An entry in The Crocodile Prize
SHE stood by the blackboard beside a picture of a crude tree that she had quickly sketched. In the middle of the trunk was the word ‘diarrhoea’ and underneath it was written the word ‘problem’.
Seated around her were health professionals; nurses and community health workers experienced in remote and urban clinical work.
The question seemed very basic, almost an insult, but they were there to learn how to facilitate a community training so took it in good faith- after all they were pretending to be community members for this lesson.
“Why is diarrhoea a problem in our community?” she repeated. The answers came thick and fast and she had to hold up her hand to stop the myriad of responses. “Okay let’s get them one by one and work through them” she said.
A good five minutes of discussion followed this statement and afterwards it was agreed that it was due to the lack of proper sanitation, the biggest of which was the lack of proper toilets.
“But why?” the facilitator inquired, “Why do communities not have proper toilets in the first place?” This led to another 10 minutes or so of discussions with the conclusion being that there was a lack of education about sanitation in communities.
The group was unanimous in its discussion however that even in communities were sanitation was taught, building proper toilets and using them was still an issue.
This led to many stories and experiences from the participants about communities who were shown how to build toilets (in some instances a good deal of money was spent in building really nice ones) that ended up not being used at all.
“But why?” came the probing question again, why wasn’t education sufficient in addressing the issue of building and using toilets?
Various answers were given and parleyed ranging from laziness and stubbornness of communities to indifference and a no care attitude.
Finally a quiet young man who worked in a health centre in a remote location spoke up; “We haven’t gone down to their level. We are telling them what we know and understand and trying to make them understand. We are telling them why they must use toilets but we need to understand what they know and why they won’t build or use toilets.”
The room became quiet and the facilitator allowed time for this statement to be absorbed by the other participants.
Finally another spoke up, “It’s our culture; sorcery and the fear of sanguma means many won’t venture too far away from their homes at night.” There were beliefs that a store house for waste would enable enemies to collect faeces to put a curse on you or attract sanguma who loved feasting on faeces.
As silly as it seemed, the health professionals each understood the reality of this issue. Education on sanitation was not going to work in an illiterate community where the belief system and world view ingrained since time immemorial held a firm grip. It was a sobering moment; the answers would not be precise, it would take hard work to change attitudes.
But the beauty of the tree diagram wasn’t finished. The reason the tree was there and being used was to show communities the impact of their belief. So working upward the facilitator started asking another set of questions.
“So what happens when people get diarrhoea?” Again the answers were fast in coming and working slowly through them the following was derived; when a child or person dies as a result of diarrhea what happens is that people start talking about sorcery.
So what happens when they talk about sorcery? They accuse a person. So what happens when persons are accused? If they are defenceless they are most likely murdered.
If they have family and connections, they rise up to defend themselves and this often leads to tribal warfare. Also the death leads to a lot of expenses in the form of payment to relatives and funeral costs.
The group grew thoughtful as they pondered the reality of this situation. Hopefully they concluded this would lead communities to the realisation that lack of a healthy lifestyle could result in warfare. This seemed quite a stretch but as the participants began discussing it they could see how it made sense.
The realisation that sanitation was rooted in animism gave new direction in how health workers approached health awareness and education.
The Christian health workers talked about replacing the fear of death and darkness with the truth of love and life. How they had to find those within the communities who professed Christianity and hold them accountable to lead in a practical way.
To show that they had no fear of poison and sanguma they must use toilets as a testament of their faith. They could engage churches and community leaders and give them sanitation lessons and help them understand that maybe more were dying from germs then from sanguma and to prove this they must build and use toilets.
Others discussed the issue of ingrained fear and how children were raised with fear as the primary method for achieving obedience.
Even if as adults they knew that maybe sangumas didn’t hang around near toilets the fear was programmed into them and would be very hard to erase. This led to discussions on intervention lessons with new parents etc.
A lot more interesting discussions were held and it was realised that maybe answers that seemed very clear in theory needed tweaking and a thorough local understanding of how issues were viewed and a very local approach in how issues could be addressed.
It seems unreal doesn’t it? Fear of sorcery leads to poor sanitation resulting in death which causes murder and tribal warfare.
Go figure, but this is our reality and for sustainable development to happen we must address these kinds of “grass roots” issues in “grass roots” terms while waiting for quality education programs and other infrastructures to reach the majority of our people which then might hasten the change in attitudes.
Meanwhile text book answers just won’t cut it. More than 30 years on we’re still addressing the same issues that our Kiaps were addressing, something has to change.
We have to change. We have to care enough to peel away the layers of easy answers and get to the root of the problems that we Papua New Guineans fully comprehend but for various reasons are hesitant to address because we will be viewed as different.
Believe the different, live the different, facilitate the different to make the difference for our communities and country.