Good health for a child starts long before the child is born. In this concept of health, growing up in preventative, preparation first country where resources and officials have a public health sector that is widely used and implemented, the idea of a child’s health and nutrition is thought of constantly. From the moment of conception to TV and movies, it is a freak out mode to understanding, learning, denial, lots of angry IKEA moments, to finally acceptance and lots of wishing you napped more in your youth.
However, in many countries where public health and the insistence of certain “practices” or options for different birthing plans, or financial situations or birthing rooms or paint colors or naming the baby immediately are as new as the past 20 years, it is common for health to fail not because of lack of knowledge, or poverty but because of culture, and resources that are not there.
To implement policy and fine tune it after and management is a long process. Here in Zambia, women are used to listening to nurses but they are also used to being told to go home after two hours of delivery. There is no recovery room because there is another girl waiting for a bed to squeeze out and scream in quiet while nurses yell at you for not being prepared when being prepared was never in your lessons.
No one teaches you how to give birth or what a baby needs and that bleach is expensive and that babies need more than a bath bucket, towels, hats and crocheted blankets. That’s what they know because they watch their families and their communities prepare and deal with so many situations ad they come but never planning ahead. They have to. They do not have constant incomes or constant variables that help get constant yearly incomes that allow the same amount of maize to be grown and harvested and sold that allows for “planning.”
They are not victims. The mothers of my village are not ignorant, or stupid or no excuse for you to state the words, “these people are likes this especially those used to this poverty.” I don’t care what you think needs explaining on why they don’t follow the “good” book of advice that your mothers and health teachers have convinced you to do. But they are not those girls who do not care. They do not have the means to care because things are handled differently than our mothers have taught us and our society has shaped us into different people. I don’t think we are better but it is easier for us to be better.
We have internet at our fingertips. No one has to stand at the base of a tree on a hill. We have expert advice and incredible upload and download speeds that allow for constant chat and feedback that is immediate. We live in a world where if we do not get an answer back, we seek out an answer or a faster response. Complaint cards were because of us. Comment emails started from the first American who decided to speak our mind. But in the world, where comments were never possible and no solution arose but continuity and constant were the culture, these women have grown in this world of not expecting there to be more. There is no other site with a different opinion or another nurse close enough for a different method. There is one choice. Get help when you can, if you can. Done.
Nutrition is something you cannot prepare for when your food comes during certain times of the year and if and only if, the rain was constant, the soil was dry but mineral rich, the workers plenty, and the seed strong.
And when kale and Vitamin E is so unavailable unless it is part of the year, or when you have the great vegetables but you have to cook it well to kill the diarrhea causing germ that grow from the soil that would harm your growing baby. You cook constant foods that exist all year round that fed you and satisfied your hunger as a child. You didn’t know they were nutrient vacant, dense, but it was filling and it energized you and filled you up and fatten you. And here, FAT is GOOD. It is STRONG. IT IS TOUGH. IT is here ALL YEAR ROUND.
So a breastfeeding campaign to get mothers to sign to feed their children for six months straight on only breast milk is a challenge. It is important, yes but you have day care and pumps and refrigeration and affordable formula mix and you don’t have to carry your child on your back after carrying your child for nine months in your stomach for years to come. These women are the epitome of strength and to breast feed for as many times as required for six months is so incredibly difficult to ask for, not even do.
Breast feeding campaigns begin with education on the importance of a good foundation of nutrition and those who attend make the time because they want to lay down that foundation and those that do not attend are not rejecting the knowledge but instead accepts the evidence that everyone around them didn’t have six straight months of breast milk but still grew up fine.
They are not rejecting knowledge, nor are they bad mothers. They are change that needs to be seen and then only will they can see the benefits. So when I started this project, I thought one person who tried would be a great win. Instead I had six women under the age of 24 try for six months. Until the fifth month, were their mothers tried to integrate slight foods like porridge and peanut sauce and softened nshima and they trust their mothers that their children will be happier with different foods than watery milk that may also have stopped flowing.
Five babies grew increasingly to the notice of so many women who have seen the change. They see that they can try harder for their child and they are ready to try. To see for themselves that they can do as better as their counterparts have done. And the one who listened to old fashioned knowledge and didn’t ask more questions were asked why she lagged behind while her fellow friends excelled. She wanted to try, she said. Of course, she loved her baby but she was not wrong. She wasn’t that convinced as the others were but people could see the difference. She still fed her baby great nutrient rich recipes when he could eat and he caught up but it was shown that her life was normal before I came in. Everything she would’ve done without me teaching would’ve not been noticed or even considered wrong but what every mother does.
My job was not to tell them they did something wrong but to help them see that they can do better and realize that they have choices. Not just to do what is done but to choose between and grow from the freedom of choice.