Thursday, December 4, 2008

The New Administration: How will it affect the rights and health of women?

When: Monday, December 8, 1: 00 PM -3:00 PM EST
Where: The WIP (Women's International Perspective)
What: An interactive online forum, with Katherine Daniels of and Anika Rahman of Americans for UNFPA

Last month, Americans elected new leadership in Washington to bring change to the nation in a time of great challenges. Barack Obama will assume the Presidency at a time when our global concerns include the fact that every minute a woman dies from preventable complications of pregnancy and childbearing, where 6,800 new cases of HIV occur every day and where 200 million women want but can't get access to modern contraception.

How will the Obama Administration deal with these challenges, and can we expect the new Administration's approach to undo the disappointments of the last eight years?

Anika Rahman, President of Americans for UNFPA, and Katherine Daniels, editor of The Women's International Perspective, will be discussing this topic, answering your questions, and sharing the insights of women who work in low-income countries around the world.

Join us between 1:00 and 3:00 on Monday as we discuss the New Administration and what it means for the health and rights of women globally.

View archived conversation.

Tuesday, November 18, 2008

2009 Student Award for the Health and Dignity of Women

We are now accepting applications for the 2009 Student Award. This year’s winner will travel with Americans for UNFPA staff to visit one of the recipients of our 2009 International Awards for the Health and Dignity of Women. Upon her return. she will collaborate with Americans for UNFPA staff to spread awareness about global women’s health and rights, both on her campus and in the halls of Congress.

Applications are available in PDF form for download here. If you require a MS Word format, email

Applicants will be judged, and a winner selected, on the basis of two short essays, a resume/activity sheet, and a personal reference. The deadline for applications to be received is March 9, 2009.

Visit to learn more.

Thursday, September 11, 2008

Advocating for Women: Stories from the Field

Thank you for joining us today to hear first hand about our experiences in Madagascar, Mexico and Nepal. We look forward to hearing your questions, comments, and your own personal experiences from visits to low income countries. Make your comments below or ask a question in the Post a Comment section below. You'll find out responses there as well!

From Rita Henley Jensen

As I write this, I have around my neck a string of beads and cloth sent to me by the women staying in Ethiopia's Tattered Rose, a resting place for women waiting to undergo fistula surgery. The founder, Rebekah Kiser, has been named a Leader for the 21st Century by Women's eNews. An independent sales consultant for Mary Kay. Rebekah founded Tattered Rose after a trip to Ethiopia. Women’s eNews heard about her and wanted to share the story with a much broader audience.

As Editor in Chief of Women’s eNews my job is to keep asking questions and supplying the answers about the issues women around the world face on a daily basis and the solutions to those challenges. I am delighted to participate in this on-line forum—which will introduce you to three women who change their own communities everyday. I welcome your thoughts and questions.

Jesse Laymon, Dang Valley, Nepal

For a newbie world traveler like me, Dang Valley, Nepal was a series of firsts: first flight on Buddha Air (tiny plane), first ride in a UN jeep along the bumpy roads of a rural outpost, and then, to my utter shock, first ceremonial welcome… Aasmani is an impressive woman by anyone’s standards. Only a few years older than me, 15 years ago she began organizing small groups of Tharu women to pool their money and save it. For years she was resisted by the men in the community, by the local rebel leaders, and even by some of the women themselves. ...READ MORE AND WATCH VIDEOS

Tanitra Partivit, Oaxaca, Mexico

Having travelled frequently to around the world it struck me as strange that before this summer, I had never gone to Mexico. Right across the border, perhaps I always thought that it was too close and not exotic enough…María del Carmen Elu Cayado is a famous social anthropologist who, early in her career, stumbled upon the high maternal mortality rate in Mexico. She has spent the last 40 years getting the Mexican government to include safe motherhood programs in their national health policies…We went to the village of Tlahuitoltepec, which is about three hours into the Sierre Madre mountains. The driver seemed to have our van confused with a Fiat. There was no slowing this man down. ...READ MORE AND WATCH VIDEOS

Joanne Zurcher, Tana, Madagascar

Though I’ve seen the animated movie one too many times with my four-year-old son, I had never thought seriously about visiting Madagascar. But I found myself on my way to visit this African nation and meet Dr. Mathilde Rabary… I was six months pregnant on this trip so this was particularly interesting to me. We toured both a rural health center and a UNFPA-funded hospital in the capital Tana… Dr. Rabary has a powerful presence about her, yet she is extremely humble. In the week that we spent with her, I developed such a regard for her that it was particularly gratifying for me to attend an event where she receiving recognition and support for her programs from various other non-government organizations and elected officials from around Madagascar. ...READ MORE AND WATCH MOVIES

Tuesday, September 9, 2008

Upcoming Event: Advocating for Women: Stories from the Field

When: Thursday, September 11, 1pm-3pm EST
Where: Americans for UNFPA blog (
What: An interactive online forum, moderated by Rita Henley Jensen of Women’s eNew


This summer, three Americans for UNFPA staff members made their first trips to the field to witness the lifesaving work of UNFPA in Madagascar, Mexico and Nepal.

We met with women who exemplify how one woman can make a difference and documented their stories with photoblogs and videos.

On Thursday, September 11, we will feature these stories and our experiences in an interactive online forum moderated by Rita Henley Jensen of Women’s eNews.

Dr. Rabary, Dr. Elu and Ms. Chaudary advocate in support of local women. At Americans for UNFPA we advocate for the U.S. to support their work.

Join us between 1:00 and 3:00 on Thursday as we discuss the health and rights of women globally and what it means to us here in the United States. Ask questions about our trips and the programs we visited, and feel free to offer your own experiences with inspiring women from around the world.

Log on to the forum between 1:00 and 3:00 PM EST on Thursday, September 11.

Friday, August 22, 2008

Americans for UNFPA Student Award Winner – Bridging the Divide

I hope you’ve enjoyed reading Fatima’s blog and enjoyed the glimpse into UNFPA’s work to improve the health and rights of women in Uganda and Rwanda.  As Fatima showcased, UNFPA’s in-country work is largely dependent on the local needs and really calls on community involvement to build programs that succeed.

As the Americans for UNFPA staff delegate, I had the pleasure of traveling with Fatima and delegates from across the United States. 

Fatima, 2008 Student Award Winner, had a powerful impact on the other delegates, and even more so, on the many women we had the privilege of visiting.  She was able to draw connections, beyond the surface, with many of the women we met – as a Muslim, Somali-American, and student.

Our leadership delegations consisted of eight women, and one man, ranging from age 18 to  60+.  Each delegate brought a unique perspective from corporate executives to an oilfield engineer.

Fatima’s blog offers a sampling of the insightful comments she shared with her fellow delegates daily.  Unlikely many delegates, her college research afforded her the opportunity to visit UNFPA funded fistula programs earlier this year in Eritrea.  From that trip, she was able to share with us an in-depth perspective on fistula – a problem affecting so many women in Africa.

Fatima’s age and position as “Student Award Winner” particularly offered significant hope to the young women we met.  The youth population in Uganda/Rwanda is nearly double that of the U.S. [25% percent of Uganda’s total population is currently between the ages of  15–24 living; compared to 20% in Rwanda and only 12% in the U.S.]

What that means is that, literally, everywhere we went we met young people who were impacted by the work of UNFPA.  From job training programs for women who have been trafficked to HIV prevention and reproductive health services, I was overcome by the young and hopeful faces we encountered. 

And, for our team of delegates, Fatima was able to connect to these young people in a unique and profound way. 

One situation in particular comes to mind.  When we visited the REACH program in rural Uganda we went to a school with about 700 students, many of whom were also Muslim.  They were immediately drawn to Fatima, I think because she didn’t seem as “foreign” as the rest of us.  At the end of our visit, she was asked by the headmaster to share some words of advice with the students.  Needless to say, she was able to connect with the girls, I think because in her they could see a role model.  In sharing her personal story with them, she was able to inspire.  And her insights about the importance of education and stopping FGC (female genital cutting), certainly hit home with both the delegates and students.

I hope that the many readers of both Fatima’s blog and Marie Claire continue to stay involved with Americans for UNFPA.  And for those of you who've caught her travel bug: our upcoming delegations are to Laos in October and Nepal in March 2009.  And for U.S. College students, keep an eye out for news about the 2009 Student Award—applications will be available in December. 

For me, this trip has brought to life the obstacles and challenges facing women in Africa, and given me a deeper understanding of the programs available to tackle these problems.  By sharing this experience with Fatima, I very much hope that readers of her blog understand the importance of US support for the work of UNFPA.

Thanks for traveling along with us.  And, thanks to Fatima for sharing her wisdom with the delegates and with the many young people we met along the way!

Abby Miller

Development Manager 

Gorillas in the forest

We arrived at the Gorilla Nest lodge last night and I had no idea what to expect. I'm not much of a nature girl, so I was imagining all sorts of scary situations- especially involving bugs and huge, furry animals jumping on me while I slept. Fortunately, the lodge was extremely beautiful and prevented animals and insects from coming into where we slept.

The Volcanoes National Park is a two hour drive from Kigali, in the northwest region of Rwanda. I have always been skeptical of safari or nature trips in Africa, just because I felt that the continent was being reduced to seeing animals. However on the trip up to see the gorillas, I realized that eco-tourism is a serious industry in some countries. During our hiking orientation, the guide encouraged us to hire a porter to carry backpacks up the mountain so that we could be providing jobs. Interestingly, he discouraged us from giving money or anything to the kids who would be assembled at the starting point. He explained that this would only promote begging behavior in the children and if they were successful in getting gifts from tourists, they would stop going to school.

The hike up the mountain was really steep at the start, but the guide broke up the difficultly by pointing out flowers and other vegetation. It's a one hour trek up to the forest and it took us another 30 minutes to find the gorilla family we were assigned. I was surprised at how close we could get to the gorillas! Each group is only allowed one hour to view the gorillas and in this time we saw a silverback, a baby gorilla, and a possibly pregnant gorilla. The guides and trekkers in the forest encouraged us to take "snaps" ( pictures) and video, but towards the end I realized just watching the gorillas was a true gift. Even though the hike was physically difficult, I left the forest with a renewed respect for nature.

For many of us, gorillas represent wisdom and knowledge and I kept thinking this was rooted in their eyes. Despite the fact that gorillas only live 35-45 years, I felt like they were witnesses to humanity. During the genocide, many Rwandans spoke of fleeing into the bushes and the entire hike I kept envisioning the forest as a refuge and I wondered how much the gorillas has witnessed. The painful legacy of the genocide is deeply embedded in every part of Rwanda, even in the homes of the gorillas.

Thursday, August 21, 2008

Guilt and Reconciliation

This afternoon we visited the Rwandan Genocide Museum in Kigali. I have struggled to understand the point of constructing museums in honor of massive extermination campaigns. However, the most important aspect of my two hours in the Genocide Museum was witnessing the busloads of Rwandan high-school and university students visiting the museum. Often in developing countries, museums and other historic parks are tourist and foreign visitor hotspots but today, Rwandans of all generations solemnly walked through the memorial.

Walking through the perfectly arranged memorial with the machetes and victim's skulls and clothes from mass graves was incredibly difficult to process. On hand, it's crucial for today's Rwandans to confront the events of 1994 and previous with honesty and respect. But on the other hand, it was extremely uncomfortable to see the products of violence that was completely and conveniently ignored by the rest of the world. Furthermore, some nations were actively training and financing the architects of the genocide and the militia that killed up to one million people. One million people- what does that even mean? One the way out of the museum, one quote let me register what I had just seen. " The interhamwe ( militia responsible for the slaughter of the Tutsi minority) did not kill a million Tutsis, they killed one another, then another, then another"…

I have told many readers I come from a big family- 8 immediate siblings and a huge extended family. Virtually no Tutsi family was left without many family members dead or tortured with living as raped victims or the guilt of surviving. About 25,000 Rwandans are buried at the genocide museum and when I read the names of those buried, I was horrified to realize that every victim was part of a group of 10-12 family. As I walked away, I was disoriented and remembered the hundreds of wedding pictures, vacation snapshots and birthday celebration pictures of the victims featured inside the memorial. Most Americans can look in their family albums and relate because these are universal moments of joy. In each face, I could see my family's faces.

Around the corner from the memorial is the hotel that is featured in Hotel Rwanda, Hotel Des Mille Collines French for "Hotel of the 1000 Hills." For many of us, this blockbuster film was our first engagement with the genocide. As we drove past it, I kept transplanting myself to this scene 14 years earlier and could imagine the roadblocks and the killer mobs. When violent crimes or deaths occur in our homes, we tend to move out because we are not able to live in the same house. Nearly every home in Rwanda was affected by violence- 99% of Rwandans witnessed violence or murder. They don't have the choice to leave because there is nowhere to run to…

Many of us on the delegation felt guilt and anger about how America did not intervene to stop the killing. Even though it is far too late to take anything 'back', we can help Rwanda recover by supporting UN and grassroots programs aimed at unity, peace and reconciliation.

Monday, August 18, 2008

Strongest women in the world

We arrived in Kigali, Rwanda last night. When I hear the word "survivor" I usually think of that TV show that pitted contestants against each other on some remote island, playing games to outlast other players and not be sent home. In Rwanda, when people talk about the genocide those who survived the conflict are called "survivors". Yesterday, we were privileged to visit a survivor's village an hour outside of Kigali and hear from women who survived extreme sexual violence and now live together.

Sevota is an organization that was founded by widowed women and orphans who, at first, came together to cry together. Tears can be therapy. As I sat listening to the testimonies of the women, I realized that in the beginning after being held captive and raped each day, after witnessing your entire family of 100 murdered, and after giving birth to a child that your rapist seeded, healing must first begin by reaching out to other women who have also been subjected to the horrors you have witnessed.

I listened to the testimony of 10 women, 6 who have been sexually defiled and 4 who were left with child by their rapists. All of these women's families were destroyed. Some were raped alongside their daughters and watched as the militias stuffed her body in the village toilet. Two women were snatched from their university and raped by the militias day after day. If they had refused like some of their friends, then they would have suffered the same fate of being raped in public and then killed. At this one school, those who resisted so enraged the militia, that they began to systematically shoot every other girl in retaliation. By the time the machetes stopped hacking, 50% of the girls were dead. We listened to women who fled to the bush after witnessing crazed children and women slaughter their families but then return back to the village after hearing announcements from the local minister that the killings would stop. When they returned to the community, the women and girls were snatched up and brutalized so much that some girls died on the spot while being raped and others were so traumatized they couldn't move.

Nearly 25% of Rwandan women have been sexually assaulted. We saw women 14 years after being raped suffering forever with machete wounds and broken rib bones. Some contracted HIV from their rapists and nearly half of the women spoke of getting fistulas after being assaulted daily for 3 months. Today these women leak bloody urine and refer to themselves as being handicapped. Sexually based violence not only leaves physical and mental scars, but it completely demoralizes the victims and terrorizes the female sex, sending warnings to those who are not raped yet.

One woman who was sexually assaulted later found out she was pregnant by her rapists and until she came to Sevota, she couldn't speak. There are still women who haven't spoken, 14 years after the events that started in April 1994. For these women, they might be terrified of speaking out because some survivors who testify are killed in the middle of the night. Some women can't speak because they are enveloped in a constant state of trauma. They say they have nothing to live for, their families gone, homes demolished and futures destroyed. I kept envisioning each woman, surrounded by her 7 or 8 children leading busy, vibrant lives and contrasting it to the woman in front of me today, completely hopeless.

For these women who were impregnated by their rapists, it was excruciating to bear a child for these men who hacked their children in front of their own eyes. One lady told us she was revolted with her fetus and when she returned to her family home when the conflict ended, she only found an uncle and brother who kicked her out as they could not accept a child of the enemy in the family home. When she had her baby, no one from her living family came to the hospital even when it was only up the road from her home. For many weeks she stayed in the hospital, having nowhere to go until a doctor sent a group of women and children to Sevota. She said her child, now 13, was a very difficult boy and blames herself for his attitude issues because she would beat him a lot when he was young. For many of these women, their sons and daughters are now adolescents asking for honest answers about who their fathers are and they are encouraged to speak honestly about what they experienced to their children.

In April 1994, the people of Rwanda suffered a magnitude of pain that humanity cannot understand. Many of us on the delegation felt conflicted just sitting and listening to these women talk. I was thankful for my notebook and pen because I could focus on writing down every word. Every time I looked up, I was unable to look away from their faces. When each bravely testified for us, the others would have an empty look in their eyes and gaze off into corners, others would have their arms folded on top of their heads, looking down. When some women gave testimony, their frail bodies would shake.

At some points, I felt that their souls were removed when they recounted and in front of us were just bodies of women with broken spirits. I am grappling with the ethics of asking women to share these brutal moments of their lives, but I understand from the UNFPA staff that these can be part of group therapies. Personally, I was relieved to hear one woman say that she was happy that we came all the way from America to listen to them speak, because some people who are a part of their community don't want to hear them speak out.

After only one testimony, I felt not only emotionally shattered and horrified to understand that these were only 10 women and millions of women across Rwanda, Darfur and the Congo were subjected to extreme sexual violence. UNFPA has been an early partner of the women and orphans of Sevota, initially funding the center with 1 million dollars. Today they need medical support for women with fistula, various STIs and those with children asked us to be advocates for them so that their children can attain education. Even though women who were raped are considered survivors, their children born after the conflict are not eligible for educational scholarships that the government offers to surviving children.

The Rwandan government has the responsibility to heal and help the entire country recover from the genocide. It is crucial for Americans to support UNFPA because they are a significant partner with the government, filling in the gaps where the government simply doesn't have the means to support small, district level projects. Interventions on the village levels are crucial because there is still distrust and fear, especially when some of the rapists are released back into the very same villages as their victims. For these women, Sevota is a haven.

The American government is blocking the funds that would support projects like Sevota in Rwanda. Perhaps it is easy for the American politicians to make these decisions when they are not shown how UNFPA support is crucial. I can only invite our President and Congress to come to Rwanda see what these groups work towards achieving.

Friday, August 15, 2008

Two Governments, One Bad Plan

This morning we visited the Naguru teen center, a health education and treatment center just outside Kampala specifically catering to the youth populations. It was astonishing to listen to health service providers on the ground describe the impact of PEPFAR's (President's Emergency Plan for AIDS Relief ) strict abstinence versus condom use policy. Recently, Uganda has adopted the U.S. government approach of addressing prevention by emphasizing abstinence only discussions. This shift is not only because U.S. directed funds have many strings attached ( including the no-condom promotion) but is partly attributed to the influence of the Ugandan first lady, who is a born again Christian.

Since embracing the Bush policy in 2003, posters encouraging people to practice safe sex and use protection went down. Like I mentioned in an earlier blog, these cartoon messages are cheap, easy and powerful ways for the Ministry of Health to advocate for behavior change. They can target the entire population and because they rely less words even the illiterate can grasp the meaning. Around Kampala I saw no condom or protection posters, very strange in a country which has constantly engaged in honest, frank conversations about sex, etc.

The more I listened, the more I felt that this plan is actually cruel to women in Uganda because we know what to do but we aren't doing it. I’m my public health classes I’ve learned that medical research has proven condoms as very effective but instead we are advocating a policy with serious holes. Though I have read about the PEPFAR policy being shortsighted or just plain stupid in terms of being a public health strategy to cope with HIV prevention and treatment, today I felt enraged about the implications of this policy. Currently, America is not supporting the UNFPA and it seemed like sheer arrogance for us to further dictate moral values to Ugandans. In fact, instead of accomplishing its missions, I perceive that abstinence only policy is hurting the country by mandating PEPFAR and not supporting UNFPA work. UNFPA funding is different to PEPFAR because UNFPA funds come with no such strings so UNFPA programs can provide condoms and promote usage, based on the wants and needs of each country.

While PEPFAR can be attributed to lengthening many people's lives by providing access to lifesaving ARV drugs, it is completely missing the point of providing preventative services that work. Out of 1000 youth tested monthly at the Naguru center, 35-40 people are HIV positive. This is just one of several district health centers and furthermore, there are thousands who haven't been tested. Yes, abstinence has a strong place in the prevention education and should definitely be part of early youth awareness programs, just like promotion of being faithful, BUT condom use should also be equally stressed. The reality is most of Uganda are young adults and guess what, youth will always be engaged in sexual activity.

Not only should we be concerned about reducing new HIV infection rates, we need to also be concerned about teen pregnancy. In many ways, condom use can promote safe motherhood by delaying pregnancy in teens with small pelvic bones.

Many of us in the delegation were complete blown away by how professional the teen health center is. We were also demoralized and angry about how a woman's access to a better life was being obstructed. Instead of supporting the Ugandan women to make choices about their futures and bodies, the American government ( and by extension, the American people) are forcing them to lead lives which we ourselves find unacceptable. The U.S. and Uganda are both nations which currently support plans that don't work but the vast economic difference is the American advantage. In the US, women can get access to many services whether it is birth control, or the ability to put unwanted children up for adoptions. Perhaps our own luxuries make us blind to what global women are suffering from. What struck me the most is how the situation for women in American or in Uganda are truly not that different in the way the government chooses to address sex.

with peace,


Thursday, August 14, 2008

Partnering with the “Guardians of Our Culture"

Today we visited the headquarters of the Ugandan NGO called Reproductive Education and Community Health (REACH). UNFPA funded REACH’s efforts in it’s early stages to support efforts promote the end of female genital cutting (FGC) and empower girls through education. The mission of REACH, which was established in 1996, clearly states that it exists to stop genital cutting, by using a culturally sensitive approach. I was so inspired by the story of REACH and an excited to tell everyone about the achievements of REACH and Ms. Beatrice.

In 1996, before the “cutting season” was slated to begin, REACH began campaigning to the community to abandon the practice of FGC. Amazingly, there was a 66% drop in the number of girls that were circumcised. After hearing about the success of the program, international media like the BBC flocked to Kapchorwa to profile the group that was behind such incredible statistics. At the time the roads to the villages in Western Uganda were impassible and but following the success story that drew many foreigners to this region, the government invested in tarmac roads and now, the roads are amongst the best outside of the capital city.

At one point, the current president came to visit the program. When the president of Uganda comes to the rural areas, there is often an expectation that food and transportation costs will be provided for locals who witness his visit. Unfortunately, there weren’t enough resources to properly accommodate the many villagers who came to the REACH program site during that time. As a resulted many of the villagers felt disgruntled and banded together as a feeling of resentment emerged with the community. Justifiably, they felt used and the anger was directed to REACH and the Western journalists who in their opinion were "making a business on us but they did not feed us or transport us."

This bitterness fuelled community members to target REACH, declaring that this program was taking away their traditional practices. The impact on young women was widespread. Teenage girls were offered incentives to revert back to the practice…cash and goats were distributed to girls who were circumcised. By the cutting season of 1998, nearly 1100 girls were circumcised This was a huge setback and sent the developers of REACH back to the drawing boards.

The backlash against the anti-FGC/M initiatives of REACH was caused not only by economic tensions but also a lack of emphasizing how REACH would be culturally sensitive. Eventually REACH integrated cultural sensitivity as a means to accomplishing their ultimate goal and in 2006, the Kapchowra village reported zero circumcisions.

One way REACH has achieved success today is the integration of the Sabiny elders in condemning the practice and telling young girls it is no longer important to be circumcised to prove strength. For a society which prioritizes cultural ceremonies like FGC as an important link in preserving tribal identity, it is extremely powerful to have the blessings of the elders who are referred to as the "guardians of the culture.” They have created alternative rites of passage incorporating other ceremonies to replace the massive festival-like atmosphere of the cutting seasons.

Hearing Ms.Beatrice explain this part of REACH's history illustrated to me why culturally sensitive models are crucial in ending FGC/M. For me, it’s important to remember that amongst the Sabiny tribe female cutting is a test of physical strength. Alternative rites of passage can help women still pass “this test.”

Female genital circumcision/cutting/mutilation is practice endemic in my Somali culture. Over the years, I have come to use the word "cutting" to refer to the practice since I find it both sensitive and accurate. Recently, as more people become more aware about the practice, they unfortunately refer to these women as being "mutilated" and this is problematic. Having grown up with many women who were circumcised, I believe it is imperative for Americans to understand that using words like "mutilation" alienates women who have been circumcised.

Early circumcision can be as traumatic as child rape. Besides the medical complications, there is a severe lost of trust and security when children are sent to be circumcised by their own parents. I make this comparison to plead that when we talk about this subject, its careful to be as sensitive as possible and realize that heavy handed approaches (even if they are well intentioned) will always do more harm. After centuries of colonization fresh in memory, many African societies which continue to practice genital cutting will continue to point to patronizing interventions as examples of Western arrogance and this will be enough stimulus for its continuation.

UNFPA once heavily funded this organization, but today REACH is an independent NGO making it an example of a sustainable program. UNFPA's initial belief in the REACH program grew to become a strong partnership and leaves a powerful example of success.

What I appreciate in REACH's mission statement is that they are taking a popular counter-argument away from those who promote FGC. In my opinion, REACH is the best strategy for ending FGC because its greatest asset is its grassroots foundation. Right before we left Ms. Beatrice she explained that there is inadequate funding to fully carry out the anti FGM-campaign with the community. I can’t help but feel disappointed at the United States is not supporting UNFPA’s work to help implement programs like those of REACH in other areas of Uganda or around the world.

The United States has defunded UNFPA for the past 7 years, depriving financial support for groups like REACH and giving women of the world the impression that Americans don't believe in the mission of REACH and the rights of young girls and women. As you may know, the U.S. is the only country in the world to withhold funds from UNFPA- the largest international source of assistance for women- for reasons that are political, not financial.

It makes me thankful for organizations like Americans for UNFPA, that are helping to show the world that Americans do believe in women’s health and rights globally. There are lots of ways to get involved with Americans for UNFPA work, check them out at Also-- I just noticed that the Americans Express Members project took at Ad on Marie Claire.Com that is posted just next to my blog. Americans for UNFPA is involved in the Amex Project and this is the last week for them to get votes for their End Fistula- Global Woman's Health Project. I've had the fortune of visiting fistula hospitals funded by UNFPA in Eritrea and I can say that their support is invaluable. If you can take a minute to vote for the project please do so at: End Fistula- Global Woman's Health Project-

Wednesday, August 13, 2008

Women NEED to Speak Up

Throughout this trip, I have sensed the surprise of the locals when they see me traveling with a white, American delegation. I am of African descent and I wear a headscarf and in many ways seem odd in this group. But I can connect to many Ugandan people on 2 levels - being African and Muslim. Some of the locals even speak to me in the local language and I have been welcomed with countless "salaams,” a traditional Muslim greeting. Today provided me a rare opportunity to reflect on my presence in the delegation and what message I was communicating to Ugandan girls in particular.

REACH is a Ugandan NGO that works to stop harmful traditional practices like female genital cutting (FGM/C). Because FGC in Uganda is a right of passage, REACH has created alternative initiation rituals. This group primarily works in Kapchowra, Western Uganda where the Sabiny are amongst the few Ugandan tribes who continue to practice FGC. Ms. Beatrice serves as the director general and is among the few female activists who don't shy away from honest discussion of reproductive health. This is ironic, because here in Uganda women can have the public space to discuss their sexual and reproductive rights openly. But in the United States reproductive health has become too polarized. I feel as if Americans don't really engage with women's health and human rights issues and neglect to understand the magnitude of problems that can arise from childbirth (ranging from fistula to maternal mortality).

After we arrived at the Nanyata primary school in Kapchowra, a REACH program site that incorporates the anti-FGC mission into its curriculum, I was delighted to learn that the majority of the children were Muslim because I felt that our bond was greater than nationality. We sat outside under a giant tree with rain clouds low in the distances and were treated to schoolchildren performing skits and singing. Throughout the performances, I could feel the curious stares of the children and wondered what they were thinking. Right then Ms. Beatrice caught me off guard by asking me to share words of encouragement with the children, especially important since I was a Muslim woman and not the typical foreign visitor.

Initially I was completely flustered but as I looked into the crowd of young faces, I could only stress education as the single biggest tool for creating a future. It’s not a coincidence that I am a university student and find myself in Africa. Being in college has expanded my understanding of history, leaving me hungry to learn more. But today I felt that I was also a role model. I don't like talking about myself in such lofty ways, but I pictured how seeing another black, Muslim woman was a powerful message to the children. I tried to stress that the biggest difference between FGC in Somalia and Uganda centers around choice. In Somalia, young girls have no choice about what is being done to their bodies but here in Uganda teenagers can choose. Amongst the Sabiny, female teens between the ages of 15-19 chose to be circumcised because it has been an integral part of their culture. The cutting ceremony is a test of strength since the courageous girls do not cry. Over lunch Ms. Beatrice stated cutting is "not relevant today" and I couldn't agree more. If FGC is a test of strength in this community, I couldn't help but wish that females achieving a high school diploma could one day be regarded strong women. The way I see it, with more education in schools, young women will be able to make more informed decisions about their bodies.

The importance of positive role models cannot be understated, especially when the public roles of women are limited. As a young child, I had strong women role models to look up to including my Somali grandmother, a single mother of ten children. Many girls today voiced their ambitions to be doctors, nurses, headmistress or engineers and I was delighted to hear this, especially after the other female delegates explained they, too, were nurses and engineers.

We also visited a secondary boarding school and met Agnes, a charismatic, confident, and outspoken student leader of the REACH program in her high school. Agnes completely blew me away and was such an inspiring product of youth empowerment clubs. Often when visiting schools or clinics, women can be shy and reticent but Agnes was an excellent public speaker. As one of the delegates stated, women should not only have the right to speak, but need to speak up in order for their societies to fully understand their lives. This remarkable young woman reminded me strongly of Ms. Beatrice. Both have the immense courage to speak loudly and clearly about genital cutting, simply stating that they are beautiful, just the way God made them. It is time we all listen.

With peace,

Tuesday, August 12, 2008

The future of Uganda

Today marked the start of our first complete day of site visits and meetings. We met many young, professional advocates who all share this desire to determine the future of their country. Some were highly educated with university degrees and others were former sex workers with no formal education. All of these women shared the desire to give back to their community and prevent other youth from risks they faced and from ever feeling hopeless or uninformed.

Despite seeing extremely impoverished areas and being confronted with stories of abuse of young teenage girls, I never left a site feeling depressed. Instead, talking with the people on the ground and recognizing the fierce pride in their initiatives left me with the impression that young Ugandans are embracing their accountability to fellow countrymen and women eagerly. This feeling of responsibility in the face of inadequate resources leaves me with great respect of their devotion and just as hopeful for the future.

We started the morning meeting with the outgoing Ms. Uganda, Monica. Like any other beauty queen, she was beautiful, statuesque and well-poised. Additionally, Monica is a positive local role model, often visiting village schools promoting the importance of school attendance and establishing rural based orphanages. Recently she channeled her energy into starting the Nurture the Future orphan foundation.

Monica lost her father at young age and her mother in her late teens. She confided that the death of her mother occurred the week of her important end of year exams and it was nearly impossible to study because she was very close with her mother. If it wasn't for her older brother encouraging her to study, Monica could have easily been another of the common orphan/drop-put statistic. Instead, having experienced and struggled with the loss of her parents, Monica has become both an advocate and activist to help fostering education opportunities for all children, especially orphans. Her courage is a great hope to the children she meets.

From there we met former sex workers who with the help of the Ugandan Youth Development Link (UYDEL) have been able to find other sources of income to support themselves. Based in the outskirts of the city, UYDEL works with former commercial sex workers, providing vocational education like hairdressing. Often, children from the rural areas flood to find jobs in Kampala but they are deceived and forced into unpaid labor jobs. I was shocked to find out that sex workers are paid just 30 cents, just enough for a snack and juice from the street vendors. In the Chimumbaza district where these woman live, I met a young woman who was a former sex worker but now teaches other sex workers how to braid hair and offering basic business skills so that they can re-enter society with some skills to generate independent incomes. For the UYDEL staff, her story is an example of a success story and gives hope that many other young women can become empowered.

Many of the young women and children who I saw today have seen many traumatic events and are thankfully able to get various psychosocial and health counseling. Seeing them in the clinics and centers gave me hope that they might be out of harm's way, hopefully having already seen the most difficult years of life.

The investments the social workers and activists have in their causes are integral to ensuring that more children attain access to education and get off the streets. When I asked what UYDEL could accomplish with more money, the answer was simply "education".

Good night!

Monday, August 11, 2008

Welcome to Kampala

I am finally here in Kampala, Uganda! I say "finally" because it took nearly 2 and half days of travel to arrive at the Entebbe International Airport and around an hour to drive into the capital city. While the flight was sometimes painful (14 hours, non-stop), the drive was an amazing introduction to the Ugandan lifestyle for four of us on the delegation. We passed Lake Victoria, the source of the Nile River and drove past groves of banana trees, with its leaves big, bright green and waxy looking. Ugandan music blared from cars and from tiny shops on the sides of the road, where teenagers and children seemed to run from shop to shop. Dusty brick red roads dipped into valleys and hills all around the main highway, leading to rectangular concrete homes with laundry hanging in the breeze. The sides of the highways were very busy with children selling tomatoes, fresh pineapples, and other vegetables.

Most of the shops we passed were painted bright pink, yellow or green and their slogans boasted "we can keep you in touch", or " we are everywhere you go". After a while, I began to realize that these ubiquitous buildings were cell phone companies. Sometimes, the same brand would be across the street from each other! Cell phones are extremely popular here, since they are much cheaper than landlines and just like in the US, major brands offer promotions package to sign on new customers.

Kampala is bustling city with nearly 3 million people and Uganda's overall population is about 30 million. Originally Kampala was comprised of 7 hills but today numbers 21 hills, partly because development has boomed in the last 10 years. Additionally the fertility rate in Uganda is amongst the highest in the world, with the average woman giving birth to 6 or more children. A population surge like this can be destabilizing because the younger the country's population, there more able-bodied fighters are available to fuel conflicts in the region. In Uganda, 60% of households are headed by someone 18 years old or younger. Clearly, teen pregnancies contribute to these sobering statistics and indicate the need for reproductive health education.

Hearing these numbers and facts was overwhelming but it's important to understand that many groups have worked successfully in providing prevention and treatment in Uganda. Tomorrow afternoon, the delegation will visit a NGO that specifically works with the youth to educate about HIV/STI/ and teen pregnancy prevention. This particular group reaches out to teen commercial sex workers (usually female) and helps empower them with jobs in addition to leading health intervention.

Many buildings and billboards in Kampala are advertisements to buy Coca-Cola or Nestlé's milk, but others are also public health posters . One member of the delegation pointed out her favorite of an old man and a quote hovering near him- "Do you want this man to stop sleeping with your daughter? Then why do you sleep with his?" This poster is part of a campaign to stop older men from seeking out younger women and another poster clearly stated "no cross generational sex". Most of these posters are blunt, but I guess honesty about health is necessary to promote safe behaviors and reaches out to everyone. I'll keep an eye out for these public health fliers and hope to include a picture in an upcoming blog…

Good night,

Sunday, August 10, 2008

Traveling to Uganda & Rwanda

My name is Fatima and I'm incredibly excited to be a part of the American for UNFPA's delegation trip to Uganda and Rwanda. I am studying international health and development at Stanford University and hope to graduate this spring. When I first heard that I was chosen as the student award winner, I was totally humbled. Out of all the people that applied, I couldn't believe I was given the chance to witness and learn from the work of women abroad. I treasure this opportunity to see the struggle and survival of women and learn from their resourcefulness and experiences.

My parents are from Somalia but I grew up in the quiet suburbs of Texas. When I first told my family (parents, aunts and uncles) about my trip, they were supportive but cautious. As witnesses to the civil war in Somali, they are justified in being nervous. But I want to show them and the readers of this blog a different type of Africa, beyond the usual depictions of today's Africans as starving, sick and warring people. In just 2 days, I will be traveling to 2 gorgeous countries, Uganda and Rwanda. Although this region has a long history of civil strife, they are also known as the "green pearls of Africa" with bright green hills and deep blue lakes. Many have heard of Uganda in the context of politicial instability and Rwanda will forever be associated with genocide of April 1994, however on this trip I would like to take the incredible opportunity to talk and listen to the many local women I hope to meet.

I grew up around many educated and independent Somali women in my family and they served as powerful role models, sparking my passion for women's health and gender equality. On this trip, I will be reporting back about the important work of UNFPA such as outreach programs to teenage commercial sex workers in the slums of Kampala, visiting fistula hospitals and speaking with genocide survivors in Rwanda. One aspect of the work of UNFPA I deeply respect is the commitment to empowering women globally and the way it accomplishes these goals in culturally respectful ways.

As long as I remember, I have wanted to be a doctor and writer. Growing up, I remember watching the war in Somalia with my parents on CNN in our living room, eagerly listing to international reporters and aid workers who covered the famine and civil war. I gained both knowledge and a sense of responsibility and I have always hoped to address this in a dual approach, medicine and journalism. I want to report the problem and share people's lives and provide context but I also want to use my hands in places of great need.

Lately I have been questioning the point of my trip. Why is American for UNFPA providing this opportunity? I am still a student and I can't provide the technical interventions, nor donate millions but I can solely focus on conveying the essence of what I see, smell, feel to all those who can't travel half away across the world. Together, we can expand our understanding of the issues and advocate for the work of UNFPA and the lives of the millions of women affected.
I hope you check the blog each day and I look forward to hearing what y'all think!


Friday, August 8, 2008

A Social Death

As a consequence of fistula, the mother emanates an unpleasant odor often driving her husband away and causes her to be socially ostracized, pushing her to isolation and depression. She is condemned to a life of loneliness – without the companionship of her husband, friends and children. While she does not die, the development of a fistula is akin to social death as the village treats the fistula victim as a scourge- pushing her to live at the edge of the community with no social support. Research shows that girls and women with fistula often eat alone, sleep alone, and pray alone. As the women were wheeled into the surgical floor, I noticed the how frail the women were- most exhibited physical signs of extreme malnutrition, some women’s backs curved and others with deep cracks on their feet, skin peeling off.

Many of these women were brought to the hospital by their parents or brothers. One of the doctors had become particularly close to a 16 year old girl with a clubbed foot, who was accompanied and supported by her doting father- she did not have fistula but a congenital abnormality that caused her to leak. Not all patients are shunned by their families and many women had been supported by their parents, husbands or siblings to seek care. The persistence of the women who actually make it to the hospital is not an indication of success, because for every 1 woman who comes 10 more couldn’t afford the journey or were too scared to travel outside their house when confronted with the ugly side of humanity. So, these surgeries are only treating the ‘tip of the iceberg’ since nearly 3 million women with obstetric fistula still need treatment.

The commitment of the Eritrean government* to repair the health infrastructure is a hearting sign of developing countries diagnosing their weakness and not simply applying bandages in the face of crushing poverty. These stronger health infrastructures are crucial to the achieving better maternal health- so that fistulas never occur.

*The Eritrean fistula team have consistently partnered with the Ministry of Health, the UNFPA, and local healthcare providers to shape brighter futures. In the past six years, together they have helped to strength the country’s fistula policies and established the Fistula repair center and hostel. For more information about the Eritrean Maternal Health Project and the UNFPA’s programs in Eritrea please refer to

Thursday, August 7, 2008

A Safe Place

Eritrea‘s culture is vibrant and its people diverse with 9 ethnic groups and a 50% split between self identifying Muslims and Christians. Across the courtyards of the fistula ward, bright cloths were hanging out to dry having been hand-washed to remove of the lingering stench of urine. The fistula wards were a place of healing and sisterhood. Sometimes the surgeries were successful, other times the women continued to leak because of the extent of scarring and damage. In the mornings, the doctors came in to examine the post-operative patients and the leaking women would turn on the sides or pull their blankets over the heads to hide their tears and disappointment. For these women, the head nurse (affectionately called “Sister”) and other patients provided comfort and encouragement- next time, maybe next time surgery would heal them.

The ward is a safe space for the women and on the last day of the surgical mission, the patients invited the team to a special coffee ceremony. We walked into the decorated ward, with flowers and grass carefully placed on the linoleum floors, and saw the women in their colorful shawls sitting around the coffee pots waiting eagerly for the doctors to take their seats. The ceremony deeply touched us because we were privileged to be included. The women danced to traditional Eritrean music, blaring from an old stereo and invited us to join them. We were pretty bad dancers, but then one of the doctors managed to hook up her I-pod and played some Beyonce and Black-Eyed Peas- we explained “this is our music” and were met with blank stares and giggles.

Luckily, I brought my digital camera to the ward this day, and I started to snap pictures of the patients, showing them on the screen how they looked. As I took more and more snapshots, the atmosphere in the ward became less formal as everyone wanted their pictured taken. The smiles and laughter humbled the team and we realized many of them had never seen their pictures.

Wednesday, August 6, 2008

God Will

I recently had the opportunity to visit Eritrea as a part of the Eritrean Maternal Health project. The Maternal Health project was founded by Stanford Medical School and supported by UNFPA and the Eritrean Ministry of Health. One if its major concerns is obstetric fistula.

Obstetric fistula is a childbirth injury that happens as a result of obstructed labor in places where medical care is largely unavailable. As a woman- typically young, extremely poor and illiterate- squats for days alone, attempting to deliver her baby, the trauma adds up and an internal hole develops. Contents from the bladder and rectum cannot be willfully controlled, so the fistula victim constantly leaks urine and/or feces. The corrective solution for the medical aspect of this disease is a surgery, which costs around $300 and is often done for free usually in endemic areas, but barriers to surgery include transportation, lack of infrastructure and limited resources of the state to reach out to very pregnant woman in the countryside.

Eritrea is a rural nation with hills and rough terrain. Traveling in the rural areas consists of riding on a camel, constantly going up and down and potentially causing more trauma to the fistula patient. Dr. Hapte, one of the OB/GYNs (and father figure for the fistula patient) at the Mendefera Hospital ( the same site of the Eritrean National Fistula Center) spoke of the shame of traveling on buses when the fistula patient is still leaking- sometimes other bus riders forcibly evict the leaking woman because of the strong urine smell.

I am a Somali-American woman who practices covering my hair with hijab- so in many ways, I looked like many of the woman. Many of the patients in Eritrea were Muslim women. Names like “Fatima”, “Zahra”, “Mariam” and “Zeinab” filled the pages of the simple hospital logbook. My “salaams” were met with timid smiles and then eager questions about who I was, where I am came from and why a Somali-American was in Eritrea. After sometime, I realized that these women were expecting that I would turn my nose in disgust and were hiding their catheters (bags that hold urine) from me, hiding their shame. It was strange to them that people would care to talk to them when from the past months and years, their families and societies had pushed them away. Many women have internalized this and believe that the fistula condition was “God’s will”.

Tuesday, July 29, 2008


Considering I’d never traveled to the developing world before, I adjusted to Ghorahi, Dang, rather quickly. Maybe it was the passage through Delhi and Kathmandu, but the chaotic streets, the mix of humans and animals, the ramshackle homes and scattered trash everywhere came to seem normal to me by my second day in the valley. I could see the parallels to the western world – Ghorahi seemed almost like a small Americans city minus the public services (police, building inspection, trash collection, etc.).

But Wednesday in the mountains was a different story altogether. And whatever appreciation of Aasmani’s programs I had Tuesday night would be dwarfed by my awe on Wednesday. This was when I learned why the people of Dang love her so much.

We drove Wednesday morning out of Ghorahi two hours on winding, narrow, steep, unpaved roads. Up into the mountains that surround Dang valley – and back down into the next little valley, and up again… For someone uncomfortable with heights, it was an edge-of-my-seat trip. All at about 10 mph.

Our destination was the first of two reproductive health-focused women’s meeting groups that existed under the umbrella of Aasmani’s RWDC. I understood going in what these groups would do: they would bring together women from a community to share knowledge about family planning, safe sex, and safe motherhood. They would do so through a combination of visits by UNFPA professionals and through the teachings of deputized local women (who were given basic training in reproductive health by UNFPA). That much wouldn’t surprise me.

What did surprise me, however, was the stunning context of the efforts I encountered that day. The groups met in huts or fields on the sides of mist-covered mountains, completely separated from the outside world. Women came to these meetings from across the mountainside, walking miles on dirt paths and up slopes to gain the knowledge these groups could provide. It was like your Sunday at church combined with a hike up the Appalachian trail. The homes they left had no running water; no sewage, no electricity. Few of these women had been taught to read. Their lives revolved around daily chores not meant to earn money or pay bills – but to produce the very food with which they would sustain themselves.

And yet, on this mountainside removed from the world as you and I know it, this place where everyone stared at me (as the only westerner they’d seen in years, perhaps), I heard the UNFPA nurse quizzing the teenage girls of the group:

Nurse: question in Nepali

Girl, front row: excited, with her hand held high, “Condom”

Nurse: second question in Nepali

Girl, middle row: “Pill”

That, I understood. No translation necessary. Here, against all odds, Aasmani has brought to the far-flung communities of Dang Valley a level of reproductive education that would make most U.S. middle schools blush.

Saturday, July 5, 2008

Reading by Candle Light

Unfortunately, a storm Friday night blew out all electricity and for the remainder of my stay we had no lights. Boy was I thankful to have a few granola bar’s left in my suitcase stash! By Sunday afternoon, the hotel managed to get some electrical source in the kitchen at least, and we were able to get some food before our flight. I was thankful to have grabbed my trusty MagLight from my car just before leaving the U.S. so I had a flash light on hand at least. The hotel staff hooked me up with two candles and some matches and Joanne let me borrow a book and I took advantage of the time to relax and read. It didn’t feel like that much of an inconvenience, and it didn’t really seem to bother anyone else, so it made it pretty easy to take in stride. I took a taxi into the city center and walked around a bit, and realized how much smaller the city seemed than it did a week before. I finally began to recognize roads and realized how close things were if you were walking. The traffic in Madagascar is so bad that I didn’t realize centralized everything really was.

Before leaving we reconnected with Dr. Rabary, her family, our translator and Camera Crew. October suddenly seems really soon and I can’t wait to reunite with Dr. Rabary and meet our honorees from Mexico and Nepal. These few blogs entries barely offer a glimpse at the incredible programs for women’s health and dignity that UNFPA is supporting. The fun continues as I head home to produce a video to produce a visual illustration of her work and impact on the women of Madagascar.

Friday, July 4, 2008

Happy Independence Day

On any major U.S. holiday it’s always a little weird for me (Angeline) to be out of the U.S. Especially when there’s no way to commemorate it where you are. In this case, I had the fortune of attending the U.S. Embassy Party- and 11:30am outdoor BBQ that is annually the biggest party of the year in Madagascar. When I arrived at the party and Dr. Rabary explained who I was, the registration people seemed a bit confused. They seemed to be looking for me, even though I was right if front of them. Finally when they realized that “Angeline” was me they said--—you’re Angeline, I thought you were another Malagasy just trying to get in. Thankfully, they had my name on the invite list, and I was greeted with many familiar sights and sounds. Burgers, cupcakes, the flag, the anthem, and even home made chocolate chip cookies, made by students at the American school in Madagascar.

Though many people know Dr. Rabary, it was rewarding to see the impact of our press conference they day prior. I’d say a third of the guests approached us to congratulate Dr. Rabary after reading the articles in the numerous newspapers that announced the award.

I had the opportunity to meet a few more mayors who, like us in the U.S., are still trying to get more women into leadership positions. They spoke highly of Dr. Rabary, who we’ve forgotten to mention, was actually a Parliament member several years ago.

Dr. Rabary had another train the trainer session to attend that afternoon, so I had a chance to visit with her husband and take a ride into the countryside. Since her husband only speaks French and today I didn’t have a translator, it was a true test of my French skills, and somehow we managed! I think my plan to only bring that one book- Mastering French—really paid off!

Thursday, July 3, 2008

Wedding Crashers

In our preliminary interviews with Dr. Rabary and her application, Dr Rabary mentioned civil status as a major factors in women’s rights. In most simple terms we equate civil status to a birth registration and/or social security card. Without it, your access to work, education, marriage is all limited. Malagasy people have to pay to get their children registered and unfortunately girls are often not registered because of the expense. Without registration a civil marriage ceremony is not possible and in turn, in the case of divorce, a woman has not rights for money or division of assets, if she was never registered.

Dr. Rabary and the center also work to improve women’s civil status, and we had the chance to see how this played out in a Civil wedding ceremony. Dr. Rabary often reminded us that lack of education/knowledge is a huge barrier and as such, they’ve integrated education into wedding ceremonies to help women understand their rights up front.

We arrived at what is the equivalent to a city hall in the U.S. to witness a civil wedding ceremony. Thanks to our driver Arthur, we were able to pick up a beautiful bouquet of flowers to present to the Mayors office for use during the ceremonies. Tons of families are lined up outside waiting for their families turn to be wed. We were greeted by the Mayor’s designee to perform the wedding ceremonies. As we took seats in the back of the room, it occurs to me how I (Joanne) feel like a wedding crasher. I remind myself that the bride and groom have been informed of our presence and have agreed to allow us to film the ceremony and attend. The ceremony itself is fascinating to me because the official from the Mayor’s office openly discuss divorce (both parties are entitled to half the assets) and family planning with the couple during the ceremony. The woman is 18 and the man is 28. They react shyly to the questions regarding how many children they want, the official states, jokingly, that there are only ten spaces in their family registry and to try to keep the number of children under ten! The joy of the day for this couple is on the faces of everyone attending the wedding. It was truly an amazing experience. Dr. Rabary insists that we stay for another ceremony and we do.

After the ceremony, we return to UNFPA offices to attend a press conference regarding our visit and Dr. Rabary’s work. I was again impressed with Dr. Rabary, she was concise and very media savvy. I (Angeline) can’t help but be a little surprised at how well media outside of the U.S. covers UNFPA’s work. Last year in Mongolia, when we visited Dr. Munkhuu, our arrival and Dr. Munkhuu’s winning of our International Award actually made breaking news on television. In Cambodia, when I visited Ms. Noeun, I was overwhelmed by the questions of the media and how much they wanted to know about Americans for UNFPA’s work. The press, both in Cambodia and in Madagascar actually hung out after the Press Conference just to get to know us and learn more.

In the afternoon we attended a Train-the-Trainer session that was part of the new CRS funded project. The training was helping in Dr. Rabary’s home in a bottom floor large conference room. In the midst of graduate students most of whom were just a few years younger than me, I’d guess, it was crazy to think I was in Madagascar. The students could have been in New York—they had the same style, hairdos, attention span, etc. as you see when you walk into any classroom. Many of the women filled out their lifelines so you should check them out.

Wednesday, July 2, 2008

SOS victimes du non droit

This morning we started the day seeing Dr. Rabary’s actual program “SOS victimes du non droit". Back in 1994 a woman was raped by 4 police officers and Dr. Rabary helped the woman. Soon after, Dr. Rabary set up a clinic in her home, realizing that many people didn’t know about their rights. She applied for UNFPA funding for the 1st legal advocacy center in Madagascar. She found 2 lawyers, who at the time agreed to work for free and Dr. Rabary’s own children helped with administrative work.

We met with the women that work at SOS and spoke to several victims and NGO partners that have benefitted from Dr. Rabary’s work.

We learned that one of the major problems is that in Madagascar most things are told orally—there is little documentation. Without documentation it is difficult to present a case. At SOS they give courage and support to victims to write a letter of complaint and press charges and they also help with amicable settlements. Like in the U.S. court processes are very arduous, and so the Center does feel like sometimes “Bad amicable solutions” and better than a “good trial” because there is less trauma and quicker resolutions.

The cases are not easy. In the case of battering, women now need to provide a medical certificate to prove it. On top of that, the certificate costs 6,000 Arial.

UNFPA helped Dr. Rabary produce a series of pamphlets on Justice, Access to Land, Family Law and Access to Work to provide women with the educational tools for empowerment.

From there we grabbed lunch at an Indian restaurant—there is a large Indian population in the U.S. I’ll note that they had music videos and good old “Usher” was on the screen. So not on my flight, per say, but still on the big screen in Tana.

We next hit the Justice Department’s Anti-Corruption Division. Dr. Rabary has made great strides in getting the Anti-corruption division to work with her to change the attitudes of the local police departments towards domestic violence. In fact, to their credit the Anti-Corruption division did a public opinion survey of the people of Madagascar to find out their experiences with the police has been and what is really going on at various police stations. What was more astounding was that they made this report public to anyone who wanted to read it. Dr. Rabary has partnered with the Anti-Corruption Division to make recommendations on what changes need to be made by the police in handling domestic violence issues. I had to admit I was a bit surprised that they let us film this discussion and that they talked to us about the various problems they face in changing the culture of the police department. To me that shows a real commitment to change.

After the Anti-corruption Division, we attend a dinner at Dr. Rabary’s house with her children and grandchildren. What a wonderful opportunity to talk to Dr. Rabary’s family and hear how they see her work. They are extremely proud of her, and as one son told us, “It is great validation for us, to have our mom receive this award from Americans for UNFPA because there were many times when she faced adversity that we suggested that she find other work that was less dangerous and more rewarding. Now we can see how Dr. Rabary’s work has truly made a difference not only in Madagascar, but around the world as well.” We were both overwhelmed by the generosity and hospitality of our hosts and enjoyed the evening immensely.

Tuesday, July 1, 2008

Voices from the Village

We began our day traveling to a rural village — Manankavaly.

This village is about an hour and half outside of Tana and mostly only accessible via dirt roads. We pass the time on the drive to the village getting to know Dr. Rabary and her husband better. Dr. Rabary has an excellent sense of humor and likes to laugh.

The ride was bumpy and beautiful. Below us we could see rice fields with an occasion worker tending to the fields. Above us we saw rich red soil and Mountainous soil trails. The road was unpaved, windy and narrow and at one point our car was over taken by a few zebu!

In addition to participating in the conversation, I (Joanne) am intently looking into any tree-lined areas for lemurs. I am rewarded when I spot one running through the forest. Finally, I can tell my son I saw a lemur.

A couple times a chicken/rooster cross the road in front of us. Dr. Rabary asked us if we knew what that meant. For a split second I (Angeline) thought—is she really going to tell us a why did the chicken cross the road joke??? Instead she explained that in Malagasy tradition, a chicken/rooster crossing in front of our vehicle suggests that we are bringing good fortune to the village.

When we arrive at the village, we are duly impressed. The mayor has made a huge effort to make a town for his constituents. There is a community center, an office building for the Mayor and a health center. It truly is a good-looking village center with a beautiful garden between the town hall and the health center.

First, we tour the health center. We are shown what would be the maternity ward and informed that each new mom-to-be must bring her own linens for her delivery. One of the main reasons for this is that there isn’t any capacity to wash the sheets at this time—there is no reservoir to bring water into the hospital area and the closest water source is 2 kilometers away. The room consists of four tables that are slightly cushioned and these are “beds” for labor and delivery. I (Joanne) think of my own upcoming labor how I will be delivering in a labor and delivery suite at Georgetown Hospital in Washington DC. I feel incredibly blessed to have the access to health care that I do.

We meet various women from the village who are waiting for various reasons to see the doctor on call. They are kind enough to let us take their pictures and be interviewed so that we can include their stories in Lifelines, our online global community for women. One woman in particular stands out, she is a new mom and she is dressed brightly in pink. Through our translator, I compliment her on her beautiful baby girl and she laughs. She offers me the baby, saying that she can be a very difficult baby at times. I empathize with her about how hard parenting is and tell her that I have a four year old at home. It strikes me that this woman and I would make really good friends if we lived closer. Motherhood is truly a universal bound.

We soon learn that the many women we saw walking towards the cultural center next to the Mayor’s office were not going to see an event. (We I guess they were going to an event, we just didn’t know we WERE the event) Apparently the Mayor had called a Town meeting in our honor. Over 400 hundred women (and a couple of men) came to hear us explain why we are in Madagascar and why Dr. Rabary’s work is so important. The village has a population of 4000 (…10% came to greet us!) but the mayor explained both for our visit and for medical services, people from other villages travel to Manankavaly.

The mayor spoke about what UNFPA could help them do to make the village even better and asked us to also speak to the audience about the work of UNFPA, Dr. Rabary and also our visit. I should note that the hospital for example is one that doesn’t currently get funding from UNFPA. The requests were big and small- from bed linens to an extension wing to the center. The mayor explains that a water source would enable them to provide water to the hospital as well as 2-3 surrounding villages. He explains that the village has enough money saved to pay the maintenance costs of a much needed ambulance, but they don’t have the savings for the actual vehicle.

When I (Angeline) addressed the crowd, I couldn’t believe the outcry of support. The number of standing ovations that both Joanne and I and the Mayor received when discussing Dr. Rabary’s achievements was a true sign of hope. We explained that Dr. Rabary would have the opportunity to speak to supporters in the U.S. about the needs of women in Madagascar.

Then the children’s choir sang us a welcoming Malagasy song and dances for us. It is amazing to witness. Both Angeline and I are very touched by the effort these children put into welcome us to their village. The mayor explained that a cultural center was necessary in town to give the children, in particular, a safe space to meet and interact. It’s interesting to see the investments in getting youth off the street.

The Mayor invited us to his home for lunch. The Mayor’s wife runs an apprentice program for Malagasy women to learn how to weave clothes and stitch intricate designs on fabric. These beautiful creations are then sold to help pay for the school. We tour the workshop and meet the women who are in the process of learning this craft and watch them turn thread into beautiful creations.

The Mayor’s wife is also a former nurse, and we chat amicably through our translator. It's a fantastic opportunity to learn more about the people of Madagascar and see how those with means live in Madagascar.

After lunch, we return to Tana to visit a UNFPA funded Hospital. The difference between the rural village health center and this hospital is night and day. We are amazed to find out that thanks to UNFPA, this health center has high tech c-section equipment and all the doctors are trained in performing of c-sections. Since they received the equipment in November 2007, they’ve successfully completed 30 surgeries and have had no cases of fistula since then either. But the doctor reminds us that their resources are still scares. They still need a labor room and a delivery room. And as a reminder that so much more needs to be done for even this hospital, in the room just next to the c-section room, three members of the hospital staff were making their own bandages and band aids.

We are blown away by the statistics that at the hospital they have only had one maternal death since 1998. Of course, that’s of the population of pregnant women with complications that make it to this hospital in Tana. We must remember that most women can’t actually get to the hospital and at best they are lucky if they are at least able to get to a clinic like the one we saw this morning in time to save the baby and the mother.

The doctor at the hospital explained to us that in Madagascar there are a lot of myths about family planning (and grave side effects) and often hesitation to use contraception due to religion. Contraception is available free of card, officially, however the hospital choices to charge a nominal fee because “things that are free are not valued.”

Next we leave the hospital to travel to the southern part of Tana to meet with a women’s networking group to interview them for our lifelines web page. These fascinating women from various economic backgrounds have come to meet us to talk about growing up in Madagascar and their various life experiences. Everything from what their childhood was like, what education background did they experience, to their marriages, life partners, and children. Definitely check out these stories on lifelines--for me the most poignant part of the conversation was after we finished the interviews and I was asked about life in the U.S.

One woman explained to me that the hardest thing for her was that she was a mom of two children, and both her husband and her had to work in order to keep a roof over their heads and keep the children fed. This woman felt lucky to have her mother helping her watch the children while she and her husband worked, but that the children were getting mixed up with other children that were introducing alcohol and drugs to her children. She asked me what we do in the U.S. about these problems. I explained to her that we face identical problems in the U.S. and that I wish I had the answers, but the best I could offer was what do with our children when we are home with them is to talk about these difficult issues.