Secretary of State Hillary Clinton hosted the first-ever event at the State Department to commemorate Zero Tolerance to Female Genital Mutilation/Cutting (FGM/C) Day on Feb. 16. Guest speakers and a panel of experts included Congressman Joseph Crowley (who has co-sponsored the “Girls Protection Act of 2011” that would make it a crime to transport girls overseas for FGM/C), and representatives from NGOs, Islamic organizations, and the UN who have worked on ending FGM/C.
State Department photo by Michael Gross.
At the Fourth World Conference on Women in Beijing in 1995, Clinton, then-U.S. First Lady, proclaimed that FGM/C is a violation of human rights. Human rights are women’s rights, and that women’s rights are human rights, she said. Since then, there has been significant global progress in the movement to stop this harmful practice that has affected between 100 million to 140 million girls worldwide, with negative physical and mental health effects. Much more attention is being paid to the harmful effects and the magnitude of the practice, from the international level down to small villages. To date, 18 African countries have outlawed the practice of FGM/C.
Clinton recalled visiting a village in Senegal in 1997 and seeing how progress can be made firsthand. The village elders had been thinking of the detrimental health and quality of life effects of FGM/C on their daughters and they decided the practice had to end, despite generations of tradition. Tostan worked with the community to put the emphasis of this social change on democracy and ensuring participation. Imams explicitly argued that there was no religious basis for FGM/C. The key, according to Clinton, was that there was no finger pointing; no one came from the outside to enforce a change of tradition. PRB’s Women’s Edition journalists learned the same lessons in their field visit to two villages in Senegal where Tostan has worked to further education and knowledge about democracy and human rights. This visit, during the recent International Conference on Family Planning, highlighted the gains that have been made in the empowerment of girls, the end of harmful traditional practices, and economic advances throughout the villages (see the slideshow below).
In Guinea, a woman receives training in problem-solving skills as part of USAID-supported efforts to encourage communities to abandon female genital mutilation. Photo Credit: Elizabeth Fakan, USAID
by Sandra Jordan, Communication and Outreach Advisor, USAID Bureau for Global Health
Today is the International Day of Zero Tolerance for Female Genital Mutilation and Cutting (FGM/C). Worldwide, 100 to 145 million women have been subjected to this practice, which can range from nicking the skin to a total removal of the external female genitalia. Every day, 6,000 girls are at risk.
Zero Tolerance Day is an opportunity to raise awareness about the harmful effects of FGM/C and unite communities around the world in calling for an end to the practice. FGM/C is practiced across cultures and religions—though notably, major religious doctrines do not mandate the practice. It is most common in Africa, the Middle East, and some countries in Asia. However, it also can be found in the United States, Europe, and other places where migrants bring their cultural traditions with them. Parents and communities practice FGM/C based on cultural beliefs about health, hygiene, and women’s sexuality. In many cases, it is considered a traditional rite of passage.
However, research has consistently shown that all forms of the practice harm women’s health. It causes serious pain, trauma, and frequently severe physical complications such as bleeding, infections, or even death. In the long term, it can also lead to recurrent infections, infertility, and difficult or dangerous childbirth that threatens the lives of both mother and infant.
A young mother lies with her newborn child. Photo Credit: UNFPA
by Mary Ellen Stanton, CNM, USAID Senior Maternal Health Advisor
When I started midwifery training decades ago in the United States, in the hospital where I worked, I first saw evidence of disrespect and abuse of women in labor. Women were separated from families and visitors from admission to discharge four days later and, in the second and third stages of labor, their legs were secured by stirrups and their wrists put in leather restraints. Soon after, I worked in West Africa in a government maternity and witnessed women being verbally abused — “if you don’t push and your baby is born dead, it will be your fault” – and physically abused by slapping and massive fundal pressure to force delivery. Women were ridiculed for making too much noise in labor — and then were chastised if they were silent and delivered alone.
Fast forward decades later. As I visit maternity services in a number of countries, I don’t need to look far to see and hear evidence of disrespect and abuse of women in childbirth. A convulsing woman in labor on the steps of an urban referral hospital turned away from because she cannot pay. A doctor who derides poor women for not using family planning to control their fertility. A nurse who tells me that postpartum mothers “sneak in” to see their hospitalized newborns at night, while the families seek to find funds to pay the bills in order to get their newborns discharged. Unclothed women laboring and giving birth as visitors walk by. A researcher who tells of a postpartum mother being detained for months because she could not pay her bill. The human rights worker who tells me that refugee women are discriminated against in childbirth and that one refugee was forced to keep her stillborn in her bed with her for 24 hours against her will.
In an essay in the Sunday, Oct. 23 New York Times, Helen Epstein asks, “Could a ‘contraceptive talking cure’ work in Africa in our own century?” With this question, Epstein zeroes in on a critical aspect of successful family planning: communication between spouses.
As she goes on to note, researchers have long known that open communication between husbands and wives is positively and strongly associated with contraceptive use. Unfortunately, the presumption that men are the decision-makers and the taboo nature of sex means that most African couples do not frequently engage in frank discussions about family planning. Women may be afraid to raise the issue with their husband, assuming that he is opposed to contraception, while men may lack information about contraceptive methods and the benefits of family planning. This absence of communication is not only an impediment to contraceptive uptake, it is also a missed opportunity for increasing gender equity.
Empowering women to make decisions about family planning often means involving men as partners. Constructive men’s engagement is an approach that increases men’s support for women’s sexual and reproductive health, promotes gender equity, and improves the reproductive health of men as well as women. Reproductive health and family planning programs that seek to constructively engage men by fostering open communication and joint decision-making between spouses not only increase contraceptive use but also promote equality within the relationship and increase women’s decision-making power overall.
by Farahnaz Zahidi Moazzam, PRB Women’s Edition Journalist
My name is Farahnaz Zahidi Moazzam, and I’m a freelance journalist, writer, and editor from Pakistan. My passion is writing about human rights with a special focus on gender issues and reproductive health. Blogging is a personal joy to me, as I put my heart into my writing and blogging allows for a more personalized style. Digital journalism is a sign of evolution – one I happily accept. My pet peeve is marginalization on any grounds. I am a mother of a teenage daughter and live in Karachi.
As part of PRB’s group of journalists in Women’s Edition 2010-2012, I recently had the chance to travel to Ethiopia on a visit that was unforgettable. The visit inspired a series of seven brief travel-blogs, based on my seven days there. Women’s Edition is a wonderful opportunity to connect with other like-minded female journalists from developing countries around the world, and learn solutions to the problems from this interaction. The program has reaffirmed my belief that our commonalities are more than the differences.
Read Farahnaz Zahidi Moazzam’s posts from her trip to Ethiopia on her blog,Impassioned Ramblings.
by Charlotte Feldman-Jacobs, program director, Gender
I went to a session at the World Bank last week and learned some valuable lessons from a colleague at Gender Action: Show up, sit near the front, listen politely to the presentations, and then ask “Show me the money, please.”
The title of the session was “Women’s and Girls’ Health: Initiatives, Impediments, and Links to Development.” The panelists were impressive: Nyaradzayi Gumbonzvanda, general secretary of the World YWCA and member of the African Women Leaders Network; Michael Anderson, director of General Policy and Global Issues, British Department for International Development (DFID); Gill Greer, director general of International Planned Parenthood Federation (IPPF); and two World Bank leaders, Ian Solomon, U.S. executive director, and Cristian Baeza, director for Health, Nutrition, and Population.
All of the panelists underscored the importance of working with women and girls, calling for recognition that investing in girls and women is “good economics,” and a “moral imperative”; pointing out the barriers that women and girls face—including low education, legal barriers, and reproductive health risks such as high HIV and maternal mortality rates. Important statistics were disclosed about women and youth—in sub-Saharan Africa, girls make up 75 percent of new HIV infections and 85 percent of Kenya’s population is under age 35 (and it should have been added that 43 percent of women in Kenya are under 15). Plans and promises were disclosed: UK’s international development budget will go up by 33 percent in the next three years, with girls and women’s share rising even more; IPPF has a new initiative called “Girls Decide” which will focus on empowerment, access to youth services; and right-based approaches in reproductive health policies (specifically in ending child marriage).
But it was in the brief Q&A period that the real lesson came for me. That was when the Gender Action representative stood up and asked politely of Mr. Baeza about the World Bank’s commitment to reproductive health for women and girls. She came armed with statistics, asking about the disconnect between the World Bank’s expressed commitment when she had just learned that in Uganda, for example, only 0.3% of the World Bank expenditure in that country is for reproductive health. She also questioned whether it was reasonable for Mr. Baeza, in his presentation, to state that the World Bank “needed to have demands from countries” in order to meet the moral imperative of investing in womens’ and girls’ health. It became clear that this Gender Action representative had come to hold organizations, particularly the World Bank,accountable—a word we hear a lot these days. I, for one, enjoyed the lesson, and I thank my colleague for providing an example of just how that works.
Recentmedia reports have focused on the stalled progress for women in Afghanistan and the shift in the international community’s focus as they take steps towards an eventual military withdrawl. Although there’s much work to be done, it’s important to note that there has been tangible improvement for women in Afghanistan. A decade ago, women weren’t allowed to go out in public alone. Girls weren’t allowed to attend school – now 57 percent of girls are in school. And gender issues are now being integrated into government policy.
At an International Gender Working Group (IGWG) Plenary in honor of 2011 International Women’s Day hosted by PATH in Washington DC, Karen Hardee, a senior fellow at PRB and president of Hardee Associates, presented her involvement towards developing the National Gender Strategy for the Afghanistan Ministry of Public Health for 2011-2015. Much international development program and policy advocacy calls for attention to “gender,” but what does the term mean? “Gender isn’t just about women,” said Hardee, but is defined as the social roles that men and women play because of the way society is organized. But these roles aren’t set in stone; they can change over time.
Funded by USAID, the Health Services Support Project worked with the Afghan government to create a plan to integrate gender considerations into all public health programs and policies, focusing mostly on mental health and gender-based violence. Interestingly, the impetus of the process stemmed the initiative of a male official in the Ministry of Public Health who requested assistance to write a plan to integrate gender into the Ministry’s policies and programs. Having participated in WHO-sponsored gender training workshops in the past, he understood the importance of mainstreaming gender awareness for both men and women. It’s a great example of the tangible effects of the work being done on gender by NGOs and international donors.
Afghan Ministry of Public Health Gender Training Workshop
Of course, creating policies does not automatically ensure smooth implementation. On paper, Afghanistan is very supportive of gender issues: its constitution calls for gender equality, it has ratified the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW), it enacted a law on the elimination of violence against women in 2009, etc. How these policies are implemented and affect the lives of ordinary Afghans across the country is the real issue. Now that gender issues have been integrated into the Ministry of Public Health, its time for the hard work of creating the operational plan. Considering the weakness of the central government in many rural areas, this could be a challenge. Another challenge in creating an environment that supports gender equality is the fact that health is more conducive to these issues than others. For example, integrating gender into land reform is much more difficult due to the deeply engrained social and political hierarchies of land tenure and rights.
Karen Hardee with a photo of the Afghan Ministry of Public Health building
In 2003 I wrote an article for the journal American Psychologist entitled “Being Born Female is Dangerous to Your Health.” It was a part of a special issue on population, reproductive health, and gender, spearheaded by psychologist and researcher, Dr. Henry David. Henry, who passed away in December 2009, was a pioneer in championing women’s reproductive health and rights and his work over many decades validated that family planning, with legal and safe abortion as a back-up, are vital components of both.
As a psychologist, Henry knew that the availability of wide-ranging reproductive health services is necessary but not sufficient. Women must have at least some sense of autonomy to act on their desire to avoid, delay, space, or limit pregnancies. He understood that autonomy in this area is not isolated but flows from a broader autonomy in women’s lives, and he applauded the growing attention to gender issues that followed the 1994 Cairo Conference on Population and Development.
Earlier this year, at a Hewlett Foundation meeting on population and poverty in Marseille, I thought of Henry as several presentations highlighted interventions that empowered women. In particular, I felt that Henry would have been delighted to hear Esther Duflo of MIT’s Poverty Labspeak about the impact of structural change on women’s status. She presented evidence that in India the law mandating that at least one-third of the seats and one-third of the leadership of each village council (panchayat) be reserved for women has had significant results. Compared to similar places where the law was not implemented, the women panchayat leaders were able to bring about positive change in areas of high priority to women, such as drinking water supply and quality. Over time, men rated female leaders as equal to male leaders. In addition, women had greater political participation in villages where panchayat leaders were women.
Today, on Women’s Day, I am glad to unite — at least in thought — Henry David and Esther Duflo, both of whose work gives us hope for the future. Someday there will be a sequel to my article, and it will be entitled “Being Born Female: It’s a Good Thing.”
PRB is celebrating the 100th anniversary of International Women’s Day with the launch of The World’s Women and Girls 2011 Data Sheet. Find more materials on PRB’s website.
March 8, 2011, is the 100th anniversary of International Women’s Day. It is hard to imagine that just 100 years ago, in 1911, women in the United States were still nine years shy of getting the vote. The women’s suffrage movement was going strong, and women in Wyoming had had the vote since Wyoming achieved statehood in 1890, but it was not until the 19th Amendment to the Constitution that women throughout the United States were finally afforded the right to vote in 1920.
In 1911, the U.S. population was 92 million, less than one-third of its current size of about 310 million. Life expectancy was 54 years for women and 51 for men. The leading cause of death, after heart disease, was tuberculosis. And 1 in10 children died before his or her first birthday. Our U.S. statistics of 100 years ago are much like those of sub-Saharan Africa today.
After spending almost a month in Mali, I am thoroughly convinced that Malian women can and will transform and market just about anything that is potentially edible, drinkable, or wearable. In this story, I am introducing three old friends. Two attended the ad hoc training program that Mariam and I implemented in 1974- 75. The third one was a leader in the Functional Literacy Office in Bamako when I worked in Mali. These three remarkable women were all part of the group I looked up during my recent visit to see what they had done since the early 1970s. It turns out that all three have built up very successful small businesses. But the most remarkable thing is that all three have combined their economic pursuits with social outreach activities, in support of women’s and youth groups. It is noteworthy that in many of these groups men participate as well, because they want to learn new skills that will allow them to be productive and earn money. However, so far the men have remained a small minority.
by Elaine Murphy, visiting senior fellow at PRB
