This article seeks to better understand the relation between local and traditional modes of communication and health literacy within the context of a rural West Nile community in Northern Uganda. Drawing on social semiotics (multimodality) and Bakhtin's notion of the carnival, the focus is on a group of women participating in a grassroots literacy program and their use of local modes of communication to address the endemic problem of malaria in the West Nile region of Uganda. The argument is that women and local modes of communication can serve a critical role in disseminating primary health care information in particular and in community health care development in general. This article also makes a case for adopting a more holistic approach to health literacy promotion; one that brings together local and new modes of communication and knowledge with desperately needed health care services and trained personnel. (Contains 4 footnotes.)