As I mentioned in the previous post, we need to get more innovative and creative with health education. I am the third Peace Corps volunteer focusing on health in my village in a row – meaning that for the past 5 years, we’ve been working on maternal and child health, malaria, handwashing, and nutrition. One of my goals has been to mobilize the community in different and engaging ways: we built designated trash dumping sites, we’ve done compound inspections around the village for bed nets and breeding sites of malaria, and now I’m trying to circulate our health education videos. But another way I’ve found to tackle health education – and beyond that, health behavioral change – is through gender and development and shifting gender roles.
Every month we have our Reproductive and Child Health Clinics (insert RCH blog here – I think we did one on that haha) where mothers bring their children under 5 for weighing, immunizations, and health education. Public Health Officers, Community Health Nurses, and sometimes me (if my Wolof is good enough that day) give health talks on various issues pertaining to maternal and child health. The women in my community are very well educated on these topics and can often answer questions on Malaria, nutrition, diarrheal diseases, and many more.
But the problem with just educating women is that they’re only half of the equation. In this culture, men rule. It’s changing (ndanka, ndanka – slowly, slowly) as girls and boys have compulsory free education, but for most families the man makes all decisions and those decisions are final. No matter how many times a woman is educated on the benefits of exclusive breastfeeding, if her husband tells her to give the baby water or food, that’s what they’ll do (there is enough water and food in breast milk and it’s better for the baby’s growth and immune system for those to come from breast milk).
In this culture, it’s taboo to talk about being pregnant. It’s funny, seeing albums upon albums of pictures on Facebook of people from USA announcing their pregnancies, revealing the gender of the baby, uploading ultrasounds and staged monthly progress pictures. Calling someone “ndaikumba” – pregnant can sometimes be a shameful insult here. So what happens is that women don’t seek antenatal care (they should go for 4 free check ups), don’t recognize danger signs in pregnancy or warning signs of labor, and have dangerous deliveries at home. Now where is the man in all of this? He’s half of the equation, right? He doesn’t want a thing to do with it. And this (along with Female Genital Mutilation – a topic for another blog) is a contributing factor to why our rates of maternal and child mortality are high.
We keep educating women – which is awesome – but they don’t feel like they have the agency to make healthy decisions for their families – buying nutritious foods, hanging bed nets, seeking antenatal care. So let’s start involving men.
I got together with the nurse who runs my village’s clinic and our Community Health Nurse and we planned a “Men Are Partners” meeting. We announced at the mosque after Friday prayers for all compound heads to come to the clinic for a meeting. We had 45 men show up, and they didn’t run away when I told them what the meeting was about! They were interested, engaged and excited. They WANT to learn better ways to keep their families healthy. I opened the discussion by pushing them a little – I told them that I’ve been here for a year but that I’ve never seen any of them ever bring their children or pregnant wives to an RCH Clinic. Some of them opened up that they feel shy and ashamed and wouldn’t want others to think they couldn’t “control” their wives and children.
They had questions about nutrition, exclusive breastfeeding, handwashing, malaria and even family planning! About 75% of them looked at me like I was crazy when I said I wanted them to help out with household chores so their wives have more time to be with the children, and 100% of them looked at me like I was crazy when I said I want to see them at the next clinic, bringing their children for immunizations.
Here’s where the 2nd goal of Peace Corps comes in – cultural exchange. I am fortunate enough to be able to share with them that when I was a child, if I got sick at school, it was usually (not always, don’t take this the wrong way, Mom) my Dad who left work, picked me up and took me to the clinic. I told them that my Mom was busy working farther away, and that my parents have a partnership (hence the name of the meeting – Men are Partners) that helped me to grow up healthy and educated and be the person I am today.
Most of them still looked at me like I was crazy.
But it’s a start! We’re going to continue the meetings in other villages and cover different topics with the men in my village. If I see one or two Dads at the clinic, I’ll be happy.