Finding root causes of health problems
WARNING! In this book, we explain how to do some procedures
that can be dangerous if they are not done correctly, such as: how
to do a pelvic exam, how to insert an IUD, or how to sew a tear.
It is not enough to read about these procedures. Before you do
many of the procedures in this book, first watch other
experienced health workers doing them. Then practice while
someone with experience and training watches and helps you.
Only after you have practiced many times in this way is it safe for
you to do these procedures on your own.
Finding root causes of health problems
As a midwife, you must find and treat the immediate causes of health problems. For
example, think again about the story of Celeste and Elena. The immediate cause of
Elena being tired was her anemia. If she eats more iron-rich foods or perhaps takes
iron pills, her anemia will probably get better. By looking at the immediate causes,
we can help people feel better or save their lives, especially in emergencies.
Treating the immediate cause is very important. But if we only treat the
immediate cause, the problem may not truly be solved. It may come back, or it may
affect others in the community. Sickness usually results from a combination of
causes — direct causes, like germs or lack of iron, and less direct root causes that
may be social, economic, or political. By finding these root causes, you can prevent
problems from happening again.
In the case of Elena, there are many root causes of her problem. Celeste could
probably figure out some of those causes herself. Better yet, she and Elena could
meet with a group of people from the community to help think about the problem,
because anemia is not just Elena’s problem, it is a community problem.
Why was Elena tired?
But why did she have anemia?
But why didn’t she eat
enough iron-rich foods?
But why else?
But why couldn’t she afford
meat?
But why do farmers make
so little money?
Because she had anemia.
Because she did not eat enough foods with iron.
She did not know which foods had iron.
She could not afford meat.
Because she is poor. She and her husband
work on a farm and make little money.
A Book for Midwives (2010)
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