Since the other foreign couple that worked in our community development project left in October, I have learned a lot about the women’s work. My wife T comes over to the office to socialize with the women’s team, but for work matters, I’m the only foreigner left for them to voice their concerns to or get help from. There are 8 women on the team, 4 that have been with the project since the start in 2005, and 4 that we hired new last March. We doubled the size of the women’s team because their participatory tools, courses, and monitoring and evaluation is more time-intensive than the men’s often “one-off” style of working.
In a culture where men and women seem to live in different worlds, our teams have found a smart way to work together. Our men’s team assists our women’s team by being the sort of chaperons and gateway guards that women in this culture must have. At least one of the men always travels with the women, and hangs out near where the women are working, to stand up for them if some trouble arises. Before our women can bring any sort of material to share with village women (training materials and aides, films, etc), the men take samples of the material and have a quick sitdown with the mullahs and other big men of the village. Without this simple explanation and introduction by the men, our women run a great risk of being labeled as proselytizers, harlots, or spies- all of which could get them stoned. Once the men get the nod, our women can safely go ahead, and any gossip that starts will be stopped by the male leaders of the village.
Our women’s team assists our men’s team in return by being informants about the inner-workings of each village. While the men can walk throughout the whole village (unlike the women), they cannot freely go into private yards, which are surrounded by tall mud walls. The women, however, can and do go into private yards all the time, and so it is very useful for our men and women to have a discussion early on in their time in each new village, to compare the information they have about life and needs both inside and outside the walls.
With all of this introduction out of the way, I am pleased to share some actual results of the women’s WASH (water, sanitation, advocacy, hygiene) work with you. In the past month the women have been doing the first +1 year evaluations of their WASH courses. This is our first chance to get a real statistical gauge of the learning and change that happened in the hygiene courses 1 year ago, and that which still remains. The way that this evaluation works is that our women conduct a KAP survey (knowledge, attitude, practice) before the course, and then repeat the same KAP survey 1 year after the course has concluded. The KAP surveys require excellent facilitators who know how to turn the list of questions into a fluid dialogue which elicits the village woman’s understanding and belief about WASH. Then the skillful facilitator also weaves an actual walk around the yard into the visiting time, so that the WASH practices can be observed. By doing the same survey before the course and 1 year after it, findings from both surveys can easily be compared to see the impact on the cognitive, emotive, and practical levels of WASH in each village where our women have a course. Below I will give you a summary of the most significant findings from the first three villages we have evaluated:
Knowledge changes:
- Understanding that unclean water is the most common cause of diarrhea increased from 64%-100%
- Understanding the causes of diarrhea in children:
- Flies: 10% - 90%
- Germs: 25% - 80%
- Not washing hands: 25% - 90%
- Understanding how to prevent diarrhea in children:
- Washing hands after toilet: 45% - 100%
- Washing hands before cooking: 27% -100%
- Washing hands before and after eating: 19% - 89%
- Preventing and killing flies: 10% - 90%
Attitude changes:
- · Reasons for washing hands:
- To avoid food contamination: 33% - 93%
- To keep good hygiene: 20% - 89%
- To prevent disease: 52% -100%
- · Reasons to have a latrine and keep it sanitary:
- Disease prevention: 38% - 97%
- Preventing flies: 26% - 100%
Practical changes:
- · Pre-treatment of drinking water (boiling, filtering) increased from 30%-100% (this is in villages where drinking water is gathered from streams).
- · Handwashing with soap increased from 41%-100%
- · Treatment of children when they have diarrhea: giving ORS: 20% - 100%
And my favorite finding: Before the course, over of 90% of the women in the courses had at least one family member with diarrhea. Exactly one year later, close to
90% of the women reported no diarrhea in their families at that time.
Certainly our work is not about stats, but this evaluation does help us to know that this course has been worthwhile, and worth continuing!
In 2011 the women’s primary purpose was these WASH courses. For 2012, this course will be continued by 4 of our women in new villages, and the other 4 have just started a training we call BLiSS (Basic Life Saving Skills). The BLiSS course is a very interactive course for traditional midwives and mothers. We feel this emphasis is also critical here, where maternal and infant mortality figures are still so disturbing. In one of the BLiSS courses we just started, the women reported that just 3 weeks ago a mother and baby both died during labor at home, just a few kilometers away from the hospital.
Please pray and cheer for our women’s team to continue to serve the women of this country with excellence, and that lives would be saved and transformed because of their interventions.
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