Thursday, 28 January 2010
Off to the villages
We have now finished our assessments into gender issues in four of the chiefdoms in which Health Unlimited operates. This is the first update for a while, we have mainly been without electricity and internet since starting the assessments on the 17th until getting back to Freetown.
I was really excited about being a part of the assessments and being able to get a better understanding of life in rural Sierra Leone. There are many reasons why women do not or cannot access healthcare and a better understanding of these will enable us to more effectively improve healthcare for women and children
The two villages that our team visited were very different. We spent 3 days each in Kamaranka and Fintonia (these are the headquarter villages for 2 of the Chiefdoms in which HU is operational in Northern Bombali.)
Staying in the villages for this period of time meant that as well as our planned assessment activities, there was plenty of opportunity for informal discussions. We wanted to explore what community members feel are the main problems they face and how the community and Health Unlimited can work together to address them.
We discovered women in both villages carry huge responsibilities for their families and often carry out all the domestic work, grow food for the family and try to generate income through petty trading.
Kamaranka is on a main (dirt) road and has facilities such as a secondary school, functioning health centre and a purpose built market place. In spite of these facilities poverty rates are high and poor farming yield is an issue meaning that many women have problems feeding their families and generating income.
Fintonia is very remote, so has a different set of challenges. It is in an a beautiful area of National Park but cut off from the rest of Sierra Leone by a river. The nearby ferry crossing point is currently out of action (which means a long detour on a very bad road). If you live in Fintonia and need to go to hospital or get to secondary school the only way to cross quickly is in a wooden canoe - you can imagine what that would be like for a woman being transferred in labour becuase of complications. Fintonia has no mobile phone coverage, so people are unable to communicate, which creates difficulty for trade and other opportunites.
In kamaranka we were shown around the village by Isatu, an extremely bright, confident schoolgirl and Hawa, a determined woman in her 30's. Many people in Sierra Leone had their education interrupted by the war and Hawa is one of them, She tried to go back to school after she had given birth to her second child. Sadly she was teased for being to old and her children were not well cared for by her husband while she was at school, so she stopped attending. There are many stories like this of lost opportunity and wasted potential.
Kadiatu who who we stayed with in Kamaranka told us her house is called 'the strangers house' in the village. Her husband has died and her children have grown up she now has just one grandchild living with her. She is often asked to provide lodging for people who visit the village. Her situation is in complete contrast to another woman who came to talk to us in the village who supports over 20 people in her house. Her husband died and she is single handedly supporting her 9 children who are all at school or college and she now has grandchildren too.
It was really useful for me to see the Health Centres in both villages and meet the health workers as I will be coming to work with them next month. One health centre seemed to be functioning well. The other although the building was new (the old health centre had been burnt down by rebels during the war) seemed very run down and neglected and in need of a bit of TLC. I will be coming back to work with the health staff in these villages soon.
In Fintonia we stayed with one of the Traditional Birth Attendants(TBAs), part of my role will be to work with these women, who are currently providing a large part of maternity care in Sierra Leone, who have had little or no training.
It has been great to meet people in these rural communities, which I will be working in over the coming year. I have even been given a new name in Fintonia - I am now know as Isatu Kamara!
There were many amazing experiences on this trip, not least people making us feel so welcome in their homes and communities. I was a bit worried about what the washing and toilet facilities would be like. I have mastered the art of feeling completely clean and being able to wash my hair all with half a bucket of water. Standing outside, up in the mountains, under mango and banana trees to have your morning wash is actually pretty idyllic.