Did I know that I could attain a GHC placement? No. Did I think I deserved it? No. Did I feel discontent about my village, my town, my city, my country, my Africa and my world? Yes. Who was I? How did I count? How did I mean something to the world and how could minute me impact change in such a big tough atmosphere?
Well, I do have one thing, my pain: my pain for social injustice and health inequity that has grown over the years, my experiences neither to the comfort.
I did have an interestingly conservative childhood, yet I breathed and dreamed liberal. Growing up and going to school in suburban Kampala, finding oneself was quite a challenge; life seemed to drift so fast yet so slow as coming of age seemed afar.
As vivid as I could recall, I loved hospitals, not just the buildings, but the fascination of those “people in white coats and dresses”. The power they had over life; the confidence and knowledge bestowed upon them. They were my gods; the one reason my little heart would race so fast at every encounter.
No surprise that when I was younger, the medical people were angelic. They took their time and care examining you and finding out what and where it hurt. They always did seem to know your pain even better than you did. Despite my ailments, I was always filled with excitement to visit the health facility as there I would find these “custodians of life”.
To me, health care begun and ended at the medical centers. The white coats and dresses were the oracle; they never got it wrong. They were pure and without fault. Naive as a child, I grew to learn otherwise; a bittersweet feeling that brought in both disappointment and enlightenment.
I live in a messy house. My town, my city, my country, my Africa and my world is messy. It took me a while, but eventually I woke up to this realization when I made the great discovery that health wasn’t the health worker. Health neither began nor ended with hospitals and worse-still not with the white coats and dresses. And in that fact, that was an end itself .
I began to open my thoughts to the fact that health is me, it is you and it is the community. And with the community being you and me, and many us with a little push being able to claim health as ours, we could be redeemed. We could stop thinking about the white coats and dresses as kings and owners of our lives. That the power we always thought we never had, we could seize.
This never ending mind trip I’m on has seen me delve further into the consideration that more than anything, health is knowing and that knowing is power and that community knowledge is health; all to negate the assumption that ignorance is bliss. Oftentimes I ask myself what the community knows about health, what and who influences their knowledge; and with the knowledge and information they have, what do they do to protect themselves. These questions remaining unanswered makes me thirst to dwell in the community culture.
From the fellowship experience so far, I’ve been fortunate to have front-line exposure to various communities, battling with diverse cultural beliefs resulting into inhibitions to uptake of health care services. This has defined mindsets anew to me, enlightening me on how derailing misinformation from a trusted source, say a local leader, can be. The community being a collection of people with similar ideals is highly prone to delusion.
Here’s a case in point: my placement organization recently started running an integrated Volunteer medical male circumcision (VMMC) and Cervical cancer screening (CACx) program in the Eastern region. Originally, only having carried out the former (VMMC) with a lot of resistance from the local folks for various mythical reasons, the CACx on the other hand is recording positive responses and high demand.
A program set up to essentially offer double prevention by protecting women from STI’s and HPV transmission by circumcising their partners. It’s seen higher opposition from the men despite the massive sensitization campaigns mainly citing fears like: male contraception, causing impotence, foreskin trade, unpopular government policy and Islam conversion to mention but a few. In contrary to this male revolt, their female partners are accepted to go for CACx, which gets me thinking – are women perceived as the braver ones or are they the sacrificial lambs?
It’s well known that women are more receptive to health care and are more willing to move through the countryside to access health facilities. It’s common to find long queues of women with their children waiting to seek care. My dissection of this health information gap has got me thinking how beneficial it is to communities that more women seek health care.
“Atim” your typical Ugandan rural woman wears many hats: she is a mother, a farmer, an entrepreneur, a wife, a disciplinarian, a chef, a builder and most important of all A HEALTH WORKER. She is our solution to health misinformation. Atim is who could be a custodian of health, being a source of synergy in her family. She is deserving of health information acquisition which she’ll radiate first to her partner then to her children, next to her siblings with a ripple effect to the community.
Atim is who we need to empower with a minimum package of WASH, food and nutrition, sexual and reproductive health and livelihood improvement information. Finding her in her typical countryside setting, say her garden for food and nutrition tips, on a market day with SRH guidelines, and at the well or water-point with WASH information.
Atim is receptive; once knowledgeable she’ll take the burden off health facilities and health workers. By embracing the best health practices she will work hard at getting her husband’s buy in and support. This will translate to the entire community.
With Atim, your knowledgeable rural woman, the community is assured of better health. It’s our call to reach out to her, continuously engaging her in health education and promoting conversation which she’ll pass on to everyone else.