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Grandmother Project Uses Elders to Help Educate Community on Health Issues

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There's an Italian proverb that says 'If nothing is going well, call your grandmother.' It's sound advice taken to heart by an American living in Rome. Judi Aubel is tapping into grandmothers to assist community health programs in the developing world. She's recognized the power of older women to help educate the young about health and wellness. Nancy Greenleese has this profile.

Judi Aubel, a modest 60-year old, is an unlikely leader for The Grandmother Project. "I think sometimes people think I'm involved in this because I'm a grandmother, something to do with trying to increase recognition for grandmothers. But, in fact," she admits with a laugh, "I'm not a grandmother."

However, Aubel is a trained observer, an anthropologist, who spent 20 years of living and working in community health programs in Africa and Southeast Asia. She recalls noting that development programs routinely ignored older women, focusing their attention primarily on the young.

The pattern became clear, in fact tactile, when she started collecting the hand-woven pillows and wall hangings from Laos, Tunisia, and elsewhere that decorate her apartment. "I think in both cases, they're beautiful, important things that are part of traditional cultures that are tending to be lost." Grandmothers are the fabric of society, she stresses, especially in the developing world, and by overlooking them in favor of working directly with new mothers learning to breast-feed, for example, or teenagers who need advice about nutrition, Aubel says aid programs are missing a key element that can make their program a success.

Iyabo Larinde is one of Aubel's close friends and a supporter of The Grandmother Project. The Nigerian woman says her grandmother taught her everything she knows about health and life, from the importance of drinking milk every day to tips on juggling housework with child rearing. She says Aubel recognizes the realities. "The grandparents are the backbone of the family, they are the core of the family in Africa. People listen to them. You listen to the adults."

But most development agencies don't and that's what The Grandmother Project seeks to change. Since it was founded in 2003, it has helped World Vision, UNICEF and other established non-governmental organizations include older women in their health education programs. That way, the grandmothers understand and can then reinforce the advice given by health workers.

Aubel says the women noticed that they were pushed aside. She recalls a conversation with a Malian grandmother. "She said that when the development workers arrive, before they even get out of the four-wheel drive car, we know who they want to talk to. They want to talk to the young people who've been to school. So automatically that excludes us."

Aubel says ignoring the elders can undermine the work of development programs. For example, health programs in Africa encourage young pregnant women to eat more to have a healthy baby. However, their mothers-in-law — with whom they usually live — often disagree. "It is thought that when a woman is pregnant she shouldn't eat too much," Aubel explains, "so that she won't gain too much weight so that the baby will be smaller and so that the delivery will be easier." She shakes her head sadly. "This is erroneous, definitely erroneous sort of thinking but this is part of the traditional thinking and the norms that the grandmothers participate in passing along to subsequent generations." So, because the young mothers listen to their mothers-in-law, The Grandmother Project is teaching these older women along with the younger ones. In parts of Senegal, pregnant women whose elders took part in health discussions were twice as likely to increase their food intake.

In her Rome apartment, Aubel shows off a small gallery of photographs of grandmothers from different cultures, evidence, she says, that older women served by The Grandmother Project are willing to learn and change. "I think all these show the dynamism and the openness of grandmothers."

In the photos, the older women from Ecuador, Uzbekistan and Laos wear hard-earned wrinkles and smiles. In one image, Aubel explains, the women are dancing and singing a song about diarrhea and what they should be doing to treat their little ones when they have diarrhea. The Grandmother Project has taught them using performances, stories and board games, traditional ways of communicating that the largely illiterate women are comfortable with.

Sarah Bodian, a Peace Corps volunteer in Senegal, met Aubel by chance in the remote village where she was working. She recently returned to Senegal as a consultant to The Grandmother Project, to discuss the issue of female genital mutilation with older women. Judi Aubel, she says, has respect for the people she's serving, "so rather than just … Judi sitting in a corner office saying 'I think it would be really great if they abandoned female circumcision,' having the ideas come from the people. Which I think is really innovative and valuable. And the people that we worked with thought the same."

But Bodian observes that sometimes, it's difficult to get the women to open up, especially when discussing this controversial practice. Grandmothers, she says, are at the heart of the illegal secretive tradition, often doing the cutting. When Bodian tried to get one Senegalese woman to talk about it, she got a tongue-lashing. "She yelled at me!" she recalls. "That happened at two sites. They said, 'You don't know what I'm talking about, you have no right to take away our practices.' And I was being very non-direct with them, non-judgmental, but they had kind of anticipated us coming in and telling them 'you must abandon this practice.'"

The Grandmother Project knows it will take years of listening, talking and working with grandmothers to eliminate this and many other harmful health practices. Aubel says it's about time the older generation was brought into the discussion. She didn't have to be a grandmother to see that they were being ignored, a point missed even by locals, including a Senegalese nurse. "He said, 'You know it's so sad … because the senior women are part of our families and communities but in our programs — in our community health programs — we've never seen them.' He said 'It's so sad that you had to come from somewhere else to help us see this resource that we had neglected.'"

Judi Aubel and The Grandmother Project have recognized that Grandma knows best. Never the retiring type, she's continuing her efforts to involve grandmothers with trips planned to Senegal and Djibouti.

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