In Mali, community volunteers strive to stem the practice of female genital mutilation

Community volunteers display flipcharts they use to inform community members about harmful consequences of gender-based violence, including female genital mutilation. Photo by Adama Sanogo/MSH

I started practicing female circumcision when I was 20 years old. I learned the practice from my grandmother and mother as a way to make money. One day, after seeing the consequences of circumcision, I realized the extent to which women and girls suffered in terms of health, psychology and morale. So I am committed as a community focal point in the village of Waïlirdé and as a woman and mother to fight against this practice that is harmful to health.

My main responsibility is to share information and knowledge with members of my community.  Informing people about the consequences of female circumcision allows those who suffer to seek the help they need and help prevent future occurrences.  Additionally this can help people understand the link between current health issues and circumcision.  Above all, I work to raise everyone’s awareness of the danger of the practice to spare young girls from facing this torture.  

–Fatouma, Waïlirdé village, Mali

In the Mopti region of central Mali, about 88% of women aged 15-49 have undergone female circumcision–or female genital mutilation (FGM); almost 69% of these women were circumcised by the time they were five years old (Mali DHS, 2012-2013). As such practices are deeply rooted in the cultural, religious, economic, and social heritage of Mopti, ending them requires strong and concerted community engagement and action.

The FCI Program of MSH mobilizes leaders and communities in Mopti to advance women’s and girls’ health and rights and to end sexual and gender-based violence (SGBV) and harmful practices such as female genital mutilation (FGM) and child marriage. With funding from the Embassy of the Netherlands in Bamako, and in partnership with the Malian non-governmental organization Conseils et Appui pour l’Education à la Base (CAEB), the FCI Program of MSH leads the Debbo Alafia Consortium of multi-sectoral, national, and international organizations to carry out social and behavior change activities and to provide essential medical and psychosocial support to women and girl survivors of gender-based violence, female genital mutilation, and other harmful practices. Leveraging political and religious leaders’ significant influence on public opinion and acceptance, Debbo Alafia also strengthens political commitment and recruits champions to publicly call for the end of harmful practices and promote sexual and reproductive rights for women and girls.

UNICEF and the SGBV Humanitarian Subcluster (awarded through UNFPA) have supported the FCI Program’s work with trained community volunteers, like Fatouma, to discourage the practice of FGM by informing community members about the harmful short-term and chronic health consequences, such as excessive bleeding, infections, swelling, menstrual problems, maternal health complications, even death. These volunteers also refer SGBV survivors to free medical, psychosocial, and legal support services; providers of these services work with the FCI Program of MSH to ensure they are giving respectful, confidential, and safe care to survivors of SGBV.

Community volunteers, forming protection teams that support SGBV prevention and response, have successfully stopped circumcision ceremonies. During a Debbo Alafia meeting of partners and government officials last year, FCI Program staff received news about a circumcision ceremony in progress in the village of Koro. Debbo Alafia partners and government officials went to the ceremony site to convince the circumciser to stop and the parents to take their girls home. Although several girls had already been cut, several more were spared.

As women and girls in the North and surrounding regions remain particularly vulnerable to sexual and gender-based violence (SGBV) and often do not seek or receive appropriate care, the FCI Program of MSH is leading a study, with support from Amplify Change, to investigate the barriers that deter SGBV survivors from accessing care. Using the findings from this study, the FCI Program of MSH will bring together local actors to develop advocacy and program strategies to reduce these barriers to care.

Standing with Women and Girls to End AIDS

By Sarah Konopka

Sarah Konopka, MA, is Principal Technical Advisor for HIV & AIDS Management Sciences for Health’s (MSH) Global HIV & AIDS Program. Follow Sarah on Twitter . This article originally appeared on MSH’s Global Health Impact blog. 

Photo Credit: Mark Tuschman

There was an awkward silence and then soft giggling as the girls looked at each other. I had just finished talking about strategies for persuading sexual partners to use a condom. Laughter during these skills-building and girls empowerment sessions with 30+ secondary school students in Morogoro, Tanzania was not uncommon, particularly given the sometimes sensitive topics of discussion, but this time, the joke was lost on me. Continue reading “Standing with Women and Girls to End AIDS”

« J’ai retrouvé ma personnalité et ma dignité ».

Photo: Adama Sanogo/MSH

For English, click here.

Le programme FCI de Management Sciences for Health (MSH) Sciences de la santé pour la santé, avec le soutien du Sous-cluster humanitaire SGBV (financé par UNFPA), travaille avec des points focaux villageois formés pour référer les survivants de les survivants de la violence basée sur le genre (VBG) 59 villages vers des services médicaux et psychosociaux gratuits dans 9 hôpitaux et pharmacies de Mopti. Une cliente de 15 ans et une survivante de viol familial racontent son histoire. Continue reading “« J’ai retrouvé ma personnalité et ma dignité ».”

“I got my dignity back.”

Photo: Adama Sanogo/MSH

Pour le français, cliquez ici.

The FCI Program of Management  Sciences for Health, with support from the SGBV Humanitarian Subcluster (funded by UNFPA), works with trained village focal points to refer SGBV survivors from 59 villages to free medical and psychosocial services at 9 referral hospitals and pharmacies in the Mopti region of central Mali. A 15-year-old client of services, and survivor of familial rape, tells her story. Continue reading ““I got my dignity back.””

Ending gender-based violence and FGM in Mali, village by village

Martha Murdock is Technical Strategy Lead for regional programs at the FCI Program of Management Sciences for Health.

Communities in the Mopti region of central Mali—which is home to several ethnic groups and to many people displaced by 2012 violence in the country’s northern region—continue to grapple with widespread sexual and gender-based violence (SGBV), including forced and early marriage and other harmful practices. A majority of Malian girls are married by the time they reach 18, and 15% before the age of 15.  About 91% of women between 15 and 49 years old, as well as 69% of girls under 15, have undergone female genital mutilation (FGM). And, as is true in so many conflict-affected areas, widespread sexual violence has been a tragic and infuriating effect of war, dislocation, and migration.

After many years of work in Mali, both in the Mopti region and nationally, the FCI Program of Management Sciences for Health is committed both to reducing the incidence of SGBV and to mitigating its devastating effects on survivors. Because harmful practices are deeply rooted in the region’s cultural, religious, economic, and social heritage, ending them requires strong and concerted community engagement and action. But the impact of this work could not be any more powerful, as we learn again and again from the women whose strength, resolve, and resilience continue to inspire us.

An SGBV survivor arriving for medical and psychosocial care
Photo: Adama Sanogo/ Management Sciences for Health

Continue reading “Ending gender-based violence and FGM in Mali, village by village”

A door-to-door campaign for antenatal care

This story originally appeared on the Management Sciences for Health website.

When her rapist was arrested, 16-year old Brigitte* thought the worst was behind her. But when she discovered she was pregnant, she had little choice but to drop out of school and work the family fields in her village, in the Manika health zone of the Democratic Republic of Congo (DRC). She certainly could not afford antenatal care (ANC) visits.

The DRC government has made maternal health one of its highest priorities, and partners like the USAID-funded Integrated Health Project Plus (IHPplus) have collaborated with the Ministry of Health to make that vision a reality. Knowing that ANC visits are out-of-reach for many women, IHPplus subsidizes free and reduced-cost care for expectant mothers. And knowing that many women are not aware of the benefits of ANC visits, IHPplus has organized a variety of campaigns to educate mothers-to-be. Continue reading “A door-to-door campaign for antenatal care”

Healthy Women, Healthy Nations

By Fatimata Kané

Fatimata Kané is Project Director of the FCI Program of MSH in Mali. This article originally appeared on the MSH Health Impact Blog. Read this article in French

Photo: Catherine Lalonde

Putting a child on the earth is a whole different type of work. Not everyone can guide a woman and her baby safely through pregnancy and childbirth.

I know what it means to keep women and babies alive and healthy because I am a midwife. Continue reading “Healthy Women, Healthy Nations”

Femmes saines, nations en santé

Par Fatimata Kané

Fatimata Kané est directrice  du programme FCI de MSH au Mali.

Photo: Catherine Lalonde

Mettre un enfant au monde est tout un travail différent. Tout le monde peut aider quelqu’un qui est malade, mais tout le monde ne peut pas faire le travail d’une sage-femme–guider une femme et son bébé en toute sécurité pendant la grossesse et l’accouchement. Je sais ce que signifie garder les femmes et les bébés vivants et en bonne santé parce que je suis une sage-femme. Continue reading “Femmes saines, nations en santé”

PROGRES requires a keen gender perspective

By Alanna Savage and Andrew Gaydos

Alanna Savage is a Senior Communications Specialist for the FCI Program of Management Sciences for Health (MSH) and Andrew Gaydos is a Project Support Associate at MSH.

In our ambitious vision to reach all people, everywhere, it is ever more necessary to examine the varying life experiences–the actual realities–of the people whose health we work to improve. Part of this examination requires a critical look at how gender plays out in the power structures of society, the daily lives of people, and more concretely, in the “who, what, where, when, and how” of health-seeking behavior and access to essential reproductive and maternal health care.

Maternal mortality in Mali remains high–587 women die for every 100,000 live births–but only 28 percent of sexually active women of reproductive have satisfied their demand for family planning.  Women and girls continue to confront widespread sexual and gender-based violence, including female genital mutilation/cutting (FGM/C); in 2015, about 126,000 women and girls received prevention services, protection, and care related to FGM/C. And thanks to the work of the FCI Program of MSH, traditional and faith leaders are advocating for family planning and coming together to provide support to survivors of gender-based violence and to identify early warning signs of imminent violence.

Gender inequality undoubtedly plays a role in high maternal mortality and unmet need for family planning and the continuance of sexual and gender-based violence. As long as women and girls must continue to fight for equal voice and an equal share of opportunity and power, their lives and health will remain under threat. Gender influences health outcomes, access to care, providers’ treatment of patients, relationships among health workers and supervisors, and health career barriers and opportunities.

Photo by Catherine Lalonde

Continue reading “PROGRES requires a keen gender perspective”

Emergency contraception is a simple part of post-rape care: Why is it not routinely provided?

By Melissa Garcia and Sarah Rich

Melissa Garcia is Senior Technical Officer for the International Consortium for Emergency Contraception and Sarah Rich is Senior Program Officer at Women’s Refugee Commission. This post originally appeared on the blog for the Sexual Violence Research Initiative

Emergency contraception (EC) can reduce the risk of pregnancy after unprotected sex, including in cases of sexual violence. Global guidance is clear that EC should be offered to women and girls within 120 hours of sexual violence to prevent the traumatic consequences of pregnancy resulting from rape.

Yet women and girls who have experienced unprotected sex, including through sexual violence, do not routinely have access to EC. The global aid communities must work together to increase access to EC for sexual violence survivors around the world, including for women and girls who are the most marginalized, like those living in crisis-affected settings. A range of strategies can be implemented to improve access to EC. Further research is also needed to identify, evaluate, and invest in new and innovative solutions. Continue reading “Emergency contraception is a simple part of post-rape care: Why is it not routinely provided?”