HEALTH EDUCATION as such is a fairly new field. We as a church, however, have always believed in health education from the earliest beginnings of "health reform" until a more complete plan of health education was incorporated into the sanitarium philosophy of operating health institutions.
This same concern with health education has also been part of the overseas church program. Many mission stories we have heard have related how individuals or entire communities have become Christians, and then have become known as "the clean people," in contrast to their unhygienic living conditions be fore they accepted the gospel.
Although it is true that the gospel should affect the entire life, a change in health beliefs and habits of daily living does not come about merely as a result of baptism but rather as a result of some form of health-education program carried on over a period of time. The kind of program presented will depend on the situation and local needs.
What follows is my personal experience while working as a full-time health educator for the Ethiopian Union Mission of Seventh-day Adventists. The continuity of the program has been interrupted several times, how ever-, while I have been on fur lough or engaged in other work. Thus the following observations are basically the result of two pilot projects carried on at separate times, but both having to do with establishing simple home-health classes for our women church members, as this was felt to be the area of greatest immediate need.
The project was carried out first in the West Field and then in the Southwest Field of Ethiopia. These two fields have a combined church membership of about 13,000, and account for more than three fourths of the total member ship in Ethiopia. Our aim was to prepare a simple home-health course that could be taught by the local church leaders under the supervision of the district leader.
The problems particular to our situation were these: practically all the women living in the countryside are not only illiterate but also do not understand the national language in which the health material would be printed; the material should be about fourth-grade reading level in order to be widely utilized by the local church leaders; and we were quite certain that owing to shrinking budgets, I would have an Ethiopian assistant only during the first pilot project. Therefore the supervision of the health classes should be made as easy as possible for the district leader who is in charge of from six to even thirty churches or groups of believers.
Our first step was to talk with the church leaders at the West Field headquarters. We then set up a health council composed of the field mission president; the secretary-treasurer; the doctor and graduate nurse from the mission-operated hospital; several church members from the community, including a graduate nurse who operates his own pharmacy; and several women, among them the cashier of the hospital and the wife of the church pastor. Whenever any of the district leaders were present they were asked to attend the health council meetings. This council acted mainly as an advisory board, while a smaller committee did most of the actual planning.
It was decided to run the course for ten or twelve weeks only so that the women would not lose interest before they finished and received their certificates. After many topics were suggested, the committee chose the most important common health topics found throughout the country and those whose solution was within the scope of a home-health course.
In the teachers' guide each lesson consists of a short introduction using an Ethiopian story or proverb, and four questions and answers, each fully explained. The class members' booklet has only the questions and short answers, with an illustration for each question. In this way, the women can study their lessons from the pictures only or have a school child read the questions and answers as well. These small picture booklets were enlarged and prepared for the teacher to use as a flip chart.
In the preparation of the material, we began with the beliefs and knowledge of the people about any of the given health topics. Then we attempted to lead them to the correct solutions. A group of women from different parts of the country pooled their knowledge of what is believed about any of the health topics, what the problems are in connection with it, and how a family could solve them in the best and medically correct way.
After plans were formulated for the course they were presented, discussed, and approved at a general workers' meeting for the West Field. We found that the best way to introduce the program was to visit the church, preach a regular sermon, then talk about the importance of health and the advantages of the health classes, being sure to appeal to the men, as well as to the women. Usually we began our classes the next day. In such a program, timing is very important, for classes must be begun when the women have enough extra money to pay the small registration fee and when they are not too busy with field work or too occupied with getting water in case of an unusually dry season.
The results of the first pilot project were gratifying. The course was conducted in seven churches. Of the 221 women who enrolled, 152 completed the course, passed the oral examination, and received a certificate. At the Gimbie graduation the local governor gave a speech and presented the certificates. Our alert public-relations secretary took pictures, and the story was printed in the leading Addis Ababa newspaper. As a result of a radio interview covering the story, the series of health lessons was broadcast in English from Radio Voice of the Gospel, sponsored by the Lutheran World Federation, in a program beamed to India, Ceylon, the Middle East, and all of Africa south of the Sahara.
From this first experience we gained these insights: We should visit all government agencies engaged in health-education programs, learn of their successes and failures, and profit thereby. It is important to collect all avail able health-education material before beginning the program. We also need to find ways whereby health education can be con ducted in all institutions and on all levels. All interested personnel should be utilized. For example, as part of their classwork, the home-economic students in the secondary school at the Ethiopian Adventist College have conducted a village home-health class using our materials.
Our efforts should be combined with those of government workers whenever possible, such as in con ducting immunization programs. It is important to depend heavily on the advice of the people living in the locality. In developing programs it is necessary, of course, to experiment constantly and to be ready to adapt or even drop a cherished idea if necessary.
Finally, and perhaps most important, we need to go out into the villages and countryside constantly and visit the people at church and in their homes and be come their friend. Only then will we begin to understand their health problems so that we can also begin to think of solutions in terms of true possibilities. This knowledge will carry over into a broader understanding and a deeper insight into the spiritual needs of the country people, which cannot be gained by working in institutions situated in com pounds shut off from the daily life of the people.
Success comes slowly and in small portions, as when after several years' absence you unexpectedly visit a woman whom you taught to nurse her baby from both breasts instead of fol lowing the local custom of nursing from the right one only. When you ask her why she is nursing the baby from the left breast, she replies, "Isn't that what you taught us?"
Success is when the district leader says he can tell a difference in the level of cleanliness and child care after many of the women have attended the health classes. It is also felt when a few parents follow instructions for better feeding and several children recover from severe malnutrition and kwashiorkor.
And you are thankful when some of your young national helpers express an interest in health education as a career, even though they have also squeezed into a crowded Land Rover taxi, and after a jolting ride, walked up and down the hills with you in the heat of the day. It is at such times that you are happy and content to be in health education, doing what you can, with God's help.
