October and November were mostly spent planning and finalizing, and fretting about, my 4-day training of local community health agents.  Since I will likely be the last health volunteer in the area, I wanted to give them a sort of mini Peace Corps health volunteer training, with info on mother and infant nutrition, sanitation, family planning, malaria, other common and urgent illnesses that are best referred to the village clinic rather than to local healers.  (I invited 2 traditional healers who were willing to participate and learn about prevention, which is great cuz so many people go to them)  I also wanted them to learn tools -- how to do health talks, how to interview during home visits, etc., -- and to inspire them to keep active.  The plan is to create and train a Village Health Committee from within the group, to help coordinate activities.  We had 35 participants in the end, from my village and many of the surrounding farms and villages in my health zone. 

Because people constantly use poverty as a reason to not eat properly, or to not go seek treatment at the dispensaire (for malaria or their child's parasites, for example), or go get on birth control, or to buy condoms, or whatever, the big theme overall was:  Prevention = more money in your pockets.  We had many activities and group work to demonstrate what seems like simple common sense to us, but not to a relatively uneducated community.  Even those who made it through most of school are not taught critical thinking skills (the French did a number on these guys in terms of the educational system!)  So, after getting the nuts and bolts of each health issue's cause and consequence and prevention means, the activities made them think about and work out the basic math:  Good nutrition for your child costs less than treating illness after illness due to a suppressed immune system (not to mention the long-term effects of slow mental growth) ; buying and sleeping under a mosquito net is cheaper than treating malaria and losing time in the fields several times a month, and the other prevention techniques are freakin free; birth control is way cheaper than raising a child (Depo for example is 60 cents every 3 months), and of course birth spacing means healthier moms and children and less medical bills all around; the various means to prevent parasites and worms from contaminating your personal water and food supply are a helluva lot cheaper than continually treating parasites and diarrhea and of course dealing with the ensuing malnutrition.  I basically was trying to convince them, so that they could convince others.

My biggest worry was keeping it active and participatory and keeping even the non-French speakers and illiterate participants engaged.  The biggest challenge in that was not only my inexperience at lesson planning and teaching, but also trying to collaborate with and teach my Togolese counterparts that the usual mode of lecture and copy and memorize was not going to fly if we really wanted these adults to LEARN.  They just weren't able to think outside the box within their specific topics to teach ... So, I had to plan out all the sessions and specific learning activities and demonstrations down to the minute, and hand the program to them to prepare their topic.  In the end, it all worked out so much better than I thought it could have.  I facilitated all the activities and demonstrations during the training sessions, as well as taught my own sessions on nutrition, breastfeeding and sanitation; our village nurse taught about Family Planning, Malaria and other diseases; our local Red Cross coach taught the session on HIV/AIDS and was an invaluable helping hand for all the activities; my friend who lost her husband last April did a demonstration on how to prepare soy-enriched porridge on the day of my nutrition talk.  I had made a training packet for everyone, with recipes for enriched porridge (they had been done in drawings for those who can't read), a home recipe for oral rehydration solution (to treat diarrhea), how to build a homemade water filter, sample home visit questionnaires, info on HIV/AIDS and on malaria...  People loved the packet, and wanted one even if they couldn't read it themselves cuz they had kids at home who could read, so I later had to make more copies.  It was great, and I am so incredibly relieved at how well it went.  After all the time and brain cells I put into it, if it had been a dismal failure, I don't know what I would have done, honestly.  Only time will tell if there are any sustainable effects to the whole thing, but at least I know I gave it all I got.  The last afternoon, I had them plan their awareness-raising and sanitation projects for the month, saying I was available to come help.  The following week, we were going to have a public ceremony on Dec. 6th, to present the newly-trained health agents to the community, complete with their certificates and T-shirt "uniforms".