Christine Sayo is a sexual and reproductive health and rights advocate from Kenya. In this conversation with Girls’ Globe, she talks about feeling judged by others for simply talking openly about issues related to sex.
“The community looks at you as a deviant, as someone who is going against the norm.”
The good news, though, is that Christine is seeing a shift in attitudes thanks to globalization and increased access to information from different channels.
“Having information coming in from different sources has helped to destigmatize some of these issues around sexual and reproductive health in young people.”
This video was made possible through a generous grant from SayItForward.org in support of women’s advocacy messages.
Beverly Nkirote Mutwiri is a sexual and reproductive health and rights advocate from Kenya. She speaks to Girls’ Globe about the challenges she has encountered as a young woman in a patriarchal society.
“In many SRHR spaces we have male dominancy, and at times it can be very intimidating, especially to a young woman.”
This video was made possible through a generous grant from SayItForward.org in support of women’s advocacy messages.
This blog post was originally posted on Upworthy.com as part of a project with Girls’ Globe, Upworthy and Johnson & Johnson.
When Jack Hisard was a young boy, he lost both his parents, one after the other, to diseases that could have been cured — if they had lived in other parts of the world.
First, Jack lost his father to malaria when he was only four years old.
“I remember that night clearly in my head because his last moments were spent sitting next to me in our small grass thatched hut in the village,” he writes in an email. “There was no hospital nearby where he could be treated.”
Malaria’s considered a Neglected Tropical Disease (NTD), which affect more than 1 billion people in over 149 tropical and subtropical countries. While these diseases are preventable, it’s estimated that 57 million years of life is lost due to premature disability and death from NTDs.
After Jack’s father’s death, life for his family became tough. His mother couldn’t provide for herself or her children for a number of reasons including the fact that she suffered from depression. Then, just two years after his father passed away, she had a stroke and died too.
The period after her death was difficult to say the least, but Jack was determined to find a way take care of his remaining family.
So, when he was just nine years old, he started fishing in Lake Victoria to pay for his school fees and feed his two younger siblings. He did this while still going to school, because he believed an education would ultimately make a difference in his life.
“Life was tough but my belief in education never faded,” he writes.
There were still some times when he couldn’t pay all of the fees associated with school so he had to miss some of it, but he still remained the top student in his class for many years. Finally, thanks to all his hard work and dedication, he managed to graduate high school and secure scholarships that would take care of his college tuition.
But while he was in high school and college, he was thinking about how to solve the problem of the lack of health services in rural areas like his hometown.
Jack had witnessed firsthand how devastating preventable diseases can be to a community when they have limited access to health care. Aside from his parents, he saw close friends, relatives and neighbours succumb to malaria and other treatable diseases.
In their village, homeopathic medicine had been the main medicinal resource for as long as he could remember, because people could easily access the herbs they needed.
“I remember the many times I accompanied my grandmother, an herbalist, to go deep into the forest to dig for roots and tree barks which would be used as medicine for various ailments,” recalls Jack.
When it came to assisting births, traditional midwives would conduct deliveries on the floors of people’s grass thatched houses. These midwives and healers didn’t wear gloves or use any form of sterilization. They would use boiling salt water to clean wounds after deliveries and, if complications arose during a delivery, lives would be lost because they didn’t have the lifesaving tools one might find in hospitals.
So he decided he’d find a way to bring better health care to his community. That’s when Mama Clinic was born.
Mama Clinic provides primary healthcare services, outpatient and inpatient care and free maternal and child health care services to people in rural Kenya. Jack started the organization back in 2012, when he was only 19 years old. In just the last six years, it’s served over 40,000 patients.
The clinic has a lab, which allows for proper screening for diseases and reliable diagnosis. They currently have 42 beds available and 14 full-time employees to attend to patients. Jack has also built partnerships with national hospitals to ensure that patients who are severely ill can be referred or transferred for more specialized care. In keeping with their mission of providing access to quality and affordable healthcare to all in rural Kenya, Mama Clinic currently manages two satellite clinics in two other remote districts in the country.
Beyond what the facility provides, Mama Clinic also conducts Community Health Outreach programs where volunteers walk from village to village providing free health screenings and treatment to the villagers who cannot go to the facility.
“No other child should have a loved one die to a Neglected Tropical Disease (NTD), and mothers need a safe place to deliver their babies near their homes” says Jack. “My experiences as a child shaped my dreams. I knew I wanted to be a doctor… a doctor who wants to make a difference in his community because I don’t want to see another child go through what I had to go through, to live without the care and love of a parents”he explains in his Youtube video for Mama Clinic.
Unfortunately he’s up against a number of obstacles. The high rates of malnutrition and the broken health care system in Kenya make people vulnerable to contracting NTDs.
Right now Kenya lacks operating facilities, medication and professionals. A mere 4,300 doctors currently work in the public healthcare sector for the country’s 38.6 million people.
What’s more, in 2017, it was estimated that around 9 million people in the country are undernourished, according to a report released by the United Nations last year. Severe malnutrition stunts growth and makes children more susceptible to diseases because it weakens their immune systems. High rates of malnutrition are also affecting almost 40,000 pregnant and nursing mothers in Kenya and their babies.
Malnutrition in childhood and pregnancy can be very dangerous. Women who are malnourished while pregnant face higher risks of mortality during labor and premature births. These are exactly the types of problems Jack’s Mama Clinic is trying to address by bringing a functioning health care facility full of professionals to his underserved community. His initiative makes screenings and treatment more accessible, which in turn is helping combat these treatable health problems.
Jack knows that in order to offer the most comprehensive health care, he’s got to flesh out his education even more.
That’s why he’s currently attending Michigan State University where he’s studying public health and nutrition, and focusing on the epidemiology of diseases and their relation to nutrition. He wants to learn how poor nutrition can make it easier for people to contract NTDs, because that’s such a huge problem in rural Kenya.
His next step is to become a medical doctor so he can acquire the expertise and experience to better attend to his patients, expand Mama Clinic’s work and run it long term.
He knows that this knowledge is essential for him to run the best health clinic he can and ultimately save more lives in his community.
But perhaps what’s most rewarding for Jack is seeing how his dedication to education is inspiring other kids in his village to follow in his footsteps.
As the first person in his village to go to college, he hopes his story will also lead to more of them attending university. “It became my dream to give that hope to other people,” he says.
Despite growing up in challenging conditions, living in a slum and losing his parents at a young age, he exceeded expectations at school, received a full ride fellowship to Watson University and has represented Kenya through the Young African Leaders Initiative. Needless to say, he’s a prime example of what hard work and dedication can lead to.
Sometimes the best motivation is overcoming the most difficult of experiences. If anyone is a testament to that, it’s Jack.
“If you have dreams and are willing to pursue them, there is a way out of poverty.”
Anne Anyango is a 35-year-old mother to five children and a wife to her 40-year-old husband. Anne’s family resides in one of Kenya’s biggest slums – Kibera, in Nairobi – where access to basic needs can be a challenge.
Before Anne started using contraception, she was consumed by the myths and misconceptions peddled around by fellow women. “They told me that I would not get pregnant, I would grow fat and that I would be ‘cold’ in bed which would make my husband divorce me,” she disclosed.
She believed these myths for a long time. Her husband was not pro-family planning either, for he believed the side effects would break their marriage. But after Anne gave birth to five children in the space of eight years, she knew she needed to do something urgently to curb the pregnancies and births, for she did not have enough resources to support them. She also said her health was quickly deteriorating. “I became weak,” she said.
During one of her clinic visit days at Family Health Options Kenya, she spoke to a nurse about her fears regarding use of family planning. She was offered guidance and is now secretly using an IUD. “My husband has no idea that I am on family planning,” she said. She fears that if her husband knows about it, he might divorce her.
It has been two years now and Anne has experienced no side effects. “I am still the same,” she shrugged. She also said, however, that her husband wonders why she is no longer getting pregnant.
Anne’s situation reflects a true picture for millions of women across Africa today.
The same report further states that adolescent pregnancy rates are highest in Sub-Saharan Africa, and it’s incidence is strongly related to child marriage. More than 1 in 4 girls in West Africa and Central Africa are pregnant before the age of 18 and 1 in 20 before turning 15.
These statistics indicate that Africa is still merely limping towards achieving its agenda regarding access and provision of sexual and reproductive health services to its people.
The Declaration on Human Rights states that every woman has control over her fertility, the number, timing/spacing of pregnancies and her method of contraception. In addition, it provides the right of women and girls to information and education on family planning and contraception, to non-discriminatory access to SRH services and to access abortion on specific grounds.
Although various Africa Union (AU) member states have made commitments to policy implementation frameworks, it is evident that challenges exist around domestication and implementation of human rights.
The reality is, national-level legislation often does not articulate women’s reproductive freedoms and rights. These issues are only reflected in policy or strategic frameworks. Very few countries realised the commitments expressed in the Abuja Declaration (2001) on health expenditures, which required Africa Union countries to allocate at least 15% of their annual budget to improve their health sectors.
Many girls and women in Africa living in rural areas and poorer communities face obstacles to their access to, and use of, SRH services. The challenges include: long distances to health facilities, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for large family size, children dying under five-years-old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programs.
However, some countries have made initiatives to enhance access. These include allocation of budgets, integration of SRH services into primary health care and the provision of free services including contraceptive methods. Some countries have also introduced mobile clinics to enhance access to SRH services for rural women.
Comprehensive Sex Education
There have been policies and frameworks that place comprehensive sexuality education and information programs as key institutional obligations for states to implement in school curricula and out-of-school programmes. Some countries have adopted them well, while others are still facing challenges in doing so.
Similarly, adolescent access to SRH services is limited when countries lack youth-friendly services. Many young people shy away from discussing their sexuality around older people. Such services provide them with safe spaces to inquire freely about anything they want to know.
Legal guarantees for access to safe abortion as articulated in the Maputo protocol indicate that abortion can only take place when the life of the mother is threatened, when pregnancy poses a threat to the mental and/or physical health of the mother, in case of foetal impairment, or in case of sexual assault, rape or incest. Abortion is not allowed on any grounds not specified in the Maputo protocol.
Every year, an estimated 1.4 million unsafe abortions take place among girls aged 15-19 in Africa. Both married and unmarried adolescent girls are at high risk of being exposed to unsafe abortions. In most countries, guidelines regarding Safe Abortion Care and Post Abortion Care are missing. These are of critical importance to ensuring the quality of accessible safe abortion services.
Effects of the Global Gag Rule
Finally, the global gag rule – otherwise known as the Mexican City Policy – imposed by the current US administration has immensely affected provision of quality SRH services across Africa.
Women in Africa are currently suffering from disruptions in reproductive health services, more unintended pregnancies, higher rates of maternal mortality, and an increase in unsafe abortions. Multiple studies have shown that the global gag rule has notdecreased rates of abortions overall, but has instead increased the number of unsafe abortions. NGOs are also suffering from significant funding shortages to provide comprehensive sexual and reproductive healthcare services.