Thursday, September 13, 2007

Cross-Cultural Comparison

Someone recently suggested to me that I should include more cross-cultural comparisons of the US and Senegal.

I’m unsure how to do that more than I have been, but I thought I would take a list of questions that people have asked and address them in blog entries. Remember that my blog is an open forum for any questions you all might have. If any of you do have questions do post them so that others can benefit.

Do you ever feel that the gender situation is so remarkably unjust that it has transcended into situations beyond reach?

The simple answer is yes; I do, all the time. Sometimes the lack of women’s empowerment is so disheartening and depressing that I don’t think I’ll ever be able to make any kind of headway. But to be a successful PCV you really have to believe that you are planting the seed and that you might not necessarily see the fruits of your labor. Someday some little girl could be inspired to go on and get through school and be a teacher, or have a little bit of knowledge that she learned from me that will help keep her children healthier. We just can’t know. But to stay sane, I have to believe that somehow, someday my work will impact at least one person. It’s just so difficult to measure.

One of the things I desperately want to work on is to have a boy’s group. In my own studies and experiences I’ve been consistently disappointed with how frequently men are left out of the development/gender/reproductive health conversation and I want to find a way to work with teenage boys.

(Also, see blog entry called “Atheist Man Hater” from July for a more thorough description of some of the more negative experiences I’ve had.)

Have you been able to do any doula work?

I have not yet been able to attend any births, but my counterpart is currently very pregnant and is due soon. I spoke with her about my volunteer doula experience and offered to be there for the birth and she emphatically agreed. I’m definitely excited about it, but also kind of nervous too. I mean the other births I attended were in a modern birthing center with teams of surgeons on call just next door. Every woman had her own room, bathroom, shower, rocking chair, birthing balls and bars, mirrors, and ample room for family members.

This time around it’s going to be a completely different experience. If the mid-wives even decide to let me in the room with her for the birth then it will be done in a tiny, dirty room with 6 “beds”, no running water, sketchy electricity, no medicine, and obviously no emergency supplies or staff. I’m keeping my fingers crossed that I won’t have to witness anything traumatic and that the birth will go smoothly. I am slightly worried because she is older and her last birth was 9 years ago. But I am still honored and looking forward to being there to support her and hopefully make her more comfortable.

What is the mother and infant mortality rate in Senegal?

The Infant Mortality Rate (IMR) for Senegal is 78 per 1,000 live births. Though progress has been made because it’s down from 164 in 1970 By comparison the USA’s IMR is 7 per 1,000 livebirths.

The Maternal Mortality Rate (MMR) for Senegal is 690 per 100,000 live births. Whereas in the USA its 17 and in Iceland it’s actually 0.

(For more statistics see the Human Development Index from the UN.
http://hdr.undp.org/hdr2006/statistics/ )

How much teaching do you get to do?

Now that I’m back at site, and summer vacation is finally coming to an end, I’m preparing to do a lot of teaching. There are actually 5 schools in my town. One pre-school, two primary schools, a middle school, and then one private school. I have made friends with many of the teachers and I’m hoping to come in and teach regular health lessons to the kids. Health lessons are written into the national curriculum, but they are certainly not comprehensive and usually the way the kids are forced to learn is by repetition and reading. So my goal is to spend the majority of Ramadan preparing lesson plans on all kinds of health topics: hygiene, malaria, first aid, dental hygiene, nutrition, STIs, family planning, etc.

Ideally I’d like to be teaching at least one class a week but even more would be great. I’m particularly excited about working with kids not just because I adore them so much (as you all know…I didn’t get voted “PCV Most Likely To Adopt A Senegalese Child” for nothing!) but also because then I can work in French and I won’t be intimidated to get started. I might even be able to do some of the lessons at the middle school level in English with the English classes.

How much do the mothers understand?

The issue that most volunteers face is not so much the lack of education and knowledge (for those who have been to school) but behavior change. My family for example knows full well that they need to wash their hands with soap before they eat, and that they should always sleep under mosquito nets…but do they? Nope. They rinse their hands with water, and only sleep under nets after I begged them too. They know about malaria, and how it is transmitted, but it’s getting them to that next step…to actually change their behavior that is the biggest challenge.

But I don’t think that that is much different than anyone else I know. How many people do we all know that are lifetime smokers? They know it’s horrible for them but they continue to do it anyway? It’s really no different. And what about obesity? Everyone knows that it increases your risk for heart disease, diabetes, cancer, etc. And yet people still don’t exercise and eat horribly.

So yes it’s frustrating and there are some myths that are so counterproductive and preposterous that sometimes even I am baffled by them. But all I can do is try to find creative ways to talk about them.
Plant the seed and hope for the best.

Is the care of their infants built on folklore?

I guess I can use some examples of typical myths that mothers and grandmothers have regarding their children.

That if a child has diarrhea the last thing you want to give them is water.
That colostrum (the first milk) is not good for the baby so you should give them water instead.
If you have a cut a way to stop the bleeding is to put it in the sand.
That babies should be fed, water, butter, and other random food scraps during the first 6 months of life because breast milk is not enough.
The list goes on…

If so, how do you even begin to break those barriers?

Breaking those barriers? I wish I knew. My strategy is to ask lots of questions, be incredibly patient, and have many conversations. Oh, and repetition. I have to constantly ask breastfeeding moms about their children and what they feed them, but also to observe their behavior because they often lie about what they are doing. Luckily because I am an outsider and a Westerner and a health volunteer I can get away with bringing up weird subjects like breastfeeding and family planning. But there are days when it seems like I’ll never be able to change anyone’s mind.

I am really only touching the surface of addressing these questions, but I hope that it has been informative and given you all a glimpse into some cross-cultural comparisons.

Please keep the questions coming. Sometimes I have a hard time knowing what to talk about and what people want to hear about.

Thanks for reading and caring enough to ask!

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