In the field...

So I was too tired yesterday to write on this blog. I went to the field in one of our health zones, where we were conducting focus group discussions with the community and traditional birth attendants to get their views on current emergency obstetric care services in the health zone. We arrived at one of the health centers, where there were a few women with their children, waiting to be assisted. I saw a baby, about 5 months old, who had malaria and kept crying. The mother was trying to breastfeed him. It was sad to see just how poor the women were, wearing dirty and torn clothes. Seeing the baby, I couldn't help but think about my own niece and nephew and how privileged they are to be in the US, have access to food and health care, and have access to toys. I sat down and tried to chat with the women... I think it was the first time that they had seen an Asian woman, and as usual, they were quite interested by my hair. Although they spoke a local language and no French or Kiswahili, all we did was stare at each other and smile. The women were telling my coworker that they had many children. Ben, my coworker, asked them who worked in the field and provided for the family. They said the women did, while the husbands stayed home or went around to drink/eat. We were told that's how it's done culturally here... the women provide for the home while the husbands are supposed to be served. It's something I've known about Mashi culture, this patriarchal kind of society where the women is seen as the property of the men. But it's changing, although extremely slowly. Ben, who is himself Mashi, was telling the women that they need to be sensitized and understand that when a family has many children and the woman can no longer work alone to feed the whole family, the husband needs to help out. I am not sure what the women responded to this... I only saw that they were nodding. It's so different to see how societies differ... for instance, in Cambodia, field work is the man's job, while here, the women do all the hard labor. And the babies just keep popping. I think on average women have 7-9 children in the villages. It's a bit crazy, especially given the poverty level. The kids can't go to school, they get sick, and there's not enough food at home. I've had a few conversations with our drivers, who are also Mashi, about the status of women in the household and family planning. They tell me the women should go and get a tubal ligation... but I tell them it's safer for the men to get a vasectomy. I'm seen a bit as a feminist here, although I'm really not b/c I just bring different points of view. It's really interesting though to see that not all men agree with how things are done here. And they agree that the men are treated as kings in the household, and that this needs to change if the family and country as a whole want to survive and move forward.

We conducted a small focus group discussions with the community on EmOC services available. There were about 5 women and 3 men. The facilitator was a man from the local health department. I was a bit skeptic, since I knew that the facilitator wasn't best trained and tended to be a bit bias. The discussion was done in Mashi, but already, I could see that he was asking the questions directly at the men, and didn't encourage the women to get involved at all. The women had some really good points to raise, especially since it concerns them. They were discussing how the local health facility doesn't provide them with adequate services b/c the nurse who works there is rarely there, always out and about. They also mentioned how they weren't properly treated at the health facilities, with the personnel not having the capacity to conduct an accurate evaluation or provide medications. They also discussed the problem of transportation. When a woman is in labor and needs to go to the health facility, she's kept there until it becomes really dangerous and she has to be transported to the hospital, about 10 km or so away. The villagers do so by carrying the woman on a locally made stretcher. One woman also complained about the nurses and how they made her wash the sheets by hand before admitting her into the facility, even though the woman was shivering all over.

For me, it was very interesting to hear the community's point of view, and especially the women's. This discussion helped us to see that the health facilities aren't necessarily being honest with IRC. True, when IRC visits in the field, we see everyone working... but I think that it's also all a show b/c IRC warns them ahead of time that we're coming, which gives them enough time to come to the facilities and act like they're working. It's the problem though with the whole health system in the Congo... too many people talking and saying what we want to hear, but not enough being dedicated to bring the support to the communities and bring about real, tangible change. The community did mention though that the health situation has improved, in comparison to a few years ago... but we're not there yet and there is work to do.

After the discussion, kids from the community were just getting out of school. As usual, they gathered around us, especially me and Ben. They spoke a little bit of French, and since we were there for a while, I decided to teach them a game. About 100 kids were gathered, watching, and just as we were getting into it, we had to go. I think it was a nice way for them to decompress and play. Not sure if I helped at all, but it was a nice interaction that I haven't had yet when going to the field. They usually just get scared of me, stare at me b/c they're curious, or smile and shy away.

Well, here I am in the office again... out for now.