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REPRODUCTIVE HEALTH RIGHTS: THINGS THEY NEVER TOLD ME AS AN ADOLESCENT!

Living on the edge

I visited my hero woman leader, Amimo who has been a longtime neighbor and friend at her home. Recently I have sought her counsel in the work I do for women‘s empowerment in reproductive health and economics. So one late afternoon on entering her dimly lit room with visitors from the Aga Khan University-Kenya, I found a timid young girl named Sasi sitting on a thin mattress with a peacefully sleeping baby of two weeks. As a health provider, immediately my mind raced to the public health implications for an infant and such a young mum. The girl appeared on the verge of tears whenever she looked at her baby. She seemed to have so many questions that perhaps had no answers, certainly not easy ones.

It was difficult to get her talk because of the traumatic events that she had experienced. Most of the time, Sasi looked at her broken fingernails, recalling the death of her parents who succumbed to HIV /AIDS when she was 3yrs old. This being also confirmed by Amimo. She had been brought up by a succession of many relatives. When one ran out of money, they would send her elsewhere. At that time the stigma of HIV was hard and people wouldn’t want to be associated with such relatives.

The World Women’s Conferences in 1985 and 1995 in Beijing and Kenya caused a revolution in the entire world like a tsunami hitting the shores of Indian Ocean. From presidents, policemen, drivers or the farmers in the villages the talk centered on gender equity. Men felt a grip of helplessness for fear that should the conference demand equality, the kitchen could become a place of judgment to repeal or amend restrictions on women’s socio-economic achievement. The conference in Nairobi was regarded by some as a whip to castrate men into mere heads of the family with no authority to prevent women from pursuing their dreams. However this attitude has come with a price over the years.

Being born to a wonderful couple in the Western part of Kenya, at the time when the ‘Beijing women’ were causing a stir in the whole world. The women of the conference made themselves visible by demanding better working conditions, healthcare, education and more. However, 17 years down the lane to be precise, Sasi orphaned at a tender age of 3 doesn’t feel their impact. She grapples with age old issues of poverty, sexual violence and being robbed of the dignity to enjoy her youth. This vulnerable girl has been plunged into the darkness of uncertainty inside one the biggest slums in Africa, Kibera, Kenya

According to UNICEF in 2007 the number of orphaned and vulnerable children adds up to 1.9 million countrywide.12 % of the households in Kenya are made up of orphans without an adult to take care of them. Orphaned girls often end up being victims of early marriages, parents to their siblings and school drop outs. The outcome of this vulnerability reports 142,000 births to teenage girls annually.

I Only Did It Once

At the tender age of 17, Sasi worked as a casual laborer for a lady who promised to take care of her because she didn’t have parents. There was a man living nearby with whom she had little contact, but one day without announcing his intentions, he pounced and gagged to silence her. The only thing Sasi could remember afterward was an excruciating pain such as she had never known in her life. She mumbles amidst clouds of tears, “It was tragic……… it was once, only once but I don’t want to remember such evil”. Later on the lady employer chased her away without payment.
Currently the world is experiencing increasing acts of sexual violence against minors and many go unreported. Under the UN Convention on Children’s Rights Article 34, a child has the right to be free from any form of sexual abuse. However this right has been heavily contravened by child molesters globally, who, for example, rake in billions of shillings in child pornography and trafficking. Even though trafficking carries a heavy penalty, it has become the second most lucrative illicit business after drug trafficking.

The law on rapists in Kenya is very strict, however too often they are walking free again in the streets. Sexual violence is rife in the urban slums. It is very scary for the girl child or boy to even go on call of nature after 6pm. Because the toilets are built on the outside of residences, the concerned parents have makeshift toilets in form of buckets in one room houses for fear of the children being defiled. A number of NGOs, in the Kibera slums have a gender recovery centre, but it is a drop in the ocean. The Power of Hope (POH) single mothers group whom I interviewed reported that, “it is not easy to report rape. The man can kill you, or you are given money to be silenced and such is the dilemma”. Those girls who get raped and have no one to turn to, too often end up with unintended pregnancies, unsafe abortion or even attempt suicide.

Girls Turned Mothers Too Soon!

The outcome of that sexual violence was unintended pregnancy. Sasi is a single mum, nursing a baby of her own without close family support. All her hopes of a better future are shattered. Life will never be the same again!

At the tender age of 17yrs she is a young girl turned mother too soon! As she looks down at her baby one can’t help imagine how she will narrate to her son in the future who exactly is his dad. She will never be able to tell the baby about his real father (the rapist). The shame and hopelessness is evident from her anguished face. Amimo, interjects, “She is so young. She was brought to me by a relative since I am known as the Women Leader of this area. My income is meager, sustaining the (mother and baby) is hard, but what to do? I can’t chase her away.’’

At the beginning of the new millennium, about 1.7 billion people —more than a quarter of the world's population—were between the ages of 10 and 24, 86 percent living in developing countries. Hence the need to address the socio-economic issues that affect this large population that is dependent for virtually every basic need from their parents and guardians is an urgent and growing concern. According to a Reproductive Health Survey conducted here in Kenya in 2003, youth accounted for 36% of the population and adolescents at 25.9%. The World Health Organization defines an adolescent as one from 10-19 years, and a youth is between 15-24 yrs.

The Constitution of Kenya is very clear on the right to health information, including the right to attain the highest standards of health care. However the youthful population is at increasing risk of sexually transmitted illness and unintended pregnancies. Advocates for youth also report that the degree of sexual experience among the youth varies across regions, but consistently indicating that 52 % of women in Sub-Saharan Africa women at 19yrs have had at least their first sexual intercourse.

With the lack of accurate and accessible information on family planning especially in the urban slums, the world will see more babies booming from young girls. It is difficult to ascertain the number of youths who consistently access and use family planning. The public hospitals across Kenya have tried to promote youth friendly clinics but they are not enough. Teenage pregnancy is on the rise. The youth have turned to their peers for information on safe sex, contraceptives and sexually transmitted illnesses. However, their inexperienced peers give inaccurate information. 70% of all adolescents in the country engage in unprotected sex, according to Reproductive Health Study (2003). While a lack of sex education is "blamed" for many teen pregnancies in Kenya, traditions that inhibit discussions between parents and children about sex also play a role, AFP/Yahoo! News reports. Conservative religious beliefs and attitudes also play a role!

Religion Teaches Forgiveness; Some Wrongs Are Hard to Forget!

Sasi has been God fearing all her life. She has been taught by her guardians that sex is evil and the young ones should not indulge in it. What she didn’t know was that some very religious teachings do not hold the perpetrators of sexual violence to blame. They are free to rob the young ones of their dignity by silencing them with fear, threats of revenge or even murder should they reveal that they were defiled. Sasi mumbles, “I didn’t know who to turn to when the man hurt me’’.
According to some beliefs, there are no small or big sins, all are equal. Thus there is no blame. But who is to blame when there is an increasing number of pedophiles and sexual abusers roaming in the neighborhoods and defiling our children? Until now the culprit who defiled Sasi is walking free and may believe he is blameless. The silence is deafening.
It is folly to speak of contraceptives in the religious context; the doctrines provide that sex is a holy gift and should be only for the married! What arrogance when the world is full of orphans, who have been robbed of their parents by HIV/AIDS. In addition, religions that have suppressed the "openness in matters of sexuality" have also contributed to the teen pregnancy rate in Kenya. Advocating open dialogue, Kang’ara of Egerton University said, "Churches are institutions of social change and should be in the first line to address these issues" (Peytermann, AFP/Yahoo! News, 7/10).

Emergency Contraceptive (EP) Is Big Business!

A spot check on 10 village pharmacies within Kibera shows that the real owners are absent and are run by workers with midlevel or little training at all in pharmacology. Even though these workers are alleged to have licenses, on further inquiry it is business as usual of dispensing drugs over the counter. A report from UNICEF in 2012 indicated a case study that was done in Kenya as having health services in Nairobi slums limited and out of 503 health facilities available, only 6 were public. Hence the mushrooming of illegal health clinics that offer substandard care, including poor reproductive health services to the youth. The buying of over the counter drugs is so common, such that the Emergency Contraceptive (EP) can obtained by any youngster. However due to the poverty levels, sometimes buying the pills is not easy. Sasi is an example of the younger generation with little information on reproductive health. There was little or no room at all to discuss this with her family members. One lady owner of a chemist points out, “I normally charge slightly higher than a public clinic for the contraceptives because I buy them, so I can’t give them for free’’.

The Pharmacy and Poisons Board in Kenya has one of the best guidelines for controlling counterfeit and illegal transacting of drugs. However it appears to be only in books as the mushrooming number of bogus pharmacies continues to dot the urban slums. In only one of the 9 villages of Kibera there are numerous chemists not fully recognized by the Board. Citizens who cannot differentiate between a genuine pharmacist and the uncertified may be oblivious of the danger it poses. A pharmacist asserts, “EP is big business. It is popular with the students especially on Friday to Monday. You can’t deny them even though they look so naïve’’.

Access to contraceptives by urban youth has challenges. The majority of the drop outs in the slums regret not having been well informed by their elders about the right to use the contraceptives or how to use them effectively. It was not encouraged for youth to attempt to raise the subject of contraceptives. Often contraceptive use is still held with suspicion and moral disapproval. Thus youth may hesitate to admit using contraceptives. With this in mind the youth end up in hiding and often miss accurate information, counseling and guidance on sex education. This complex subject has been left to classroom teachers who are overwhelmed with school curricula and end up giving random and perhaps incorrect bits of information to fulfill the education system requirement.

The health Institutions are not faring well enough. The initiating of youth friendly clinics seemed a noble step towards reaching to our youths, in reduction of unintended pregnancies and sexually transmitted illnesses. The Kenya Health Survey of 2010 showed that only 7% of health facilities in the country can offer youth friendly services. Also the studies conducted by the Division of Reproductive Health showed that the competency of health providers at these facilities in provision of reproductive health was in dire need of improvement. Other health workers cited moral reservations, religious values and cultural considerations that reduced the utilization and efficacy of these services.

Hope Is Here Again for the Youth and Adolescents

Since this generation constitutes a huge percentage of the population there are hopeful and meaningful interventions coming up. Family Health International (FHI360) , an international organization, in partnership with the Division of Reproductive Health, have currently introduced text messages by mobile phones where the public can access information on maternal and reproductive health. There is a peer education programme that is being strengthened by the Family Health Options Kenya in view of reducing cases of unintended pregnancies and sexually transmitted illness. Their approach is very crucial in that during the August school holidays they bring together youths all over the country to have a one week long camp that addresses reproductive health and sexuality.

On the other hand the Ministry of Health is increasing access of the services to the youth by employing more nurses to address the unmet reproductive health needs. I see twitter as the next big thing to link the youth and nurses in addressing their reproductive health issues.Safaricom is a mobile company in Kenya that has reduced the price of text messages so that majority of Kenyans can tweet. An average urban slum youth has an access to a guardian’s phone or a community phone. The youth require a friendly environment where they can explore issues on gender and sexuality.

Sasi’s One Best Wish

Sasi speaks of her determination to bring up the baby with the help of a foster mother. Her one best wish is to train as a hair dresser or tailor. With $ 150 dollars, she would be able to undergo a 6 months course and become independent. I hope her wish will come true one day. On an optimistic note she wants her son to grow to be the governor of Kibera, so that he protects the girl child from sexual violence. With the support and example of women like Amimo, Sasi may become an advocate for youth at risk. She is in a unique position to reflect on her experience and draw lessons to be shared with her peers and eventually with her son. She has a message to share if she only has the opportunity to find her voice.

This article is part of a writing assignment for Voices of Our Future, a program of World Pulse that provides rigorous new media and citizen journalism training for grassroots women leaders. World Pulse lifts and unites the voices of women from some of the most unheard regions of the world.

http://www.unicef.org
http://www.un.org/womanwatch/beijing
http://pharmacyboardkenya.org/index/
http://kaisernetwork.org
http://www.drh.go.ke

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Comments

Rachael Maddock-Hughes's picture

Powerful Solutions

I love the solutions you talk about in this article! It is wonderful to know that both local and international groups are trying to address the issue of sexual health in youth. You make a strong point that since youth make up a huge percentage of the world's population, not educating them on such basic issues is a major problem. I also love your suggestion for using Twitter as the next step for address this issue. Are you or anyone else looking into this further? There are more and more foundations out there that are funding technology based solutions.

Cheers,

Rachael

"In every human heart there are a few passions that last a lifetime. They're with us from the moment we're born, and nothing can dilute their intensity." Rob Brezny

Okeny-Lucia's picture

Technology

The answer is partly.The Division of Reproductive health has a partner.And am looking at how the pool of the members (nurses) association can take this opportunity to reach the youth.I am still exploring the issue.Any that you know of I will appreciate

Lucia Buyanza
Reproductive Health

Potter's picture

Hooray for Lucia and Sasi

Lucia, women like you and Amimo and the woman Sasi will become will have a major impact on the critical need for adequate, empathetic sex education for youth. This is a solid article and I encourage you to explore opportunities to publish it. It is an article that needs to be read widely. Thank you for taking on such a huge and potentially hugely sensitive topic. Well done!

Okeny-Lucia's picture

Potter ,One hooray for you too!

It is an area that has given me alot of courage to pursue it. I believe this story will be a bench mark to other women in the world to see what can be done.
Thank you

Lucia Buyanza
Reproductive Health

Potter's picture

Encouragement and support

With encouragement and support I think Sasi can turn her horror story into an inspirational success story. She can be a role model and a hero to other young women in similar circumstances. I believe in her!

usha kc's picture

dear Lucia,, I love your

dear Lucia,, I love your courage to give voice about such sensitive matter! hatts off to you sis.

great article.

hgs

Okeny-Lucia's picture

Usha,Dear

I am so greatful since we first met here in Pulse.I have grown to have courage to speak and to amplify the voices of other women.Thank you for taking time to read my story.

Lucia Buyanza
Reproductive Health

ikirimat's picture

vulnerable

Hello Lucia, Your choice of topic was just the right one. These young girls are left on their own and those supposed to protect them (older ones) are the very ones abusing them. It is my hope that you and amino are able to reach out to many more of the Sasas. Take on the challenge and giude Sasa to see her dream come true.

Be blessed.

Grace Ikirimat

"It takes the hammer of persistence to drive the nail of success."


Okeny-Lucia's picture

Thank you Grace

Hi Grace,
The challenge is huge,am ready to face it and pursue it.If it will be the only to rescue other girls from this challenges.
Thank you

Lucia Buyanza
Reproductive Health

bennettml's picture

Sadness and Hope

Thank you for this story of sadness and hope. The sheer magnitude of the problems you have captured is overwhelming but the solutions you talked about give hope. The social media solutions seem to be the very fastest way to change the culture- but there is also so much danger. The girl in the story did not choose her situation and this cannot be overcome by education on reproductive help. She was a victim and it sounds as if there are so many more victims. I wonder what the solution to provide safety are

MLB

Okeny-Lucia's picture

Sadness and hope

Thank you dearest Sister
While writing this story ,it really tore me up as a health worker that there are some areas in health that have been neglected.Where we need to put emphasis on prevention,we have looked into curative.The problem is huge it touches on very sensitive issues about goverments commitment to care about the young generation.It is sometimes politically.And when you think about it,there is need for united effort to help the youth in the world.

Lucia Buyanza
Reproductive Health

Your story will touch many hearts and open many ears! It is a story that is much too common around the world. Thank you for sharing Amimo and Sasi with us and putting real faces and stories to this issue of our youth. You have indeed created a strong message and given hope in your discussion of solutions. Well Done! Thank you for staying with this story to its completion.

Many Blessings,
Mary Ann

Okeny-Lucia's picture

MaryAnne,I owe you one!

Thank you MaryAnne for the sharing.I imagine where we started from,brainstorming and finding a route to follow and weave the story,the insights given to put forth this story can be overlooked.
Following up on Amimo has brought meaning to my advocacy,I have rewakened the need to amplify this story to policy makers and my colleagues to.The gap must be narrowed,between the halfs and halve not.

Lucia Buyanza
Reproductive Health

Aurore's picture

thanks!

very interesting article, well-written and with real thought in it...all my congratulations and admiration!

Okeny-Lucia's picture

Thank you Aurore

This article has been made courtesy of women undergoing this problem that has just refuse to go away with time.Sexual violence! Thank you for having taken your time to read and find meningful reflection.

Lucia Buyanza
Reproductive Health

vivian's picture

common story but always touchy

Sasi's story is not different from the usual child rape case but each time it is tell, it is very touchy.

Very story is well packed with necesary information on RH and innoviative solution. Thank you for sharing sasi story.

Vivian

''Every woman have a story at every stage of Life''

Okeny-Lucia's picture

Yes,touchy!

Vivian ,I find it so frustrating sometimes to know that the problems that we can solve for our girls are
being taken as business as usual.This issue of teenage pregnancy,early marriage is an every day thing in communities,however we need to think widely and resolve this RH issue.
Am glad you took note of the innovations.Thank you

Lucia Buyanza
Reproductive Health

Judy K's picture

Where can change begin?

The problem is soooo huge. Clearly, governmental rules and laws are not being enforced and many entrenched cultural mores are used to support sexual abuse. Your article raisies our awareness of these problems. Where you think change can begin? How can people be mobilized to make a difference?

Judy Kugelmass

Okeny-Lucia's picture

Thank you Judy!

Thank you for your time.
Change is broad and varied in the issue of reproductive health.It is further creates complexity when we talk of behavior change in sexuality,reproductive health.

However we are not lost in it,Since I have been working within the urban slums for long,I found that awareness of sexuality in the context of cultural perspective carries weight,and when it is your own person in the community linking it with health implication this helps.The community participation in some of this policies is very crucial.What am currently doing is working with local women leaders to understand socio-cultural aspects of it.

Use of current innovation is great but not exhaustive,it needs individuals who will remain altruistic in solving this problem.
School Health was once a point of entry to helping pupils cope with life,s transitions but it was thrown out of the window(in my country) because of its funding implication.I still believe it was great.

In 2010,I did an own initiative of School health in urban slums on cervical cancer,I tell you young people were keen to follow the preventive measures i gave.I received alot of queries from my phone about sexuality.It is another route to follow for reproductive health issues.

Lucia Buyanza
Reproductive Health

Judy K's picture

Change

Lucia -- I apprecaite your response. It helps me understand the important work you have been doing. It sounds powerful. What you describe are the kinds of initiatives that will result in deep and lasting change. Success will build on success!!!

Judy

Judy Kugelmass

Tripti's picture

The world needs to hear this

The story you have here is very tragic. I feel very vulnerable as a woman just reading this, i cant even imagine how Sasi must be feeling.. great post to share with us.. thank you for this.

Okeny-Lucia's picture

Thank you !

Hi Tripti,
I agree with you this is tragic,it cuts across all nation.We need to push for change wherever we are.At least every week I receive calls from folks in the slums ,reporting of a case of sexual violence.

Lucia Buyanza
Reproductive Health

Celine's picture

Hello Sis, Thank you once

Hello Sis,

Thank you once again for sharing insights of your professional experience with us. I agree with you, reproductive health rights issues as they pertain adolescents is very complex. Societies often times shy away from educating the youths, while at the same time plant religious beliefs in their minds.

In Nigeria, legalizing abolition is like taboo-- majority opinion says that it is against all religious beliefs in Nigeria. Yet, young adults secretly patronize quack pharmacy stores for solutions when they are in difficulty. Who do you blame? The young girls are not brought up to open up to their families on issues of reproductive health, neither will the quacks tell anybody that they are responsible for the girls deaths or future complications that might arise when the girl is ready for child-bearing. It is so sad.

There are cases where mothers went to dump their girl-children in an unknown place because the girls are 'illegally' pregnant. They monitor the girls and few days after delivery, the grand-mother go back and take the girl-mother. They leave the baby for the unknown home to sell to anybody who shows interest to 'buy.'

Celine

Okeny-Lucia's picture

Thank you Celine

Thats is a big tragedy in Nigeria.And it happens too in some parts of Kenya.This idea of hiding girls until pregnancy is over only fuels a repeat of the same incidence.

Lucia Buyanza
Reproductive Health

MaDube's picture

Dear Sis Lucia

You story captures the inter-sectionality of poverty, crime, orphan hood, sexual abuse, education-including reproductive health education, teenage pregnancy and HIV/AIDS. It is a well written piece and I love the solutions you suggest to give these young, orphaned and poor girls a chance to make it in life.

Best,

MaDube

Okeny-Lucia's picture

Ma Dube my sister,Thank you

Much said and much more to be done and am getting now a little bit of usage of twitter by a childhood friend who is a computer wizard,so that we truly launch at the end of the year to schools ,communities.
Thank for your inspiration.Your feature story was powerful.
Regards

Lucia Buyanza
Reproductive Health

Ruun Abdi's picture

Dear Lucia, Congratulations

Dear Lucia,

Congratulations for a well written story.... Thanks for staying on this story and for the Twitter suggestion for this kind of issues. I really enjoyed reading it as if you were telling me the story face to face as before.

Looking forward reading the other story we talked about :)

Much love and admiration

Okeny-Lucia's picture

Thanks Ruun

I am also inspired by some f the stories you wrote.It was challenging for me t take in some f the comments the guardian and the girl had to say. do hope to take health issues to the next level.

Lucia Buyanza
Reproductive Health

Farona's picture

This is one of my favorite

This is one of my favorite written article of yours! Despite the obvious hardship, what you achieved here is remarkable. Congratulations!

Okeny-Lucia's picture

Thank you Farona!

Dearest Farona,this article had alot of team work to make it reach this far.I am greatful for all the insights you provided.This is why VOF is so powerful because of the strength we get from each other.Thank you

Lucia Buyanza
Reproductive Health

Stella Paul's picture

Group education

Dear Lucia

This is a fine piece of writing and very well researched too. I really feel that churches can play a far more active role than they perhaps do now, in checking sexual violence against teens and pre-teens. Its in human nature to look for reassurance and solace, especially of the spiritual kind when hurt. This is why church can, through its youth ministry, reach out to the young ones,counsel them and help them though the difficulties. But yes, the church also has to act more like a friend than a rod-wielding teacher of sort.

The other thing is a helpline. I think a toll-free phone number would really help a lot of people in seeking timely help and intervention.

All the best to Sasi and her child. And love to you!

Stella Paul
Twitter: @stellasglobe

Okeny-Lucia's picture

Group Education

Your reflections have always helped me reflect on possible alternatives I could take.I like the idea of a toll-free-helpline.It is appealing,already am exploring means of meeting with other stakeholders who work with the youth to find an affordable way of reaching to pupils and the youth.

Thank you and I wish you also well in your endeavors in London.

Lucia Buyanza
Reproductive Health

mrbeckbeck's picture

Growing up fast

Wow, Lucia, you've really done a great job tackling a big topic here. Sexual health education is so important for shaping behaviors, culture and the future that youth will be living in soon. It will take time to see changes, but it seems that work is being done to help accelerate that-- I love the idea of text message and Twitter help lines and resources. Funding education in schools is another step, part of a more holistic approach that takes care of kids all around. I applaud your work to support these changes and make a better world for Sasi and girls like her.

You're so inspiring Lucia! Keep up the great work, I know you are going to make Kenya's future so much brighter!
Scott

Scott Beck
World Pulse Online Community Manager

naught's picture

education

I do believe that education is the key to success it sounds like a cliche but it is true. these young girls are not getting the information they need to keep themselves safe well safe as possible. Even education about what rape is and that they are not to blame would be a helpful tool for young women. Even in the united states rape victims are afraid to tell anyone about being raped because they feel like they are in some way to be blamed for the criminal act but with more education and open talks about rape that could change someones life. Of course this type of education will be stopped just like sex education in schools has been seen as the parents job but parents are not doing their job very effectivly. Many parents want to protect their children from any harm and growing up to fast but if I had to choose between my daughters knowing that rape wasn't their fault and growing up too fast I say let them grow. I want all children in this world to be safe from harm and if talking to them about some uncomfortable issues helps them stay safe then we as parents have to put that uncomfortable conversation at the top of our to do list.

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