Questioning FGC

I am reading a book called “However Long the Night”. It is about the practice of FGC – Female Genital Cutting.

The first thing I learned from the book is to not call it FGM – Female Genital Mutilation because under this name, it is a “heinous act of cruelty born from gender inequality that girls are forced to endure.”

“But the issue is far more complex than this”, the book continues, “and to consider it from the point of view of the millions of women in twenty-eight nations where the custom is practiced is to understand a far different reality. The truth is, women who adhere to the tradition do not view it as an act of cruelty, but rather as a necessary act of love. Cutting one’s own daughter is critical to her future, ensuring that she will be a respected member of her community and preparing her to find a good husband in cultures where marriage is essential for a girl’s economic security and social acceptance. To not cut one’s own daughter would be unthinkable — setting her up for a lifetime of rejection and social isolation.”

The book is about Molly Melchin, an American student who came to Senegal in 1974 as an exchange student. She eventually formed the NGO Tostan in 1984.

Tostan is a new type of educational program, one that engages communities in the process by working in their own language and using traditional methods of learning, such as dialogue, theater, dance.

The book starts in 1996, in a village where a Tostan facilitator was working with a group of 35 women who were in class three days a week for a three year course. The facilitator, in a departure from her normal topics, starts a conversation about FGC and is met with silence.

“What I’m about to read is a statement from the World Health Organization,” she said. “Female Genital Mutilation is an act of violence toward the young girl that will affect her life as an adult.” … “Would anybody like to share their thoughts about this?”

“We all know that mothers practice this tradition out of love for their daughters, so that they will be respected and accepted members of their society. Why do you think the World Health Organization would make such a statement?”

The women were silent and the facilitator ended the session for the day.

Two days latter, the women returned to class.  “We’ve prepared a theater on the topic,” the facilitator said, asking for volunteers to come to the center of the circle. “It’s based on a story about a girl named Poolel. Who would like to take part?”

“The women came alive in their roles. As the story went, the day came for Poolel to undergo the tradition. She was taken to the cutter for her procedure, but afterward something terrible happened. Poolel began to bleed profusely, greatly worrying her mother. When the bleeding worsened, her mother took her to the village health agent. Her efforts to stop the bleeding failed, and it was obvious to her mother that Poolel was in great pain. She was eventually taken to the regional hospital, where the doctors tried to save her life. But it was too late. Poolel died the next day.”

At the end of the theater, the facilitator asked. “What consequences befall a girl who is not cut?” She was met with silence. For a long time no one spoke.

Then “Takko the village midwife and a mother of three, hesitantly raised her hand. ‘I know this is an uncomfortable topic for many of us here,’ she began, ‘but all last night I thought very seriously about this. We never talk about the tradition, but maybe it’s time.’”

“Takko went on to describe the problems in childbirth she’d witnessed in her work as a midwife, and how difficult it was for the doctor to sew up scar tissue, therefore requiring more time for a woman to heal. She had long suspected that women who could not have children may have suffered infections following the cutting, causing their infertility. In Senegal, the majority ethnic group—the Wolof—do not practice the tradition, and during her training as a midwife, Takko had assisted in the births of some of these women. She had noticed they were more elastic and therefore had much easier and less painful deliveries. ‘What Ndey (the facilitator) is telling us is true. This is not a healthy practice.”

After awhile her friend Aminata  spoke. “As you know, I’m a Toucouleur,” Aminata said, referring to the predominant ethnic group from the north of Senegal, “and according to my customs I was cut as an infant and sealed shut afterward.” The women knew this was sometimes the type of cutting practiced. After a girl was cut, her legs would be tied together until the wound closed. Aminata’s mother had arranged for her to be married at fifteen.”

“On the night before my wedding, my mother explained I would have to be cut open the next morning in order to consummate the marriage. I panicked and tried to refuse all of it,” Aminata said. “Marriage to the man chosen for me, being cut open. But I had no choice. The procedure to open me was agonizing.” Afterward, still in pain, she fled her village. “I’d been told that if I wasn’t penetrated that night,” she timidly told the class, “my wound would again close, but I didn’t care. The pain was so severe I couldn’t imagine having intimate relations with my new husband.” She remained in hiding for a few days until the pain subsided. That man eventually divorced her, and she was married a few years later to another. She ended up having several children, but each time she had great difficulty in childbirth. “My body was so damaged, I could hardly be put back together again,” she told the others.”

When Aminata finished, another woman stood to speak. And after her, another.

One by one, they cautiously shared their experiences of the tradition.

One woman could not tell her story, it was so painful. Her own daughter almost bleed to death, like Poolel in the story. Eventually she became a champion for ending FGC and said she would not let her second daughter be cut. Then the other women in the class joined in and decided that their daughters would not be cut. Eventually they found allies with other women and ended the practice altogether in their community.

Hunger strikes Emburbul

The price of maize has risen beyond the reach of 105 women and their families. Instead of each person buying smaller, more expensive bags, which they could not afford, we bought large 100kg bags and brought them to Emburbul, then distributed them. Unfortunately, funds were taken from the women’s loan program to do this.

100 kg bags of maize

100 km bags of maize

Women with maize bags

Three Teen Girls off to Secondary School and Maasai Harmonial Registered as a Community-Based Organization

In our quest to move adolescent girls out of child marriage and into women’s empowerment, we have found a high school that takes girls who have failed the National Exam. This school is run by the Pastoral Women’s Council, a mighty voice for pastoral women in Tanzania.

This school, Emanyata, has a tuition of only $500 – half of what it costs to send the girls to English boarding school. Maasai Harmonial’s patrons, Ben and Karen, have decided to send three girls and they were taken there a few days ago.

Teen girls, ages 15-16, going to Emanyata Secondary School

The girls’ school was near Loilondo, which is also the region where CBO’s (Community-Based Organizations) can be registered. So our efforts to produce a Maasai Harmonial constitution paid off, and now Maasai Harmonial can hire an administrator, plan projects, and receive funding from private individuals, other NGOs or public institutions.

Maasai Harmonial official registration, January 2017

Maasai Harmonial official registration, January 2017

Cattle and Maasai Harmonial

One of the goals of the Maasai Harmonial project is self-sufficient sustainability.

For this reason, we try to make capital investments into the project and not contributions that will have to go on year after year.

Currently the Emburbul cattle business is on the low end of sustainability if you look at the sustainability of the majority of Emburbul’s residents, who are extremely poor. One person, however, owns most of the cattle, which does not benefit the rest of the residents. This person’s cattle consumes water and grassland from the same source as the other, poorer, people’s cattle. Since quantity of water and grassland is often not enough to meet everyone’s needs, this is a problem.

Cows not getting enough grass

Cows not getting enough grass (note the zebra in the background)

In 2008, a volcano spewed out ash and the ash covered the ground and destroyed the grasses, killing the cows. Many of Emburbul families lost their cattle and still have not recovered from this disaster.

These two situations alone are enough to set a Maasai man’s mind into a fatalist mode. It probably explains why the men refuse to sell a few of their cows in order to purchase a bull of a breed that would be more suited for the area. And why they don’t invest in worming medicine for the cows.

We thought about buying a strong, quality bull for the widows and women without husbands (who have run off due to poverty) to use as stud service. But the men are entrenched in their formerly sucessful ways and won’t hear of it.

In the past several months, a dry season came upon the Embulbul Depression, drying the grassland, and goats started dying from lack of water. The cattle fared a little better, but definitely showed the effects of low water intake.

Goats are dying. Giving them medicine

Goats are dying. Giving them medicine

Cattle upstream from the water supply poop in the water, leaving it contaminated. Even if water filters were available, having large amounts of material in the water makes filtering several times more difficult. Water-borne disease is a common ailment, especially for children. Water is boiled for infants, who are often weaned at only three months because mothers are malnourished and are spacing their children too close together.

Building watering troughs for all the cattle (including those of the rich man) will go a long way towards solving this problem.

In addition, there are a great many invasive plants in the grasslands, which the cattle will not eat. An intensive invasive plant eradication program is needed.

Someone built a cow tick dip station for the cattle, but the concrete was not sufficient and the bottom of the dip trough was destroyed the first day someone walked on it. A new dip station is on the list of things we need funding for.

Livestock, including cattle, bring another problem. One of the girls we sent to boarding school was sick due to eating unboiled meat. It is common for livestock of pastorals to be infected with this bacteria, which can damage organs. Treatment is usually a course of antibiotics. Many villagers are affected.

Often, when the water is diverted for the cattle, women have to walk four miles each way to and from the water source. This takes time away from their children and house keeping duties. It may also interfere with their ability to have a livelihood such as beading or livestock raising. And it may also interfere with the ability of girls to attend school. Their mothers may need them to haul water.

Improvements to the water system and conservation of water at the village end will go a long way towards eliminating this eight mile walk each day.

The Pastoral Women’s Council (PWC) has a program where the women have their own cattle-raising boma (small village). We are thinking of sending a group of women without men (widows and women whose husbands have left them) to PWC for business and livestock training. Raising goats or chickens may be what these women can do, if they can get enough water for these animals.

Cattle are used to pay a bride price so a man can get married. If a man does not have enough cattle, he or his parents may want to marry off his sister to receive the bride price. This is one of the things that puts young girls as young as age 12 in early marriages.

If a man cannot raise the bride price, he may be tempted to leave the village and move to the city in order to find a job.

These problems having to do with the cattle business must be addressed in order to achieve sustainability, women’s empowerment, and smaller families.

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Contraception: Is it cultural barriers or is it lack of supplies?

It is so often claimed that shortage of supplies is not the real reason for low contraception usage, but here is a case where the shortage is indeed the problem. In 2015, lack of information about family planning may have been the reason, but we have solved that problem with family planning training of a few women and the development of a family planning video in the Maasai language. Consequently, in August, when Marie Stopes showed up with their mobile clinic at a nearby health clinic in the small town of Nainokanoka, 28 women walked 4 miles to get family planning implants.

Now, when more women are showing interest, Marie Stopes has cancelled their mobile clinic, at least until next year. This means that the women who wanted to get a method can’t get one, and that women who were having undesirable side effects from the hormones in the implant can’t easily get it removed and can’t get a new method. It has been shown that women who reject a method that does not work for them are at a large risk of rejecting modern contraception altogether.

We had been hoping that the doctor at the small, woefully inadequate, government health clinic at Nainokanoka could be talked into providing family planning services there. Finally our Maasai team members have become acquainted with the facility and the staff and have convinced the doctor to provide family planning services. This doctor even suggested a mobile clinic to make monthly rounds to serve all the people in the area.

But, gosh, I had really underestimated the sad state of affairs at a government-funded clinic.

This like peeling an onion.

So now I am looking for an NGO who can supply the clinic with the needed contraceptive methods. And then there is all the other equipment needed.

Below is his letter, listing all that is needed.
Dear Karen,
Greetings,
Thank you for your response.
I have impressed on what you have started on Family Planning issues.
I thought that,your plan would be sustainable if we can equip Nainokanoka HC (health clinic) with enough instruments and supplies to facilitate services for the entire population and the nearby.
At our Centre we are providing the following methods of Family Planning:
1.Short term methods-Pills; Combined Oral pills and Progesterone only pills, Male and Female Condom, Calender method.
2.Long term FP methods -Implanon 3 years and Jadedly 5 years.
Permanent FP methods – Bilateral Tubal Ligation(BTL) and Vasectomy meanwhile not practicable as we do not have theatre,.
 
There are 3 Health Care Workers who trained to provide these services.
It is therefore, they are able to put and remove implants without dought.
Giving them a refresher course will be an advantage.
 
The following items will facilitate to run Family Planing services at our Centre:
=A supply of Oral Pills and Implants, Lignocane, Surgical blades, Surgical gloves, Iodine solution, Syringes 5cc and 2cc,Cotton wool, Gauze and Antiseptics.
 
=Instruments needed -Cheatle forceps, Artery forceps, Dissecting forceps, Speculum(cusco), Kidney dishes 5, Gall pots 5 ,Sphygmomanometer (Blood pressure machine), Sterilizer,Examination bed, Examination light and Weighing  scale Adult.
 
Diesel engine Generator is needed for sterilization of Instruments.
 
=Mobile outreach clinics to the community will increase the number of Clients but not Family Planning alone in separate, other services like Vaccination to Children, Health education, Antenatal services will be rendered if fuel and Allowance for driver and 4 Staff will be available. 

Progress Report

We are still finding pieces of the solution of the water system.We still think that conservation by means of water tanks is a good part of the solution.

The Emburbul primary school children have started going to boarding school in Nainokanoka.  We have provided 28 girls’ uniforms and 20 boys’ uniforms as an incentive to the kids and parents. This will be a big help towards the goal of getting girls into school and keeping them out of child marriages.

There are two hitches in this plan:

1) Children can’t start at the boarding school until age 9 unless they can learn to wash their own clothing. This leaves a gap between nursery school (ages 5-7), which is at the village, and the time they can go to primary boarding school. So if they are to start primary school at age 8, they must walk 4 miles each way, every day, to school.

Possible solutions: a. teach the younger children to wash their own clothing. b. enlarge the scope of the nursery school at the village.

2) About 50% of children fail the Leaving Primary School exam, which means they cannot go to secondary (high) school.

Fortunately we have found a girls high school that takes failed girls: Emanyata in Loliondo, 135 km away. The school wants only $500 per girl per year, plus there are personal expenses of about $100. We have promoted a Facebook ad and we are soliciting donations to send several girls to Emanyata. See more here.

The three girls who are attending Shepherd School (English Boarding School), came home for their holiday this week. One of them, Nopenyi, had a rash and was sick. The doctor said she had brucellosis, a disease common among pastorals, contracted from eating unboiled meat and milk. If untreated, it can affect the organs of the body. The rash is a symptom of the disease. Except for the rash, the school staff did not seem to notice she was sick. I noticed that she rarely smiled although the other two girls did. Fortunately, Nopenyi has now been treated and her rash is gone. She is on a 28 day treatment plan.

We were hoping to have Marie Stopes come back this month to supply more contraception to the Emburbul women. We had finished our family planning video and Samwel has gone around and talked to the women about family planning, and at least one woman (maybe more) is interested. Plus there may be women who had unwanted side effects from the hormonal implant and needed to have it removed. But Marie Stopes said they were not coming back until next year – they were short-staffed. However, we now have reason to believe that the clinic in Nainokanoka may start family planning services. See more on this.

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Girls Education, Health, Sustainable Development Goals, and Population

Adapted from an article titled “Meeting the Sustainable Development Goals Leads to Lower Population Growth” by IIASA – International Institute for Applied System Analysis See http://pure.iiasa.ac.at/13348/1/WP%2016-007.pdf.

In September 2015 the leaders of the world under the umbrella of the United Nations in New York subscribed to an ambitious set of global development goals, the Sustainable Development Goals (SDGs) which unlike earlier goals give specific targets which apply to all countries of the world. If pursued, several of these targets, particularly in the fields of health and female education will have strong direct and indirect effects on future population trends mostly working in the direction of lower population growth.

An analysis by the International Institute for Applied Systems Analysis (IIASA) quantitatively illustrates  that demography is not destiny and that policies – such as the recently agreed Sustainable Development Goals (SDGs), particularly in female education and reproductive health, can greatly contribute to reducing world population growth.

Based on a multi-dimensional model of population dynamics that stratifies national populations by age, sex and level of education with educational fertility and mortality differentials, we translate these goals into SDG population scenarios resulting in population sizes between 8 and 9 billion in 2100.

Today, the future of world population growth looks more uncertain than a decade ago, due to a controversial recent stall of fertility decline in a number of African countries and a controversy over how low fertility will fall below replacement level, particularly in China.

In 2008 projections by Lutz, Sanderson, et al. gave a 95% interval for the global population ranging from 5.2 to 12.7 billion in the year 2100.

In 2015 a different approach by the UN Population Division gave a much narrower 95% interval ranging from 9.5 to 13 billion in 2100.

Another recent set of world population projections defined in the context of the work of the IPCC (Intergovernmental Panel on Climate Change)  showed in the medium scenario a peaking of world population around 2070 at 9.4 billion, followed by a decline to 9 billion by the end of the century with high and low scenarios reaching 12.8 and 7.1 billion respectively (Lutz et al. 2014; O’Neill et al. 2015).

In this paper the most relevant of these goals were translated into SDG population scenarios to quantify the likely effect of meeting these development goals on national population trajectories. This method shows the world population peaking around 2060 and reaching 8-9 billion by 2100, depending on the specific variant of the SDG scenario.

World population growth is sometimes called the elephant in the room due to its capability to cause environmental degradation as well as in making adaptation to already unavoidable environmental change more difficult (Ehrlich & Ehrlich 1990; O’Neill et al. 2001; The Royal Society 2012).

Population is widely perceived as a politically sensitive topic: the 1994 International Conference on Population and Development explicitly opposed the setting of “demographic targets” saying that the role of the state is to assure reproductive rights and to provide reproductive health services. It is presumably for this reason that the new SDGs do not mention population growth or fertility explicitly in any of the 169 targets.

There is increasing evidence that education, particularly in countries in demographic transition, has a direct causal effect on lowering desired family size and empowering women to actually realize these lower fertility goals with availability of reproductive health services also helping to enhance contraceptive prevalence. Universal primary and secondary education of all young women around the world is a prominent goal in its own right (SDG 4) and is politically unproblematic.

Lowering child mortality and decreasing adult mortality from many preventable causes of death are also politically unproblematic policy priorities. For child mortality the SDGs give precise numerical targets which could be directly translated into demographic trajectories and could be complemented through estimates of the indirect effects of better education of survival at all ages.

The population growth trajectories that would result from the successful implementation of the SDGs will come to lie far outside the 95% uncertainty range given by the 2015 UN probabilistic population projections.

The extrapolation model used by the UN gives all national fertility trends given equal weight, irrespective of whether they summarize the experience of just a few thousand couples or hundreds of millions of couples. In fertility, couples and not states are the relevant units of decision making and  couples rather than countries should be given equal weight, which would greatly change the projection results.

The world community under the leadership of the UN launched an unprecedented global effort to strongly accelerate global efforts in development within the framework of the SDGs. Many of these goals, if reached, will have important effects in lowering future fertility and mortality rates, particularly in the least developed countries. Leaders of all countries and the entire UN system have committed themselves to do whatever it takes to reach the specified targets. This new global effort is  a discontinuity of past trends and hence cannot be captured by statistical extrapolation of past trends.

Policies in the field of reproductive health and female education can have very significant longer term impacts on global population growth. Progress towards reaching the SDGs can result in accelerated strictly voluntary fertility declines that could result in a global peak population already around mid-century. These strong effects of the SDGs on lowering global population growth in a politically unproblematic and widely agreed way provides an additional rationale for vigorously pursuing the implementation of the SDGs.

See http://pure.iiasa.ac.at/13348/1/WP%2016-007.pdf for the full article.

Note: This article does list not the benefits of a lower population in any family, community or region. Smaller families means parents are more able to feed and care for their children. Fewer people mean fewer cattle to compete with wildlife over forage. Fewer people means less competition for livelihoods such as beadwork or bee keeping and less competition for jobs. Fewer people means governments are less likely to run out of funds for schools and road building.

 

Village Conference – Constitution for Community-Based Organization

From Samwel:

We had a good meeting and the number of attendance very good, we discussed a lot family planning and  project that we have in our CBO many ladies were very interested in family planning because I had private talking with ladies before the general meeting, men were asking about water, school, and beekeeping  then I told them all the project are on the process to be done but after the registration for our CBO all projects we will done one by one.

We come also in agreement that all Emburbul students will go to boarding school (free) except standard one (age 7-8) only.

samwel-talking-to-village-women-foreground-1

Samwel talking to village gathering

Girls Education

On September 6th, Mapena and Grace took three young girls to Arusha to go to English Boarding School. Since Grace is attending Health College in Arusha, we thought she could be a big sister to the three girls if they were also in Arusha.

The girls will learn both English and Swahili, among other subjects.

girlseduc-3-girls-sep2016

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