Giving birth should be a joyful experience. But for Africa’s poor, the process is often life-threatening.
Women from the marginalized communities face numerous challenges. They lack access to quality medical services, resources, as well as the right education around pregnancy.
This is the story of Cherop, a young girl from the Maasai tribe in Kenya. It is a reflection of what thousands of girls go through every year to bring a baby into this world.
Cherop is a 17-year-old girl from the Maasai Community. She is expecting her firstborn baby, and like most of the mothers, she is very eager to meet her unborn child.
Since she was three months on, she has been making endless trips to the midwife – Mama. Everyone in the village knows and trusts Mama. For over 30 years, she has helped hundreds of women give birth.
What is surprising is that she does it all in her small grass-thatched house, on top of a not-so-stable table, with no equipment, no gloves, no medication, just her bare hands. And although she manages to handle the process successfully, there are times when the baby, the mother or both lose their lives.
But the fact that one too many lives get lost during delivery does not stop Cherop from employing her services. In fact, she believes that hers will be successful, because she’s been strict with her checkups, and that she has followed the midwife’s instruction to the latter. Besides, she has no reason to doubt the ability of Mama. After all, she was the one who helped her mother give birth to her about two decades ago.
Journey to the hospital
Even though Cherop dropped out of school before she could read, she knows the importance of going to the hospital. Her favorite radio program talks about this all the time. But this is not an option for her. The nearest hospital is about 150 KM away, and the only vehicle that goes there passes at four o’clock in the morning. Unfortunately, the bus fares are often too high. If she decides to go to the hospital, she would have to walk for two or more days.
There is also an option of using a bicycle service as a transport mode; however, the roads are hilly and rocky. And because the Maasai village sits in an arid area, temperatures go beyond 45-degrees during the day and about 10-degrees at night. All these conditions are unfavorable to a pregnant woman.
The state of public hospitals
Despite all the journey troubles, Cherop could still make to the hospital. But if she considers what awaits her there, she would rather have the midwife help her with delivery.
It is a good thing that the government of Kenya declared free maternal care in all public hospitals. The problem is there are inadequate resources in these facilities. Therefore, it beats logic for one to go through the struggle only to find out that there is insufficient personnel in the hospital to help with the delivery.
Most hospitals in the marginalized areas do not have the necessary equipment, such as incubators, monitors, overhead heaters, IV, feeding pumps or ventilators, so nothing can be done if a baby is born prematurely, for there are
Also, Cherop does not see the need to go to the hospitals where she has to share a bed with three other pregnant or lactating women. She thinks it is uncomfortable, unhygienic, and frustrating – and she is right.
Negligence is another thing that scares her.
“I have heard cases of women delivering on the floor! The negligence in hospitals is just too much. Just the other day, four women and seven infants died at the hospital because of the looming blood shortage,” she says.
Midwives play an incredible role in the society. However, it is essential for every pregnant woman to have access to quality medical services. These children are the leaders of tomorrow, and if nothing is done, then many things go wrong. It is, therefore, our duty to speak out to ensure governments develop more hospitals in the marginalized communities and ensure that these hospitals are fully equipped with the right tools of the trade, so no life is lost.
The Challenges Facing Internally Displaced People in Africa
Today, there are five times as many internally displaced persons as they are refugees. This makes them the largest groups of people affected by forced displacement.
IDPs are people who are forced to flee. Like refugees, they have to leave their homes because of fear of persecution or conflict. But there’s a single fundamental difference between the two: to find safety, IDPs move from one area or region to another but still stay within their country, while refugees leave the country that they live in and cross the border for safety.
Why don’t IDPs leave the country like refugees?
Some IDPs may want to stay close to their homes with hopes that things would get better soon, so they can return. Others lack the physical strength or the means to go through the uncertain and sometimes, dangerous journey to a safer country. Often, the internally displaced persons are stuck in conflict areas where threats like violence restrict them from reaching the border.
The troubles that IDPs go through
When refugees move to another country, they are protected by the international law. However, the IDPs depend on their government for protection from persecution and violence. In most cases, the government may not be able or may be unwilling to offer such protection. For this reason, internally displaced are among the most vulnerable displaced persons across the globe.
But like refugees, they also face challenges like loss of jobs, properties, and even livelihoods. Some get injured, some lose loved ones.
IDPs in Number
African countries have more IDPS than refugees – Precisely, there are nearly five times as many internally displaced persons. Towards the end of 2010, there were about 2 million refugees and 11 million IDPs in sub-Saharan Africa.
For the longest time, Africa has been leading region with the most IDPs in the world. From approximately 26.4 million IDPs globally in 2011, 9.7 million were from sub-Saharan Africa.
One would imagine that because the IDPs are in their country, they would receive a special type of care. Unfortunately, this is never the case. Most African countries still do not have a comprehensive and coherent policy or legal framework to address the internal displacement issues. And while they may have a range of laws that they can use to take care of the problem, it’s highly likely that none directly focuses on protection and provision of help to the internally displaced and affected communities.
Following the Post-election Violence incident in Kenya, for instance, the government initiated Operation Rudi Nyumbani (go back home) campaign and provided goodwill payments to the IDPs. While this intervention sufficed the immediate need, it did not take care of the long-term need as envisaged by the Kampala Convention or the UN Guiding Principles.
Problems facing the internally displaced persons in Africa
Some documented challenges that the internally displaced persons in the African countries encounter are:
- Finding employment
- Finding housing’
- Impact of disrupted education
- Financial difficulties
- Ongoing mental issues because of trauma
- Community attitudes
- Changes in status and roles of family members
- Separation from family members
Impact on children
Children face specific challenges because of their experiences and age. It is difficult for them to forget what happened, so they stay with the scars of violence and displacement. And while children are often resilient, some will:
- Experience psychological effects of trauma
- Have identity and belonging issues
- Go through changing family responsibilities
- Loose out in education
Impact on women
During wars or violence, women and children experience all kinds of abuses, including sexual and physical violence. They even end up losing their husbands or fathers, who often, are the providers. And when they flee, they have to figure out a way to fend for the children. It’s difficult because they have to start from the scratch.
Since the IDPs are moving to a new place, and are doing that suddenly (without preparation), they are forced to stay in temporary structures like tents. This means they will experience frigid nights, lack of clean water, bites from insects, and even attacks from people and animals.
There are three ways to handle the IDP situation: resettlement in a third location, voluntary repatriation, and local integration. Repatriation is perhaps the easiest solution to displacement because most displacement crises are temporary. However, it can be a poor option due to limited prospects of a safe return.
In cases when the displaced people can neither continue to live in the temporary shelter or dire camp nor go back to their homes, then they can be resettled in a new and safe area within the country.
The Plight of African Women Migrating to Europe
“From what I hear, there are plenty of job opportunities in Europe. I believe when I get there, my life will be better,” a Congo migrant.
Thousands of African women risk their lives as they go on a boat journey to Europe in search of what they imagine would be a better and easier living. Many begin the journey with much hope, but sadly end up in despair.
In an interview with one woman migrant who left the Congo with hopes of getting to Europe, one of our crewmembers asked about the trip. Here’s what she had to say:
“That trip was hard and easy at the same time. We started our journey from Congo, and we went through to Cameron, where we stayed for two days. Then we left for Nigeria and spent only a single night there. We proceeded to Niger and then to Libya. I had to work in Libya to get the money to go on with the trip.”
We asked, “How did you find your way to the boat and the smugglers?
“There was a black guy in Tripoli who asked people whether they had the money. When I asked him how much I needed to pay for the journey, he told me $1,000. I worked for a few days and managed to raise three-quarters of that amount, which he accepted. We were hidden somewhere in a bush without food– only some biscuits and a little water. We weren’t allowed to speak. In total, we stayed there for five days. On the fifth night, at around 9 PM, the guys came and told us we were leaving. The journey to the seaside took about two hours on foot.” She says.
We asked, “How did you feel when the boat took off?
“I have never been happier in my life,” she says smiling.
We asked, “Are all of you traveling for the same thing, and if so, what is it?”
“Yeah, most of us, if not all, are traveling to get a better life. We believe that the developed countries like America and Europe flow of honey and milk. Even when you lack shelter, once you are there, life is just good.”
We asked, “And do you believe that?”
“Of course I do believe that. Once I’m in Italy, my quality of life is going to improve,” she concludes.
The shocking reality
Migrant women are on the move for various reasons – to escape conflict, poverty, and devastation within their community or country, to join their loved ones, to further their education, and even to get better opportunities and livelihoods.
Unfortunately, most women migrants go through hell. In our interview with over 100 women, nearly 50% said they had been victims of abuse or rape during their journey. They say they were treated like chickens; they were beaten and denied food and water.
It is true that these women make a conscious decision to trust the smugglers with their lives – because they pay to be able to get across a country that they are not allowed to get across legally. However, they do not sign up for abuse and torture.
Women migrants rely on the smugglers to get overseas, often under a “pay first system” which leaves them vulnerable to trafficking, exploitation, and violence including rape and prostitution.
People traffickers demand hundreds to thousands of dollars from migrants to take them across the desert before packing them onto inappropriate boats for the journey across the Mediterranean Sea.
How can we stop women trafficking?
Trafficking is a complex issue that needs a multifaceted approach. What makes it so tricky is the aspect of willing buyer, willing seller. Even so, there is still much that can be done. For instance, both NGOs and government programs can identify the women who are at risk and offer them adequate tools that they require to find work overseas without exposing themselves at risk.
Government and NGO programs should also take short and long-term measures to address trafficking. Short-term approaches include raising awareness and education, while long-term actions include improving the socioeconomic position of vulnerable women and lobbying efforts for reforms on the national laws.
How Lack of Sanitary Pads Affects the African Girl-Child
In Sub-Saharan Africa, about 65% of girls and women lack access to sanitary towels. Most of them resort to shocking alternatives like using goatskin, chicken feathers, soil, leaves, cups, pieces of cloth, and even ashes to hold the periods.
The onset of menstrual periods should be a joyous moment for any girl because it is a transition into womanhood. However, for some African girls, the process is dreaded, because many of them cannot afford to buy sanitary pads. For them, the menstrual cycle comes with frustrations, embarrassments, fear of stigma, anxiety, and stress.
“In Africa, many families survive with a dollar or less every day. It is impossible for a family to spare $0.50 for a sanitary pad when they don’t even have enough for one meal,” says Wakasa, a Human Rights Activist in Nigeria.
Since these girls and women lack the money to buy sanitary pads, they resort to using other methods to prevent leaking, and staining their clothes; they use:
- Chicken feathers
- Tissue paper
- Exercise books
- Cotton wool
- Maize cobs
- Cow dung
- Old clothes
- Old mattresses
While these ad hoc alternatives come in handy, they present a range of health and psychological effects.
According to Dr. Lagat, a Gynecologist at the Nairobi Women Hospital, unhygienic practices are the leading cause of severe reproductive tract infections and even cervical cancer among these women.
She says, “When a woman uses goatskin or old clothes to stem the bleeding, she exposes her uterus or urinary tract to bacteria from outside, which makes them prone to infection. But when they use sanitary pads, the risk is reduced.”
In another context, the fear of leaks, cultural stigma, lack of menstrual materials, and lack of knowledge can put too much pressure on the girls. Some African communities believe that periods only come after a girl loses her virginity.
Lack of sanitary materials also paralyzes the day-to-day activities, because women are forced to stay at home.
“I use scraps of fabric and cotton because sanitary towels are too expensive,” says Nafula, a 19-year-old Kawangware resident. “They sting, they burn, and they irritate my skin. But what’s worse is they leak and soil my clothes. During my periods, I cannot walk around, or carry on with my daily duties because I fear that people will see the blood stain on my clothes, so I seat at home.”
Impacts on education
Studies show that many girls in Africa miss about three to five days of school every month during their menstruation periods due to lack of sanitary pads. Often, they feel unclean, uncomfortable, and even embarrassed to stay in school. The discomfort and the fear of leakage also cause some to lose concentration in class.
For others, the problem is as basic as lack of access to toilets. In most parts of Africa, there’s only one toilet for every 300+ students.
The monthly absenteeism makes it difficult for the girls to keep up with the syllabus, let alone compete with their male classmates, so they remain a step behind throughout their education. Some will even choose to drop out of school to avoid the pressures altogether.
“I got my first period while I was in class. Unfortunately, a boy who was sitting behind me shouted that I had blood on my dress. It was terrifying because no one had told me that at some point, I’m going to have periods,” narrates Maya, a 14-year-old girl. “Everyone started calling me ‘the immoral girl’, and after months of struggling with self-esteem issues, I chose to drop out of school.”
What needs to be done?
Having monthly periods shouldn’t be shameful or a cause for health problems. It also shouldn’t hinder the women from empowerment or education. It’s therefore vital for policymakers to ensure that all school-going girls have access to sanitary ware.
Furthermore, school curriculum should include information about the biological processes to demystify all issues around the sexual and reproductive health to benefit students.
If male and female contraceptives are accessible free of charge in all public hospitals, the same should be for sanitary pads. After all, contraceptive use is optional; sanitary ware isn’t.
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