Sunday, June 15, 2008

Updated My First Health Lesson

I forgot to bring my USB drive last time with my real blog update so I wrote a half hearted entry. Here is the newest entry, in full.

Updated My First Health Lesson

On Thursday the 12th, I gave my first health lesson in Morocco. It was very satisfying, after three and a half months in country, to do something other than observe and learn.
I was able to do a lesson ahead of schedule because of special circumstances in my douar. Two doctors from Meknes have been sent to my community to do evaluations and check-ups of school aged children. My community is very lucky to get this special treatment and they will greatly benefit from it. Talking to other volunteers in rural locations, this seems to be out of the ordinary, to say the least. Unfortunately, from talking to the doctors, it seems like they only have the time and resources to spend time in the central douars in my commune, leaving the outer douars untouched. But it’s better than nothing.
During the check-up of the children, each child goes through a different part of the evaluation with a different nurse or doctor (eye exam, height and weight, respiratory exam, etc). To do my lesson, I just latched onto the end of the exam cycle, so I was able to talk to each child individually. I sat them down, and basically said, “There are microbes on everyone’s hands, that cause sickness. You need to wash your hands with soap and water before you eat and after the bathroom so you don’t get sick.” A few of them didn’t understand me very well, probably a consequence of my poor language skills and them being to frightened/excited to listen very well. However, I think most of them understood me, as I was able to get them to repeat back to me what I had said.
The big question, though, is not whether they understood me. It’s whether or not they will change their behavior. Honestly, I don’t think that a single one of them is going to wash their hands on a regular basis as a result of their two-minute talk with me. Microbe and disease transmission is a totally foreign concept to most of the kids, so it’s going to take a sustained effort. When the kids go back to their home, no one else is going to be washing with soap, so even if they remembered what I said, they’re not likely to call attention to themselves by doing so.
In order to actually get behavior change amongst the kids (just like kids in the states), there has to be an authority figure (parents) constantly reminding them to wash their hands. Unfortunately, that leads to two problems. First, the parents aren’t likely to wash their own hands with soap before eating. And second, mothers and other women are in charge of childcare and I don’t have much access to women, given social taboos.
One idea I have to help me break into that social space is to enlist the help of my host mother. Our household is very casual and open. At a lot of households, the men eat separately from the women, but we eat together at my house (which may have something to do with the fact that there are only three of us). My unstructured plan of the moment is, sometime down the road, to give a full on health lesson to my mom, with the help of the female nurse from the health clinic. Maybe if I can stress the importance of spreading this information, she will help me talk to other women about it, or do so herself.
Another idea for educating women involves waiting a while longer. At first, when I walked around my douar, I was lucky to get a response from a woman passing the other way. Generally, the women are still unsure of what to make of me, but more of them are friendly with me. It also helps that my host mom thinks I’m a saint and surely says good things about me to all her friends. If I’m patient, my relationship with other women will probably improve, possibly giving me an opening to speak with them about health care ideas. Or maybe that will just never be a possibility for a male volunteer in this site. For now though, the doctors are here for another week, so I’ll keep telling kids to wash their hands. It’s good practice for me and, if nothing else, will get people in town to associate me with health care.


Things are going well and it’s good to have a little routine and real work reintroduced into my life, thanks to the work with the check-ups with the doctors. My language is coming along pretty well and I can definitely communicate now, but people still have to slow down their speech and help me out in order for me to understand. My own patience for my language ability is wearing a little thin. It’s frustrating that the three year old next door speaks better than I do.
I’ve been playing soccer with some guys in town, which is pretty fun. It’s nothing like soccer back home, but it’s a good way to interact without having to speak or listen. In other exercise news, I’ve started running again and have got my sights set on the January marathon in Marrakech. My biggest obstacle will be motivating myself to keep running on a regular basis, which is hard with out someone to run with. In literary news, I finally finished reading Manufacturing Consent, a Chomsky book that I recommend. Thesis: the American media present the news with the interests of the state and big corporations in mind; they’re not the objective “watchdogs” that they make themselves out to be. It’s also got a whole lot of political history in it, so I learned a lot. Now I’m reading a book called “The Nine,” (thanks Dad and Joyce), which is a retrospective on the last 12 years of the Rehnquist Supreme Court. It’s well written, interesting, and informative. I’m having trouble putting it down; in fact I think I’ll go read a chapter now…

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