22-8
Adapting new ideas to old beliefs
In Lardin Gabas, Nigeria, health workers learn to teach new ideas through the
local tradition of story telling (see p. 13-5). They also learn to adapt their health
advice to local beliefs.
An example is a story they tell to help mothers and midwives learn about the
prevention of tetanus in newborn babies. Midwives in Lardin Gabas traditionally
rub dry dirt or cow dung into the end of a baby’s cut cord to prevent bleeding. The
result is that babies often die of tetanus from the infection that enters through the
cord. But people think the illness is caused by a certain kind of bird that lands above
the baby. They believe that when the bird sings, the spirit of the baby flows out
through the cord, causing the baby’s body to stiffen with spasms.
The story the health workers tell
describes how a village midwife learned
to prevent this form of infant death. After
carefully washing her hands, she would
tightly tie the baby’s cord with clean strips
of cloth, then cut it with a boiled bamboo
knife. Later, when the bird landed over the
baby and sang, the baby’s spirit could not
escape because the cord was tightly tied.
Questions for discussion:
If you tell this story to a group of health workers-in-training, have them discuss its
strengths and weaknesses. Ask questions like these:
• In what ways does this story help mothers and midwives gain greater
understanding and learn healthier practices?
• In what ways does the story mislead people or block their understanding of
important causes of disease?
• Which is more likely to help people gain control of the events that affect
their health and lives, a magical or a scientific understanding of causes and
results?
• What are some problems that might result from the fact that the story makes
it seem like tying the cord, rather than cleanliness, is the key to preventing
tetanus? Can you retell the story in a way you think is better?
Reporting information about births
Keeping records of prenatal care and providing accurate information when
referring emergency births or complications to a hospital is an important part of
any birth attendant’s job. On page 10-8, we discuss the need to keep such forms
simple and useful. Health workers and midwives who can read may want to use the
RECORD OF PRENATAL CARE (WTND, p. 253). But for those who cannot read,
other solutions are needed.
Health workers in Ecuador have developed a reporting system for midwives,
using different colored cards. Local midwives learn to associate each color with a
specific problem: red if the mother is hemorrhaging, white if she is very anemic
(pale), blue if the baby has delayed or difficult breathing, and yellow if he is
jaundiced (yellow).