Baby Mamas!!!!

Written for Peace Corps The Gambias June Health Newsletter

Long ago when I was fresh out of training, new to my village and still trying to figure out what the heck I was going to do for two years other than sweat, eat rice and try to set the record for most consecutive boils, I read Nine Hills to Nambonkaha by Sarah Erdman, a former PCV in Cote d'Ivoire. I remember thinking a) this is a lot like being a PCV in The Gambia, b) she is much more funny and eloquent when it comes to describing her experiences than I am and c) the health competition that she does in her village sounds really f-ing cool.
So what was I to do but steal her idea and try to recreate it in Kerr Jarga, hence "Baby Mamas" or "Yow Yaay Yaay" (You are the Mother) was born. I decided that though I liked the model of the Hearth program, positive deviance and mothers learning from each other, that in my community where everyone is in each others business all the time it would be hard to run a program with such obvious benefits to the participants and limit it to ten or twelve women; a larger scale competition, incorporating the Hearth model, with incentives for participation seemed like a better fit for my village. But before I started I felt like I needed to gather more information about how community members perceived their personal health and the health for their children/family. So I invited potential counterparts and key village people (the VDC chairman, CHN, VHW, TBAs, alkali, district chief, literacy instructors and women involved in the skills center) to a village health assessment meeting. From this I was able to gain a better understanding of the health challenges faced by the community and realized that for most mothers of children under five there is a lack of basic knowledge about personal health. Not that the women are stupid--far from it--but they don't understand why things like exclusive breastfeeding or hand washing are important; additionally very rarely do people take the time to explain it to them in a way they can understand.
So from this starting point I developed a project proposal and budget, applied for a Peace Corps Partnership, begged my friends and family for money, received the money and realized, "Shit, now I guess I am actually doing this Baby Mamas thing."
The heart of Baby Mamas is six health lessons, each lesson to be taught twice, dealing with issues identified in the village health assessment, such as RCH and exclusive breastfeeding, nutrition, personal hygiene, environmental sanitation, malaria, and female reproduction and anatomy. For every lesson women attend they get two points if they are on time and one point if they are late. They also can earn points for attending RCH. Due to the women's lack of literacy I included lost of visual aids and games in the lesson plans to encourage better understanding and participation. In writing the lessons I wanted the information to focus on preventative health care and also on the women's personal health. So often they hear about how to properly care for their children but what about themselves? How are they supposed to care for themselves if they get a cut while cooking? Why should women make sure they are eating a balanced diet? And what in the world does the vagina actually look like? I wanted to give them the knowledge to make informed decisions about their health as well as the health of their children.
Once all of the lessons were written it was time to get the women actually excited to come to them. What better way to do that in the Gambia than have a program? After a few, mostly unsuccessful, village sensitization meetings we called everyone in the village for an "opening ceremony" and myself, my two host moms and a bunch of my neighbors kneaded, balled and fried twenty-five kilos of flour into panketo party favors. At the opening ceremony I gave every women who was interested and eligible a green scorecard for the duration of the competition and inshallah if they don't lost them or destroy them I'll collect them at the end to see who has accumulated the most points.
Since the opening ceremony in mid-May we've held three health lessons and we're on track to get the bulk of the lessons done by the end of June. I have been blown away by class attendance, usually around ninety women each day. My counterpart, Papa Sam, a Public Health Officer at the health center near me has been teaching the lessons and he has really embraced using games and visual aides in the health lessons. The other day at the end of the nutrition game he actually said, "That was fun." The women have learned that if they're on time they get more points so they have started actually showing up on time. Of course having ninety loud Wolof women in one room can be a bit difficult to control but slowly they are starting to embrace the four class rules, 1) listen 2) raise your hand 3) one person talks at a time and 4) work together.
So what have I learned so far?First, I've realized that readjusting expectations is healthy and necessary. I initially wanted a high level of participation for men in addition to women, sending the message that health is every ones concern, not just women's. That level of buy-in would be great but is a long way off. I've come to see that they lack of men allows the women to act more freely. They are less shy about raising their hands and speaking up; and men don't have a chance to dominate the conversation. They have taken ownership of their "school" and the lesson space as a place for them to be together and discuss things in a way that gender roles might not otherwise allow.Second, use your toubab power for good. Baby Mamas has worked because its a completely new idea and format for health education in Kerr Jarga and people know that I'm the one who has been organizing it. I used to be concerned because Baby Mamas events were always referred to as "Ramatoulie's" this or that but then I realized that labeling things in this way gave Baby Mamas a higher status than just another village program. People came and participated because it was associated with me. I think many people are still confused about how the competition actually works but they continue to come to the lessons because of the "toubab tipping point." They want to see what ridiculous thing I will do, what strange drawings I will have made on perfectly good rice bags or what Wolof word I will mispronounce. Rather than getting annoyed by the fact that I'm the butt of most jokes I am embracing this as just one of the ways I con the women in my village into learning more about health.Finally, I have learned "it will be what it will be" so just go with it, stressing out does nobody any good. All I can do is try to write good health lessons, explain to counterparts why I think health education is needed in my village, tell the women how important this information is to them, and then let the chips fall where they may. There have been lots of false starts and definitely a few failures because of this approach but for all of those there have equally been great successes. When the women realized that just because something is more expensive, i.e. sugar and bread, it doesn't mean its better for you or when all ninety women chanted "We should exclusively breastfeed for good birth spacing in Kerr Jarga" --well if that's not a Peace Corps fist pump moment I don't know what is.
With three lessons down and nine more to go we've got a lot more ground to cover, and that ground includes the vagina apron, but I'm confident that in the end the women in my village will have increased their knowledge about personal health and will have some rad, shiny new bowls, buckets and pans to show for it.