By Amy Harris
In their hearts, In Her Presence’s founders recognize the connection between knowledge, health, and wellness. That is why they created the “Heal Your Body” component of their language acquisition programs from the very start of In Her Presence.
I was lucky enough to be invited five years ago to help with the Heal Your Body Program. There were only three of us at first: Susan Doughty, NP, Bronwen Berlekamp O’Wril, NP, and myself, a certified nurse-midwife. From our first session, we prioritized meeting the women’s needs and answering their questions. Many topics we discussed were sensitive and taboo such as birth control, menopause, sexually transmitted infections, and mental health. As current Executive Director Claudette Ndayininahaze said, “This require(d) someone with patience, thoughtful judgment, and a commitment to developing trusting relationships. It also requires a serious effort to create confidence, bridge the cross-cultural gap, and break the fear and silence.”
It has been an honor to teach these women about their bodies and health over the past five years. The Heal Your Body Program is successful because it creates a safe space where women feel supported and empowered. News spread of the exciting collaboration, and our three-person team soon grew to the current team of two MDs, five nurse practitioners, and four nurse-midwives. We built our COVID-19 education programs upon this original foundation of trust and confidence.
Supported by generous donations and In Her Presence support staff’s hard work, IHP has continued weekly Saturday morning classes virtually through Zoom. IHP participants got access to Wifi, tablets, laptop computers, and Zoom accounts.
In the fall of 2020, the Healthcare team combined information from the Centers for Disease Control (CDC), the World Health Organization (WHO), the Maine Center for Disease Control, and the American Academy of Nurse Practitioners (AANP) into presentations given to individual Saturday classes. We chose to focus on the importance of mask-wearing, where to get tested, and how to isolate correctly and quarantine.
We organized a second Zoom learning event on February 27, 2021, to focus on COVID-19 vaccines. Participants submitted questions to the Health Team via WhatsApp ahead of time. Slides were made of the questions and answers ahead of time and translated into French to maximize comprehension. During the two-hour question-and-answer InfoZoom session, six health team members answered questions from more than 20 attendees. The event was an overwhelming success.
“After the presentation, we were told that misperceptions about the vaccine were reduced. Everyone had time to reflect and exchange concerns together. This raised awareness and understanding of the topic,” said Bondo.
To reinforce topics covered in the InfoZoom, the Health Team taught individual language classes in two-hour sessions the following week. From the class discussions, we learned that many of the IHP women have family members and friends in their home country with whom they talk frequently. Because COVID-19’s impact upon life in some African countries is very different from life in the pandemic here in Maine, many women are confused by these two parallel worlds. They questioned mandates for mask-wearing, social distancing, quarantining, and vaccination efforts here in Maine because these do not exist in their home villages and countries.
Participants also struggle to determine what is true and what is not. Friends, family, religious leaders, and other trusted members of their communities may inadvertently send misinformation to them, for example, posts about people dying after receiving the COVID-19 vaccine; bottles of coca-cola testing positive for the COVID-19 virus. This misinformation seeds fear and mistrust. During the classes, the team identified credible sources of information: WHO, the Maine CDC, and their doctor or health center.
Because In Her Presence’s primary mission is to build English language acquisition and career integration, the Health Team created COVID-specific English learning exercises. For example, over Zoom, the women practiced calling a medical office in English to make an appointment for a COVID-19 test or the COVID-19 vaccine. Students practiced selecting past and present verb tenses while putting more complex COVID-19 vocabulary into context.
Feedback from class attendees showed that addressing women’s questions and their fears were the keys to decreasing vaccine hesitancy.
A few participants shared their feedback: “Dr. Margaret and Nurse Susan responded to my worries, and to the questions that I was asking myself. It was clear and obvious. I liked the class.” “The session taught us a lot and took away our fears.”
“At first, several of the women in our group were hesitant about receiving a vaccine, but after the discussion, it seemed like there was more openness and the number of great questions that were raised made the whole discussion very lively and humorous. Laughing is good for us, even while talking about something as serious as COVID-19,” said Kathy Beach, CNM.
The Health Team has also set up an online GoogleGroup to answer non-emergent health-related questions women might have outside of class time. The health team then rewrites the questions, removing all personal identifiers, and shares the questions and answers with the entire group. This way, women can learn from one another’s questions without sacrificing privacy.
The Volunteer Health Team is deeply grateful for the opportunity to work with the women of In Her Presence, especially in these challenging pandemic times. Over the past five years since the launch, we have learned as much from the women of In Her Presence as we hope the women have learned from us. We hope our collaboration will be a step towards realizing culturally competent healthcare in Maine. Many health team members are still active practitioners and take what they learn from the IHP women and the COVID-19 education sessions back with them to their practice settings. In this way, In Her Presence, participants help shape a more inclusive and accessible healthcare system in pandemic times and beyond.
This blog post has been adapted from an article originally published in Amjambo Africa, in April 2021.
