COVID-19 is Leaving More Girls at Risk of Female Genital Mutilation and Child Marriage

The global COVID-19 pandemic is taking a particularly heavy toll on girls and young women across Africa.

Sadly, many girls in Africa are disenfranchised from birth.

They are born into poverty and vulnerable to inequalities in health and education, along with socio-economic and gender inequalities. Access to health and education is not automatic. Many girls remain marginalized throughout their lives, both geographically and economically. This exposes girls to collateral risks associated with poverty – and, at the moment, with COVID-19.

I have been lucky to be able to pursue my passion for the health and rights of women and girls for a number of years now. My work has focused on sexual and reproductive health, gender-based violence, female genital mutilation or cutting (FGM/C), and child, early and forced marriage. My experience has mainly been built by working with marginalized communities in Kenya that practice FGM/C – including the Maasai, Samburu, Kalenjins, Meru, and Somali communities.

Education Opens Horizons

In 2016, in the early years of my work in Kenya, I visited a rescue center in Samburu County. I was devastated by the reality of life for many Samburu children. Living a nomadic lifestyle in geographically vast areas, basic infrastructure to support health and education was lacking.

It took us a whole day to drive to the main town, Maralal, where the center was located. Along the road, I saw children herding cattle and goats within the national park, which is full of wild animals such as lions, elephants, giraffes, zebras, and antelopes.

The perplexing thing was that among the children were many girls, the youngest of whom looked about six years of age. Spending their days and evenings herding cattle in the woods away from home. Outside the protection of adult family members, means these girls are exposed to sexual and gender-based violence.

While visiting the center the next day, we found a newly rescued nine-year-old girl. She was rescued from forced child marriage to a seventy-year-old man who already had multiple wives. The young girl had just undergone FGM/C. Her wounds were still raw. She was brought to the center to heal and attend school, since she hadn’t previously had the chance to receive an education.

My colleagues and I were left debating how a girl will ever make it in life without an education, good health, or any future economic opportunities. For many girls in Kenya and elsewhere, their progress is curtailed and their horizons limited from childhood as a result of traditional practices which are linked to livelihoods.

Co-existing Crises Leave Girls at Risk

I can only imagine how much harder life is for girls in Samburu in the face of COVID-19. I have heard many horrific stories from my colleagues about how lockdown measures, combined with school closures and the subsequent dwindling of family resources and general livelihoods, have left more girls exposed to FGM/C and child marriage.

They are forced by their circumstances to be “sold” into marriage, either for money or cattle.

Unfortunately, in Kenya the COVID-19 crisis has also been accompanied by many natural calamities including a locust invasion, drought and flooding in many parts of the country, meaning that food is scarce.

Nomadic communities like the Samburu have been hit particularly hard. They rely on markets to sell their animals for money to satisfy their basic needs. When markets are closed, as they are currently, they cannot sell. The food crisis is likely to lead to even more girls being married in exchange for food for their families and a semblance of security.

At the same time, the focus of law enforcement in Kenya has been on stopping the spread of the coronavirus. This has resulted in many cases of gender-based violence, FGM/C and child marriage being shoved onto the back burner. As if they are not a crisis that deserves immediate attention.

Community activists working in Samburu have reported feeling powerless and hopeless. They are between a rock and a hard place, sometimes having to choose between reporting cases to the authorities and their lives being threatened.

Listening to Communities is More Important Than Ever

The Kenyan government has not embraced a multi-sectoral approach in dealing with the overall impact of COVID-19. Instead, they’ve taking a rather narrow approach to public health. Because of the focus on curbing transmission, fostering strategic engagement that includes stakeholders working in gender-based violence, FGM/C, and child marriage has been sidelined.

Including community systems in the prevention of and response to FGM/C and child marriage is more important than ever. More women and girls are now at risk of harmful practices and gender-based violence.

These strategies should include:

  • working closely with community advocates and activists,
  • working with community health workers who can play a significant role in surveillance of at-risk girls,
  • mapping them and linking them up with healthcare and legal services, and
  • setting up rescue homes and centers that could house them temporarily until the COVID-19 crisis subsides.
The majority or all of the safe centers or homes were ordered to close as part of the lockdown measures. The girls and women being housed in those centers were asked to return home in the midst of Covid-19. A doubly tragic situation for them.

So what can we do, in the face of these co-existing crises?

The greatest lesson that we can learn is that it is crucial to deliver multi-sectoral responses to FGM/C and child marriage. This means actors working together. A broader approach is needed. One that considers the wider socio-ecological aspects of livelihoods including education, health, emergencies, climate crisis and other factors which impact on the harmful practices of these communities.

State and non-state actors need to widen their nets and protect African children and girls in particular – who, as is so often the case, carry the heaviest burdens of poor health and well-being.

Dr Esho is the Director of the Amref Health Africa End-FGM/C Centre of Excellence; Secretary General, African Society for Sexual Medicine; and Associate Member, Africa Coordinating Centre for the Abandonment of FGM/C.

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.

Leading Youth Advocacy Movements in the Wake of COVID-19

Nobody ever prepares you adequately for the long and winding road of leadership. One has to be brave enough to quickly rise to the challenge. For Evalin Karijo, her youth leadership role at Amref Health Africa – especially during this time of the pandemic – has put those skills to the test.

When Y-ACT (Youth in Action) was set up a few years ago, it was Amref Health Africa’s first fully youth-led initiative. It was designed for and by the youth. We knew that this was going to be exciting. Three years down the line, the energy and creativity of the youth has been more than anyone ever imagined. Y-ACT has been operating at a time when the role of young people in decision-making processes on issues that affect them is at its highest. Y-ACT is now one of the fastest-growing youth advocacy networks in the region. It also hosts the Youth4UHC Pan-African youth movement.

Before taking on the mantle at Y-ACT, I had spent two years in different leadership roles at Amref. At the time, I was the youngest project lead in the organisation.

Youth and COVID-19

During this pandemic, my experiences in adapting to changing times and leading teams to do so has come in handy.

The youth – in Kenya and across Africa – are likely to bear the biggest burden of the effects of COVID-19. We’re experiencing:

  • rapidly rising cases of unemployment,
  • inadequate access to routine health services,
  • and increasing cases of sexual and gender-based violence among vulnerable adolescents and youth.

A study that we recently carried out with youth highlights how the pandemic is affecting the youth in Kenya.

Youth are great catalysts of change

While the youth are vulnerable in this crisis, it’s inspiring to see their innovation. Young activists and youth volunteers are constantly generating ideas in their spaces to contribute to ending this pandemic.

Young people want to be at the forefront. They want to feel heard and consulted about policies, services and systems that are developed for them.

To amplify the youth voices during the pandemic, Y-ACT is

  • working with youth advocacy movements to co-create solutions,
  • lead teams to work with policy-makers,
  • and ensure that youth are meaningfully engaged in the fight to end the pandemic.

The #ChampionsKwaGround campaign, launched by Y-ACT, has been amplifying voices and efforts of youth and youth-led organisations. They are making incredible contributions in the fight to end COVID-19.

The campaign features youth movements who have taken to digital media to make their voices heard. They spur collective action on COVID-19 and on their priorities, at a time when everybody needs collective action the most.

The campaign also features young health workers on the frontlines of ending the pandemic. It has featured grassroots youth-led organisations leveraging their creativity through arts, murals, and music to create awareness on COVID-19 and influence youth to adopt positive behaviour change to stop the spread of the pandemic.

Other youth advocates at grassroots level innovate and develop income-generating activities including manufacturing home-made soap and masks, while ensuring that they stay safe.

Youth-developed resources and tools: COVID-19 and beyond

Y-ACT has further developed an innovative info-site. It is designed by Kenyan youth and for youth to meet their growing needs as the pandemic continues to evolve. The info-site provides accurate and up-to-date opportunities for young people. It includes:

  • online resources, webinars, and training programmes,
  • helpline numbers set up by the government and partners,
  • employment opportunities,
  • protection services,
  • and COVID-19 youth-related advocacy campaigns.

The team is now co-designing a virtual innovation lab that will provide a platform for youth to co-create solutions to deal with the post-pandemic future.

By focusing on the immediate needs of the youth and co-creating solutions towards a brighter post-pandemic future, Y-ACT is leading the youth to be in a position of authority and influence. This provides the ability to spur different outcomes based on youth creativity, and innovation, during this time of the pandemic.

Evalin Karijo is Project Director of Y-ACT (Youth in Action), an initiative of Amref Health Africa that aims to mentor, support and increase the capacity of youth advocates to influence policy and resource priorities in the areas of gender equality and sexual and reproductive health and rights (SRHR).

3 Gendered Impacts of the Coronavirus Pandemic

The World Health Organisation officially classified COVID-19 as a pandemic on 11 March 2020.

While the full impact of this pandemic cannot be fully articulated yet, evidence from previous global crises indicates that the impacts of disease outbreaks are not gender-neutral.

Crises such as pandemics and natural disasters can exacerbate already existing gender inequalities. Successful efforts to address and mitigate the consequences of the pandemic will require considerations of its gendered impacts.

Here are 3 possible gendered impacts of the coronavirus pandemic.

1. Increased Burden of Care

In many societies, women and girls are responsible for the majority of domestic work and caregiving responsibilities within the family. According to estimates, women work (both paid and unpaid) 30 minutes to one hour more per day than men.

With schools closing and turning to online learning as a measure to limit the spread of the disease, women may have increased responsibilities in caring for their children and their education. Many will also have to manage a full-time job at the same time.

The traditional caregiving role of women also goes beyond the home. Women account for the majority of health care workers in many parts of the world.

Globally, 70% of the health care workforce are women. More than 90% of health care workers in the Hubei province in China, where the virus was first identified, are women.

As such, women are at the forefront of the fight against the disease and risk exposing themselves, as well as their families, to the virus. 

2. Lack of Access to Sexual and Reproductive Health Services

During disease outbreaks, sexual and reproductive health services are not a common priority, as resources go towards dealing with emergencies. 

However, a number of organizations such as the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists have stated that reproductive health care, including abortions, are essential services that should remain available during emergencies. 

According to the WHO’s recommendation, sexual and reproductive health care should be available regardless of a woman’s COVID-19 status:

“Women’s choices and rights to sexual and reproductive health care should be respected irrespective of COVID-19 status, including access to contraception and safe abortion to the full extent of the law.”

The consequences of lack of access to sexual and reproductive health care services can be devastating, as previous disease outbreaks show. 

During the Ebola outbreak in West Africa, the maternal mortality rate rose by 70% as maternal health clinics in the region were forced to close.

Marie Stopes International explain that in the 37 countries where they operate, COVID-19 is causing delays in production and delivery of condoms and contraceptives, They estimate that this can lead to 11,000 pregnancy-related deaths, 2.7 million unsafe abortions, and 3 million unintended pregnancies.

3. Increased Risk of Gender-Based Violence

Countries in every corner of the world are seeing an increase in reports related to domestic violence – from India to France to the United States.

In Singapore and Cyprus hotlines have seen an increase in calls of 33% and 30%, respectively. Argentina has seen a 25% increase in domestic violence-related emergency calls since the start of the lockdown.

In a webinar about gender and COVID-19, UN Women’s Anita Bhatia highlighted this grim reality:

“Domestic violence is what we’re calling a shadow pandemic… We are asking for shelters to be designated as essential services [during COVID-19] and for police to receive additional gender-sensitive training.”

As the global economy struggles through the pandemic, gender-based violence can exacerbate financial issues. Violence against women and girls costs about 1.5 trillion U.S. dollars globally. 

These are just some of the many possible impacts of the current coronavirus pandemic related to gender. While authorities attempt to stop the spread of the virus, they cannot ignore the secondary impacts of this outbreak. 

Fighting for the lives of those infected must remain a priority. But deaths caused by gender-based violence, unsafe abortions, and childbirth also need to be considered. Disease outbreaks and global crises tend to exacerbate existing gender inequalities. The gendered impacts of COVID-19, then, must be an integral part of current and future efforts to address this pandemic.

Grassroots Activists Reflect on the Nairobi Summit on ICPD25

The Girls’ Globe team met youth advocates and SRHR-leaders at the She Decides Open House in Nairobi. She Decides is a global movement with the vision of a world where every girl and woman can decide what to do with her body, with her life and with her future. Without question. In this video grassroots activists speak about their priorities and reflections of the Nairobi Summit on ICPD25.

This summit is all about young people.

Naisola Likimani, Lead of the She Decides Support Unit talks about how the decisions made at the Nairobi Summit on ICPD25 are in essence about the lives of young people. Several young activists within the She Decides movement have take the stage at the Summit to highlight their concerns, priorities and optimism for the future.

Yet, young people also have a lot of worries. These include the representation of minorities in conversations and the opportunity to partake in dialogues with decision-makers. There has also been a lot of opposition towards the ICPD25 convening from ultra-conservative actors. This has been visible at a local level and many Kenyan civil society organizations have felt the pressure. Furthermore, Kenyan civil society representatives and local media faced a major accessibility issue on the first day. Where foreigners were allowed in, Kenyan actors were denied entry by security. An issue that was resolved once President Uhuru Kenyatta had left the Convention Center.

“I think something that is coming out very strongly is our understanding of postmodern colonialism. This has been the way things have been conducted and how relations have been in some instances. Not in the Nairobi Summit’s entirety, but there have been such cries from different actors, especially Kenyan civil society actors and young persons,” says Linda Kroeger, Activist and Human Rights Defender Kenya.

See all of the Girls’ Globe coverage of the Nairobi Summit on ICPD25 here.

This video was produced by Y Dowedoit for Girls’ Globe with support from the Children’s Investment Fund Foundation.

Why is the Nairobi Summit on ICPD25 important?

The Nairobi Summit on the International Conference on Population and Development is taking place 25 years after the first conference was held in Cairo in 1994. The Summit gathers civil society, youth activists, UN leaders, ministers and heads of state in the Kenyan capital this week. There are very many aspects as to why this Summit comes at a critical time. We asked grassroots advocates: “why is the Nairobi Summit on ICPD25 important to you?” Here’s what they said…

At the Nairobi Summit commitments are made to accelerate progress and meet goals to eliminate gender based violence, child marriage, female genital mutilation and maternal mortality. Commitments include advancing all aspects of sexual and reproductive health and rights, including comprehensive sexual education, LGBTQI rights and access to safe abortion. Other key issues include gender equality, forced migration, indigenous people, and climate change.

“It’s a time to recognize ourselves as decision-makers. That if we stick together and we keep a unified message to protect, defend and ensure our human rights, we are stronger together.” 
​- Genesis Luigi, IPPF and Safe Abortion Access Fund
Jennifer Kayombo

Girls’ Globe has asked grassroots youth advocates for their input through other channels too. Today, Jennifer Kayombo, a sexual and reproductive health and rights advocate from Tanzania took over the Girls’ Globe Instagram stories to share her views on why the summit is important. Yesterday, Sonali Silva, a SheDecides 25×25 Champion from Sri Lanka gave us her opinions and priorities through her takeover.

We know that these voices matter. If women and girls are being listened to at the Summit true change is possible. A lot has happened since 1994, thanks to the women’s rights activists that spearheaded the Programme of Action that was adopted in Cairo. Now is the time for the next generation that is marching and taking action to lead.

Find out more about the Nairobi Summit here and find all of Girls’ Globe’s coverage here.

This video was produced by Y Dowedoit for Girls’ Globe. Reporting at the Nairobi Summit was supported by the Children’s Investment Fund Foundaiton.