The Gboguhé Women’s Health Project
Côte d’ Ivoire, West Africa
Proposed by Erin Hereford, Peace Corps Volunteer
Introduction
After spending 6 months in my village of Gboguhé, I am beginning to understand the way of life here. Although my work is mostly with the men, I would like to understand more about the women and their health. Little is really known about the health of women in Africa, and as I work with them side by side, and observe their daily routines, I am overwhelmed with how hard their lives are. I can’t help but think that there must be some links between their health, living situation, and workload, factors which all change with the ethnic group. I would like to document this in a systematic way so to begin to identify common health problems in the hopes that those that come behind me might begin to create some change to improve the health of women.
Background and Significance
Women play a very important and often overlooked role in West African society – it is their work, sweat and blood that supports each tribe, village and family. The men work hard in the fields to be sure, but they spend their evenings drinking (tea for the Muslims), strolling around the village, and visiting their friends. It is the women who must walk round trip to the wells, pumps, or other water sources morning and night with 15-gallon containers on their heads. They prepare every meal, generally a two-to-four-hour endeavor, and usually for many more people than just their immediate family. They join their families in the fields for eight to ten hours a day; carrying back any needed firewood or foodstuffs on their heads. If there is a market nearby, time is spent preparing something to sell for a little income, even if that means missing a few nights of sleep. They wash the clothes, the dishes, the house, the children, and in most ethnic groups they are even expected to stop whatever they are doing at any given time to carry their husband’s bath water to the shower area for him. Many areas find women bowing to their husbands every time she addresses or hands him something. And yet I sit in my village and listen to the men explain shamefully that their “women are too lazy.”
Girls as young as 7 carry nearly as much weight as adult women, sharing as many chores as possible and often the charge of younger siblings. They are expected to learn everything they need to know about being a good wife before they move away to a new husband’s village. Even pregnancy doesn’t slow down the work. On a daily basis one can see an extremely pregnant woman (generally with another baby tied to her back) weeding her cassava field, pounding boiled plantains into foutou, or bending down to lift a ridiculously heavy item and place it on her head. I have been with a friend who went into labor while doing her daily chores, and insisted on finishing washing the dishes before going to have her child (an hour and fifteen minutes of labor, being her seventh child), and then returning to the fields two days later.
The primary problem with this scenario is that, with such an overwhelmingly full schedule, women never have time to care for themselves. If they get sick, they may go to a local healer for some herbs or other traditional medicine, but generally they don’t have the time for even that, and continuing such a work level when sick would be debilitating to even the strongest worker. In the Ivory Coast, local health services, if they exist in the village at all, generally take up more time and money than women can afford. Health workers are assigned to regions throughout the country, to intermingle the ethnicities, so if a woman doesn’t speak French (as many do not, due to lack of money and access to education) she can never explain any symptoms, and many would just never go to talk to a strange man about her body.
Secondary problems are numerous. Polygamy is seen by many men as a great way of easing their wife’s work; if there are TWO wives, it cuts the work in half. Plus, when one wife is pregnant, as one almost always is, he has another bed to turn to. Young girls are kept out of school to work and care for younger children. They hold their self-worth so low that many are embarrassed just to tell you their name in front of other people. Females continue to see themselves as objects, workhorses, and possessions.
Project Description
Sampling
There are three main ethnic groups represented in my village and the surrounding campements: the Bété, a rather rowdy, mostly Christian group with some outspoken women, known for being feisty and jealous; the Djoula, mostly Muslim, generally found in a neighborhood of their own and not really interacting with the others; and the Burkinabé, immigrants from Burkina Faso who live mostly in the campements located outside of the village proper, whose women are always expected to bow.
The three groups provide such a contrast that I can’t help but want to compile comparative information on the women of each. Every Saturday at our market, women from miles around come to buy, sell, trade, and chat. So I would like to spend Saturdays interviewing as many women as possible about their health, their work, their stories. Three Bété women and one Djoula woman, all friends of mine, have shown interest in translating for me (I am on the search for an intelligent, French-speaking, outspoken Burkinabé woman, as well). For four consecutive Saturdays, we would rent a booth at the market, and verbally invite any interested women to come answer some questions. Questionnaires will have been translated by myself and my friends into French and the answers will be written out in French. Those who participate will receive their choice of a small gift or the equivalent in cash.
After initial interviews, women will be invited to share further information. These conversations will take place during a time agreed upon between myself and the woman (and a third-party translator, if needed or requested) and will be tape recorded. I would like to take two Polaroid photos with each woman, one for my records and one for them to keep. Women who participate for three or more interviews will receive a t-shirt, as will the translators. The translators will also be reimbursed for the market days that they spent doing interviews and for the time taken away from their own work to prepare for this project.
Protection of Human Subjects
The participants will be assured that their names will not be known to other people. We will keep a log of each woman and give her a number; if they consent to coming back a second time, we will be able to track each woman with her number. Names and numbers will be kept privately so that no one but the researchers will have access to the identities. Women do not have to participate in the project if the questions offend them or if they become uncomfortable answering them, but partial interviews may be used. The information will be kept in the Peace Corps house where the data will be analyzed.
Data Analysis
I may or may not have access to a computer. The questionnaires will be analyzed by using descriptive statistics – a count and sort method of data analysis. I will be able to give percentages for each of the responses. The interviews that are tape-recorded will be analyzed by listening to the tapes and writing down important content that women have to offer.
Risks and Discomforts
The biggest risk of answering questions about health for many of these women will be their husbands. The men may be concerned or jealous about the women getting too much attention, especially if it is a topic that does not concern them or that they find to be of little import. There may also be some individual discomfort in discussing issues around reproduction and sexuality. In either case, the individual may indicate that she is uneasy, and assistants will stop that line of questions. The participants will be told that they don’t have to answer any question that makes them feel uncomfortable.
Potential Benefits
The most important benefit from this project, I believe, is that the subject of women’s health will be a topic of discussion in our market for weeks. I hope that the fact that I have used great discretion in choosing projects to work on over my two year service will give these women a sense of worth and the realization that their health, their lives, and their work is very important. The women involved in the study will also be compensated for participating. The benefit to the community as a whole is identification of women’s health problems in this underdeveloped village. Projects could then be identified to create change.
Funding and Budget
I will seek private funding from US citizens who are interested in helping with this project. My family, church, and community will be specifically approached to assist by giving a contribution of not more than \\$10 USD each.
Budget Projections
Following is a budget based on 200 participants. 1 US Dollar = 700 CFA.
| |
$US |
CFA |
| Paper, pens and photocopies |
17.14 |
12,000 |
| Booth rental |
14.29 |
10,000 |
Presents for the participants:
$0.70/500cfa each (x200) |
142.86 |
100,000 |
Reimbursement for Translators:
Market day:
$4.29/3000cfa per day, 4 days,
5 women
Non-market day:
$1.43/1000cfa per day, 6 days,
5 women |
85.80
42.90 |
60,000
30,030 |
| Polaroid Camera, film and batteries |
200.00 |
140,000 |
| Tape recorder, tapes and batteries |
60.00 |
42,000 |
|
|
|
| Total |
562.99 |
394,030 |
The t-shirts have been offered as a separate gift and will not be included on this budget.
The Gboguhé Women’s Health Project
Questionnaire
Age: Ethnicity: Village -- Campement
Religion:
Where were you born?
Where do your parents live? How many km from Gboguhé?
How often do you see your parents?
Did you go to school? Until what grade/age?
Daily Life
On an average night, how many people do you feed?
How many meals do you prepare each day?
How much time does an average meal take to prepare?
What meals do you usually prepare?
What is your favorite meal?
Do you sell anything for extra income?
What crops do you plant throughout the year?
How many days a week do you go to the fields?
How many hours a day do you work in the fields?
Do you belong to a women’s work collective?
What days and how many days do you meet?
What activities/crops do you work on?
Do you belong to any other groups?
Living Situation
Are you married?
Is it your first marriage?
If no, how many times have you been married?
At what age did you first get married?
Do you have any co-wives? If yes, how many?
How many children have you had?
Did any die during childbirth or within the first 6 weeks of life?
How many are living now?
What age and sex are they?
If deceased, at what age did they die? How?
Where do your children live?
If not with you, how often do you see them?
Do your children go to school? What grades?
Who pays for their schooling?
Who else lives in your house? In your courtyard?
Do any of these people help with your daily housework?
Menstruation/Circumcision
At what age did you have your first period?
Were there any rituals or parties associated?
Describe your average menstrual cycle - how often does it come, how long does it last?
Any discomforts with it? (cramps)
Do you experience any discomforts the week before your period, such as headaches, breast tenderness, or moodiness?
Are there any traditional treatments for it?
What do you use for feminine products (to collect blood)?
Are there any traditional taboos that go along with women’s periods?
At what age do women usually stop having periods/go through menopause?
Are there any rituals associated?
Have you experienced menopause?
If yes, have you experienced any changes with menopause, such as hot flashes?
Are there any traditional ways of dealing with any symptoms?
Is it usual for women to be circumcised in your family/tribe?
At what age?
How does the society view this tradition?
How do the women of the society view this tradition?
Family Planning and Health
At what age did you first have sex?
How many times have you been pregnant?
Have you ever had an abortion? If yes, how many and at what age?
Were there any complications?
Are there any taboos connected with abortions?
Do you use any means of family planning? What, duration:
Have you ever?
How did you learn about it?
Do you ever get sick? How often?
What kinds of problems?
Where do you go for treatment?
Does it keep you from working?
How often do your children get sick?
What kinds of problems?
Where do you take them for treatment?
Other
What is a common age for elders to die?
What do you think are the major causes of death in your village?
Do you know about AIDS?
Is it common?
How do you think it is passed?
How could it be prevented?
What do you worry about on a daily basis?
What do you enjoy doing?
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