This question is a great question, though very hard to explain as I myself am still trying to figure this out. I ask myself this question at least a few times everyday here and have no concrete answer, so instead I’ll use some PC material we’ve been given to explain a little about our goals here in Morocco, as Rural Health Workers and hopefully interject a little of what I’m doing/plan to do/hope to do here in my community.
“Project Purpose: Rural community members will achieve better health status through preventive practices reinforced by positive social and environmental change.”
To accomplish this project purpose PC has met with the Ministry of Health here in Morocco (this is our main point of contact here, and who operated the local sbitars) and created 3 goals that should be our main point of focus when we’re creating educational programs for the schools, organizing trainings or even informally talking to people in our community. As Volunteers here in Morocco, we’re in such unique, since we live among the people, learning the language and live like them. Most people in my community look at me as more of a friend/family member than anything else which gives me a great opportunity for informal education, whether it be sitting with the woman preparing couscous (which is called souc souc here--- its couscous backwards!) for a wedding, having tea at my neighbors or attending a new birthing ceremony in a nearby dowar. The following are the 3 goals that have been created for us:
Goal 1:
Community members (men, women, and children) will actively participate in activities that promote personal health and reinforce appropriate health behaviors.
So- what does this mean? Working with men and women to teach them about pre-natal care, which means teaching them the importance of checkups and where they can go to get these checkups. Also, educating the children in our community about nutrition and proper hygiene- the things we’re taught as children and take for granted: brushing your teeth, washing your hands with soap before eating/after the bathroom, etc.
How can/will I do this? Inchallah (this is a phrase used very often, it translates to “god willing” and can be used in almost any and all situations). I do a lot of this informally with my woman, during tea or just in passing when I meet a pregnant woman. This problem here is the lack of staff at my sbitar, as woman sometimes have to wait for hours to speak to a nurse, and they have a lot of work they do at home (other children, tending the animals, cooking for the family, cleaning) so its tough getting them to go wait for hours when they don’t usually understand the importance of visits anyway. As for the education for the children, I hope to do some pretty basic lessons in some of the schools and also make it a point to wash my hands and talk about teeth brushing informally to them often. The biggest challenge here is its behavioral change, which is the most difficult thing to change. We’re taught from a young age about this, its reinforced by our parents, school system and in books/tv we watch. This is news to a lot of these children, and if their parents don’t understand the importance/want to spend the extra money on the toothbrush or soap it’s a hard lesson to teach.
Goal 2:
Targeted professional and non-professional health workers will have enhanced capacity to deliver effective preventive health education throughout rural communities.
So what does that mean? This means working with our local community to assist in training health professionals in preventative health education through non-formal education, etc. It also means working with our Ministry and community to help train woman to become traditional birth attendants (TBAs). These are woman in the community who know how to properly birth a child through safe general hygiene practices and know the signs of a problem during birthing. These TBAs also refer the woman to care for pre and post natal checkups.
How can/will I do this? This is where I want to focus a lot of my attention because I’ve seen first hand (with my host mother) what a problem this is. Also, being a female volunteer I’m able to work a lot more with the woman than a male volunteer would ever be able to and I want to take advantage of this position I’m in. A challenge here is my Ministry (boss, essentially) would rather us try to make the woman go to the biggest clinics (about 30 K) away, which would be great if it was realistic. There are a lot of obstacles to doing this, such as lack of money, husbands not wanting their wives to do this , lack of transport and not understanding why this is important to name a few. The last TBA training that was done in my site was over 10 years ago, with a lot of these women now dead. I was told by my host mother that my 13 year old sister helped birth my host mothers 8th child. I think my community could greatly benefit from something like this and I hope to organize 3 day training, inviting woman from all my outlying dowars… wish me luck. (Realistically this is more of a 2nd year project, but its something I want to start working on, as projects like this take a large amount of time)
Goal 3:
Communities, local organizations and local institutions will have increased capacity to reinforce healthy lifestyles through environmental and social change.
So what does this mean? It means working with my community to find organizations that are able to properly assess and address community health needs. It also means working with local institutions such as clinics, schools, mosques, souks to properly collect and dispose of their solid and liquid wastes so as to prevent health and environmental hazards.
How can/will I do this? My main focus here is the disposal of waste. An obvious problem is how waste s disposed of at my sbitar.. I have recently learned from a previous volunteer that at one point we did have an incinerator so that’s something I need to check on. There is also a big push from the ministry to focus on this goal, as a lot of health related problems could be prevented/minimized if there wasn’t trash in the river beds, around the dowars. They way they see things is if we get rid of the trash we get rid of the rats/mice, stray dogs, flies that come with the trash and can therefore prevent a lot of problems these creatures cause. I agree with this 100%. The solution to this problem, however, is again behavioral change. People don’t understand why they can just through all their trash out in a field. I burn what I can, and carry what can’t be burned into the city, but that’s not realistic for big families, especially ones who never go into the city (like Ouarzazate and Marrakesh that have trash disposal programs). This is a huge topic of conversation among volunteers; because if we don’t know what to do with our trash how can we teach others what to do with it? Yes, we can teach them to bury it… but where? And how do we get them to want to do this?
