The village of Saré Woudou has 164 children attending its primary school. Through its participation in Tostan’s Community Empowerment Program (CEP) since January 2013, the community has been learning about the rights of these children to education, health, and freedom from violence, just as they have been learning about the rights and responsibilities of their entire community. Saré Woudou, along with 59 other communities in the Kolda and Sedhiou regions of Senegal, completed the Kobi 1 phase of the Tostan program in July of this year, which focuses on human rights, democracy, and conflict resolution. These communities are now in the Kobi 2 phase, which focuses on hygiene and health.
The mortality rate for children under the age of 5 (U5MR) in Senegal is 65 in 1,000, according to the UN’s 2011 data. Since 1990 the rate has dropped by 48 percent, but in a list of 205 countries, Senegal still has the 45th highest U5MR. In comparison, the U5MR in the United States is 8 in 1,000.
Some of the causes for this high mortality rate are malnutrition, acute respiratory infections, diarrhea and vaccine-preventable illnesses. In an effort to reach Millennium Development Goal 4, which is to reduce the U5MR by two-thirds, the government and organizations like Tostan are working to increase vaccination rates among children. Increasing the availability of vaccines and removing the cost are important steps, but education about the importance of vaccines is critical; many families are not aware of the importance of vaccinations or do not understand the vaccination calendar that must be followed.
During Tostan’s Kobi 2, participating communities learn about vaccines and the role that they play in reducing child mortality. In Saré Woudou, Tostan facilitator Boubacar Diao has begun the four-session series of classes on vaccinations. Like with the rest of its curriculum, the Tostan classes on vaccination use culturally relevant teaching methods to ensure that communities, whose adult populations may have received little or no formal education, receive the information in ways that are familiar to them.
In the first class on vaccinations, Tostan uses a form of story-telling to introduce the topic. Sitting in a semi-circle of over 35 people, the majority of whom are woman, Boubacar Diao begins to read a story in Pulaar. In the story, nine illnesses that are preventable by vaccination are given human form. The nine characters seek out Satan to tell him about their dilemma, which is that they are instigating fewer and fewer mortalities in children because of the rise of the use of vaccinations. Throughout the dialogue, each illness tries to impress Satan by explaining why it is harmful to children, the symptoms that it causes, and how it is transmitted. At the end of the story, Satan consoles these nine illnesses by assuring them that they will still have child victims because people are ignorant: they don’t know the importance of vaccines in preventing childhood death so they ignore the vaccination calendar and do not immunize their children.
Before reading the story, Boubacar asked the class participants what they knew about the nine child illnesses and about vaccinations. After the story, he asked the same question. The participants answered with responses like, “Now I know that other illnesses besides malaria can be transmitted by mosquitoes,” and “I now know that different illnesses sometimes have the same symptoms.” Boubacar asked the participants to raise their hands if all of their children were up to date on their vaccinations. There were many hands that did not go up. Boubacar emphasized to the group that vaccinations in Senegal are free. While they may have to pay money to transport their child to the nearest health post, it is worth it if it will prevent their child from suffering dangerous and costly health problems later on.
Each community implementing the Tostan program creates a Community Management Committee (CMC) at the start of the program, and within each CMC is a Health Commission. The health commission is responsible for keeping the community informed about healthcare information such as when vaccines will be available at their health post, or when health professionals are coming to their community to conduct check-ups. In cases where families may not be able to afford the cost of taking their child to where the vaccinations are being given, this commission is charged with ensuring that these children are still able to access health services.
Saré Woudou’s participants will have three more classes on vaccinations. They will explore the vaccination calendar in greater depth to learn at what ages children should receive which vaccines. In the third class, participants will split up and conduct a survey in each neighborhood of their community to determine the vaccination status of their children. In the final class, they will evaluate the survey results and prepare an awareness-raising activity to disseminate the information about what they have learned to the rest of the community. With a community that is well-informed about why and when to vaccinate their children, the infants and children of Saré Woudou will have a greater likelihood of being vaccinated and protected from illnesses so that they, like their 164 older brothers and sisters right now, will be able to grow up and attend their village’s primary school.
Story by Allyson Fritz, Regional Volunteer, Tostan