One in eight

From the NYT Lens blog, “Showcase: from birth, death“:

Standing in the only operating room in the only medical hospital in all of Guinea-Bissau, Marco Vernaschi watched a nurse take an unsterile needle out of her pocket and, without anesthetic, suture a woman’s vagina after a difficult childbirth. The woman screamed. Mr. Vernaschi took a photograph. Moments later, she was required to walk out of the filthy room and go home.

The slideshow is not recommended for the faint hearted.

Amnesty International released a report today, calling the alarming rates of maternal and child mortality in Sierra Leone a “human rights emergency”, as one in eight women risk dying during pregnancy or childbirth.

According to USAID:

“Both maternal and child mortality rates in West Africa are among the highest in the world where outdated clinical, social, and cultural norms create obstacles to quality maternity services. It is estimated that for every woman who dies as a result of childbirth, at least thirty others are severely incapacitated from fistulae, chronic pelvic pain, and infertility. Poor sanitation and nutrition, along with inefficient health service management, put young children at risk of easily preventable illnesses.”

Gordon Brown is slated to announce millions of dollars of new funding to provide “free healthcare for millions more women and children in the developing world.” I wonder if this promise will go to rest in the great graveyard of broken promises. “Throwing money (with many strings attached) at the problem” has been the rich country M.O., requiring governments – like Sierra Leone’s – to spend inordinate amounts of time and resources proving to donors they can manage aid transparently. It takes months, years, for countries to turn around their public sectors and make their public health delivery systems functional.

Meanwhile, one in eight women in Sierra Leone faces the risk of death for becoming a mother – so how do we solve the “emergency” part of this equation?

One possibility could be training midwives and other pregnancy and child birth attendants in areas where access to clinics and health centers is limited. Many NGOs and agencies have the capacity to deploy such programs in a matter of weeks — pending funding. Africare was implemeting such a program last year in Liberia. I am cautiously hopeful that a renewed commitment to solve issues affecting women will create the political space necessary for emergency interventions to complement longer-term, more systemic efforts at improving the state of maternal and child health in West Africa.

This ‘n’ that

Amazing conversation/fight between Bill Easterly and Jeffrey Sachs going on right now over at Huffington Post – the “Cliffs Notes” of it are available here. I’m pretty amused by all of this – it seems so very modern for two of the world’s most renowned development economists to duke it out via their blogs and columns. And Easterly just joined Twitter: 

penelopeinparis@bill_easterly vs. J. Sachs: http://ow.ly/aInw.amusing – although I wonder if this is sorta lowering the standards of educated debate.
bill_easterly@penelopeinparis @saundras_s u mean that educated debate that includes Bono&Angelina?
penelopeinparis@bill_easterly – touche. Still, 2 bad muck raking takes over the constructive discussion,& thats what ppl will focus on,instd of real issues

I’m so very entertained by modern media and information exchange. 

In other news, I just finished reading Tears of the Desert, the memoirs of Dr. Halima Bashir, a woman doctor in Darfur. In spite of the fact that I spent most of the second half of the book swallowing my tears, I really enjoyed her story. The horror… Goodness. We have all seen, read or heard accounts of rape as a weapon of war (in Liberia, in the DRC, in Sudan….), but the personal nature of her account made it even harder to bear. It almost makes me in favor of celebrity advocacy – how could you not want to be outspoken if you knew you could draw media (and potentially, political) attention? 

UN Sexual Misconduct Allegations Won’t Go Away

I haven’t had the time or energy to blog lately, in spite of my repeated “notes to self” to do so… But this caught my eye – I remember discussing this back in 2005 in a graduate seminar, so clearly things are not moving very quickly on this front. 

If UN missions are to successfully achieve their goal of stabilizing a country and bringing peace to it, then this type of behavior needs to be eradicated. Again, enough of the lip service paid to a zero tolerance policy…
Full story below, and here is the link. (HT: The Road to the Horizon)
Soldiers implicated in abuses have been sent back to India, but locals say prostitution remains rife at peacekeeping base.

By Taylor Toeka Kakala in Goma and Lisa Clifford in The Hague (AR No. 186, 12-Sep-08)

Although a group of Indian peacekeeping soldiers accused of sexual abuse in eastern Congo have returned home, allegations of misconduct continue to surround the battalion.

The United Nations confirmed last month that an internal investigation had uncovered credible evidence that members of an Indian unit stationed in North Kivu province “may have engaged in sexual exploitation and abuse”.

A UN source said around 100 peacekeepers from India allegedly used children both to work for them and to hire Congolese girls for sex. The source said the children were used as domestic servants and to pimp for prostitutes, some as young as 12 or 13 years old.

UN secretary-general Ban Ki-Moon said he was “deeply troubled” by the findings, and the Indian government promised a swift and thorough investigation. 

Under the regular six-monthly troop rotation, the soldiers concerned left the UN Mission in the Democratic Republic of Congo, known by its French acronym MONUC, in January but local women say their replacements are continuing to break UN rules.

Peacekeepers are strictly forbidden to socialise with local people, but Mapendo Polepole, a 28-year-old prostitute from Goma, who heads an organisation of women living with AIDS, told IWPR that Indian soldiers from the camp in central Goma are regular customers.

“They have sexual intercourse with us, without condoms, in their jeeps, during a patrol and in their camps,” she said, adding that the soldiers pay 20 US dollars for her services rather than the going rate of two dollars. 

Peacekeepers are not allowed to seek entertainment outside the barracks or leave the camp after 6 pm. The UN says all personnel are made aware of the mission’s code of conduct and “no-go areas” before signing on – and their battalion commander is responsible for their actions while they are on a peacekeeping mission.

A UN official in New York admitted the regulations were sometimes hard to enforce. “No matter how many rules we have in place, there is always a way to go around them. It is so hard to monitor,” said the official.

Polepole says peacekeepers in Goma have continued to flout the regulations since the 100 peacekeepers left. Her allegations that prostitution was continuing on and around the Indian base were repeated by other sex workers in Goma.

Mado Kahindo, 24, says Indian peacekeepers still come to her home for sex. “They stop their patrolling jeep in front of my hut after midnight,” she said, adding they refuse to enter the house as they do not want to be faced with a prostitute’s children. “I have to come outside for sexual intercourse in their jeep.”

Feza Ramazani, 30, said she is among the many prostitutes who wait beside the road for the Indian soldiers as they pass by on their patrols. She says the sexual encounters can sometimes be rough. “Very often we get bruises on our breasts because of the way they touch them,” she said.

Polepole recalled an incident back in April when a sexual encounter with an Indian soldier turned violent.

“After the trick, he gave me 30 dollars before handing me over to his fellow soldiers who raped me in a chain,” said Polepole, who was injured after she protested that none of the men were using a condom. 

An NGO worker told IWPR that sex without condoms is common practice for local prostitutes and their UN clients. 

“Prostitutes tell us that the blue helmets insist on having sex without condoms,” said Zawadi Binti Sharif. She said that out of economic necessity, the women have little choice but to comply, “Poverty is a threat in our fight against AIDS.”

Nick Birnback, chief of the peacekeeping force’s public affairs section in New York, told IWPR that a “zero tolerance” policy was in place and any peacekeeper who broke the rules would be sent home.

“There is simply no excuse,” he said, adding that MONUC has recently increased foot and vehicle patrols to ensure soldiers are respecting the curfew.

In light of the problems, Birnback said the MONUC official responsible for military conduct and investigations is to be relocated from the capital Kinshasa to Goma. “Over 90 per cent of MONUC forces are in the east and so it would make sense for him to be much closer to the troops who are the source of disciplinary concern,” said Binback.

For those who want to complain, MONUC has set up a hotline where locals can report any wrongdoing by peacekeepers. Safe areas have also been established where Congolese can meet confidentially with UN officials.

However, Birnback admitted that these measures might not always be effective. “It doesn’t necessarily mean that people are aware of it – or they may be afraid to use it,” he said.

Polepole said she would not report the attack on her, as prior experience suggested there was no point. She said Congolese police believed women like her deserved this kind of treatment, and reporting incidents of sexual violence to the police was most likely to end in the arrest of the woman herself.

The Congo peacekeeping force has been beset with bad publicity in recent years, with 140 cases implicating soldiers in prostitution or sexual abuse recorded in 2004-06.

News that the Indian contingent was accused of abusing young girls came to light last month after an investigation by the UN’s Office of the Internal Oversight Services. 

With no power to prosecute, the UN has handed details of the allegations to the Indian authorities, who are responsible for the troops they contribute to the peacekeeping mission, and will decide whether to pursue the case further. 

UN troops from India and Pakistan have also been accused of smuggling gold and trading weapons with Congolese rebels.

Birnback says bad publicity of this kind is tremendously damaging to MONUC, the world’s largest peacekeeping force, with 18,500 troops deployed in Congo.

“Anyone who takes peacekeeping seriously is deeply disturbed when they hear about things like this,” he said, “UN peacekeepers have played a central role in the stabilisation of the DRC over the past several years. When the hard work and sacrifice of so many is overshadowed by the unacceptable actions of a few, it’s bad for the UN and bad for the people of the Congo.”

The Congolese wars have claimed millions of lives and have been marked by sexual violence on a massive scale. 

A recent report from the Human Rights Centre at the University of California, Berkeley, the Payson Center at Tulane University and the International Centre for Transitional Justice found that almost 16 per cent of those surveyed in three eastern provinces – North and South Kivu and Ituri – had been sexually violated. Nearly 12 per cent of those were the victims of multiple assaults, the survey found.

The Hague-based International Criminal Court, ICC, has three Ituri rebel leaders in custody and an arrest warrant outstanding for a fourth man. Sexual violence charges feature in all but one of the cases – that of Thomas Lubanga Dyilo, who is accused of recruiting children to fight in the Ituri conflict.

Reports that the soldiers sent to Congo to protect civilians from the violence are themselves accused of sex crimes against children has angered many in the region. 

Christine Musaidizi from the NGO Children’s Voice says extreme poverty makes minors particularly vulnerable to exploitation. 

“The striking poverty of parents and the abdication of [responsibility] of the Congolese state is happening at the cost of children’s lives,” she said.

The Girl Effect

Great video, don’t you think?

Trusty MS alerted me about the existence of The Girl Effect and this video – I find this film to be really powerful, and, even though I’m tempted to say that it tends to oversimply/dramatize issues surrounding the empowerment of women, if I’ve learned anything in the past couple years about attracting the general public’s attention to these types of issues, it’s that you NEED to present facts simply and dramatically. So, the development practitioner in me says ” oversimplified”, takes away from seriousness and complexity of the issue….etc. The non profit manager in me says “Fabulous! what a powerful video!”.

To me, it seems that NGOs always have to toe the line between getting attention for their cause and keeping the integrity of their message, as well as of their work. It’s definitely a debate when it comes to celebrity endorsement of humanitarian causes – sure, you mobilize public opinion a lot easier and faster that way, but are you educating the public, or merely bringing the issue into the spotlight in a unidimensional fashion? Doctors without Borders (again) rejects celebrity endorsements, while others, like the Red Cross embrace it. Check out the (ridiculous??) video below…