Teen Girls Health & Empowerment in Uganda

Third term is quickly coming to an end for the students in Uganda. The kids are preparing to begin exams, after which they will be on the longest holiday of the year. We are attempting to squeeze in as many classes as we can with some of the local schools before they go on break.

Thus far, we have gone to two primary schools, and are planning one more this week. We are giving talks on health and wellness, primarily focusing our hour long discussion on menstruation, teaching it in a positive light.  Giving the workshops has been a lot of fun, as well as beneficial on both ends. Personally, I am learning quite a lot about what and what not to do or say when it comes to addressing a group of 50 girls between the ages of 10 and 14.

The first group we spoke to was at Luwero Boys. We arrived expecting to talk to only girls, as we were instructed, and found a group of both boys and girls seated before us anxiously waiting to be addressed by the group of mzungus. A bit surprised, I questioned the head teacher about the arrangement and before I knew it she was chasing the boys away. Now, arranged upon the grass was a group of 60 or so girls- chatty and intrigued. I greeted them in English, as Madame Jolly interpreted what I said into a language they could better grasp. I must say it was quite noisy; we were situated opposite the main road in Kasana and speaking over the bodas and speeding matatus as well as Madame Jolly’s interpretation…I hope that the girls at least learned a bit.

Towards the end we opened the floor to questions, but received only two: “What if I jump too much” as well as “Why we get pains?” Answering both to the best of my ability, we ended the discussion a bit earlier than I would have liked.  But lesson learned- bring a midwife to do appropriate translating.

The next school was Luwero Islamic Primary. I arrived with a tinge of fear, as there was no midwife to accompany us. We waited in the main office for 15 or so minutes, and were greeted through the barred windows every couple of seconds by heads of recess goers bobbing up and down through the barred window. After the “bell” rang (a car tire rim and a metal rod) we were escorted to a classroom 54 young ladies in hijabs.

Emanuel, their English teacher, introduced us and then took his seat at a desk on the side of the room. I would speak, and if there seemed to be a misunderstanding he would rephrase, in English, what had said. I was very excited as it was obvious the girls had taken a class before on reproduction and knew the answers to the questions I asked- so we turned the table to them. At first they were modest and quiet, but as soon as we gave out scraps of paper to write questions the questions came pouring out.

The modest common question was about pains, what they are, and how to deal with them. But others were about breast milk, discharge, and even HIV. This a good note to have for future reference, that when the Q and A portion of the talk arise it is a good idea to have them write questions down. I am very grateful to have had Emanuel, as he assisted the entire lesson and cleared up any misunderstandings on for both the class and myself.

Unfortunately this time we were on a time crunch, as there was a staff meeting happening at the same time. We ended with a wave of thank yous on both sides, and scurried out the door to make it to Nsaasi Village on time. We were late, but happy. 

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it is the only thing that ever has.” - Margaret Mead

It is one of my last days at the beautiful Shanti Uganda birth centre. Suzan, a first time mom-to-be, is labouring in the shade of the garden surrounded by singing birds and the always shining Ugandan sun. I am so proud to see one of our passionate, skilled and committed midwives being with her and giving her new ideas about positions that can ease her labour. She is rubbing her back and helping her to breathe through the contractions. The words she said to Suzan were full of empowering and encouraging messages. Shanti is one of the rare maternity centers in Uganda where mother-centred and respectful care are part of the core values and mission.

In the 6 months I spent in Uganda, I was also working in a government hospital and was shocked by the conditions. There it is common for the staff to be overworked and be assigned work with a devastating lack of materials under miserable hygienic conditions. I have seen midwives shouting at women and slapping them during one of the most intimate and intense experiences in their life. I have seen women left alone in pain in the maternity ward, almost delivering on the floor. The women do not expect any privacy or respectful care during labour. According to the World’s Midwifery Report of 2014, a woman in sub-Saharan Africa is 100 times more likely to die during childbirth than in an industrialized country.

This is where Shanti makes a difference. The Teen Girls workshops and other programs that Shanti has created change the lives of women and girls in Uganda; giving them ideas about their rights and options by giving them the courage to articulate their thoughts and feelings. These projects have a great, long-lasting and sustainable impact on their lives and are vital because of the many challenges that women in Uganda have to face when it comes to pregnancy and birth. There are a wide variety of issues regarding access to health care, transport to a facility, the Ugandan health system, knowledge about pregnancy and birth related issues, nutrition, gender roles and, most importantly, skilled and trained birth attendants. Shanti is facing these many challenges by searching for solutions and responding to the real needs of people in the community. The midwives working at Shanti are blessed to have monthly training, helping them to provide the best maternal care possible. In my last week, I facilitated a training session about obstetric emergencies and neonatal resuscitation. It was a pleasure to share my knowledge with the midwives and see how interested and keen they are to learn more. All of our midwives are working together to accomplish the goal of having a healthy and happy mum and baby... and they are doing such a great job! I am so glad that a birth center like Shanti exists in a rural village in Uganda. I am thrilled to see how it is going to develop in the upcoming years, as Shanti continues the awesome work they do.