Great column in today's NYTimes about relearning breastfeeding in Niger.
-- Marguerite Herman, Wyoming
The Breastfeeding Movement in Rural Niger
By NOREEN CONNOLLY
<http://kristof.blogs.nytimes.com/author/noreen-connolly/>
/Saumya Dave, a student, and Noreen Connolly, a teacher
<http://www.sbp.org/>, are the 2011 "Win-A-Trip" winners and are
currently traveling with Nick through parts of North and West Africa.
Noreen's second post is from Niger. /
You know the saying, "You can't teach an old dog new tricks"? I never
thought much of it or about it. But today when we visited two different
health care centers in southern Niger to talk to health care workers and
breastfeeding mothers, I remembered why I thought it was nonsense.
A large group of women had come to the center with their babies because
they had been told that guests of Helen Keller International
<http://www.hki.org/> wanted to see firsthand the benefits of exclusive
breast feeding of infants up to age six months. Along with the moms and
babies came other family members, mostly children and a small group of
Traditional Birth Attendants (TBA's), untrained and illiterate village
women who deliver babies. Nick had said they could be a real threat to
mothers' and children's health-even their lives -- because they deliver
babies under really unsanitary conditions, aren't unequipped to handle
any complications and don't encourage breastfeeding from moments after
birth, depriving the newborns of all the health benefits of colostrum.
But here was a group of TBA's sitting proudly on the floor of the
integrated health center of the village of Doubatma surrounded by young
mothers holding their chubby, healthy looking babies. The TBA's told us
how much prettier, bigger and stronger babies are when they are
breastfed from their first moments of life to six months.
Maybe because I am older --perhaps older than the TBA's -- I had a soft
spot for these women even though I was well aware of the terrible damage
they had done and still could do. They are entrepreneurial and
apparently important members of the village social structure. Elders.
And, more importantly, they probably would not be pushed aside by the
health centers' offers of safer and superior care during childbirth. One
health center official told us that when the TBA's deliver babies in the
village they are paid in CFA (the currency of this part of Africa) and
probably get many other in-kind payments like chickens or millet. Four
TBA's, Alama, Tassa, Balkiwa and Taroua, could have been put out of
business by the health centers and everyone would have been better off.
Except them.
Shawn Baker <http://kristof.blogs.nytimes.com/author/shawn-baker/>, Vice
President and Regional Director for Africa for Helen Keller
International, who organized our visits to the health centers, hospitals
and other health, nutrition and educational initiatives , told me there
was no way that the TBA's could be marginalized if the maternal and
infant health programs were to succeed. So HKI figured out how to bring
them along. They do local training and community information sessions.
And the health centers pay the TBA's 1,000 CFA (just over $2) for
accompanying the mothers to the center for childbirth. The TBA's take a
financial hit but they don't continue to impede progress and maybe their
standing in the village remains. Virtuous bribery.
Through the interpreter I asked one TBA, Tassa, why she didn't
exclusively breastfeed her own infants. "They didn't do that," she said.
"They didn't know." If she and other TBA's really buy into the health
centers' teachings on exclusive breastfeeding and safe childbirth, other
women's children can be saved. New tricks? Maybe so.
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