A lot of people, knowing English is Sierra Leone’s official language, ask if we teach in English.  The answer is a clear “No!” as very few women speak English.  Few adult women have attended any school, so speak their tribal language.  We work among the Mende people, who live in some of the most remote areas of the southern part of Sierra Leone and are one of the largest tribes.

 Mende is a difficult language to learn.  Like Mandarin Chinese, it uses four tones which are hard for many Westerners to even hear, much less speak.  An ancient language spoken by people who are isolated, the vocabulary does not accommodate modern society very well.  It doesn’t include words - or even the concepts - for much of the health care we teach.  

The first time we taught nutrition, we began to talk about fiber.  Our translator, Jitta Rogers-Seisay sighed, and was quiet for a moment.  Then she proceeded to speak for several minutes, waving her hands and pointing to a nearby field.  We stopped her to ask what was going on. She told us there is no word for fiber; and she was explaining that goats eat weeds, and when cleaning a goat’s entrails after slaughter, the residue in the intestines is fiber.  We were surprised by the idea that a language didn’t have this concept and by our translator’s creativity.  

Since then, Jitta has repurposed and created terms to convey health terms and ideas.  For example, the word for food sounds like “meh-heh” and she made up the term “proto-meh-heh” to represent protein, and similar words for carbohydrates, vitamins, and minerals.  To differentiate between veins and arteries, she has created terms for “flow tubes” and “push tubes.”  

Jitta, in her ten years of work as MOMS Translator, has added much to the Mende language.  Health officials, hearing her translate, marvel at what she has done.  Genius is the term they use most often, praising her ability to speak deep Mende.  Most shake their heads and admit they could not begin to do what she does.  

Most health officials are educated in English and use English terms.  When they translate for us, they simply use the English word with a Mende accent.  The students are confused and miss important concepts.  Translating for us is not a simple matter of exchanging Mende for English words and grammar.  Conveying the concepts requires our translators to understand what life is like for village women and use analogies and stories that make sense to them.  

In training trainers, the challenge is multiplied.  The new trainers are health care professionals who speak English, Krio (the nation’s lingua franca) and Mende.  We teach them the content of the course they will teach in English.  Then they discuss the concepts in Mende among themselves, asking us clarifying questions.  An essential part of the Train-the-Trainer sessions is for them to watch Jitta translate the material for a live class, and to translate for us themselves.  Then each evening, we debrief what we taught that day, getting clarity around both the content and the teaching techniques we use.  

These new trainers, who have completed one-third of the Train-the-Trainer program, are so excited.  They are anxious to begin teaching more and more students to provide evidence-based maternity care and how to work together to advocate for change in their communities.  They are thrilled with all the new information they are learning about both maternity care and teaching skills.  

This program has been a long-time goal for MOMS and seeing this pilot go so well is deeply satisfying.  Now we have to finish the program and buy the visual aids they need to teach the classes well.  We will return to Sierra Leone in November for session two of the Train-the-Trainer and another health worker class.  Then we will finish the Train-the-Trainer next spring, with one more health worker class.  At that time, the new Trainers will respond to requests for training in Mende-speaking areas, while we answer the call to work among the Loko and Temne in the northern part of the country - and train up new batches of trainers there!

We are excited, too!



Patricia Ross is a CPM and the Education Director for Midwives on Missions of Service (MOMS). MOMS is a humanitarian, non-profit agency whose mission is to improve maternal and infant health in the poorest areas of the world. MOMS teams build capacity among women in rural areas, teaching traditional birth attendants to be the bridge between the community and the clinic system, to make changes to solve women's health problems, to provide evidence-based maternity care, and to teach their neighbors about women’s health needs, sanitation, and nutrition.