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.