Keeping Girls Healthy in DRC

October 11 is the International Day of the Girl, one of CARE’s favorite days of the year. In some ways, we celebrate girls every day. After all, empowering girls and women is the focus of CARE’s mission, and we believe they are the key to overcoming global poverty.

This year, International Day of the Girl is focused on the empowerment of girls in crisis situations. According to UNICEF, approximately 535 million children worldwide were living in countries affected by conflict, natural disasters, epidemics, and other emergencies last year. The Democratic Republic of Congo (DRC) is one such country.

DRC is located in the Great Lakes region of Africa and home to breathtaking scenery and vibrant people. Although civil war here officially ended in 2003, conflict between government forces and various armed groups has persisted and remains ongoing in certain regions. DRC is rich in natural resources, but it remains mostly poor in terms of infrastructure and economic opportunity for its citizens. Women and girls, in particular, face enormous challenges just to survive and provide for themselves and their families.

The health system in DRC is weak and unable to fully meet the primary health needs of the population, including sexual, reproductive, and maternal health needs. Tens of thousands of Congolese women and girls die each year from pregnancy and childbirth – many are only teenagers.

Adolescents and young people in DRC often find it difficult or impossible to access health care. Information and services related to sex and reproductive health (SRH) are especially hard to find due to cultural norms and expectations (such as abstinence before marriage) that prohibit young people from seeking them out. If a young person does manage to reach a health clinic or provider, it is not uncommon for them to be denied care because of their age or even shamed for seeking it out.

“Why do you need condoms? You’re too young to be having sex! Go home!”

Of course, teenage girls and boys in DRC (and around the world) are having sex whether or not adults approve. And without knowledge of sexual health or access to contraceptives, girls are accidentally getting pregnant. Girls like Claudine.

Claudine is 19 years old and lives in Goma, the bustling capital of the North Kivu province of DRC. Not knowing how to protect herself, she became pregnant and gave birth to a child at age 17. She has returned to school and is studying social sciences at the Uzima Institute.

Fortunately, SRH information and services are becoming more available to Goma teenagers through Vijana Juu (translates to ‘Stand Up for Youth’), a project implemented by CARE DRC and funded by the UK Department for International Development. Adolescents and young people partnered with CARE staff to identify barriers to accessing and using contraception, brainstormed solutions, and worked with community leaders and health administrators to change the situation.

They recognized that their peers did not feel comfortable going to local health centers because they might run into judgmental adults, so certain clinics responded by setting up discreet side entrances available to youth only and created adolescent-specific referral cards to improve access to health services. Open meeting spaces designed by young people were established next to health centers where adolescents could come to talk with their peers about issues related to SRH in a relaxed environment that belongs to them, and teenagers could volunteer to be trained as peer leaders, providing information and referrals to their friends and neighbors.

CARE is helping to train health providers to recognize and challenge their own values and biases toward teenage sex that could discourage youth from seeking services. CARE is also supporting health facilities to provide a full range of contraceptive options and reproductive health services to adolescent girls and young women.

Over 6000 adolescents received sexual and reproductive health counseling and services through this program, and many began using contraception for the first time. About 30% of these new contraceptive users are girls, and 65% of them selected a highly effective, long-acting and reversible method (implant or IUD).

After her child was born, Claudine visited one of the Vijana Juu youth-friendly health clinics for an IUD so she could finish school without the risk of getting pregnant again. She has become a vocal advocate for safe sex in her community, and advises her friends to use contraception. When we asked why, she explained:

“Girls my age forget that sex can lead to harmful consequences like unwanted pregnancy, sexually transmitted diseases, abortions, and even death. Young people need to be informed. Adolescent girls and boys have a right to sexual health to make a better future and realize their dreams.”

Talking Family Planning with Beth Schlachter

On July 11 2017, policymakers, donors, and advocates from around the world gathered at the Family Planning Summit in London to discuss efforts to reach the Family Planning 2020 goals – ensuring greater numbers of women and girls are able to plan their futures by enabling 120 million more women to use contraception by 2020.

We caught up with Executive Director Beth Schlachter after the Summit to talk about expanding access to contraception and giving girls and women the ability to control their own lives.

Wherever you live, and whether or not you’re happy with the information, services and support you’re currently able to access, there are ways that each of us can take action improve the sexual and reproductive health of women and girls in our own communities and elsewhere in the world. Beth explains:

Feeling inspired?

Visit the Family Planning Summit website to learn more and to access resources

Follow @FP2020Global on Twitter

Engage with Family Planning 2020 on Facebook

Join the conversation using #HerFuture

Breastfeeding and the Sustainable Development Goals

Breastfeeding is an essential part of the Sustainable Development Goals (SDGs), and can be mirrored in not only the most obvious ones – like Zero Hunger and Good Health and Well-being but in many (if not all) of the other goals. Its impact and benefit for the baby, mother and thus society as a whole might not be the main target of the goal, but indirectly many linkages can be recognized.

Breast milk is, and always has been free. The costs for formula on the other hand, can have huge impact on a household’s budget. Our babies don’t need anything else – not even water – for the first six months of their lives, if they are exclusively breastfed (of course, there are always exceptions to the rule). With adequate information and support, nearly all mothers can breastfeed their children, no matter their financial situation. What an amazing, effective and inexpensive intervention in the battle to end poverty!

Zero Hunger and Good Health and Well-Being are essential goals towards global sustainability and equality, and they include plenty. Increased rates of exclusive breastfeeding (EBF) is such an important step towards these goals, since breast milk will always be accessible, available and give the best nutrition possible for children. UNICEF recognizes that the greatest potential impact on child survival of all preventive interventions is optimal breastfeeding of infants under the age of two. Also, in terms of food safety, EBF protects children from infectious diseases by decreasing their exposure to water and food borne pathogens, and improves infant resistance towards infections. In the end, fewer children will suffer from for example diarrhoeal diseases, which is the second leading cause of death in children under the age of five.

The health benefits for mothers include lowered risk for certain cancers, osteoporosis and post-natal depression, just to mention a few. Breastfeeding is vital in both preventing and treating diseases, in the short and long run, both for children and their mothers. 800 000 lives per year could be saved by breastfeeding interventions!

Breastfeeding offers so many benefits both for children and mothers, and it is a human right directly connected to the right to food and health. It is part of a woman’s sexual and reproductive health, and can be such a unique emotional and empowering experience if adequate, unbiased information and support is given. WABA recognizes several globally spreading determinants – such as dominant structures, institutions and social values – that both undervalue and put women’s physical needs at risk, as well as their reproductive and productive contributions. Protection, facilitation, encouragement and (in the end) increased rates of breastfeeding is imperative to reach gender equality.

Optimal breastfeeding is, and encompasses so incredibly much and this needs to be recognized and prioritized when national governments develop their action plans to achieve the global goals. It improves health outcomes for children and mothers, reduces poverty, increases gender equality, saves our planet’s resources by decreasing the use of plastic bottles, contributes to more sustainable consumption, contributes to higher IQs and thus educational attainment, and most importantly: it saves lives.

breastfed-babies

Cover Photo by DFID – UK Department for International DevelopmentThe importance of breastfeeding from birth.

Girls Shouldn’t Feel Ashamed at That Time of the Month – Period!

My name is Barbara Namuddu, a peer educator with Reach A Hand, Uganda (RAHU) and I would like to tell you a story. A story that am not afraid to talk about because I am a girl and am proud to say that being a girl is not a punishment.

I have been volunteering with RAHU for nine months now under the Peer Educators Academy program where I have had an opportunity to interact with my peers in schools. My interaction is mainly premised on listening to their issues so that I, as a peer educator armed with the right information, can help them overcome their challenges.

It’s not a surprise that as a girl, fellow girls always feel open to share problems that they go through with me since they know that I, have also gone through the same. I am sure any girl reading this is nodding her head in agreement.

From the peer learning sessions I conduct, I always find out so many terrible tales happening to young girls in school (but also out of school) as young as twelve.  One of those things are the experiences they go through during menstruation.

Burdened with cramps, heavy flow and surprise menstrual periods (since some are so young to know when the cycle starts), and interacting with rude or unsympathetic boys and men who don’t know how it feels to go through menstruation, girls are still living in terror.

Getting their periods  in school can be such a hassle. Some are constantly running out of class to the bathroom every hour, making sure they are stocked with enough pads, and some try to pretend and seem like they’re not  bleeding profusely out of their vaginas.

To some, If they’re caught off guard and their periods start in class, it  becomes their most embarrassing moment as one girl I interacted with narrated;

The shame of blood leaking through your skirt, boys calling you names, sores and infections, to mention but a few, makes you hate being a young healthy girl.”

Girls can you hear me?


Watch Barbara’s 6o seconds video on menstruation

This gets worse in a country like Uganda where menstruation is plagued with taboos. “If you’re menstruating and you climb a tree, then that tree will stop producing fruits”, “If you get periods, you must start having sex”, “girls in periods contaminate food”, “girls in periods cannot participate in schools.” etc.

Societies have the tendency to view women and girls as submissive to men and boys, and menstruation as a topic and issue has been stigmatized and made into a taboo topic that should only be discussed in private. This, in turn, prevents women and girls from accessing the information they need about menstruation and their bodies.

In this age and era, the last thing you expect to hear is a man or boy saying that a menstruating girl is dirty or can cause harm to others, and yet my interactions as a peer educator prove otherwise. It is therefore harder for girls to be in school during menstruation because these myths contribute to low confidence and fears of humiliation by others.

We need to make men and boys aware of the fact that menstruation is a completely natural part of life and ensure that girls are not inducted into puberty with feelings of shame. It’s unbelievably upsetting to discover how poorly we treat young girls — kids, really — going through this biological phenomenon that is no fault of their own, and more importantly, nothing to be ashamed of.

To overcome these challenges, we need to move beyond the stigma of menstruation. We need to educate boys and men on the importance of open dialogue on the subject. After all, men still make up a larger proportion of governments and corporate policy-makers in Africa.

It should be accepted that menstrual health is not just a “girl’s issue” but everyone’s issue: women and girls cannot drive development in communities  if their menstrual health is not given due consideration. Oh and also – don’t make us we feel ashamed at that time of the month. We’re not faking it. It’s nature. Period!

Featured image: Barbara conducting a focus group discussion. Image courtesy of Reach a Hand Uganda.