Clovis Sangwe, a medical doctor and public health advocate, knows all too well about the lack of healthcare accessibility in rural areas of the country.
As a child growing up with asthma in the rural community of Ndop, in the country’s northwest region, treatment for his condition posed a major challenge for Sangwe.
“Even though my parents could afford medication, it was just not available. They had to go 50 kilometers away when I had an asthmatic crisis to get those meds,” he told Global Citizen.
His mother, worried about the possibility of him having asthma attacks, would discourage him from being active. Sangwe avoided playing with other kids and stayed indoors instead.
His experiences served as the primary motivation to become a doctor. In medical school, Sangwe began a volunteer group called “The Medics.” Every summer, he would travel to a rural community together with fellow students and doctors to provide basic screenings and sensitization.
Upon graduating, Sangwe worked as a primary healthcare provider at a district hospital in Manoka District, with a population of 19,000 people living on 47 islets, or very small islands.
Clovis Nchinjoh Sangwe, founder of the NGO Rural Doctors, is photographed in Yaounde, Cameroon on Sept. 18, 2024.
There, he “had real first-hand experience of what access truly meant” when a pregnant woman who was bleeding came to the hospital. Although she needed to be referred to another hospital, this was not an option. The island only had one boat that departed once a day to various other islands and the mainland, and it had already left.
“We had resource constraints,” Sangwe said. “We didn’t have a blood bank, we barely had staff, [but] If we didn’t perform the surgery, the patient would die.”
Sangwe called colleagues at the referral hospital, who guided him on how to perform the cesarean section given the circumstances. Both the mother and baby survived, and there were no complications.
“It was a hard moment, but a big lesson that changed everything for me,” Sangwe said.
He wanted to do more than work in a primary health facility to treat patients who sought care. Instead, he sought to prioritize preventing illness and disease by transitioning to working in public health, where he could take a more holistic approach to improving community members’ health and well-being.
“I realized the best thing was for me to go to the patients instead of them coming to me,” he said.
Clovis Nchinjoh Sangwe (R), speaks with traditional birth attendants in the Dahomey, Manoka Centre Health Area in Cameroon during a trip in 2020. There, he provided community based antenatal care services with his team at Rural Doctors.
Sangwe was passionate about sensitizing people in rural communities about a range of health issues, from vaccinations to preventing malaria, and he knew that it would be key to build trust amongst them through visiting their communities regularly, which is why he founded the non-profit Rural Doctors.
“If they [rural populations] are dying of malaria and you come with vaccinations, they don’t trust you. [They wonder] how come you don’t treat us for malaria for free, but you give us vaccinations for free?”
According to Sangwe, if healthcare providers aren’t meeting the perceived needs of individuals, “it’s easy for them to agree with anti-vax sentiments.”
As of 2021, nearly 150,000 children in Cameroon had never received a vaccination, according to Gavi, with the highest rates of zero-dose children (those who have never received routine immunization services, such as a first dose of diphtheria-tetanus-pertussis containing vaccine [DTP1]) being in the Southwest (31%) and Northwest (24%) regions of the country. The percentage of zero-dose children is higher in remote and disadvantaged communities. For example, in Manoka District, where Sangwe previously worked, nearly 92% of children under 2 years old are zero-dose.
Rural Doctors, which has implemented healthcare access interventions in remote rural communities, has reached nearly 8,000 people in more than 20 remote communities in Cameroon.
Rural Doctors
Clovis Nchinjoh Sangwe (C), founder of the NGO Rural Doctors, speaks during the Rural Doctors senior management team retreat organized in Douala, Cameroon on Sept. 16, 2024.
Rural Doctors
Members of the team at Rural Doctors speak to one another during the senior management team retreat for the organization in Douala, Cameroon on Sept. 16, 2024.
Rural Doctors
The senior management team at Rural Doctors pose for a picture during the team retreat organized in Douala, Cameroon on Sept. 16, 2024.
The organization has also successfully implemented a community-oriented primary healthcare (COPC) model, which integrates various systems to increase trust and expand reach among rural populations. For example, COPC encourages community healthcare workers, who seldom visit communities and may not be highly trusted, with community-based healthcare providers such as herbalists whose ongoing presence in communities makes them trusted. These individuals work together to listen to communities’ health needs and priorities and provide care as needed.
The model has proven to be highly effective, with Rural Doctors vaccinating 64% of zero-dose children in some communities. Despite the challenges in providing healthcare to rural communities — such as the lack of resources — Sangwe believes unlocking health for all lies in building trust with populations who are typically excluded and neglected from healthcare systems.
“No one wants to be sick. People want to be healthy, but they also want to trust you,” he said.
By building relationships with vulnerable and marginalized rural populations and showing up year after year, Sangwe is doing just that.
Dr. Tasha Manases (L) speaks with Clovis Nchinjoh Sangwe (R), founder of the NGO Rural Doctors in Douala, Cameroon on Sept. 16 2024. Clovis works regularly with Tasha on medical campaigns.
Disclosure: The World’s Best Shot is a profile series dedicated to sharing the stories of vaccine activists around the world. This series was made possible with funding from the Bill and Melinda Gates Foundation. Each piece was produced with full editorial independence.