of single-use materials, which, over there, have several lives. Hygiene is also on a different level. It explains the higher rate of infections, resulting in excessive use of prophylactic antibiotics.

Learning to adapt

Access to complementary examinations is also limited, available only in certain towns or neighbouring countries. I had to adapt my medical thinking to take account of the country's limited resources. My future practice will certainly be marked by this experience, but I would like to keep the best of it and learn from their system. For example, the family is very much involved in treatment and medical thinking: they are an important member of the medical team. The team spirit between nurses and doctors was also very pleasant. It improves care and makes the atmosphere much lighter. I feel lucky to have had this experience, to have been able to appreciate the differences, the weaknesses and the strengths of each country. It was a very formative experience in human terms. It pushed me to push my limits every day and confronted me with new and certainly unique situations. The Cambodian people are some of the most smiling people I've ever met; they're very welcoming and always have a smile on their face, no matter what the situation."

Since 2006, Mutualités Libres and Louvain Coopération have been working together to create and develop health mutuals to guarantee access to healthcare for the entire population. These structures play a vital role in women's health. Christian Horemans, International Affairs Expert at the Union nationale des Mutualités Libres, and Brice Titipo, Head of the Access to Healthcare and Health Promotion Programme in West Africa for Louvain Coopération, talk about our joint health projects. Interview.

LC: Why did Mutualités Libres want to get involved in health and social protection in the South?

C.H.: As a mutual, solidarity is in our DNA. So it seemed logical to us to put our expertise at the service of Louvain Coopération's projects, in an intermutualist and intercontinental spirit. Access to healthcare is a basic right. However, in the countries where we work with LC, only 10 to 20% of the population benefit from state health cover. Contributing to improving the well-being and security of families gives us great satisfaction.

LC: How does the development of mutual insurance companies in the South help to improve women's lives?

C.H.: First and foremost, mutual insurance companies provide financial access to quality healthcare. What's more, with the carnet de mutuelle, it's easier for women mutualists to receive treatment or have their children treated. Mutuals can also play a role in prevention and health promotion initiatives, which can also target women. Finally, the democratic structure of mutuals gives women the opportunity to be represented. In fact, some mutuals are run entirely by women.