In Conversation with Kizanne James

Let us introduce you to Kizanne James. Kizanne is a physician from Trinidad & Tobago working on reproductive health and rights.

In this conversation with Girls’ Globe, Kizanne speaks about the challenges she has faced as a woman – and especially as a black woman – working in the field of sexual and reproductive health and rights in the Caribbean.

“We were taught that if you had sex or you had a boy touch you, it’s like a tomato – the more that a boy touches you the less valuable you would be. And that’s not the same narrative for boys.”

Kizanne explains that it’s being grounded in her values that helps her to handle difficult circumstances. In the face of negativity or even hateful abuse from those who disagree with her, knowing her work and advocacy empowers women and girls to make decisions about their own lives keeps her motivated.

“Regardless of what I may be feeling, or the negative voices or concerns people may have…I feel like I’m on the right side.”

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

If you liked this post, we think you’ll love our conversations with KingaWinfredScarlettNatasha & Tasneem, too!

Women in Rural Zimbabwe are Being Left Behind

Being a young woman living in a rural or remote community can be very daunting. You have to fight tirelessly to loosen yourself from the grip of sociocultural stigmatization to have any sense of autonomy over your sexuality.

The situation is worsened by the absence of easy access to modern family planning methods. The problem lies in the fact that when coming up with sexual and reproductive interventions for women and adolescents, our governments still rely on ‘a one size fits all’ approach.

But women in rural areas have different lifestyles and challenges than women living in urban communities.

When it comes to sexual and reproductive health, one size fits all really makes no sense. One size fits all isn’t good enough.

In Zimbabwe, the fact that young women and adolescents in rural and remote communities are still struggling to access modern family planning methods – or even comprehensive sex education – is overlooked. These issues are still regarded as taboo, and in my community you can’t talk openly about them.

It’s a different scenario for women and adolescents in urban communities within Zimbabwe. In urban areas, it’s possible to access both information and services through youth friendly centres, Non Governmental Organisations and other diverse forums.

I believe that women can only enjoy their sexual and reproductive health and rights if they have access to relevant services and supplies – including access to contraceptives and accurate information on how to use them – regardless of geographical area or socioeconomic status.

The government of Zimbabwe is committed to ensuring improved availability of and access to quality integrated family planning services for all women irrespective of age, marital status and their geographical location by the year 2020.

A sizeable number of interventions have been made. For example, we now have an ambassador for Family Planning to advocate for family planning. This is a great initiative, but in rural areas this ambassador is not visible, and so issues are misrepresented! This type of intervention is relative – it primarily benefits the adolescents and young women in urban areas the brand ambassador is engaging with – which makes it an unfit approach for women collectively.

I believe that this kind of intervention leaves a lot of women behind. 

A large percentage of Zimbabwean women are in rural communities. Adolescents and young women in rural areas need interventions they can relate to – services that resonate with their particular reality and their existing level of understanding.

As much as there have been family planning and contraceptive outreach services, it is still absurd that in rural areas adolescents and young women continue to have unwanted pregnancies and new cases of HIV infections. The reason behind this is a lack of positive and affirmative approaches towards women’s sexuality.

From my experience in a rural area, the healthcare service providers are not youth friendly and they tend to have a negative perception of young women trying to access family planning. As a result, adolescents and young women shy away from these health centres as they don’t trust the service providers.

This is very disturbing, as trust should be one of the core values health service providers should strive to uphold at all times. I believe that it would be a great idea for genuinely youth friendly centres to be established in rural and remote areas. This would encourage adolescents and young women to seek out sexual education and feel comfortable asking questions about the family planning methods that will work best for them. It would also help conservative rural communities to recognize family planning as not only a priority, but also a right.

Sexual and reproductive health and rights of women and adolescents in rural communities should be prioritized in Zimbabwe, and the government must be held accountable for delivering meaningful and diverse approaches in tackling the family planning challenges our country faces. Without this, achieving the FP2020 targets will not be possible.

If truth be told, rural women and adolescents have had enough of being left behind.

“A world of hope for adolescent girls” – Olive’s story

This is the fourth and final blog in a series sharing personal family planning stories from around the world – presented by CARE and Girls’ Globe in the lead up to the 2018 International Conference on Family Planning. Catch up on the whole series with stories from HawaParmila, and Oun Srey Leak.

Rwanda has made significant strides in empowering women and girls and ensuring they have access to affordable healthcare, including access to family planning.

Access to contraception has steadily increased from 17% in 2005 to 53% in 2015.

The government has decentralized and subsidized healthcare to ensure the most remote areas are reached and the most vulnerable communities can access services. However, the biggest unmet need for family planning is predominantly among young and unmarried women. In 2016 alone, 17,000 girls reportedly became pregnant before turning 18!

In 2016, the Government of Rwanda began providing comprehensive sexuality education in schools, however there is still a long way to go to ensure teachers are equipped with the skills and information needed to engage in age-appropriate, open and honest conversations with students.

I work for CARE in Rwanda, where I advocate for increased access to age-appropriate, integrated sexual and reproductive health services, rights, and education for in-school and out-of-school adolescent girls. Although the country has made notable progress in promoting women’s and girls’ rights in recent years, teenage pregnancies have continued to rise, leading to dire socio-economic and health consequences for Rwandan girls.

A few weeks ago, I attended an information session for young women in Kigali where a medical doctor explained available methods of contraception. I realised then that there is a lot young people do not know. But it made me wonder…

If the youth of Kigali don’t know how to prevent pregnancy or to take care of their sexual and reproductive health, what about women and girls who reside in rural areas where access to information and services is still a challenge – even a luxury?

In my time at CARE, I have seen the tremendous work the organisation is doing around the world to increase demand for sexual and reproductive health information and services, including contraception. Much of our work focuses on addressing underlying causes of poverty and vulnerability and helping communities to challenge harmful and negative socio-cultural norms that hinder women and girls from enjoying their rights and reaching their development potential.

Two weeks ago, I met a group of adolescent girls in Karongi District, Western Rwanda, where CARE is implementing the Better Environment for Education (BEE) project to increase chances of girls staying in school. During my visit, the girls talked to me about the various problems that they faced, including unwanted and early pregnancy. As I listened to their stories, I wondered whether we are doing enough to address these issues.

One particular 17-year-old stood out to me. As she narrated her story with teary eyes, she recalled the difficult time she went through when she found out she was pregnant, and described how she was abandoned by her family. She felt she had failed them and failed herself. At some point she was forced to quit school to raise her infant. But when the BEE project began, she decided to join one of the clubs and suddenly found hope. According to her, the clubs have provided a space and a voice for girls to talk and to get accurate and comprehensive sexuality education.

Although the local health centre is just a few metres away from the school and provides condoms and other contraceptive methods, young people in Karongi told me they feel judged and shamed when they go there to seek services that they are entitled to. The BEE project aims to address this as well by giving adolescent girls a platform to dialogue with the school administration and local leaders to express their needs.

Studies have shown adolescents are increasingly becoming sexually active before they turn 18 and this is a reality we should not ignore. Too often, in countries like Rwanda, adolescent girls do not have information regarding their changing bodies or sexuality in general.

Adolescent pregnancy undermines a girl’s ability to exercise her rights to education, health, and autonomy. It’s not only a health issue, but a human rights and development one too. 

I believe that CARE’s integrated approach to empowering adolescent girls, including economic empowerment through savings clubs, sexuality education, addressing gender-based violence and engaging power holders such as parents, boys, school administration officers, and local leaders is powerful in ensuring the problem is addressed from all sides. I have no doubt that this will bring about transformation in the lives of girls and their communities.

We have no more time to lose.

“Now I Use Contraception” – Oun Srey Leak’s Story

This is the third blog in a 4-part series sharing personal family planning stories from around the world – presented by CARE and Girls’ Globe in the lead up to the 2018 International Conference on Family Planning. Catch up on the whole series with stories from HawaParmila, and Olive.

Oun Srey Leak, a 26-year-old mother of one, navigates her way to work on a crowded street in Phnom Penh, Cambodia. She has worked in the Gladpeer garment factory for five years.

The garment industry is a huge part of Cambodia’s economy, employing over 700,000 workers. About 90% of these workers are women.

Srey Leak, like many of her colleagues, moved to Phnom Penh from a less populous area of Cambodia in search of job opportunities. She met her husband and shortly after became pregnant with their daughter.

Photo by GMB Films

“After I got married, I heard using contraception could stop us from being able to have children in the future. So, that’s why I decided to have a child soon after I got married. Two months after the wedding, I got pregnant,” Srey Leak explained.

Although half of female garment workers report being sexually active, less than a third of them use modern contraceptives.

Just as soon as Srey Leak became a new mom, she was faced with the demand to return to the garment factory. “After the birth, I needed to get back to work. So, I took my daughter to my mother back in the province. I am now far away from my child because I don’t have time to take care of her.”

Srey Leak’s story is not atypical. Most Cambodian garment factories operate six days a week, eight hours a day, and workers are often paid based on the outputs they produce, rather than the time they put in. Taking time off to go to the doctor may cost them more income than they can afford to lose, and there are limited health providers and pharmacies operating on Sundays when the factories are closed.

For the past five years, CARE has been working in garment factories to help women like Srey Leak make healthy decisions. Chat! is a package of activities that reaches women inside factories, where they spend most of their time. The innovative package includes sessions providing information on various sexual and reproductive health topics.

Srey Leak welcomed the opportunity to take control of her health. “One day, CARE came to invite workers to join a short training. They showed me short films about understanding the different types of contraception, safe abortion, and the ways in which we can avoid unplanned pregnancies.”

The sessions are paired with videos that feature fictional characters, in which the women can relate to and identify real health challenges. There is also an app that provides interactive quizzes and activities that are tailored specifically for garment workers, to facilitate ongoing learning.

After she learnt about the various modern contraceptive methods available to her, Srey Leak decided to start using oral contraceptives.

“I now take the contraceptive pill every day. If I’d known about this method before, I could have used it before falling pregnant,” she shared. “For me, after I joined CARE’s training, it changed my life. Now I use contraception and I have a greater understanding. So, it means I can have enough money for my next child.”

Chat! is supported by the Australian government’s Partnering to Save Lives (PSL) initiative and the Cambodian Ministry of Health in an alliance to reduce maternal and newborn mortality in Cambodia. Workers who participated are twice as likely to use modern family planning methods and health services. Factory managers have reported increased productivity and reduced absenteeism within their workers.

Learn more about CARE Cambodia’s garment factory work here, and read an interview with Chat! co-founders Maly Man and Julia Battle.