On performing illness, part 1.

We break for lunch. The meal is a small piece of overcooked goat slathered in a salty brown sauce (quite literally salt, onion, water and brown coloring) and millet bread (actually kind of a dough) served on multi colored plastic plates. I get pulled out of the room by the chairman who complains that we have not purchased soda for everyone. I explain why I think buying sugary soda instead of clean water (in a camp that has no running water or sustainable food supply) is not something I want to do. Instead, we have brought raspberry leaf tea. The chairman is annoyed. He wants soda. I return back to the lunch area and Olivia explains the benefits of this herb for women and gives everyone some seeds along with their cup of tea, for their own harvest. We do a ‘raw foods’ demo- talk about the nutrient and medicinal value in eating raw veggies that grow in their area- like garlic and avocado- we make guacamole and it’s a hit. Women scramble on top of each other and argue about who had a bigger sample. Is this as good as the bliss of a cool, bright orange Fanta sipped from a glass bottle? It's all in how you look at it.

Upon return to the workshop space there is a commotion. Everyone is huddled around a woman and speaking rapidly. It seems this woman’s money has been stolen. She brought her entire months earnings with her (20,000 shillings, or about $13), and it is gone. She is inconsolable. There is a group discussion about who and how. Someone suggests that we all give 500 shillings (30 cents) so that she can recover the $.
Everyone agrees but the woman refuses to accept it. She says it is gods will that the money was taken. Upon her refusal everyone turns to us to begin the workshop. There is nothing more to be done.

We begin with stories. The playback theater was so succesful we do it again. The first woman stands and delivers her tale in rich detail. As she comes to the climax of the story the woman whose money was stolen falls to the floor. She is unconscious. Everyone gathers around her and begins fanning her and a group prayer invoking jesus into the room is instantly organized. Olivia and I check her pulse- it is strangely normal for someone who has just passed out. The decision is made to move her to the middle of the room and out of the seating area. As we lift her, she becomes rigid. Not the body of someone who is unconscious. She is performing. And her audience is responding. Women are wailing and praying, others have run to get medicine from the nearest health unit, some sit and silently witness. Olivia runs some cold water through her hair and she opens her eyes. She moans loudly and everyone who was sitting to the side rushes to her again. A woman returns from the health unit with some sort of pill which she places in her mouth, washes it down with water.
What is that pill? I ask.
It’s for high blood pressure, the woman responds.
There seems to be no logic to the giving of the pill or its intended function in the body- instead it seems that the notion of medicine, any medicine, as instant healer, will work.
And it does. The placebo effect of the high blood pressure medicine takes immediate effect in this performance and the woman sits up and returns to her seat. Everyone is greatly relieved and we return to our regulary scheduled programming. By the end of the day she is smiling and laughing with everyone else and eventually announces she will in fact accept the offer of everyone antying up 500 shillings.

On the ride home I think about illness and how it works in the body. We know that most illness is indeed psychological and so is there ever really anything that goes on in the body that isn’t in some way performed through the will of the mind?I know this to be particularly true in childbirth. Once women are able to overcome any fears that are psychologically blocking labor and accept the support and love of those around her, labor tends to happen much more quickly and with fewer complications. And to what end do we need to perform our illness or pain (especially if it is ‘real’) in order to engage the necessary response of help and care from our community? As illness is an extremely isolating experience, it is also one that directly calls on the community to witness and to be present. An interesting juxtaposition.

How to do interventions with words

Return. Re-focus. Re-shape. Re-shift. Reflect.
Those 'Re' words all have to do with turning something around. The 'Re' is an intervention on the word itself.

People ask how the trainings went and I realize I am uncomfortable with the word because it sets up a necessary information hierarchy.
So, I have been using the word workshop, because I think it is more descriptive of the dynamic of Olivia and I as ‘facilitators’, not information providers.

It seems to me that issues of power are largely issues of voice and inherently, listening- who feels empowered to speak, who is listening when one speaks and how that voice shifts or effects change.

The last few workshops were magical. We were talking about how the war effected birth, and used playback theater techniques of having women share their stories and then other members from the group ‘playback’ and act out the story they heard. What happened was that as the stories came to life, more and more women wanted to share and the details in their narratives began to grow more and more vivid. Stories of pushing babies out while hidden in barns and gunshots are being fired down below, stories of running in labor to escape abduction, stories of giving birth alone in the bush while villages burned to the ground in the background, I could go on and on but you will all hear the audio soon. These stories were enacted with such talent and love and enthusiasm I was brought to tears many times.
Women in general and especially women of color and especially women of color in third world countries and especially women of color in third world countries that have been ravaged by war, have historically been and still are, an underheard population. In order to create a holistic health space where each midwife is an equal part of the team, I cannot think of anything more important than cultivating voice. Cultivating voice inherently cultivates listening, cultivating listening cultivates questioning, cultivating questioning cultivates best practices.


As the workshop continued I asked the questions: How can our stories act as a political intervention? How can what we do as midwives help to shape and shift this countries next generation?
Women broke off into groups and we discussed the questions and tried to come up with answers that led to direct action steps.
As I have written here before, apathy is a very real coping mechanism after severe trauma. Those who study poverty cycles note that ‘the sense that one does not have any personal power or ability to make change leads in their own lives is the key to the continuation of poverty’. Apathy, or a sort of numb waiting for others to hand you information creates the necessary conditions in which a community can accept with little resistence, gross violations of human rights.
So how can midwives create an active space? One in which there is a sense of individual investment in the work and therefore, community change.

I want to ask the same questions of anyone who might be reading this blog as well. How can we use our agency as women with voices/stories as both political intervention and as medical intervention? How can apathy be addressed and redressed, reshaped, redone?

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