Yesterday I ate my last Kenyan fish fry with ugali and sukuma wiki, which nearly left me crying over my plate. I am already telling myself I’ll come back and bring my husband and hopefully family so that they can also appreciate this beautiful place. I am so grateful for the opportunity to work and live here for a bit, and I have such deep respect for colleagues that continue to advocate for a world where no woman or girl ever dies from unsafe abortion- a world where women can decide if and when to have children, and access the resources needed to raise them in a healthy and supportive environment. We can’t know whether this might be a reality in our lifetime, but the deep transformations of the community members, providers, and decision-makers that the Ipas Africa Alliance works with fills me with optimism.
Last week I had the chance to present to Ipas staff on some of the work I’ve been privileged to do while here. Though I primarily sought to collect and organize feedback from community health volunteers, providers, youth champions and leaders of community-based organizations on how Ipas can improve its’ work to refer young women for contraception, I quickly realized the positive impact that these efforts are having on the people implementing the program themselves.- people like Silvester, from community organization Mitume Mantix, and Nerrie, a Youth Champion at Maseno University. They are the
“If I am a man, when my girlfriend tells me she wants to go for contraceptives, it’s high time for me to stop thinking she’s being unfaithful, or that she’s being promiscuous. Let us support them. I tell them (young men), ‘If you are in form one and your girlfriend is in form two, and if by bad luck you impregnate this girl, you won’t be at peace, because maybe you’ll be arrested, maybe you’ll be taken to court for these things, or rather maybe you will run away from your place, your home, so you’ll also be affecting your education… If you feel you are in an in-love relationship, support her! Go for the contraceptives, and see her through her education, so that if you meet somewhere in the future, you can enjoy your relationship.’ “ – Silvester, of CBO Mitume Mantix, an Ipas community partner
“The project has changed me in lots and lots of ways. It has provided me with a platform to develop my leadership skills and to also empower others on issues dealing with their sexual and reproductive health. Implementing Ipas’ Choice for Change project and working with the Youth Champions across Maseno University has been very fulfilling and a good learning experience regarding challenges faced by the youth on matters regarding their reproductive health. Ipas has taken me places I would have never dreamed of and provided me with invaluable experience that I wouldn’t have stumbled across on a normal day.” – Nerrie, Youth Champion with Ipas’ Choice for Change program, which seeks to increase young women’s access to contraceptives.
These and many more agents of change are the hopeful vision for a more just world that we must all invest in. For every person who has told me that Kenya has a long way to go regarding sexual and reproductive rights, I fully believe that Kenya is already well into that journey, with Ipas staff and those they work with leading the way.
As I think about arriving back home, I am filled with excitement to see family and friends, but a part of me will always remain in Kenya. It’s been one of the honors of my life to be here. Thank you, Ipas and thank you to the Ipas Liz Maguire Fellowship for Young Leaders for this incredible opportunity.
The highlight of this week was co-facilitating focus groups with Youth Champions in charge of implementing the Ipas Africa Alliance’s Choice for Change (C4C) project at two universities in Eastern Kenya on what resources they think young people need to care for their sexual and reproductive health and live their best lives. This was an activity to inform a webage that the Alliance is designing, which will link to their Nimechanuka Facebook and Twitter feeds (Nimechanuka, I am told, means “I am enlightened/empowered” in Kiswahili).
Spending time with these awesome young people reminded me of how much I miss working directly with youth, how much I love sex ed, and how full of hope and amazing ideas so many of them are. There were also several hilarious moments like when we we talked about the fear that sooo many young people have that the natural size and shape of their genitalia are abnormal. This is apparently a global concern for young folks since the youth I worked with in North Carolina and Georgia were equally worried. ALL OF YA’ PARTS ARE NORMAL. lol We had a good laugh.
After the focus groups were over, I had the honor of sitting down with two of the brilliant Youth Champions one-on-one to talk about their work to refer young women on their campuses for contraception. They had a lot to say about the work and what motivates them, and how the training and support they’ve received from the Ipas Africa Alliance has changed the way they view themselves and the importance of sexual and reproductive health and rights. They’ve generously given me permission to share their feedback and photos.
Meet Morra*. Don’t let her small stature fool you- she’s is on fire for reproductive health and rights! She’s also got great style, so we clearly hit it off! 🙂 Here’s what she had to say about her work with Ipas during our interview this week:
“They (other young women) tell me they admire my confidence and I tell them they too need to be confident. It’s important in our society where the feminine gender is considered inferior.”
What impact has the Choice for Change (C4C) program had on young people in your community?
“Through this program, youth have been able to learn facts about contraceptives. You know there’s been so much fiction and in fact, (before) if you ask a lady why she can’t go for contraceptives, people surely will tell you that, “You know, I would grow fat, I would grow thin, I would lose my shape.” But now… they are able to get the facts on importance and effects of contraceptives. And they have been able to access contraceptives in the right place from the health practitioners… They’re first advised by the health practitioner, they’re given a variety (of options) so you make a decision, an informed decision.”
What has your experience been like working with Ipas to implement C4C?
“When I first started this I was green. But you see I have gained a lot of information. Initially I was afraid of talking about contraceptives, but now I’m courageous. I can teach people. In fact, I have really gained knowledge. I have also been able to convince some other people. I have advised them on the right way to make informed decisions.”
How has the program changed you?
“Initially, I wouldn’t advise somebody to go for contraception. The only thing I knew was you would bleed. But now I know it is not that bleeding like I thought. That bleeding is just for a short time before the body gets to be compatible with the new substance that has been introduced into the body. So it changed by perception about contraceptives and in that way, I’ve also helped change other people’s perceptions who thought the same as me. They (other young women) tell me they admire my confidence and I tell them they too need to be confident. It’s important in our society where the feminine gender is considered inferior.”
What motivates you do refer other young people for contraception?
“I was born out of wedlock. Because one, my mom wasn’t informed about contraceptives… She was the only bread winner. She told me my father left before I was born. So, at least I can help a few.”
“There’s (also) a number of drop outs on my (campus)…. I just want to reach out to any people so that they can make informed decisions. Prevent the unplanned pregnancies, the STIs, the HIV, and children who are born out of wedlock.”
How do you feel when you refer other young people for contraception?
“The feeling is incredible. I just can’t get a suitable word. But it makes me smile knowing that I have achieved my objectives (sensitization and referral). Helping the youth, especially ladies, make informed choices is just my happiness.”
If only we were all this wise in college! Can we please give this woman a standing ovation? ❤
The other young person I had the honor of talking to this week was Cleophas. Here’s a photo of him breaking down the importance of safe sex and contraception for his peers during the focus group,* and what he had to say about his work with Ipas:
“I’ve had the chance to change the lives of those other innocent students, because we have had cases of students who are procuring unsafe abortion before, but now they are able to access contraceptives so that they do not reach to that stage of unsafe abortion.”
Tell me about your work with the Ipas Choice for Change (C4C) program.
“What I do normally, I reach out to students. I attend to so many students. I do counseling, peer education…. I also do referrals to the link students to health centers that Ipas is working with. So these are just the kind of groups we are referring students to. I also do a lot of phone calls to attend to students. I do one-on-one chats. We do chats on social media. At times I even stay awake, like, throughout the night because students just keep on asking me questions.”
How confident do you feel answering the questions students ask?
“At first I didn’t feel that confident because my experience with Ipas has been gradual. It has not been so immediate that way, because the research, at first I was a bit naïve talking about matters concerning sexuality, but through the training, capacity building, networking and advocacy trainings that we were taken through, I was able to gain that confidence and I’m able to counsel and offer guidance.”
What has your experience been like working with Ipas to implement C4C?
“It has been extremely positive working for C4C as a champion, I am reaching (out) to other students and changing even my life as an individual… I know much on contraceptives and I’ve had the chance to change the lives of those other innocent students, because we have had cases of students who are procuring unsafe abortion before, but now they are able to access contraceptives so that they do not reach the stage of unsafe abortion.”
How beneficial has C4C been to your community?
“It has been extremely beneficial because since the time I came here the lives has just changed. People have just changed with Ipas…When I came here back in 2014, there was a lot of pregnant women in the community. People even branded the university… like a maternity (ward)… So, you know, that time so many students were pregnant but within a short while this pregnancy just disappears. So, it never disappeared in a positive way, you know in a good way, but people are procuring unsafe abortion. But now through the information Ipas has impacted students, and you know even when I walk along the corridors of JOOUST, there is a name a lot of students have branded me, they do call me “Ipas.” Because when they see me they see hope… When they see me, they see a solution to reproductive health (problems).”
Aren’t they AMAZING?! If there’s hope for the world, it rests on our willingness to invest in youth like Morra and Cleophas.
*Both Morra and Cleophas gave written permission to be interviewed and for their photos and names to be shared.
Since arriving in Kisumu last Sunday, I’ve met some amazing staff at the Kisumu Africa Alliance Office. They’ve been incredibly kind to me, insisting that I “take tea” with them, introducing me to their delicious pilau rice and teaching me some very helpful Kiswahili phrases, like habari za asubuhi (good morning) and habari yako (how are you).
On Monday, a younger staff member around my same age invited me to visit her friend who had just given birth. I didn’t want to intrude on the visit, but she insisted that she wanted me to come along. Just three days old, her friend’s baby girl was so sweet, with chubby little cheeks tucked under a little hat with a baby giraffe on the front, and I had fun entertaining her two-year-old brother as the adults chatted.
On the way back from the visit, I thanked my new co-worker for inviting me along, and we got to talking about how precious the baby is and how we both want to be mothers one day. We also laughed about how we also treasure our sleep and freedom, and how drastically motherhood would impact those things. Then she said, “It’s also that pregnancy is dangerous here you know? Even at the hospitals, sometimes they can’t save you. Many women die.” Her words made my chest ache and were a testament to the perverse amount of privilege I carry. This talented woman, formally educated, well-traveled and doing quite well by Kenyan economic standards, had to factor-in to her decisions about childbearing a maternal mortality rate 13 times that of the U.S.
This is why I am proud, every day, of the work my Ipas colleagues do to reduce maternal mortality and advocate for women’s dignity no matter her reproductive choices. That’s part of what reproductive justice is about after all- freedom and dignity when exercising one’s reproductive rights. The Sistersong Women of Color Reproductive Justice Collective, a U.S.-based network of individuals and organizations that works to improve institutional policies and systems that impact the reproductive lives of marginalized communities, provides a more complete definition:
“Reproductive Justice is the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.”
I believe we can and must work diligently to demand, defend and uplift reproductive justice, within our own communities and as allies to the communities of all women and their families. Don’t you?
Today marks the end of my second day of the Ipas Maguire Fellowship at the Ipas Africa Alliance in Kenya and I am still STOKED. Monday was spent meeting many new and friendly faces and getting acclimated with the support of the Alliance’s amazing HR staff. Today, I celebrated my birthday with the most delicious surprise birthday cake, something I was not at all expecting, being so new to this office. I was pretty moved. I mean, who does that for someone they barely know? Apparently the Alliance Office does ❤.
In the afternoon, I traveled to Kiambu County to shadow Choice for Change (C4C) Program staff. C4C is an Alliance program that promotes uptake of long-acting reversible contraceptives (LARC) among adolescents and young people by 1) Improving service delivery at health facilities through provider training in values clarification, youth-friendly services and LARC placement (basically, how to provide LARC to youth and be nice about it!), 2) Activating community groups to mobilize them in favor of promoting and/or referring for the use of contraception, with a focus on LARCs and safer sex via condom use, among the young people in their county, and 3) Working with county health officials and other stakeholders to advocate for the inclusion of reproductive health funding in county budgets.
The program ‘s slogan is Maisha Poa, Future Poa, Chaguo Langu– Swahili for “Good life, Good future, My Choice”. I love that it embraces reproductive autonomy, a pillar of sexual and reproductive health and rights. The program aims to reach girls with information about contraceptives, especially the benefits of LARC, from age 10 up through age 24- taking into account the realities of the young people they aim to reach and the need to inform girls of the options available to them well before they are sexually active. While many adults may be loath to admit that someone as young as 14 may need LARC, there is undoubtedly a need to equip very young women with more discreet options and less user-dependent methods of preventing pregnancy, especially given the reality of early sexual activity and power imbalances in too many sexual relationships. While the program doesn’t address gender inequality directly, it’s beyond argument that programs like these help facilitate women’s and girls’ access to opportunities toward self-fulfillment by delaying childbearing.
Kiambu County is in the Nairobi Metropolitan Region, and hosts beautiful stretches of green farmland. 14% of girls aged 15-19 years have given birth in this county, which is lower than the national level of 18% (Kenya National Bureau of Statistics, 2010). This rate is still pretty high, and county health officials are eager to see it come down. Side note: I think one of the things that felt incredibly ironic today, was the fact that many Kenyan health leaders seem to want everyone in their country to have a basic level of access to medical care, whereas my leaders largely seek to strip it away from anyone they see as undeserving. I’m over-simplifying here, but I think the overall point is still valid and shameful in a country with a GDP as high as that of the U.S.
Anyhow, on this visit, the Alliance’s Youth Program Advisor, Moses Kidi, gave an overview of the program to Kiambu County Community Health Workers (CHWs). Peppering his explanation of the program’s comprehensive Community Referral Strategy with anecdotes about the unfair burden carried by too many young girls, particularly those born into poverty, who have been denied access to information and reproductive healthcare, Moses makes a compelling argument for working to improve the life chances of women and girls. He described the story of a girl who was forced to sleep with her uncle as he paid school fees for her and her siblings. If there wasn’t a way to remove her from that situation immediately, LARC might be her only option for delaying pregnancy, but adult judgement at her request for contraception would likely shut-down her down and squander the one chance to help her from within the healthcare system. He also made a strong economic argument for the program, highlighting the negative impact overpopulation can have on a country’s economic growth. The CHWs seemed to identify strongly with his arguments, and shared some of their own.
I could see that promoters seemed genuinely interested and committed to this work, and a visit later in the day to a sub-county hospital (mid-level hospital) and dispensary (primary care clinic) provided evidence that their work is paying off. At the first facility, the number of patients seeking family planning services has nearly doubled since it became an official intervention site just about six months ago. The provider there shared with me that Implanon is most popular among young women, and that having LARC prevents young girls from having to return to the facility regularly, which is important as her community may speak poorly of her, assuming that her frequent visits are for contraception. While the program doesn’t address abortion directly, any person who appreciates real (not alternative) scientific research, can agree that this program prevents unwanted pregnancies, abortions and, given that safe, legal abortion is still out of reach for the vast majority of Kenyan women, girls and people with female reproductive organs, I have no doubt that it’s saving lives. One would think that anti-choice folk would be gaga over a program like this… but that’s another post!