Crossing Gender Lines for Children’s Health July 9, 2013 by jamiep
Photos and Story by: Caitlin Kleiboer, 2013 CFK Peacock Fellow
A few weeks ago, several community health workers and I gathered in a room on the top floor of Carolina for Kibera’s Tabitha Medical Clinic. Men and women came in wiping their brow from their long walk in the mid-afternoon sun from three Kiberan villages—Kianda, Gatwekera, and Soweto West—served by the CHWs working through the Tabitha clinic. Roosters crowed outside, and out of the windows, all you could see was a sea of tin roofs colored brown by years of rust and dust.
Those images may not be what usually come to mind when someone begins a story about breastfeeding workshops.
Lately, the Tabitha Medical Clinic has been holding these workshops for the community health workers (CHWs) on staff. CHWs extend the Tabitha Clinic’s message of accessible healthcare for everyone by traveling to different parts of Kibera and interacting with community members in their homes. They assist with a number of initiatives, including home-based HIV/AIDS testing and counseling.
So far, the clinic has held 2 breastfeeding technique trainings, with 6 more coming up. Before the session a few weeks ago, I was able to meet briefly with Dr. Grace Irimu, the workshops’ instructor, to learn more about the training and the community’s need for it. Dr. Irimu is a pediatrician and professor at the University of Nairobi’s School of Medicine. She explained that breastfeeding has not been taught in medical schools in Kenya, and that there is little to no emphasis on the importance or benefits of breastfeeding for the child or mother. After years of being a pediatric nephrologist (a children’s kidney specialist), she became frustrated with the cases she saw day after day—cases that were almost always preventable. She now focuses her time instructing classes and workshops such as those being offered at CFK’s clinic.
For me, the most fascinating aspect of the training was how much emphasis everyone put on the male community health workers’ attendance. 7 of the 20 participants were men, who were very engaged in the conversation and excited to implement what they learned. Future trainings are going to focus more on male CHW attendance.
When I asked why that focus will shift for upcoming trainings, I learned that the women who the CHWs serve are more likely to listen to advice on breastfeeding from men, rather than advice from other women. This surprised me, given that much of what I learned in my public health training at UNC suggested that women are more apt to listen to health advice from other women, especially their female family members.
Following up with this, I spoke to Mark Muasa, the Clinic Manager at the Tabitha Clinic. He explained that men need to be involved in the discussion and practice of breastfeeding because they are most likely to represent the role of decision-maker. Training more male CHWs will open more avenues for informing the men of the household. If you can get buy-in from men and impress upon them the importance of breastfeeding, the women will be more likely to also accept it.
It’s really a genius idea. By acknowledging that gender roles shape relationships, the staff at the Tabitha Clinic are using them to help improve health in the community while they also work to re-shape those roles.