First of all, remember in August and September when I described doing a door-to-door health census and making a map of Villa Faro to inform our newly-trained community health promoters there? Well, since then, these promoters have been visiting neighbors’ houses, checking on the sick and educating the well. We have presented workshops on potable water, HIV/STD’s, dehydration and diarrhea, respiratory illness, women’s health, and other topics. We’ve visited each promoter every other month or so to ask how visits are going and to sometimes accompany them. Overall, the Villa Faro Health Promotion program is in full swing and doing well.
But about three weeks ago it came time to think about giving the vaccine training workshop. We realized that our materials – our manual, posters, etc. – were out of date, and that we’d have to start from scratch in designing the workshop. Somehow the task of compiling a new manual fell to me, and I was left to sort through the government's public health nurse training manual, our old manual, and a medical dictionary…. all in Spanish, of course. I decided what from the public health manual was important to include and what was too technical; I updated the information in our old manual to include the new vaccines available and the new schemes in use; and I distilled the medical dictionary entries on each illness to give a basic overview of exactly what these vaccines are preventing. After I typed it up and the other two members of the team checked it, we were left with a simple, clear, 23-page manual on the importance of vaccines, how they work, special considerations, administration scheme, the preventable illnesses, and how to approach a family about vaccines and verify the children’s vaccine records. Our medical director added images, a cover page, and brought it back from the printer’s bound in shiny plastic and ready to go! Yes!
Then we decided to base our presentation on the manual, using the same topic order. We split the manual into four sections and each of us was responsible for organizing and presenting our chunk. Channeling middle school, I made a big chart showing all the vaccine information together for the presentation: 
That poster earned me much admiration from the team and before I knew it I was making everyone’s posters, tracing pictures of babies, coloring with crayons, and block-printing definitions and lists. (Kids here don’t get much practice/play with construction paper, markers, rulers, and glue in school, so everyone is consistently impressed with my ability to print and color. It’s a reminder of the privilege I had even in elementary school – how sad that children miss out on that.)
The night before the presentation, I stood in front of the mirror and practiced my five-minute chunk over and over. It went something like this: Ah! I forgot the indirect object pronoun! My tongue catches on double “r” sounds! I can’t say “domiciliaria” and sound like a human! Ah! Ah! I could hardly sleep I was so nervous. In retrospect, it’s pretty funny. After years of presentations and performances, memorization and improvisation, I flip out over five minutes of common sense and spend an evening staring at my flip-flopping tongue in the mirror. Haha!
But the next day, I felt ready and excited. The day of passing out my lovely manual, showing off the beautiful posters, and doing my first chunk of group training in Spanish had arrived! My chunk was last, so I took pictures, prepared the snack, and helped with small-group activities until then.
In small groups, promoters brainstormed common reasons parents give for not vaccinating their children. These can include:
- The last vaccine made my baby sick and gave him a fever, so we’re not going again.
- All vaccines cause allergic reactions.
- Grandma and I were never vaccinated and we’re still around, so why should I vaccinate my baby?
- My baby has/had a cold/fever/spots in his mouth/diarrhea/etc.
- It’s been too long since his last vaccine, so we shouldn’t finish them.
Groups presented their ideas and we talked about ways to address these concerns, and clarified questions about contraindications to vaccines. Did you know that a baby can be vaccinated even if he is sick, is taking medicine, is recuperating, is malnourished, has allergies, or is very behind on the vaccination scheme? Many people in our workshop didn’t.
During the afternoon, promoters learned vaccination methods, practiced reading various hypothetical vaccine records and identifying missing vaccines, and enjoyed a break:
Ten minutes before our scheduled ending time, it was my turn to present. I stood up and talked about how to interact with families during a home visit about vaccines. My favorite part, where I got to do some acting, was showing that it’s better to encourage rather than criticize. For example, it’s not a good idea to say: “Look! Your child is missing vaccines! You’re a terrible mother!!” (Here, the audience graciously chuckled – score one for Kate!) Rather, it’s better to say: “OK, here is evidence of part of the scheme; let’s talk about your plan for completing it.” I also emphasized that every home visit, whether it’s just a check-in or a requested visit to assess an illness, is a chance to talk about vaccines or to check a child’s vaccination record. When I asked at the end if everyone had understood me, they all smiled in an encouraging way and said, “Yes!” Wahoo!
We thanked people for coming, packed up the jeep, and headed back to the clinic. That evening, I reflected on all the hard work I’d put in to the presentation, and thought about all the work the rest of the team had done, delivering invitations, reserving the church space, organizing activities and buying supplies, and doing the majority of the presenting, in addition to all their regular clinic duties. Truly, I am so proud to be a part of this capable and dedicated team.
Next, we will start training promoters in new communities to follow the path of the Villa Faro group. We are currently gathering volunteers, doing our preliminary census, and making maps, but soon the program will begin in two new communities. And I’ve already been assigned a big chunk of the next presentation, most likely on how to be a health promoter. Here we go again!
I hope everyone had a peaceful Easter. Enjoy spring, and if you see a crocus, please say hello for me!
1 comment:
wahoo indeed! that is so impressive, kate. you'll have to re-teach me spanish when you return. Also, you were in my dream last night! i miss you! xoxo me
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