This blog post was contributed by Hellen Kotlolo, one of the fifteen Young Champions of Maternal Health chosen by Ashoka and the Maternal Health Task Force at EngenderHealth. She will be blogging about her experience every month, and you can learn more about her, the other Young Champions, and the program here.
In South Africa and for myself January symbolizes the beginning of a new season, the New Year, the beginning of school…but mostly it symbolizes the beginning of new things. Former South African President Nelson Mandela now aged 92 years has been sick and hospitalized. I was saddened by the news and praying daily. The fear I have is that many South Africans face the reality of one day losing a legend who has transformed our country, our world and our people. I realized my own selfishness yet also my attachment to this man whom I have never personally met. I am only 27 years old and the life I know is the life of inspiration, freedom, democracy and diversity, ‘the rainbow nation’. I just realized that many outcomes of my life are based on his sufferings and as I was talking to Faatimaa Ahmedi and Ifeyinwa Madu about many other issues I realized the spirit of his life when Faatimaa said to me, “Some people like Nelson Mandela recognized their mission in this world and accomplished it perfectly! Now it is our turn to identify what our role is and what we are supposed to achieve.”
I have been in India for 5 months and the project here is at the intervention and implementation phase. On the 18th of January we travelled to Jodhpur for a training of trainers and for field visits. The first two days consisted of training sessions on Birth Preparedness and Complications Readiness and then there were four days of field work in ten villages. We used the picture books on government entitlements, danger signs during pregnancy, birth and postpartum teaching as well as safe delivery including the birth preparedness calendar. We also took time to visit a Primary Health Centre and a Community Health Centre in Jodhpur, Rajasthan, and the conditions were not the best with an iron bed and a bucket below for blood which I think is one of the core reasons of home deliveries. Some of the major challenges we faced were:
- Social and gender inequalities; women were refusing to talk if men were present
- High illiteracy in almost all the villages and for the registration the women had to do thumbprints as many could not sign their names
- The role of women was considered to be that of being housewives and bearing children, and all the women complained about having little time for the training as many were either pregnant with an infant of less than 12 months breastfeeding or with two or three young children around her
- Women were very shy about the female reproductive system or pages in the picture displaying a woman giving birth or bleeding, and it was followed by giggles or women turning away or bending their heads down
- Poverty displayed a major role in lack of access though the results also differed from village to village
- Children were malnourished and at risk of kwashiorkor and many were not attending school regularly
The presence of men in the meetings was not welcomed, yet I felt there was both an interest and a need to learn. Allowing the men to sit amongst the women to learn about women’s issues may be a very necessary intervention in this area. There is also a great need to explore such issues as understanding of the body’s anatomy and physiology and issues around family planning, but I realize we cannot achieve all these changes in one day.
In the evening of our return to the training centre where we were staying there was an eager boy who took us to the sand dunes for sunset. We watched cricket matches together with other colleagues, between South Africa and India. South Africa eventually won the five day series. Many people had either never seen a black person or had little knowledge about Africa except for its poverty. My new friend indicated they were taught in school about the poverty in Africa. It was initially hard to relate on a social level but as soon as I mentioned cricket it was easier to grasp attention. Even when giving health education and engaging with the women in the field somehow cricket allowed an entry to the hearts of women and their relatives on discussing maternal health issues. One evening I gave the boy one of my books and sat with him to try and teach him how to read English better. One my favorite stories is that told by Yeabsira Mehari in her previous blog, “A Starfish Saved.” In all the days in rural Rajasthan I was often disheartened to see the children not going to school while their parents could not read and write. It is a vicious cycle of events but this boy showed something different: a passion to thrive. And it was not I who made a difference in his life, it was he who wanted to learn more. I realised hope exists amongst all of us.
In the end I realized my mission has many unaccomplished aspects. Thinking back over the things that occurred: one man has inspired us to be better and achieve missions impossible, and with patience they can be achieved. Sometimes the oddest things can link people and assist communication, in this case the sport of cricket connected me with people. A young boy’s efforts to read and learn the skill showed me that even desolate environments cannot remove inspiration and hope. May these lessons bring me closer to achieving maternal health outcomes.