The App Empowering Young Women in Uganda

In Uganda, young women and girls face many sexual and reproductive health and rights (SRHR) challenges. For example, a high unmet need for contraception leads to dire consequences like unplanned pregnancies and sexually transmitted infections.

Challenges that limit provision of SRHR services to adolescents and young women include lack of privacy and confidentiality, knowledge gaps, cultural and social stigma, biased service providers, and inconvenience in accessing SRHR services despite their availability. Although there have been improvements in creating a youth-attractive environment for SRHR services and access to tools, more work is needed.

We are constantly reminded of the need to provide avenues where young people – including women and girls – can access sexual and reproductive health and rights services that are equitable, appropriate and effective.

At Reach A Hand Uganda, we help to address this need through our youth empowerment centres, and now, we have introduced the SAUTIplus app.

The SAUTIplus app is an innovative part of the SAUTIplus ecosystem,  helping to fill existing gaps in information. Uganda is experiencing a smartphone boom, with over half the population now owning one, and this number is increasing day by day.

Internet penetration in Uganda is at 41.6% – with 19 million Ugandans connected to the internet. In 2017, the Uganda Communications Commission recorded that the total number of mobile phone subscriptions was 23,529,979, up from 21,039,690 the previous quarter.

The SAUTIplus app was revamped two months ago to further engage Uganda’s high youth population and, at the time of writing, has 1,600 downloads on Google Play Store. The iOS version is in its final stages of going live.

On the app, information is available day or night. With a few taps of their phone, young women and girls can quickly find answers to their burning questions about sexual and reproductive health.

It’s the young people at Reach a Hand Uganda producing the content for the app and answering the questions – with support from the Programs and Communications departments. We understand the needs of the young women and girls and can craft our responses to reach the users in a relatable manner.

Users are able to see answers to questions other young people have asked and read tailor-made stories addressing issues faced by girls. Questions can be submitted on the website (hopefully soon to be added to the app) and the questions and answers can be viewed on either the app or website. The questions can be anonymous to maintain a safe and confidential space.

The app provides accurate information on SRHR, rather than simply promoting abstinence, which has proven an ineffective method of protecting young girls in Uganda.

The section named ‘Senga’ is a reference to a trusted relationship between a woman and her father’s sister (auntie). This relationship is commonly one where information regarding sexual and reproductive health and rights is passed on, but there can be a gap in appropriate or accurate information. This is where the SAUTIplus app comes in.

‘Senga’ provides an opportunity to view answers to questions you may have had yourself, smashing the common myths and misconceptions surrounding SRHR in Uganda. “My boyfriend says we don’t need contraception because he will pull out at the last minute. Is this a good idea?” is an example of one of the questions asked by a young girl on Senga.

The SAUTIplus app is providing a platform for women and girls to take charge of their sexual health. The knowledge the app provides is giving power to young women.

With power comes increased agency and the ability to negotiate within relationships – for example, with regards to contraceptive use to prevent pregnancy. No topic is taboo on the app. This includes menstruation and menstrual hygiene, a key SRHR challenge Reach a Hand have identified among young women in the country.

The for-the-youth attitude of the SAUTIplus app means it is an engaging platform for young people to access reliable information. Multimedia content, including photos, videos and blogs, provide a plethora of youth-friendly, easily digestible resources on SRHR.

The app is in continuous development, striving to meet the changing needs of young women in Uganda. It aims to create a positive relationship between young people and SRHR information, showing that information is a tool of power and not something to be dismissed. 

Motherhood in Conflict: Colleen’s Story

In northern Uganda, many mothers have lived through armed conflict. Some gave birth in a time when murder, abduction, mutilation and rape were common practices. It was a time when child soldiers were forced to kill loved ones. What would it be like to become and be a mother in this context?

Colleen* is one of the women I grew very close to during my time volunteering in a counselling centre in Northern Uganda. Like Achola, she told me about her experiences of motherhood during and after the war.

Becoming a Mother in a Conflict Zone

I visited Colleen at her home in rural Ngetta, close to the city of Lira in the northern part of Uganda. The region has been badly affected by the Lord’s Resistance Army (LRA) insurgency. There were great consequences for all, and especially for pregnant women and mothers.

Colleen told me that she was abducted by rebels from the LRA when she was only 15. She escaped them by hiding in the open stem of a bush. Colleen told me that she became a mother at the same time as losing both of her parents, who were killed by the rebels. She spoke about how hard it was to flee from the rebels night after night, while ensuring the safety of her siblings and her baby.

Colleen’s experiences of the war have been debilitating, and she is still recovering. Though the war ended more than a decade ago, Colleen continues to be in emotional and physical pain. She tells me:

“When I was with my baby hiding in the bush, somebody stepped on my waist. It affected my waist so much up to date. Whenever I laugh, I could just fall unconscious for some minutes. It is still painful.”

What is very striking about Colleen’s story is that it demonstrates that life after war can still be filled with terror. For Colleen, the days of violence are not over.

‘Post-Conflict’ Motherhood

Just after Colleen had been abducted by the rebels, she was married at 16 to her current husband. The day I spoke with her, he was out working on nearby land. Colleen leaned towards me and whispered in my ear:

“I never wanted to marry him, my brothers forced me to marry him cause they needed money and animals [bride price] so that they can marry their wives.”

The practice of bride price is one of many practices that highlight the negative effects of poverty and patriarchy on women’s wellbeing.

The women I worked with told me that in their communities, girls are usually seen as a commodity by both their natal family and their new husband. As soon as a girl is born, she is a source of income for her family. This puts girls and young women at great risk of being forced into early or childhood marriage. This is exactly what happened to Colleen.

Colleen is now in an unhappy and abusive marriage. The years of grabbing her children and running into the bush have not been forgotten. These days, however, when she runs with her children it is not to escape the rebels, but the violence of her husband.

For Colleen, instead of a safe place, her home is a place of terror.

The end of the conflict with the Lord’s Resistance Army was supposedly meant to be time of peace. For many women, however, peace-time violence continues to disrupt and negatively influence their well-being.

Colleen’s Way Forward

Though Colleen’s daily life is characterized by the violent relationship with her husband, it does not define her. Colleen experiences a lot of joy in the relationship with her children, and with her female friends who she meets in her neighbourhood and in the local counselling centre. The women often sing and dance together:

“During the rebel time there was no music, now there is music and we can dance and feel better. I dance! … I always dance and listen [to music] because it is telling me about peace, if it is gospel it is counselling me also. There are songs which you listen to and it teaches you about peace.”

Community groups, the church, gospel songs and the local counselling centre are all crucial for Colleen’s recovery. We need to acknowledge the importance of creativity and body work in psycho-social and mental health support. For Colleen, dancing and singing is not only simply enjoyable, it also offers a way of healing.  

*Colleen is a pseudonym. The image accompanying this article does not depict the woman who told this story.

4 Ways to Create Opportunities for the Next Generation

Celebrating International Women’s Day 2019 at the inaugural Girls Festival – organized by Reach A Hand Uganda (RAHU), Global Livingston Institute, Women Deliver and partners – got me in my feelings. 

 The Festival theme was ‘Gains from Equality’. It had me thinking about all the women who came before me and the opportunities they created for me to succeed in school, as well as in my personal and professional life. It reminded me of my mother’s stories of a time when the world refused to see girls and women as anything other than wives and mothers.

Creating opportunities for the next generation at the 2019 Girls Fest organised by Reach a Hand Uganda. 3 young women hold up a sign and smile.
2019 Girls Festival

Let us toast the movements that paved the way for women to do powerful things. 

We must honour the women who marched for us to vote, to get into the workforce and the political space. And not forgetting the women who made it possible for us to eat chicken and eggs. Yes, shocking I know, but there are several tribes in Uganda where not too long ago women were forbidden from eating chicken or eggs.

Despite numerous obstacles, the contributions of women in the past have eased the path for girls and women today.

We owe it to ourselves to create equal opportunities for the next generation of men and women. We owe our children true equality. I love lists, so here are 4 ways to create opportunities for the next generation of women and men.

1)     Reinvent Feminism

There are numerous misconceptions about what feminism is. Some people are reluctant to label themselves as feminist. I am often asked if I am a feminist. It scares me to respond to this question, because I may be viewed as a ‘bitter man hater’.

We should remind girls and women that feminism is not a bad word. Girls and women should know that feminism is about having choices. Carly Fiorina, the first woman to head a fortune 500 company, described a feminist as a woman who lives the life she chooses. “A woman may choose to have 5 children and home school them, she may choose to be CEO or run for president.”

Let us rework feminism by getting more men involved. Feminism is for everyone. Working with men and boys is key to achieving equality. They should be encouraged to stand alongside women to support gender equality and the empowerment of women and girls. Men and boys need to abandon all toxic masculinity. Harmful stereotypes should be thrown out to embrace respectful, mutually beneficial and healthy relationships.

2)     Create Safe Spaces for Girls and Women

The Girls Festival was such a safe space for girls and women to receive sexual and reproductive health services. It was a space for girls to be girls. We need to create rooms full of role models for girls to aspire to be like. We need to create worlds where everyone can feel safe, accepted, loved, challenged and encouraged.

3)     Mentorship and Positive Role Models

My biggest struggle over the years has been to find a great female role model who is also a young adult. I look up to former Vice President Specioza Kazibwe, however, I wish I had a female young adult to look up to. I’d love to have someone like me who is doing powerful things. We need to introduce the next generation to remarkable role models who are powerhouses and forces to be reckoned with. I particularly loved how the Girls Festival 2019 introduced us to role models like self-taught makeup artist Monalisa Umutoni.

4)     Invest in Women

The inaugural Girls Festival was a satellite event leading up to the Women Deliver 2019 Conference in Vancouver. Women Deliver’s mantra is that investing in women creates a ripple effect that yields multiple benefits, not only for individual women, but also for families and communities. Investments in women and girls are not mere acts of charity. They should be looked at as investments that can generate high returns for humanity.

These are just 4 ways we can create opportunities for the next generation. I know it won’t be easy, but every little action matter. Marie Curie, the first woman to win a Nobel Prize, famously said that the way to progress is neither swift nor easy.

Let us do whatever is in our power to pave the way for future generations to enjoy the gains from equality. I look forward to the opportunities we can create for the next generation.

Doreen Kihembo is a Communications Officer at Reach A Hand Uganda.

Mental Health Treatment & Gender Equality in Uganda

Conflict, poverty and instances of social injustice can provide the context within which a person develops mental health issues. And yet, while studying to become a creative/psychomotor therapist, I learned very little about this.

I didn’t question it at the time, because mental health is a personal issue, right? My time in a counselling centre in Uganda last summer showed me that the answer to this question is, in fact, a clear no.

I volunteered as a psychomotor therapist in the Bishop Asili Counselling, Rehabilitation and Community Centre in Ngetta, northern Uganda. The local population living here suffered badly during the Lord’s Resistance Army insurgency.

More than a decade after the end of the war, I came to Uganda with a stack of books on trauma and post-traumatic stress, ready to do creative therapeutic interventions that might help women cope with their war-time experiences.

Very quickly, it became clear to me that the conditions these women lived in asked for something different. Something more.

Sister Florence, an Ugandan psychologist who founded and runs the counselling centre, reminded me that next to their history of war, “there are so many [other] sources of trauma, so many, so many, so many”.

Women in Ngetta face many challenges. The patriarchal context leaves women with few, to zero, rights.

They have no right to land or any kind of ownership, and the moment a woman marries, her new husband acquires rights over her sexuality and reproductive ability.

Ellen, one of the women I worked with in the counselling centre, described the patriarchal culture: “I was now in the hands of my husband and I was now under authority of my husband. I need to respect him and do everything he tells me.”

Her words reflect the complex power dynamics and hegemonic masculinity that undermine women’s social status and power. On top of this, many women struggle to feed their families every day, while often their husbands drink away the little money there is. Other women have lived through (often multiple) more recent traumatic events, such as emotional and physical abuse by a husband or brother.

It made me wonder how much help my therapeutic interventions focused on (individual) war-trauma could be.

Recognizing the unequal social position of women, I needed to have a clear feminist ideology underlying my therapy. This meant focusing on women’s social position and equality.

Our sessions were related to resilience, visibility and communication, grounding techniques, personal boundaries, and more. Work related to the strive for equality for women was essential. However, paying attention to – and ultimately challenging – violent and unjust structures is not often included in mental health interventions in the Global South.

The importance of women’s mental health for general health is widely recognized. Mental health in international contexts is slowly becoming more of an acknowledged topic within the field of international development. This is really good news, especially considering the fact that only a small minority of the 450 million people suffering from mental or behavioural disorders worldwide receive treatment.

In 2013, the World Health Organization published their Mental Health Action Plan: 2013-2020. It is an ambitious action plan that understands ‘the essential role of mental health in achieving health for all people’. Global Mental Health (GMH) is thus an emergent topic in which more and more people are currently working. However, with this renewed focus on mental health, many critiques have emerged, some of them accusing GMH of being a colonial practice.

GMH is accused of globally enforcing biomedical systems, which are characteristic of the Global North’s approach to health. The biomedical framework locates illness, including mental illness, within a person. Though psychological and social principles are sometimes taken into account, biological variables are the most central.

Issues of social injustice and structural violence (such as poverty, conflict, sexism, racism) are not taken into account, despite their significant impact on women’s mental health.

Very important work is being done in the field of GMH. Organizations like SOS Children’s Villages or Action for Child Trauma International are great examples of a rights-based approach to trauma.

We must be careful to avoid new forms of imperialism in which the Global North enforces its biomedical approach to health on all cultures. We should work towards locally-informed care which approaches mental health not as an individual issue, but as something to be addressed on personal, community, national and global levels.

Mental health should be seen as a social issue.

This would allow us to challenge discriminating structures, both globally and nationally, while also focusing on community and personal struggles.

In order to achieve mental health for all, there is an essential role for work towards an equal world, and this work is should be integrated in the field of Global Mental Health.