Before I travel to a new place, I make it a habit to read a couple of books on the country I’m visiting in order to get an overview of a country’s history, culture, politics and other pertinent issues. When I was selected to go to Ethiopia as a fellow with the International Reporting Project where I’d be learning about newborn, child and maternal health I found several fabulous books highlighting these issues.
One of the most powerful non-fiction books I read before I left for Ethiopia this past June was “There is No Me Without You” by award-wining journalist Melissa Fay Greene.
Greene’s moving book chronicles the life of one woman’s fight to save Ethiopia’s AIDS orphans during the height of the AIDS epidemic in Africa. Before reading the book, I honestly had no idea that Ethiopia was the second most impacted country in Africa by HIV/AIDS. Greene herself was unaware of the severity of the AIDS epidemic until she came across a New York Times Article in the summer of 2000.
On page 20 in her book, Greene writes:
Per the United Nations, in 2000 Africa was “a continent of orphans.” HIV and acquired AIDS had killed more than 21 million people, including 4 million children. More than 13 million children had been orphaned, 12 million of them in Sub-Saharan Africa. 25% of those lived in 2 countries: Nigeria and Ethiopia. In Ethiopia, 11% of the children were orphans.
Greene realized she could not turn a blind eye to this horrible tragedy and spent the next several years researching the origin and history of the HIV/AIDS, the development of antiretrovirals, the impact of AIDS in Africa and the plight of an entire generation of AIDS orphans. Her research resulted in her powerful book “There is No Me Without You” which is all shown through the eyes of one woman, Haregewoin Teferra, who dared to rescue these children, deemed untouchable and tragically left behind in the aftermath.
A book written on Amelezewd’s life.
It was within this mesmerizing, heart-breaking true story that I learned about Amelezewd and AHOPE for Children. Amelezewd Girma and her two younger brothers were AIDS orphans living with Haregewoin when it was discovered Amelezewd and one of her brothers were HIV positive and too sick for her to care for.
At the time, Ethiopia was overwhelmed with HIV/AIDS orphans (there were over 1.5 million in Sub-Saharan Africa by 2005) and Haregewoin searched desperately for a place that she could send Amelezewd and her brother to be properly cared for. Through Haregewoin’s search, she found Enat House for HIV-positive children which later was renamed AHOPE for Children, and Amelezewd and her brother Michael were placed there.
Sadly, it was too late for young Amelezewd who as a young teenager dreamed of getting an education and becoming a professor someday. Life-saving anti-retrovirals (ARV) that were widely available in the western world were still unaccessible in Sub-Saharan Africa where they needed them most. ARVs were not available in Ethiopia until 2005. Amelezewd passed away leaving behind a legacy of heartbreak and hope while her younger brother Michael survived thanks to the availability of ARV treatment. AHOPE meant that there was finally a hope for HIV positive children and they were no longer being sent to a place to be cared for before they died.
It was against this backdrop that I contacted AHOPE for Children and scheduled a site visit to meet with the director Mengesha Shibru during my reporting fellowship in Ethiopia this past June.
When I arrived in Ethiopia, it was impossible not to notice the frayed clothing worn by most rural Ethiopians. As an avid reader on global issues and extreme poverty, I couldn’t seem to get the fabulous non-fiction book “The Blue Sweater” by Jacqueline Novogratz out of my head. One of the unforgettable moments in Jacqueline’s life was when she was living in Rwanda and saw a young boy wearing her blue sweater that she had donated eleven years ago to a local American charity. Somehow that sweater with her initials still written clearly inside, made it all the way to Africa and was still being worn despite being tattered and frayed. It made Norogratz, a successful investment banker, think about how our world is interconnected, and it steered her life towards philanthropy.
Driving throughout the rural countryside of Ethiopia where over 90% of Ethiopia’s 90 million people live, frayed clothing is an omnipresent reminder of the high level of poverty in this part of the world. I saw toddlers wearing no bottoms, little boys wearing pink jackets, girls and women in a pell-mell of skirts, tops and dresses, and men wearing worn-out, patched up trousers. Shoes were rarely present especially on children. If shoes were worn, they were either too big, too small or torn.
I thought about my own children, comfortably back at home in Minnesota with more clothing in their closets and drawers than they could possibly wear to the point of wearing them out. The fact that twice a year I make the annual trip to Goodwill or Salvation Army where I unload all the unnecessary clothing that is supposed to go to the local community but like Norogratz’ blue sweater, most likely ends up somewhere in Africa.
Was some little girl out there wearing my daughter’s favorite dress? I am certain she is.
You cannot change the world, but you can change someone’s world.” -Mother Teresa
One night in 1992, Serawit “Cherry” Teketel, a young Ethiopian college graduate was driving home from dinner with her family when they came upon a moment that would change Cherry’s life forever. As their car pulled to a stop at a street corner in Addis Ababa, they saw a young woman flash them. The sight of this desperate prostitute who had no other way of earning a living, started a debate and made Cherry question her own circumstances in life. Although she was a recent university graduate, she had been unable to find a job for over a year but thankfully she had her family to fall back on. What if she didn’t have that luck? What if she was uneducated, poor and a single mother with no job? What would she do? Cherry’s questioning and compassion inspired her lifelong quest to get women off the streets and into a productive life away from prostitution.
After spending time on the streets, talking with girls and learning more about their issues, Cherry founded Women at Risk, a one-year rehabilitation program that aims to get girls and women out of prostitution and into a sustainable, self-reliant job and lifestyle. Women at Risk works on many different levels of rehabilitation. For the first six months, the women go through an extensive mental, physical and spiritual rehabilitation program that deals with addiction problems, health issues and psychological healing. The next six months involves skill training. Since Ethiopia has an extremely high unemployment rate and most of these women lack an education and come from severe poverty, vocational training is not an option. Cherry and her team realized that the women would need to have skills that would require little education and minimial training yet would provide them a livable income. After much brainstorming, Women at Risk implemented training courses in weaving, cooking and hairdressing.
During the year rehabilitation program, a woman must desire and commit to changing her life. In addition to the rehabilitation and skill training services, she will receive health care, day care, pocket money and groceries each week. Once she successfully completes the program, Women at Risk helps her gain employment or start her own small businesses a viable alternative to prostitution. Today, Cherry’s program has been a wonderful success. Women at Risk has helped over 360 women and over 90% of them have continued to live lives away from prostitution.
Ethiopia has one of the highest levels of poverty in the world. Many women are forced to work or live on the streets to support their family.
Close to the end of my two-week trip in Ethiopia as fellow with the International Reporting Project, my friend Elizabeth Ataley and I went to visit one of Women at Risk‘s partners Ellilta Products. We had heard about their gorgeous scarves through our social good blogging and work with ONE and fashionABLE. Both Elizabeth and I are proud owners and supporters of the Ellilta scarves sold in the US through fashionABLE so we wanted to meet with the women behind the scenes.
It is impossible to understand Ethiopia without visiting the countryside. In a country of 90 million people, the rural land of Ethiopia is where over 90% of Ethiopians live and catching a glimpse of their way of life is absolutely fascinating.
During my two weeks in Ethiopia as a fellow with the International Reporting Project, my favorite times were when we were outside of the cities and venturing along the bumpy, cattle-filled roads of rural Ethiopia. For me, the countryside is where the true heart and soul of Ethiopia and much of Africa lies. While some of the other fellows used our lengthy drives as time to catch up on much needed sleep, I sat at the edge of my seat with camera in hand, mesmerized by the world around me. A world I had never experienced yet a world I had imagined in my dreams.
This past June, I visited Ethiopia as a fellow with the International Reporting Project with the primary goal of examining the impact of Ethiopia’s success at achieving Millennium Development Goal (MDG) 4 – reducing child under age five deaths by two-thirds – well before the 2015 MDG deadline. Granted it is a stunning achievement that has put the spotlight on Ethiopia, it can also be argued that Ethiopia as well as many other countries around the world are failing to reach critical milestones for other MDGs such as maternal health. MDG 5 – to reduce maternal deaths by 75% and achieve universal access to reproductive health – is trailing way behind the other goals coming in near the bottom.
According to a recent article published in The Lancet*, only 16 countries out of the 189 United Nations member states who committed to the goals are expected to meet MDG 5 by 2015. The consequences of this are devastating to women and their families.
The tragic facts about maternal deaths
Every day, 800 women die from causes related to pregnancy or childbirth.
When a mother dies, the risk of death for her children under the age of five increases by 50%.
The number one killer of 15-19 year old girls worldwide is pregnancy and childbirth. Every year, 70,000 young women die as a result of pregnancy and childbirth – over 70% of these deaths are preventable.
Access to universal reproductive health, the other piece of MDG 5, is also lagging behind. There are millions of women, mostly poor and rural, who have no access to family planning and are unable to space or plan their children. Furthermore, this year alone it is estimated that nearly 22 million unsafe abortions will take place around the world resulting in millions of preventable maternal deaths and longterm disabilities.
Ethiopia, the second most populous country in Africa, is one of the five most dangerous places to be a mother in the world. One in 27 women die from complications of pregnancy or childbirth (25,000 annually) in Ethiopia.
With a population of 90 million, it is estimated that anywhere from 80-90 percent of mothers give birth at home with no trained assistant. In rural areas, where over 85% of the population live, it is even worse. Only an estimated 5% of mothers give birth in a health center with a trained delivery assistant. The chart below illustrates where Ethiopia falls compared with her neighbors:
How Ethiopia fares compared with her neighbors. Source: Marie Stopes International
This means that Ethiopia’s maternal mortality rate is estimated at 420 per 100,000 live births (2013 WHO/UNFPA) which lumps Ethiopia along with India, Pakistan, Afghanistan and Nigeria, as the top five highest maternal mortality rates in the world. As the population continues to boom in Ethiopia, it is critical that improvements are made to women’s access to family planning, safe abortions and labor and delivery care which would significantly reduce the number of women dying and having serious injuries during childbirth.
The alarmingly high ratios of health care professionals per patients is another factor in high maternal mortality rates in Ethiopia. It is estimated that only 34% of women have received prenatal care and 57% of women have received no pre or postnatal care during pregnancy. Source: Marie Stopes Ethiopia.
Seeing a huge, unmet need for family planning and reproductive services, Marie Stopes International begin working in Ethiopia in 1990. Marie Stopes International works to provide sexual and reproductive healthcare to millions of underserved women around the world and has been delivering family planning, safe abortion, and maternal health services to the world’s poorest and most vulnerable women for over 35 years.
“Women are dying because of lack of services and information. Having better access to family planning helps improve the lives of women and their families”.
– Marie Stopes Ethiopia Director Abeba Shibeau
Marie Stopes works in seven administrative states in Ethiopia, and runs a three-tier level of service throughout the country through Marie Stopes clinics, Blue Star franchises (600 Blue Star clinics in Ethiopia) and a call center that works nationwide. Before Marie Stopes entered Ethiopia, only 13% of the private sector clinics provided services in family planning yet the demand for contraceptives to space and limit children was and remains high. Only 29% of married women in Ethiopia are actively using contraceptives (Marie Stopes, Ethiopia) and an enormous unmet need exists for family planning.
Marie Stopes has filled this need by providing a call center and clinics that offer education, information and low-cost contraceptive options, pre and post natal care, HIV/AIDS prevention, diagnosis and treatment of sexually transmitted infections, and safe abortion when permitted, to woman and their families.
Expectant mothers checking in at a Marie Stopes Clinic in Addis Ababa.
“Ethiopia is a much better place to be a mother today than when my mother gave birth”.
– Nurse Shewaye, the Central Area Manager for all Marie Stopes Clinics in Addis Ababa.
An expectant mother relaxes a bit at a Marie Stopes clinic with her husband and son.
Another area that is helping save lives of women in Ethiopia and around the world is the provision of safe abortions.
Worldwide, one woman dies every 11 minutes from an unsafe abortion. Yet providing access to reproductive healthcare is one of the simplest and cheapest ways to save women’s lives. The World Health Organization (WHO), estimates that 5.5 million African women have an unsafe abortion every year. As many as 36,000 of these women die from the procedure, while millions more experience short- or long- term illness and disability. (Source: Guttmacher Institute)
Infographic on the impact of unsafe abortions. Source: Marie Stopes International
In 2005, Ethiopia expanded its abortion law making abortion legal for cases of rape, incest, fetal impairment, and if the pregnancy or delivery endangers a woman’s life. A woman may also legally terminate a pregnancy if she is a minor or physically or mentally unable to raise a child. Despite the changes in the law, almost 6 in 10 abortionsin Ethiopia are unsafe causing 13% of all maternal deaths.
A woman entering a place to have an unsafe abortion in Ethiopia. Source: Marie Stopes.
Progress has been made yet continued expansion of affordable and accessible family planning and reproductive services is critically needed especially for rural women who represent 82% of all women of reproductive age in Ethiopia.
There are many reasons for pursuing an unsafe abortion however most of the time it is due to the false belief that it is the cheapest method while in fact many of these underground illegal abortions cost more than a safe one.
Furthermore, religion, fear and cultural issues are other reasons why women especially young and rural ones, will pursue an unsafe abortion and risk their lives.
The Make Women Matter Campaign
As the deadline for the Millennium Development Goals draws to a close, Marie Stopes International has launched a new campaign calledMake Women Matter. The goal of the campaign is to ensure that maternal mortality remains at the top of the world agenda for future development goals. It also calls for achieving women’s rights and empowerment, universal access to sexual and reproductive health and rights, and ending unsafe abortion.
World leaders will be meeting in New York this September during UN Week to discuss the future of MDGs. To ensure that maternal health gets the critical attention it deserves, please spread the word by sharing this post. You can also personally make a difference by signing Marie Stopes petition at change.org by clicking here.
#makewomenmatter
Newborn baby in Hawassa, one of 10-20% of Ethiopia’s 3 million children born in a health facility.
Material in this post was provided by Marie Stopes in Ethiopia and the UK. To learn more about Marie Stopes International, please visit their webpage here. #makewomenmatter
USAID, Achieving the MDGs: The Contribution of fulfilling the unmet need for family planning, Washington DC: Futures Group International, 2006.
“If she wasn’t bleeding, she would have suffered like I did and delivered at home,” said Fasika’s* mother Menesch at a Lie and Wait center for expectant mothers in rural Ethiopia.
Menesch was inside the room with her expecting daughter Fasika while nursing her three-month-old daughter on a chair. It was Menesch’s eighth child who, like all the rest, she delivered at home with no trained labor assistant.
Menesch cradling her with-child in her lap at the Lie and Wait house in rural Ethiopia.
Fasika was a mere 15 years old with baby fat still surrounding her cheeks and a shy smile that often looked down at her largely pregnant belly. Meeting Fasika and her mother on the last day of my trip was the defining moment of my two weeks of reporting on maternal and newborn health in Ethiopia.
Ethiopia, a magical land of over 90 million people, is one of the most diverse nations in the world with over 83 distinct languages and 200 dialects. What stunned me the most about Ethiopians is how such a diverse group of people live in peace and harmony. Over half the population is Orthodox Christian and the next largest religious group is Muslims making up around 45% of the population. Despite their different religious beliefs, Muslims and Christians live side by side and oftentimes there can be a mixture of religions within families due to marriage. The main eight ethnic groups also live together peacefully which says a lot about this poverty-stricken nation in the heart of Africa.
While I was in Ethiopia these past two weeks, Oxford University released The Global Multidimensional Poverty Index (MPI), ranking Ethiopia as the second poorest country in the world just ahead of Niger. The report claims that although Ethiopia has made some progress, Ethiopia is still home to more than 76 million poor people, the fifth largest number in the world after India, China, Bangladesh and Pakistan. The report also claims that the highest percentage of poor live within the rural areas which is no surprise given the fact that over 85% of Ethiopians earn a living off the land.
Despite the often heartbreaking, overwhelming poverty of the Ethiopian people, the one thing they all seemed to have in common is resilience and resolve with their place in this world. I had never seen so many genuine, welcoming smiles upon their faces despite the hardships they face. I was always greeted with curiosity, warmth and kindness by the Ethiopians I met. Here are some of my favorite faces of Ethiopia.
Reaching Mosebo village, about 42 kilometers outside of Bahir Dar in rural Ethiopia is not for the faint at heart. It requires a land cruiser, patience, and a bit of adventure to cover the hour and a half drive on bumpy, muddy roads to reach Mosebo and see how over 90% of Ethiopians live. If it starts to rain as it frequently does during Ethiopia’s three month rainy season, the road becomes dangerous and impassable.
Once you leave the tarmac, you reach endless gravel roads and see the way the majority of Ethiopians live.
I visited Mosebo village as an International Reporting Project fellow to learn more about the miraculous success Ethiopia has made by achieving MDG 4 – reducing child mortality rates for children under five by two-thirds. Ethiopia stunned the world by achieving MDG 4 well ahead of the 2015 deadline yet there is still much progress to be made in reducing newborn deaths, particularly within the first 28 days of life which are the most dangerous days to be alive.
Per Save the Children’s “Ending Newborn Deaths Report”, every year one million babies die on the first and only day of life accounting for 44% of all deaths for children under the age of five. Nearly two million more children will die within their first month. Four out of five of these deaths are due to preventable, treatable causes such as preterm birth, infections and complications during childbirth.
Ethiopia, one of the poorest countries in Africa with a population of 90 million people, stunned the world by achieving the Millennium Development Goal #4 of reducing the mortality rates of children under age 5 by two-thirds well ahead of the 2015 deadline. In a country in which 95% of the population lives outside of an urban center in rural, remote and hard to reach areas and a shocking 80% of women birth at home without a midwife. Health Extension Workers (HEW) have been the key ingredient to Ethiopia’s success. However, sadly the rate of newborn survival in Ethiopia has not shown nearly as much progress.
Children in Mosebo Village 42 k away from Bahir Dar in Ethiopia.
As an international reporting fellow with the International Reporting Project, I am in Ethiopia for two weeks reporting on newborn health. I am meeting with a diverse variety of people around the country such as doctors, health officials, mothers, NGOs, midwives and health extension workers to learn about Ethiopia’s maternal, newborn and child health systems, policies and strategies for improving newborn health. On Monday, we had a presentation on maternal, newborn and child health in Ethiopia given by Dr. Abeba Bekele, the Program Manager at Save the Children Ethiopia’s Saving Newborn Lives Program.
I arrived early Sunday morning into Addis Ababa, the capital of Ethiopia, after a long haul flight from home. My day began Saturday at 3 am and after two fights totaling 16 hours I found myself in Africa’s highest capital Addis Ababa which translates into “new flower”.
Street shots of Addis Ababa
The earliest people living in the Shewa region surrounding Addis Ababa date back to the 9th century and are believed to be the Gurage people. Over the centuries the Somalis and Abyssinian kingdoms laid claim to the land, followed by the arrival of the Oromo in the 1500s. The actual city of Addis Ababa was not founded until 1886 when Emperor Menelik II decided to move his military base from Mount Entoto to the vast fertile plains below of Addis Ababa.
Today, Addis Ababa is Ethiopia’s largest city with an estimated population of over 3 million people and is a magical place where tradition and modernity are intertwined in unexpected ways. Walking down the busy streets of Addis Ababa you can see high rises and western hotels reaching towards the sky juxtaposed with dirt sidewalks, donkeys leaving the market and undeveloped slums. It is a place filled with contradiction. Looking outside the window of my newly built luxurious western hotel lies one of many slums slightly hidden behind corrugated tin fences and walls. Men in well-tailored suits sit outside in a chairs along dirt sidewalks getting a shoe shine. High rise buildings are going up alongside a pell-mell of depressing slums. Everywhere you look is something that makes you scratch your head and wonder.
Sometimes it is true that a picture can paint a thousand words. This week’s photo challenge: A Split-Second Story, inspired me to dig deep throughout my vast archive of photographs, each one telling a story of a certain place and time. In my opinion, there is no place on earth that a simple photo can tell so much about a place than India.
India, one of the most populous countries on the earth, is full of color, contradiction, glory and pain. It is a place of wonder, sorrow, fear and hope. India bursts with humanity on every street or corner you pass. You can see it all there – poverty, wealth, good, bad, happy, sad, beauty and tragedy.
Behind the beautiful, lavish parts of India always lies the most abject poverty imaginable. Nothing can prepare you for the stark reality of desperation, misery and despair of walking through a real live slum in the heart of India’s capital. Sometimes the most severe poverty is hidden behind the walls and within the confines of a slum. Other times, it stares right back at you like a hard slap across your face. You try to look away, and ignore the creeping, uncomfortable nagging guilt. But you can’t.
Dignity
Woman leaving the newly constructed toilet compound thanks to WaterAid.
Irony
Women living on the street, outside the walls of the American Embassy near Vivekananda Slums in Delhi, India.
In the background of the lush green, beautiful grounds of the American Embassy lies the Vivekananda Camp, one of many unauthorized slums that surround every single part of Delhi. I visited this slum as part of a tour with WaterAid, a global NGO that provides safe drinking water and sanitation to areas around the world that do not have access to it.
The stark contrast between the neighboring American Embassy and the Vivekananda Slum were almost too hard to morally comprehend. These two places represent the immense contradictions and inequalities that can be found all throughout Delhi and India as a whole. One of the greatest inequalities ever seen anywhere in the world is right there staring into your face, making it impossible to not feel deeply distraught.
In the Vivekananda Camp, a slum of approximately 500 households, there is no running water, no sewer lines and people live in absolute dire circumstances. Thanks to WaterAid, improvements to sanitation have been made by the building of a Community Toilet Complex (CTC), a compound containing 20 toilets for women, 20 for men and a few for children as well as a couple of showers, providing some sort of dignity in a place where dignity hardly exists.
When I saw the old woman leaving the Community Toilet Complex, I couldn’t take my eyes off her. She was moving slowly, at a snail’s pace, with the help of an old wooden cane. She was heading back into the deep confines of the dirty, dingy slum, to her home. I watched her gait with wonder and hope. She had to be in her eighties and most likely spent almost all her life without a proper toilet. Finally after all these years she had the one thing every human being on this earth is entitled to: Dignity. It brought tears to my eyes for the simple things we take for granted.
Less than a third of people ( 772 million people) have access to sanitation in India, and 90 million people in India do not have access to safe water per WaterAid. Over 186,000 children under five die from diarrhea every year. With 17% of the world’s population (over a billion people), the water crisis in India is only getting worse and is becoming life or death for millions of people.
-WaterAid
This post was inspired by the Weekly Photo Challenge: Split-Second Story. To view more entries, click here.
Last Friday was a beautiful, summer day in Minnesota. After a long winter, bright blue skies and warm weather had finally arrived and I was looking forward to a lovely, three-day holiday weekend that would launch us into summer. Then I read the news and my heart sank. Another devastating killing spree had shocked our nation. Another disillusioned young white man by the name of Elliot Rodger had taken out his displeasure on the world by killing six innocent others near the campus of University of California in Santa Barbara . Yet this time, he had another motive: Misogyny, the hatred of women and girls.
Screenshot of a tweet. Photo source: CNN
His disturbing YouTube video illustrating his utter hatred of women has shocked and angered people across the globe. And his shooting rampage has sparked a global feminist outcry of anger, rage, grief and sadness in social media with many women sharing their own stories of harassment, sexism, violence and rape.
“Hi, Elliot Rodger here. Well, this is my last video. It all has to come to this. Tomorrow is the day of retribution, the day I will have my revenge against humanity, against all of you.
For the last eight years of my life, since I hit puberty, I’ve been forced to endure an existence of loneliness, rejection and unfulfilled desires, all because girls have never been attracted to me. Girls gave their affection and sex and love to other men, never to me. You girls have never been attracted to me. I don’t know why you girls aren’t attracted to me but I will punish you all for it. I take great pleasure in slaughtering all of you. You will finally see that I am, in truth, the superior one, the true alpha male. [laughs]
The social media hashtag #YesAllWomen that has been used on Facebook and Twitter since last Friday has been trending worldwide and continues to rush out a torrent of tweets at breakneck speed. On Sunday, the hashtag peaked at 61,500 tweets per Twitter and continues to run strong with continuous tweets about life in a sexist world. The hashtag which didn’t even exist before May 24th has been attached to over 1.2 million tweets and isn’t showing any signs yet of slowing down per Mashable. Similar to the hashtag #BringBackOurGirls that was invented as an outcry over the Nigerian school girls kidnapped on April 15th by extremists, #YesAllWomen has become a social media phenomenon as a way for people to use their collective voice to promote change.
Photo of a tweet. Source: CNN
Some of the most powerful tweets I’ve read on #YesAllWomen are a powerful reminder that women are not safe, no matter where they live. I’ve written extensively on my blog about women’s rights and violence against women in poor, developing countries however obviously violence against women and sexism continue to be blatant even in our own country.
There is no woman that has never been touched by sexism. The lucky ones live their lives without being harassed while many live their lives with the painful dark nightmare of being hit, groped, abused or raped.
