Water is essential to life. Without water, humans and our world would not survive. Yet, 11% of the world’s population – 783 million people – do not have access to safe water. Although many people living in the western world including myself often take water, sanitation and hygiene (collectively known as “WASH”) for granted, there are millions of people around the world who do not.
In fact, the figures are shocking:
2.5 billion people – almost 35% of the world’s population – do not have access to adequate sanitation. (WHO/UNICEF)
More than 500,000 children die every year from diarrhea caused by unsafe water and poor sanitation – that’s almost 1,400 children a day. (WaterAid 2012/WHO 2008/The Lancet 2012*)
The weight of water that women in Africa and Asia carry on their heads is commonly 40 pounds, the same as an airport luggage allowance.
Providing water, sanitation and hygiene together reduces the number of deaths caused by waterborne diseases by an average of 65%. (WHO)
When I was in Ethiopia this past June, I witnessed firsthand the drastic unavailability of water and sanitation services. It could be seen every time I left the nation’s capital, Addis Ababa, and headed out along the roads leading to the rural population which make up 90% of Ethiopia’s 90 million people. Woman walking for hours with yellow jerricans on their backs. Mule carts loaded with empty and full jerricans. Even children carrying jerricans and walking miles in search of safe water.
The 5th Annual Social Good Summit was held this year at 92nd Street Y from September 20-22, 2014 and streamed around the world in multiple languages.
Last night I returned home after attending my third Social Good Summit in New York City, this year as a United Nations Foundation Social Good Fellow. The Social Good Summit is a unique convening of world leaders, new media and technology experts, grassroots activists and voices from around the world that come together for a two-day conference coinciding with the United Nations General Assembly meeting held during UN Week.
“Social media is one of the most powerful tools in creating social change” ~ #JimmyCarter #2030Now
The theme of this year’s summit – #2030NOW: Connecting for Good, Connecting for All – challenged speakers, participants and a growing worldwide community to explore how technology and new media can be leveraged to benefit people everywhere, to spark discussion and ignite change in creating a better world for all by the year 2030.
On one of my last days in Ethiopia as a fellow with the International Reporting Project we visited Project Mercy, a not-for-profit relief and development agency that provides services to help alleviate human suffering and overcome systemic poverty in Southern Ethiopia. The visit ended up being one of the most enlightening moments of our entire trip.
In order to combat Ethiopia’s high maternal and newborn mortality rates, Project Mercy opened a “Lie and Wait” home for rural woman to come to stay before delivering their child at a nearby hospital. In a country in which an estimated 90% of women deliver at home with little or no trained birth assistance, a Lie and Wait house ensures women from the far away, remote villages will come to wait to stay and deliver at a hospital with a trained midwife or doctor. Lie and Wait houses have saved many lives of both mother and child.
Many of these expectant mothers walk miles on foot on various terrains and topographies to reach a Lie and Wait house. At Project Mercy in the Yetebon community of Southern Ethiopia, pregnant women can walk hours through rugged, mountainous terrain to reach the Lie and Wait home. It is a true test of endurance to walk on foot carrying almost a full term baby.
Reaching the Yetebon community on rough gravel roads that end when they hit the mountains where most of the population live.
It is unquestionable that the Internet has changed the world. It has opened doors and global pathways that never existed before and has made the world a smaller place. With the Internet, things once deemed impossible are possible. The Arab Spring, the rise of instant millionaires and celebrities of previous “no names”, the power of a voice to change and move governments, companies and people. The small ideas such as the “ALS Ice Bucket Challenge” a social media phenomenon that started with one person and went viral raising an unprecedented millions of dollars for charity. The Internet has become so engrained and so much a part of our lives it is almost unimaginable to not have access to it.
Yet out of the estimated 2.7 billion users worldwide of the Internet, a shocking one-third of these users do not have free, uncensored access per Google’s Senior Policy Analyst Ben Blink. Millions of people are denied the basic human right of the freedom of speech on the Internet. They can’t comment, they can’t “like”, they can’t post pictures, they can’t write, they can’t blog, and they can’t freely search the Internet without censorship.
Imagine living in a faraway, mountainous community in the Himalayan Kingdom of Bhutan. Despite its unbelievable beauty, most people live in rugged, remote communities with poor infrastructure, difficult lives and few educational or economic opportunities. In fact, Bhutan has one of the lowest literacy rates in Asia meaning countless children and adults are left behind, trapped in an unescapable cycle of poverty.
In 2008, READ (Rural Education and Development) Global, a not-for-profit organization based in San Francisco, changed the future by opening their first READ Center, a community library and resource center that teaches people to read. Before READ began working in Bhutan, the country had only one public lending library in the entire country. Today, there are five READ centers reaching over 37,000 rural villagers creating a culture of reading and providing access to information and resources to help farmers, children and women’s empowerment.
I learned about READ Global’s work before I went to Nepal in 2010. I had wanted to give back to the community and through research on different non-profit organizations, I found READ Nepal, a part of READ Global that works to provide literacy services in Nepal. I fundraised enough money to donate $4,000 before I left and was thrilled the money would go towards such an important cause. (I have written about it here). Experiencing the rugged remoteness of Nepal during a two-trek in the Annapurnas made me see firsthand how incredibly difficult it is for children to learn. Schools are far and few between. I wondered what life would be like if I couldn’t read or write. It was unimaginable.
The statistics regarding illiteracy are heartbreaking:
773.5 million adults are still illiterate around the world.
17% of children in the developing world will not enroll in primary school
39% of South Asia is illiterate.
50% of women in South Asia are illiterate.
On average, kids only go through 4.7 years of schooling in South Asia.
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.
