This speech was given by Faridah Luyiga Mwanje, Communication Officer with White Ribbon Alliance in Uganda, to the Canadian Parliament today, on the International Day of the Midwife.
I stand before you today as a woman, as a mother, as a citizen of Uganda and an advocate for reproductive health and rights.
I am happy and honoured to be here, but a few years ago I never would have imagined that I would come to Canada to thank the Canadian Government and Canadian organizations for their continued investment in the health of women and children globally – and specially to talk about the realities faced by adolescents in my country.
But my life changed forever when my own sister, Remie Wamala, died in childbirth in 2013. She bled to death at a hospital in Kampala leaving behind a heartbroken husband and four children. Her baby, my nephew, Lucky Wamala survived but suffered brain damage.
Remie was only one of the 17 mothers and 106 newborns who still die every day during childbirth in Uganda. My sister was a mature married woman who worked for the government on women’s health – but a disproportionate number of those who die giving birth are still children themselves.
Following my sister’s death, my response was to join White Ribbon Alliance, which like the Canadian Network for Maternal, Newborn and Child Health campaigns to put an end to these preventable deaths.
Earlier this year when the members of White Ribbon Alliance Uganda met to discuss our plans for the future, we collectively decided to focus on the rights of adolescents. Why? Because one in four babies born in Uganda is born to a girl who is aged less than 19 years old. Not only does that end her chances of education and better future, but early pregnancy puts the lives of both mother and newborn at even greater risk than faced by older Ugandan women.
So why are young people in Uganda having babies so young? Poverty, early marriage, the low status of girls and women, lack of education and poor health services – including family planning – are all interconnected causes.
Uganda is not alone in having suffered conflict in recent years, and yet we know that girls in conflict settings are at high risk of rape and other forms of gender-based violence. Issues of sexual assault, domestic violence, genital mutilation, early or forced marriage are often seen as ‘normal’ or swept under the carpet in my country. Lack of education and society’s perceptions of gender mean that the only way these things can change is when citizens are involved in that change from the very start.
We can only guess at how many of these girls even had a choice about having sex. All too often, girls are preyed upon by older men, or ‘sugar daddies’ with their gifts of food and money. Even some teachers are accused of trading good marks for sex with pupils. In a hungry family, parents may turn a blind eye to such abuses, while marrying off your daughters means one less mouth to feed.
And once a girl is having sex, what can she do to avoid pregnancy? What will happen if she asks the health workers in her community for family planning? Over and again, we hear how adolescents are too afraid and ashamed to approach health staff in case they are shouted at and abused for their ‘wicked’ behavior.
I can tell you that even older, married women still lack access to contraception. And once a girl is pregnant, what can she do? She may hide her pregnancy for as long as possible, missing out on critical ante-natal care. Despite the risks, she may give birth while hiding at home, alone and without help from a midwife. And because she is still so young, her risk of dying during the birth is five times higher than for her older sisters.
And who is to speak out and hold to account those who are raping and exploiting or simply neglecting young people, and those who are failing to provide them with critical health services? Currently, instead of those responsible having to change, it is the young – voiceless and powerless – who are blamed and stigmatized.
Yet it doesn’t have to be like that. White Ribbon Alliance Uganda has already shown that by harnessing the power of citizens to hold our leaders accountable, we can achieve rapid and tangible results.
In my country we have brought communities, health workers and policy makers together in a series of Citizens Hearings. We continue to be a watchdog through our Community Based Monitoring Teams and Citizen Journalists. As a result, we have seen real and rapid improvements in life saving emergency obstetric care, with new operating theatres built and staffed for the first time in three rural Districts.
Now we must make sure that adolescents are no longer neglected. I welcome this Voice of Women event and I urge you to pursue a comprehensive approach to Reproductive Maternal Newborn and Child Health, and to also to intensify your efforts towards adolescent health, Sexual Reproductive Health and Rights and fragile states, key areas that were missed out by the Millennium Development Goals (MDGS).
Although many of the MDGs were of critical relevance to adolescent girls, no targets focused on them specifically, resulting in adolescent girls being hidden. Healthy girls, mothers and newborns are vital to the success of the sustainable development goals. We know that healthy empowered women will send their children to school, have them vaccinated, and feed them well. They can also say “I DECIDE …if I marry, I DECIDE when I marry, I DECIDE if I have children, I DECIDE when I have children…”
It’s been acknowledged that the MDGs lacked a strong accountability component. The commitments made to women’s and children health by the United Nations were not discussed adequately by political leaders, civil society, the media and other key stakeholders. Clearly inputs from citizens were absent. It is therefore critical that we now make every effort to ensure the participation of citizens in the Sustainable Development Goals (SDGs).
We must support adolescents to participate actively to hold their governments accountable since they bear the worst brunt of discrimination and poor service delivery. The motto of White Ribbon Alliance is NOTHING ABOUT US WITHOUT US – so let us involve adolescents, and their communities, and our government in creating the change we need.
I thank the people of Canada for their support, and I call upon the government of Canada to continue helping people in disadvantaged regions whose lives are at risk. Women, children and adolescents should not face death simply because of where they live or who they are. None of us can calculate the value of the lives of girls and mothers lost during pregnancy, childbirth and afterwards. Only our many orphans, widowers and close family members know the true cost of a mother lost, and I can tell you that these lives are priceless. That is why we must invest in the health of girls, women and newborns.
Thank you for listening.
Faridah Luyiga Mwanje is a communication officer with White Ribbon Alliance in Uganda. She became involved with WRA Uganda after her sister died while giving birth, leaving behind a devastated husband and four children. In the wake of her family’s tragedy, Faridah, a mother herself, vowed to do all that she could to prevent the needless deaths of mothers and newborns.