Her name is Pach. At 30 years old, she has three daughters. The youngest is nestled against her chest, waiting to be fed. The other two are sitting close by, wondering and whispering. I thank her for inviting me into her home, encouraging her to be open about her experience with IRD. Her smile is warm, her shirt bright orange.
She knows IRD well. The acronym, standing for International Relief and Development, flies around this village like the common mosquito. IRD’s Child Survival Project, funded by the United States Agency for International Development (USAID), has been running for close to four years and is ending in September 2010. Striving to educate and equip the most vulnerable in the rural Tuk Phos province of Cambodia, the program’s main aim has been to counter the reality of infant mortality by decreasing malnutrition among children under five. Using the PD/Hearth model, IRD utilizes positive deviance as an effective teaching method for women. Educating mothers on health during pregnancy and proper breastfeeding techniques are just two ways IRD is encouraging behavioral change within the villages of Cambodia. It is the hope of the organization and the aim of the grant that these women who come to model positive health practices will in turn share their practices with family, neighbors, and friends. The passing on and passing down of knowledge are ways that IRD seeks to ensure the sustainability of its project.
The impact of the grant is noticeable. I ask Pach how IRD has been active in her village. “Education on hygiene and child feeding, hand washing, breastfeeding” is her response. As a model mother in the PD/Hearth Program, such a response is not surprising. Recognized by IRD for her commitment to adopting and upholding their health practices, Pach’s answer should be consistent with IRD’s goals for the program. IRD depends on women like Pach.
Her eldest daughters return from a trip to the small convenience shack up the road, bearing treats for themselves and their baby sister. Pach’s youngest is presented with a plastic cup of red jell-o that becomes her teething toy. As her baby finally occupies herself, I press Pach: “What behavioral changes have you noticed in the health of your children because of IRD?” She admits that she “didn’t know how to care for a child before IRD.” Until she learned of the positive effects of breastfeeding from IRD, it was common for her children to experience high fevers and constant diarrhea. She had yet to abandon her own mother’s advice to exclusively feed newborns water, a major cause of her children’s sicknesses.
The training she received from IRD undoubtedly taught her the advantages newborns receive from breast milk. Pach’s youngest, now 14 months, was exclusively breastfed for six months. She is now steadily gaining weight and is beginning to eat a wider variety of foods. Clearly, jell-o has been added to the list. Diarrhea and fevers have sharply decreased in Pach’s household, whereas money saved on medicine and health care have increased.
Not only does her daughter’s health serve as a testimony to the effectiveness of IRD’s work, but Pach herself now makes a concerted effort to share her involvement with IRD with those she encounters. She has told both her brother and sister about how IRD has helped improve her family’s health. She also shares her story with pregnant women in her village, promising to “continue doing what IRD has taught me to do.” Not only is Pach determined to maintain the changes she has made in her own family, but she is also determined to positively impact the health of those in her village.
I was impressed by the sincerity and vulnerability with which Pach shared her story. Through our conversation, the project’s objectives were revealed in a fresh light. IRD does not seek to provide rules for temporary behavioral modification. Instead, it desires to implement guidelines for lasting behavioral change. This lasting change cannot come from IRD’s training alone. It comes from the collective action of the community—a unique form of action that upholds and perpetuates what it learns.
Although her mother preferred water, Pach has witnessed the positive effects of breast milk on children, her children. Committed to making a change, Pach is now equipped to pass down and pass on knowledge that is life-giving. Her child will receive milk instead of water, health instead of sickness. Her village will receive aid instead of abandonment, life instead of death.