Sexual Violence During COVID-19: Insights from an Addis Ababa Healthcare Professional

Hiwot Girma is a 26-year-old clinical pharmacist in Addis Ababa, Ethiopia. Together with Amref Health Africa, she is campaigning to end sexual and gender-based violence, particularly at a time when COVID-19 puts women and girls at even greater risk.

“My name is Hiwot. I’m a clinical pharmacist working at Ghandi Memorial Hospital as a drug information focal person. This is a specialised hospital that focuses on maternal and neonate childcare.

I also volunteer at the hospital’s sexual violence centre where I provide guidance, care and comfort for survivors of rape and sexual assault, along with medical advice.

I currently live with my brother and father because girls and women cannot leave their family household before they marry, even in the capital city. Although most people are stuck at home, I must still go out for work.”

What work do you do with Amref Heath Africa?

“I work as a youth volunteer in the AYAP (Amref Youth Advisory Parliament), which advocates for meaningful youth involvement in project implementation. I’ m also the new FGM Champion, meaning I visit other Amref projects and share information about this practice.

Fortunately, I haven’t gone through FGM because my mum and dad knew about the negative consequences. Many people still do not know about the complications. Just because I did not go through the cut, it does not mean that I should not fight for my sisters”.

How has COVID-19 affected your area, especially in terms of sexual violence?

“In Addis Ababa sexual violence largely centres around rape. In more rural areas, FGM is also performed on girls.  Lately it has been crazy in Addis Ababa – women and girls are getting raped, and the violence is increasing.

I think sexual violence during COVID-19 has risen, but the government doesn’t know the official reasons yet. Is it because everyone is at home or other factors? The Ministry of Women, Children and Youth Affairs is currently researching why the rape of women and girls is rising”.

How has COVID-19 affected you and your work with women and girls?

“At work, we have emergency triage corners set up. A nurse will take your temperature and test expecting mothers for COVID-19 when they enter. We always wear masks and gloves to give out medication, so nothing has changed there.

As I mentioned, sexual violence during COVID-19 is increasing.

My role is listening to women and girls about their experiences and the emotional impact. They are supposed to take HIV prophylaxis – a medication intended to help prevent the spread of HIV – as well as medicines to treat possible exposure to other STDs. So I also share information about those medicines and counsel them on their use”.

What motivates you to be an FGM Champion and fight against sexual violence?

“Because girls and women, I believe, should have equal opportunities. FGM is taking women and girls back – FGM causes sexual dysfunction, complications during childbirth, and things like anaemia. It also increases the risk of HIV due to exposure to unhygienic conditions.

We shouldn’t forget the medical side of it either. I heard from another medical professional that sometimes young women do not even know that they have been cut. One young woman did not know until she met a guy and decided to have a sexual relationship. Shockingly, sexual intercourse resulted in her bleeding to death. This could have been avoided.

It’s not fair that women go through these things; there’s no need. We need to make it safer for women and girls.

If we cannot protect and include women, we cannot achieve the things we want to accomplish as a country or a continent.

That is why I am passionate about participating.

We should not be afraid to fight FGM. Everyone should be responsible – whether they live in cities or the countryside. I believe everybody should say no to GBV, and everybody should come together to fight it”.

Hiwot joins four other pan-African champions in Amref Health Africa’s No More Violence: Daring to Speak Up campaign, designed to raise awareness about increasing rates of sexual violence during COVID-19.

Accessing Safe Abortion during Lockdown in Africa

We have seen how pandemics negatively impact access to reproductive health services, especially access to safe abortion. As the pandemic spread globally, MAMA Network saw a growing demand for self-managed abortion and access to telemedicine across Africa.

As a Network we have seen how the COVID-19 pandemic disrupted availability and access to safe abortion medication and contraceptives. Transport is less accessible. Clinics have reduced hours or are closed. Services are more expensive and community activities are on hold.

MAMA Network is a regional movement of activists working to share evidence-based and stigma-free information about self-managed medical abortion.

Sexual and reproductive health and rights (SRHR) information is shared with women at the community level across Sub-Saharan Africa.

In 2016, MAMA network was founded by Trust for Indigenous Culture and Health (TICAH) in Kenya and Women Help Women. Over the years, the network has supported organizations in their efforts to increase access to safe abortion services and information. This is possible through mentorship, coaching, trainings, sharing of information, joint activism and creating spaces for linking and learning.

The pandemic led to an increase in demand for self-managed abortion, post abortion care, contraceptives and telemedicine or tele-counseling. In May 2020, we launched three hotlines in Cameroon, DRC and in Zambia. This brings the total of hotlines in the network to 9 including Nigeria, Kenya, Tanzania, Malawi and Uganda. MAMA Network’s approach to telemedicine and tele-counseling trusts women to have autonomy over their bodies.

In Kenya, Aunty Jane Hotline (launched in 2012) provides reliable, safe and confidential information to save women’s lives.

The hotline is toll-free since 2018. Recently women calling the hotline faced difficulties in accessing misoprostol in pharmacies due to global shortage of commodities. Women who accessed services, said they were asked to pay between $90 and $250. Before COVID-19, services in private clinics were $30. Online campaigns by Aunty Jane Hotline have intensified, including virtual meetings and strategies to strengthen collaboration with service providers.

In Nigeria, Ms. Rosy Hotline (launched in 2014) is toll-free since 2016 and operates 24 hours daily. The hotline has received approximately 135,000 calls from across Nigeria. Aunt Kaki was launched in Uganda in 2017. In Tanzania, Shangazi Shani was launched in 2018. Women Help Women’s online platform also exists to assist women and girls from all over the world.

In Uvira, DRC Congo, MAMA partner organizations have supported at least 10 women to access safe abortion in recent weeks. The rise in transportation costs has created barriers in accessing reproductive health services. With secure communication; a WhatsApp group is used to record community cases and refer to nearby healthcare providers and clinics. Community champions are doing home delivery of pills, one on one counseling, and follow ups. They have noticed a spike in the demand of pregnancy prevention methods in the Uvira region.

Changed Women Project in Zambia offers in-person services on a case by case basis. “Public hospitals are overwhelmed, women and girls are not going to hospitals. They are sent back due to congestion and go back to quacks because they can’t be helped,” a representative said. In the previous week a girl in the community unsafely induced an abortion and suffered serious complications. Changed Women stepped in and assisted her to go for post abortion care at a government hospital.

MAMA Network has remained active to shine a light on the importance of access to information and services for safe abortion.

On May 28th, the International Day of Action for Women’s Health, we ran a campaign receiving support from 10 countries and collected 56 photos of solidarity with the hashtag #AbortionBeyondLockDown. The purpose of the campaign highlighted that despite the lockdown, safe abortion remains an essential service.

MAMA Network has also continued to implement capacity building webinars, providing necessary tools to support activists and actively fundraise to support community based organizations. These efforts have been successful and we expect to launch 4 more hotlines in 4 countries in the coming weeks.

MAMA Network (Mobilizing Activists around Medical Abortion) is a collaboration of grassroots activists and feminist groups based in Sub-Saharan Africa. MAMA Network is a Safe Abortion Action Fund grantee partner.

In Conversation with Natasha Salifyanji Kaoma

Allow us to introduce you to Natasha Salifyanji Kaoma! Natasha is a Zambian medical doctor and the founder of Copper Rose Zambia – an organization working to advance adolescent sexual and reproductive health.

We sat down with Natasha to talk about starting her own organization, the taboo around menstruation and abortion, and how she takes care of her own wellbeing in her work. 

“I noticed a menstrual hygiene problem in my school. Not because the girls couldn’t afford the products, but most people didn’t know what was going on with their bodies.”

It can be incredibly challenging to work on issues considered to be taboo, sensitive or ‘controversial’, but Natasha clearly isn’t going to let societal norms in Zambia – or anywhere else in the world – stand in her way. 

“I believe that women, if empowered, can change the narrative of the African continent.”

This video was made possible through a generous grant from SayItForward.org in support of women’s advocacy messages.

North-South Cooperation in Fighting FGM

In recent years, it has become apparent that international cooperation is important in promoting inclusive and sustainable development, especially to achieve global development agendas. African countries recognize the importance of partnerships for enhancing and consolidating the growth of the continent.

Many African states have benefitted from the traditional North-South cooperation, through sharing experiences, technical assistance, as well as the cooperation of other  emerging economies. It is along such lines that the Anti-FGM campaign has picked up much-necessary momentum after years of lip service.

The campaign against FGM has had a long history, but it has been confined to board rooms and workshops, with few targeted grassroots campaigns. For instance, as recently as 2010, Kenya did not have an official policy addressing FGM and relied upon Presidential decrees. However, with the Anti-FGM policy put in place, in 2011, there has been considerable investment of resources and strategies from the North.

The international immigration crisis brought FGM to the doorstep of the developed north. Waves of migrants from nations that practice FGM began arriving and settling, and brought their deep-rooted cultural practices – such as FGM – with them. While the developed north had been known to condemn the practice in principle, the changing dynamics required a more proactive approach, both at home and abroad.

It is in this context that a new impetus to fund anti-FGM work at the grassroots by organizations based in the north came about.  Notably, in 2015, The Guardian Media UK launched the End FGM Guardian Global Media Campaign in Kenya, The Gambia and Nigeria. The Guardian pioneered identifying and training young activists in the use of new and traditional media to work towards ending FGM.

The use of media has been a powerful tool in influencing perceptions and educating people about the realities of FGM. The media has also broadened the platform, reach and visibility of anti-FGM efforts. The use of activists has built upon young people who are already playing leadership roles and have what it takes to be future opinion leaders in their respective communities.

Similarly, The Girl Generation, an African-led global movement aimed at ending FGM within a generation, focuses on building a critical mass for change which helps unlock regional, national and international commitments to increase resources that can sustain and scale up efforts to end the practice.

Other notable strategies include Alternative Rites of Passage (ARPs) spearheaded by AMREF Health, in Kenya, Tanzania and Ethiopia. ARPs allow a girl to safely transition to womanhood without undergoing the emotional and physical risk of FGM while preserving a community’s’ culture. ARPs has been adopted by the United Nations as a model of eradicating FGM.

In Djibouti, Mali, Guinea, Senegal, Somalia, The Gambia, and Mauritania, is Tostan – a human rights Community Empowerment Program that allows community members to draw their own conclusions about FGM and lead their own movements for change. The program also focuses on community public declarations which are critical in the process of abandoning the practice, eventually leading FGM to becoming a thing of the past.

Elsewhere, 28TooMany is consistently working on research around Africa where FGM is practiced (28 countries) and across the diaspora. They also advocate for the global eradication of FGM and work closely with other organizations in the violence against women sector. Research and data is a crucial element that guides Anti-FGM strategies and campaigns.

What these efforts have in common is support from the north, with campaigns being led by local activists, many of whom are beginning to gain attention for their efforts in eradicating FGM in their countries.

The North-South cooperation has resulted in accelerated efforts to end FGM – evident in the recent ban of FGM in countries like Nigeria and The Gambia.  A drop in FGM overall in some countries, and public community declarations in others, are tangible results. Intangible results can be seen in increased reportage of FGM cases, a surge in involvement of young people and institutions in Anti-FGM Campaigns, increased awareness, the launch of regional campaigns such as the Saleema Initiative in Sudan, the Not in My Name campaign in Sierra Leone and the He for She campaign worldwide.

Being a Woman and an Entrepreneur in Malawi

By Mayamiko Chiwaya, Student Driven Solutions graduate, age 16

Starting a business in Malawi is not an easy thing. Most people think that once you come up with a business idea you can implement it right away, which is not always true. To start a business requires hard work and dedication. In this edition, I will share with you the challenges women and girls encounter while striving to start small businesses in Malawi.

According to my investigations, the first challenge that women and girls in Malawi often meet is lack of recognition. Women and girls are not recognized as people who can develop Malawi as a country through business. It’s for this reason that they often fail to start small businesses because they are not given the chance. For example, in most banks in Malawi, women are given smaller loans than men.

Pamela Banda, age 18, a successful young lady operating a shop selling fashion items once experienced this challenge when getting a loan from the bank, but still managed to get a small loan from her mother’s bank to launch her business. She shares her story:

“At first people underestimated me because of my age. People thought that at my age I couldn’t run a business because most of the time, people my age have not completed secondary school in Malawi. Apart from being underestimated, I also met different discouragements. I received negative comments from people. They said business was for uneducated people. They said educated people work in offices and other institutions while uneducated people have to do business since they do not have the capability to work. As for me, I did not believe it because nowadays in Malawi things have changed and the economy is not normal so one needs to work and do at least a small business in order to live a decent life.”

Pamela started her business because she saw that her parents had a big responsibility in taking care of all the children. They weren’t able to help everyone so she decided to start the business to support herself. She makes profits and is able to support herself through college. Her parents pay school fees and the business supports her with pocket money. She was even able to buy a laptop using the profits!

Agness Ngozo, age 30, operates a butchery business and said she also encountered the same problems that Pamela described:

“I faced a lot of discouragement from different people, including my own husband. They said to own a butchery was a masculine business not feminine so I had to stand firm to the idea and now I own several butcheries.”

Agness started her business because she didn’t want to be a housewife with nothing to contribute. She hated always asking her husband for money and it caused them to fight. She got a loan to start her business two years ago and has managed to expand the business to new areas. She says, “I have many customers and people love to buy from me because I sell quality meat.” She is able to take care of her family and pay her children’s school fees.

It seems the discouragements most women face when they want to start a business come from their husbands and friends. Mostly people do this out of jealousy since they think they can’t do it themselves.

When I asked Pamela how she managed to overcome her challenges, she said:

“I put God first in everything. I know that I may have the knowledge, a good attitude and a hardworking spirit to do business but if I don’t put God first God will not reward me. Apart from putting God first, I also have confidence in me. I believed in myself and I believed I could do it no matter what. I also challenged the people who discouraged me from starting a business. The more I challenged them, the more I took control and their discouragements over me diminished.

“I would like to encourage my fellow girls who are fighting hard to start businesses that they should have self-confidence because confidence makes us win before we have started. I also had some goals, which guided my decisions and actions so whatever I was doing was in line with my goals. If I had not set goals, I could have been easily moved by what people were saying.

“Lastly I learned through my past experiences, which helped me make better decisions. I know that the good decisions I’ve made in my life have come from learning from errors, mistakes and pains. If I had not failed, I could not have learned and I could not have become a person who makes good decisions today. It was through all of this that I managed to overcome the challenges I faced during the start of my business.”

At such a young age, Pamela did not allow age to be the barrier for her to start a business as she knew that age doesn’t matter, but what matters is how you age.

 

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About the Author, Mayamiko Chiwaya:
I am 16 years old. My ambition is to become a successful entrepreneur in Malawi. I am passionate about writing, designing, and baking. I like to play football and read novels. My favorite quote is, “Age doesn’t matter but how you age matters.” I was raised in a family of two by a single mum who is a nurse. I am a graduate of Student Driven Solutions and am now running a business.

Student Driven Solutions has launched a crowdfunding campaign to support their work: “Please consider making a donation as little as $1 and as big as infinity! All donations help support girls like Mayamiko start businesses to jumpstart their future.”

 

The Power of Knowledge in the Fight against HIV/AIDS

Correct information empowers people to make the best possible choices in all aspects of life. Conversely, incorrect or poorly communicated information can cause a degree of harm that can be worse than knowing nothing in the first place. It is time to stop focusing solely on access to education, and start working on improving the quality of education.

Rightly so, education is often considered the ‘first defense’ to the HIV/AIDS pandemic. When people know how to prevent transmission and why preventing transmission is so important (ie. there is no cure for HIV), the majority of people will, to the best of their abilities, take action to protect themselves and their families. Knowledge gives people the power to prevent HIV transmission in the first place, thereby eliminating the need for medical interventions to mitigate the effects of the virus.

The ‘knowledge is power’ principle has created a focus on simply getting children and youth enrolled in school as a key strategy to combat the spread of HIV.

But is getting children and youth enrolled in school enough? Sadly the answer is no – or at least, not always.

Help LesothoIn many countries where the AIDS pandemic continues to hold fast, the education systems are rarely equipped to properly convey this essential information. Perhaps it’s because so many educators fall victim to AIDS themselves, leaving schools under-staff with qualified teachers. Perhaps it’s because out-dated school systems do not include HIV/AIDS education as part of the curriculum, and many teachers avoid the subject entirely because they fear they will be overwhelmed by the intimacy of the questions and comments.

Or, worst of all, perhaps many teachers still hold traditional views about HIV and insist on perpetuating damaging myths rather than sharing accurate information. In any case, school enrollment does not guarantee that children and youth will learn the correct information about HIV/AIDS.

A recent Help Lesotho life skills camp for adolescent girls revealed how serious the education gap in HIV/AIDS really is. One girl, eager to share her knowledge, confidently spoke up to answer a question about modes of HIV transmission, replying that:

“Contaminated food, air or water can transmit HIV.

Shockingly, none of her fellow campers challenged her response. This girl is currently enrolled in high school. She has been in the Lesotho education system for 10 years, and she is still unaware that HIV is transmitted through bodily fluids, especially during sexual activities. This girl is old enough to be married (under Basotho law), and old enough to become pregnant – so she is certainly old enough to encounter situations that could put her at risk of contracting HIV. The education she has received has left her with no way of preparing for or mitigating these risks.

How can she be expected to be part of the solution to fighting HIV/AIDS when no one has ever given her the relevant education?

In another instance, a group of 60 youth in a Help Lesotho program – all of whom were high school or tertiary graduates – were asked whether a person can get HIV the first time they have sex. Only 75% of respondents said ‘Yes’. In actuality, 25% of Lesotho’s population is HIV positive.

It is widely known that HIV affects adolescent girls at a much higher rate than their male counterparts. In southern Africa, according to UNAIDS, three quarters of all new HIV infections among adolescents aged 10–19 years are among adolescent girls. If access to education is actually an effective deterrent to the spread of HIV, one could assume that whichever gender has higher enrollment in education should be better prepared to avoid HIV transmission.

However, in Lesotho, more girls than boys are enrolled in primary school (up to 70% of some school populations are girls), and yet adolescent girls are infected twice as much as their male peers. There are of course other factors at play – girls are more vulnerable to HIV as a result of gender-based violence and other factors.

One thing is definitely clear: Simply going to school cannot be relied on as the first defense against HIV/AIDS.

Girls’ Globe is present at the 2016 International AIDS Conference in Durban, South Africa (17-22nd of July). Follow us on social media and by using the hashtag #EndHIV4Her for inspiring blog posts, interviews and updates! To sign up for the daily In Focus Newsletter visit crowd360.org/aids2016/