In August of last year, we started a health committee in the village of Koutie. Koutie is home to one of the most active Adventist churches in the Atacora region. Because of this, we decided that, if this idea of a health committee was going to work, it would work here. Uli presented the idea to the church and asked them to choose three to five people to serve on the committee. They chose five, and we then presented them with a survey that I had adapted for the villages. It asked questions like, “Do you wash your hands before you eat? Is soap easy to get in the village? Is there a health center in the village, and if not, where is the closest one? Do lots of children die, and if so, what do they die of? What is the biggest health problem in your village?” After the committee had taken the survey and we had all studied the results, we understood the two biggest problems in Koutie were diarrhea and sores.

Since it was the middle of rainy harvest season and the roads were bad, we planned to do the first teaching session in October. We decided I would work on the diarrhea problem. First, I started develop teaching aids. Since all but one person on the health committee are illiterate, I worked up picture stories that they could put together as they pleased.

Knowing the habits of the people here helped us understand a lot about how they end up with diarrhea. The foremost problem is dirty hands. We had asked them if they wash their hands, and, laughing, they’d showed us how they do it by wiping their hands on their pants or skirts. As I taught, I would recount a scenario of how a person might get diarrhea, and everyone would have a good laugh. Then one or two of the committee members would recount something similar. A couple of them really got into it and told long and funny stories. For example: A man defecates, and a pig eats it (very common here). Then the pig drinks some water from a pool where children play. Then the mother picks up a child and contaminates her hands. She then wipes her hands on her skirt and makes supper. The next day, the whole family has diarrhea.

We also talked about fly feet. “Where do flies like to sit? On sewage. Then they land on your food, and you eat what was on their feet.” Everyone laughed, but they got the point.

Another scenario: “You go to the field in the morning. About noon, you are very hungry, and you come home. You take the Pâte d’hier (the corn cereal from yesterday), put it in a bowl, and pour in some water. Then, with your unwashed hand, you mix it all up. You have just washed your hands in your cereal.”

They nod and laugh. “Yes! That is what we do.”

About six weeks before this program, we had to go to the hospital to pick up the body of a young boy who had likely died from blood flukes and complications from some very toxic tea his mother had given him. This tragedy was fresh in the minds of the church folks—the mother was a member.

Schistosomiasis is a problem in villages near rivers. When people swim or drink the river water, they catch this sickness from the snails in the river. Even if they then go to a hospital, the doctor may not test for schistosomiasis. I have personally treated three people from that village for this disease. I made a little educational booklet about it for the people and told them this was one kind of diarrhea that was easy to not get—just don’t go in the water.
To help teach about the dangers of diarrhea and dehydration, I made “Bébé Bouteille.” On a clear bottle, I drew a baby. Using nails, I poked holes for the body orifices and plugged them with nails. By filling the bottle and then pulling out various nails so that water streamed out, I illustrated how quickly a child could lose water and become dehydrated, especially when losing water more than one way at a time, as with diarrhea and vomiting.

When we returned a month later, we were delighted to learn that diarrhea had nearly vanished from Koutie church membership. I had told them that the hardest part about learning new things is putting them into practice, but they had done so and seen a drastic change for the better. They are now reaching out with what they have learned to help others.

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