Denis Mukwege & Sexual Violence in Conflict

I recently had the honor of attending a speech by a truly inspirational person, 2018 Nobel Peace Prize recipient Dr. Denis Mukwege. 

Dr. Mukwege has devoted his life to the rights and health of women in the Democratic Republic of Congo (DRC). For more than two decades conflict has been tearing the country apart, and over those years rape and sexual violence have been used extensively as weapons of war. Sexual violence has been used throughout history and continues to be used to this day as a weapon of destruction (anyone can be a victim, although it is most often women and girls).

Dr. Mukwege recognized not only the health-related consequences, but also the psychological and social devastation, that sexual violence in conflict was causing in the DRC. As his country continued to go through turmoil, his medical practice in the city of Bukavu turned into a refuge center.

Thousands of sexual violence victims targeted by armed militias came to him. Women and girls of all ages sought his help.

During his talk, he showed the audience an image of a very young child who was brought to his practice after being brutally raped and disfigured. It is an image I will not forget for a long time. What I realized at that moment is that our emotions of disgust and anger around sexual violence in conflict are minuscule in comparison with what women and children have gone through and the pain they have experienced.

In 2012, Dr. Mukwege gave a speech in front of the UN assembly in which he denounced the violence against women and girls in his country. Shortly after, his home was attacked by armed men who held his family at gunpoint and killed one of his closest friends inside his home, and in front of his friend’s own children.

I can still hear the doctor’s voice, coloured by sadness and grief, as he told this story. His emotion was so raw, as though the tragic incident had just happened.

After the attack, Dr. Mukwege and his family were forced to flee the country, leaving the women of the DRC behind. Their vulnerability did not prevent them from taking action.

Dr. Mukwege relayed the women’s courage, strength and persistence in finding creative ways of getting their doctor back.

They first wrote to authorities but received no response. People urged them to give up hope that he would ever return. Dr. Mukwege shared the women’s words:

“We took a decision, we [are] going each Friday to sell fruit and vegetables and bring the money here at the hospital until we get the total amount to buy the ticket for him to come back…”

“If no one wants to give him security, we are thousand[s] of women…each night, 24 hours, we will get 25 women around the house and we will be around him so if someone want[s] really to kill him [he will] have to kill 25 women before killing him.”

Dr. Mukwege was so moved by their efforts and bravery that he returned to Congo in the midst of all the chaos and the threats to his life. The admiration he had for these women overshadowed all his doubts: “This was very strong…when I was treating them, I could say that they were weak but there, I was weak, and women were strong, and they brought me back in Congo,” he told us. 

I had tears in my eyes as I listened. I don’t think there was a single individual in the room that day who was not moved by Dr. Mukwege’s story.

He portrayed the strength of the women of the DRC through his words. I believe that women worldwide are the epitome of strength and resilience and Dr. Mukwege’s story clearly portrays that resilience.

It is from these very convictions that we at the Swedish Organization for Global Health – along with so many others across the world – work towards achieving our goals and aspirations for women’s health, safety and empowerment worldwide.

At times when we feel utterly defeated and consumed with our own worries, when our own uncertainties take over our thoughts and conquer our emotions, it is people like Dr. Mukwege and the brave women of Congo who put life back into perspective. We are a force when we come together! We can, without a doubt, overcome all obstacles and injustices. 

Listen to Dr. Mukwege’s amazing speech and read more about his efforts and work here. Read more about The Mukwege Foundation and the wonderful work they do.

In Conversation with Tasneem Kakal

Tasneem Kakal is an advocate for sexual and reproductive health and rights. Born and raised in Mumbai, she spent 5 years taking a daily train to and from university. In this interview with Girls’ Globe, Tasneem tells us what the experience taught her about navigating public space as a young woman.

“I would walk up the stairs and go to my platform in this huge crowd of people. And I realized I was doing something that I didn’t know I was doing…”

We all have the right to move through the world without fear. Public space should be accessible to all, regardless of gender. By raising her voice and bringing attention to the everyday nature of inequality, Tasneem stands in solidarity with other women and girls.

“I had to push the boundaries, little by little.”

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 interviews with Kinga, Winfred, Scarlett and Natasha, too! 

My Menstruation is not a Sin!

Throughout the world, menstruation shares a common universal feature; women have historically been shamed because of it.

Although female sexual and reproductive health has started to become more important as a topic of study and discussion in the last few decades, many women to this day experience an overwhelming level of stigma around menstruation.

In many low-middle income countries, access to sanitary products such as pads and tampons is extremely restricted, forcing young girls and women to use inappropriate products, such as a piece of old cloth or banana leaves. A dire consequence of using unsanitary products is the development of genital and urinary tract infections that can, if unimpeded, cause severe complications.

While this is a truly worrying situation, it is not highlighted enough as a public health issue – primarily due to the stigma and shame surrounding menstruation.

The lack of proper sanitary products and/or facilities often forces girls and young women to miss school. This in turn affects women’s long-term economic development. This is not only seen in low-middle income countries; in the UK for example, girls and women often cannot afford the sanitary products they need – a problem known as ‘period poverty’.

In many countries across the globe, menstruation is considered dirty and repulsive. In some cultures, it’s even seen as a sign of ‘loss of virginity’ – insinuating moral and ethical depravity. In many countries, women and girls are ordered to leave their homes for the duration of their menses to prevent ‘desecration’ of their homes. In all these scenarios, girls and women find themselves ostracized, humiliated and expected to accept this without question or debate.

Even in parts of the world where the situation may not be so extreme, some degree of stigma remains around menstruation – large enough to prevent girls and women from seeking medical care because they feel too ’embarrassed’. Within the bounds of such societies, menstruators may not seek medical help and may not be able to recognize important health-related problems should they arise.

In the UK, almost 80% of adolescent girls have experienced a distressing symptom relating to their menstrual cycle but have not approached a medical professional for advice.

A large contributor to these misbeliefs is the lack of education and awareness on menstruation. This leads to an inundation of false conceptions and misrepresentations. Due to the restrictive social norms in many parts of the world, it is a topic rarely discussed within the family structure.

Not only does this mean an uneducated society when it comes to female sexual and reproductive health, but it also means that many young girls have no or very limited knowledge on what to expect and how to react when their menses start. Instead, they become more confused, isolated and unable to manage their menstruation in a safe, clean and dignified manner.

Many countries have addressed several of these demanding issues. In Kenya for example, free sanitary products are available and in neighbouring Ethiopia, menstrual hygiene clubs have been established in many schools.

How we are trying to help

The Swedish Organization for Global Health (SOGH) – in association with Uganda Development and Health Associates (UDHA) – has launched a project titled Ekibadha: Our Periods Matter, in recognition of this extremely important matter.

The UDHA Dignity Project

The project aims to understand and highlight the difficulties women and girls in rural Uganda are facing regarding their cycles. The project is in its first stages, but our goal is to develop a community-based initiative that involves the entire community which will be sustainable – economically and environmentally.

“Men should be more involved” said one of the women we interviewed last summer in one of the rural villages in Muyage District. We agree! Men need to be part of the conversation, this is not just a ‘women’s issue’.

To learn more about the project, please visit www.sogh.se/ekibadha-our-periods-matter/

How you can help

You can help us take this project forward. We are currently raising funds to support preliminary data collection, which is fundamental to shaping and guiding the project. Data will also give us the basics to apply for institutional funds. Click here and help us out, every penny is worth it! https://www.gofundme.com/MHproject-Uganda

Interview with a woman in Muyage District about menstrual health by SOGH and UDHA.

For any further information or to get personally involved please email us at MHproject@sogh.se. You can also help by spreading the word, sharing this article on social media.

#OurPeriodsMatter #BloodyIssues

Contraceptive Funding in Crisis

On this World Contraception Day, some 214 million women and girls in developing regions have an unmet need for modern contraception. These are women and girls who want to avoid a pregnancy but are not using a modern method of contraception. While the reasons for this are multiple, the costs and availability of contraception remain major barriers. 

Access to contraception is a basic human right. Governments affirmed women’s right to have access to safe, effective and affordable methods of contraception of their choice 24 years ago, at the International Conference on Population and Development in Cairo. In 2015, in the landmark Sustainable Development Goals, governments pledged to ensure universal access to family planning by 2030.

Yet, three years on, global funding for contraceptives is in crisis. There is a major gap between needs for funding for contraceptives and the resources provided by both domestic and donor governments. In low- and middle-income countries out-of-pocket payments by individuals account for more than 80% of all spending on contraceptives. Domestic governments only provide around 8% of spending, while donors fund 10%.   

Out-of-pocket spending is an inequitable form of financing health services. Those least able to afford it carry most of the cost burden. The impact on household finances exacerbates inequalities and pushes people further into poverty. The gender implication is huge. Women and girls rely heavily on access to contraceptives and reproductive healthcare, and yet many do not have the financial means.

Demand for contraceptives is expected to increase, which will further widen existing funding gaps. Estimates of the difference between today’s spending on contraceptives and the cost of meeting projected needs in low- and middle-income countries in 2020 show an additional funding gap of US$290m if current trends in use continue. Unless domestic or donor government finance increases substantially, most of this gap will have to be met by relying on user fees.

Domestic governments have the main responsibility for ensuring access to contraception, yet donors continue to play an important role, particularly in the world’s poorest countries. In the 31 lowest income countries, donors currently finance 65% of all contraceptives, while domestic governments fund 7%. Individuals’ out-of-pocket spending accounts for 28%.

Yet, while donor funding remains essential, it has faced a downward trend in recent years. Funding from the United States, the largest family planning donor, has been fairly stable but is now at risk. Funding pledges made by European and other donors in 2017 in support of the She Decides initiative and at the July London Family Planning Summit are promising, but it is too soon to tell whether they will bring a reversal in longer term funding trends

Domestic governments must live up to their responsibility to increase their funding and ensure access to contraception and healthcare. Yet, donors must also continue and step up their support. Millions of women and girls depend on it.

Raffaela Dattler, Financing for Development Advisor, IPPF

Learn more about contraceptives and how they work here.

Sexual and Reproductive Health in Kenya’s Big Four Agenda

Of recent, the Government of Kenya (GoK) prioritized Universal Health Coverage (UHC) in its Big Four Agenda over the next five years. The Big Four Agenda which is aimed at accelerating economic growth focuses on food security, affordable housing, manufacturing and universal health.

The Government is set to roll out Universal Health Coverage to all households by 2022 to guarantee access to quality and affordable healthcare by reconfiguring the National Hospital Insurance Fund and reforming the governance of private insurance companies to align them to the universal health coverage.

Focus on universal health stands out as the most significant and conceivably the most important strategic priority for Kenya. The reality is that a majority of Kenyans can hardly afford or even access health services in their various communities.

The governments’ agenda to invest in health will indeed spur economic growth. The move demonstrates that the government values the need for human capital. A healthy population will engage in various economic activities hence contribute to the growth and development of Kenya.

Sexual and reproductive health and rights cut across each of the three dimensions of sustainable development – economic, social and environmental. Sex and reproduction are essentially intimate affairs, played out within personal and familial relationships. However, the consequences of a lack of access to sexual and reproductive health services, supplies, information and education are felt across entire populations, in social and economic life.

The recently launched State of African Women Report by International Planned Parenthood Federation Africa Region (IPPFAR) warns that unless countries make urgent commitment to invest in tangible actions for improving the Sexual health and lives of women and girls in Africa, the continent will continue to have poor development outcomes.

Making This a Reality

To realize this the Kenyan government will work the county government to scale up the provision of specialized medical equipment and increase the number of health facilities at the community level, including mobile facilities in order to increase access to health services.

The existing Linda Mama program, a free maternity care program is slated for expansion to mission and private hospitals to enlist community volunteers who will assist in healthcare service provision at grassroots level.

Training of medical doctors is also set to commence, including the sourcing of health specialists from outside in order to fill the existing medical gaps.

In terms of realization of sexual and reproductive health, the Ministry of Health, civil society organizations and other stakeholders have this opportune moment to work with county governments to ensure that part of the chunk that is set for health goes into the improvement of sexual and reproductive health.

Why is this Relevant?

In the national context, the Big Four are rightly pegged on the Kenya Vision 2030 and well-mainstreamed in the third-Medium Term Plan (2018-2022) of the Vision, due for launch soon. At the continental level, the Big Four Agenda aligns well with Africa’s Agenda 2063 themed “The Africa We Want”. At the global level, the Big Four Agenda is effectively aligned to the 2030 Agenda for Sustainable Development, upon which the seventeen Sustainable Development Goals (SDGs) are anchored.

 

Midwives of the World: Part 3

In order to reach a completely equal society, all basic human rights need to be secured. One of these is maternal health. The success of a country can often be traced back to successful maternal health programming. Therefore, my project partner Anna and I decided to create a documentary series about midwives around the world.

This is the final part of the documentary series, which also marks the end of Project Let’s Talk Equality. (You can still catch up with Part 1 and Part 2 if you missed them!)

To create this documentary and to get a fair picture of the situation for mothers and midwives around the world, we have collaborated with the White Ribbon Alliance (WRA). The WRA is an incredible organization for maternal health, and a network for volunteers from all over the world. We decided to focus on White Ribbon Alliance Indonesia, or Aliansi Pita Putih Indonesia  (APPI), and visited their team in Jakarta earlier this year.

With the three parts of our documentary, we hope to do two things. One is to present a fair picture and comparison of the maternal health situation in Sweden and Indonesia. The other is to inspire people to make a change in their local communities, just like the volunteers of the White Ribbon Alliance do, or like midwives do in their daily work.

It has been an inspiring adventure, and we hope that our documentary series has captured some of the remarkable energy volunteers and midwives from both Indonesia and Sweden put into their work every day to help others. From when we first brainstormed our ideas for the project in September 2016, throughout our site visit half a year later, to completing our documentary series, we have been continuously overwhelmed by the wonderful people we’ve encountered and the great response we’ve received from sponsors, mentors and our audience.

Although the project has come to a close, we hope that it has sparked discussion that will continue for years ahead, and that it will encourage more people to contribute to work for women’s rights in their communities.

Feel free to share, comment and spread the word. Thank you for watching, and remember – let’s get together for moms, and let’s talk equality!

Do you want Girls’ Globe to be able to support young women to create inspiring material like this in the future? We are crowdfunding for 2018!