C’est Mon Choix

As a result of a number of contributing factors, teen pregnancy is a significant issue here in Togo.  Many young people feel pressure from peers to engage in sexual activity, rumors run rampant about the dynamics of sex and love, girls get bribed into having sex for gifts, teens often receive no education about their developing bodies, and there is little awareness about contraceptive options available.  

Partly for these reasons, as part of my rounds talking about family planning, I of course found myself talking to students about not having children until they have finished their studies and were ready to support a family.  I found that talking to students is a bit different than talking to adults.  With such a mix of ages and maturity levels, getting students to participate can be a challenge and talking of sex can set the group into nervous giggles.

This time around I was with a team of Red Cross workers.  We began by explaining why waiting to have children is important for them as students, followed by a brief discussion about using contraception if they do choose to have sex.  At this point the school director who had been lurking in the doorway cut in. He spoke of abstinence and that it was the only method of family planning the students were to use.  Later when we were saying our thanks and goodbyes in his office, the director brought up once again—to the Red Cross director of their HIV/AIDS program—that he should not be talking condom use with students, only abstinence.  He “knew his students, and if you open the door just a little there will be a flood of sexual activity.”

The school director is not alone in his thinking about teaching “abstinence-only” to students.  In the U.S. there have been a number of pushes to implement this type of sex-ed in public schools; even withdrawing funding from school who choose to teach about condom use and other contraception.  Distributed by PSI, the slogan “L’Abstinence, C’est Mon Choix” (Abstinence, That’s My Choice) can be found on billboards and T-shirts all over Togo.  And these believers in abstinence are right, the only surefire way of avoiding teen pregnancy and the spread of STIs is by having teens abstain from sexual activity, but abstinence-only is also misguided in its belief that talking about sex and contraception will cause teens to start having sex.

I for one—someone who started getting a sex-ed, including contraction, in middle school—can attest that, upon hearing that things such as condoms could keep me from getting pregnant or a nasty STI, I did not run off to have sex.  Assuming that contraceptives are the key towards teens starting their sex lives is very naive, and over-estimates the amount of thinking that goes into some teenagers’ sex lives.  Yes, we very much want to think that the number one concern of a newly sexually active young person is their health and babies, but in reality when that moment strikes, if they have never been educated to think about protecting themselves, they won’t.

The reality is that teenagers often mature sexually before they do mentally.  Unfortunately teenage sex is not a decision purely driven by a logical assessment of the possible consequences of their behavior, no matter how many times someone tells them, just say no.   There are of course many youth who do abstain from sexual activity, but it isn’t because they have never discussed sex or contraception.

Youth should be taught to value their bodies and wait to have sex until they are mature enough to evaluate the consequences, but a balance needs to be struck.  Even if we close our eyes and pretend it doesn’t exist or hope desperately that it will just go away, time has shown us that teen sex happens.  In Togo teen pregnancy is a large contributor to girls not finishing school and apprenticeships.  It is not because someone didn’t tell them not to have sex that they became pregnant, it is because they were never told to use contraception. We need to show these youths, who—besides our pressure for abstinence—still choose to have sex, how to protect themselves and avoid having to suffer from the very real consequences of unprotected sex.

Grab the Cooking Pot Too!

It rained this morning, no, it poured.  Usually the rain seems to calm everything down as everyone runs to seek shelter, but not my compound, not today.

Our pump is broken and we have been living without water for just about a week.  Some of my Peace Corps friends may give me a, “boohoo, you poor thing.” As they live without running water everyday, but being used to running water and being unprepared to not have running water can be somewhat more of a hassle.  Now I am not completely unprepared; my water situation has been notoriously finicky and after a few times of wanting to cook or take a shower and having no water I have started keeping a large plastic trash can filled with water.  But that water store is not meant to last for weeks at a time and my water supply is becoming perilously low.   Do not worry that when my water runs out it perilously means death—there is another pump a few hundred meters away—it just means a little more lugging of water.

Other than our privately owned pump we do not have any other super conveniently close water source.  So when it rained we all jumped into a flurry of action.  Unlike my host family who had cisterns to collect rainwater our compound is hopelessly pump-bound, but that didn’t stop us from making the most of heavy rains.

At the inside corners of the U that is our building, where the roof comes together, there is an amazing spigot of water when it rains and we all took advantage of it.  Grabbing our buckets, bowls, and as my neighbor shouted, “Grab the cooking pot too!” we filled up as much as we could with water.  I hastily washed some dishes and did some laundry so that I could run out and collect more water.  Only the littlest ones sat back dry and laughing as everyone else dashed around filling one container then the next.  I managed to finish with three large buckets of water after doing a load of laundry and my stack of dishes.  I am so glad for that rain.  Though I’m still hoping my pump will be fixed soon, it is a relief to know that I have a few more days’ worth of water.  

Everybody Was Kung-Fu Fighting

There is a young girl about the age of three in my compound.  She lives with her two grandmothers and a teenage relative.  As you may or may not know about me I am not a big kid person.  We get along fine, but I tire quickly and really could do without.  This little girl though is quite adorable.  She directs all visitors—even those not here to see me—to my door, and shouts my name and runs over to pet me every time I catch her eye.  For all this cuteness, though, she is one of the most annoying and temper-tantrum prone children I have ever dealt with.

Within seconds her laughter turns to rage if things don’t go her way.  If it is meal time and her grandmother comes over to collect her she quickly throws herself against the wall beating her little fists and screaming.  Sometimes she screams and cries for hours on end.  If you’ve talked to me on the phone you’ve probably heard her, she is by no means quiet.  I feel for the women who care for her, who must be at least well into their seventies.

A few weeks ago when I returned home from traveling she seemed worse than ever.  I heard louder and more frequent tantrums; I hadn’t thought she could or would get worse.  For near a week I went about my evenings thinking this little girl had amplified her screaming, until I ventured over to share a snack of fruit and a woman emerged from the house leading a boy of about ten years.  The boy, Kossi, and his mother had been living in the house for the past week, I had never seen them, but boy had I heard them. It had been the young boy’s screams I had contributed my little girl. 

Upon seeing Kossi I felt a profound sadness and sympathy for his mother; he was visibly mentally handicapped.  While a handicapped child anywhere can be a great hardship for a parent, here there is nothing for these children.  Unlike in the U.S. there are absolutely no resources for families with handicapped children.  With no counselors or teachers specializing in mental disabilities and no state funded support, families are left to fend for themselves.  Without a halfway house or a way to earn money, as they get older and their families can no longer care for them, many of these mentally handicapped individuals are left on their own; becoming a town fou, living in rags, and begging around town.

As an outsider and childless I cannot imagine the strain this boy’s mother is under.  I don’t even take care of him and I have already grown weary of my 4:45am wake-up call as Kossi pounds on our metal gate screaming to be let out of the compound.  I flinch as he hits the other children or naively steals things from their hands, leaving them in tears.  I got annoyed at a little girl’s relatively normal tantrums and his were so much worse.  To feel that desperation that you cannot take care of you little boy forever and that he will never be able to take care of himself, I can hardly imagine.

The other day as I sat on my porch and Kossi played in the courtyard, he picked up a stick and began to practice his Kung-Fu.  It was such a normal and endearing thing for an ten year old boy to be doing I had to smile and when I looked over I saw Kossi’s mother leaning in the doorway eyes content on her son and a soft smile on her lips.  I was wrong when I said there was nothing here in Togo for the mentally handicapped, through it all there is still the patience and love of their families.  For all the screaming, hardships, and such uncertain future, you could still see how much Kossi’s mother loved him.  We can all hope that as things develop more options, support, and resources will become available to families such as his, but for now there is always his mother’s embrace and of course a little Kung-Fu fighting.

Talking Trash

This morning my homologue told me he slept much better last night than he had all week. Yesterday marked the last day of a three day training we gave for seventy community leaders on the importance of community waste management and public waste bins. After all the planning and worries that it wouldn’t go smoothly it was relaxing to finally have it over with, but there is still much more to do.

The three days of training were only the first phase in a project to install public waste bins in Vogan.  With the help of the mayor and the director of Hygiene and Sanitation for the prefecture of Vo we sought to educate the community leaders (including all Chefs du Quartiers among others) on why public waste bins are important and how they, as community leaders, can help make this project a success.  The appreciation for the project was evident in the participation we received at the trainings, and of course everyone wanted a bin in their quartier.

Felicity and Delphine with an example bin.

As of now we are installing sixteen public waste bins around the city in locations that are most frequented, such as the marché and public areas of assembly.  We have had a local welder make the bins and we hope to get them all installed later this month. With the availability of public waste bins we hope to encourage people to place their trash in the bins rather than tossing it on the street. 

Installing the bins is, however, not the hardest part of this project; it is going to be getting people to actually use the bins. Simply having public bins and a trash collection program in place doesn’t make people use them.  It is habit for nearly everyone to toss their empty water containers and plastic bags on the ground and simply toss household trash into a pile next to the house.  Hopefully the community will recognize the importance of a clean city and the bins will catch on and people won’t simply toss their trash at their feet. 

To achieve this behavior change we trained community leaders, are having radio public service announcements, and are even working with the mayor to institute fines to those found littering.  With the community’s participation I hope that we can make Vogan a cleaner city and that after we have set the example for the first few bins that the community will take the initiative to make them multiply.

Without the help of many of my Togolese partners, and the community itself, I would not be able to make this project be a success, because as I so tackily said is my speech at the training, “It is not the waste bins that will create the change, but the people of the community.”

Let's Do a Little Planning

In the past month I have seen more of my prefecture Vo (comparable to a county) than I ever thought I would, and all of it was from the back of my counterpart’s motorcycle.  From our journeys I am convinced my counterpart, Fogan, knows everyone in the prefecture or possibly just that he really really likes to wave and honk his horn.  I have seen Vo’s phosphate mines and fields of manioc, napped under the trees, and stumbled off the moto with stiff legs, but most of all I have been able to speak with rural villages all over the prefecture about family planning.

In my work here in Vogan I have been so lucky as to pair up with a local NGO—ASFECDI—that works with health and women’s rights.  Much of their work is with sixty-one different farming cooperative groups (groupements) around the prefecture of Vo; promoting women’s leadership and helping to connect these rural agriculture groups to sources of micro financing.  For the past month ASFECDI has assisted me in working with these rural groups in another way—through educating about family planning—an endeavor the NGO hopes to continue after I leave.

For those of you a little rusty on what family planning is: Family planning is making the active decision of how many children you want and when you want them.

Along with Fogan and two women from the NGO, Felicity and Delfine, I have visited about four to six groupements every week to explain the advantages of family planning and the planning methods available in Togo.  We tag-team answering questions and getting the group involved with a small sketch, and of course my three Togolese coworkers serve as my translators for local language.

Having a large number of children is ingrained in much of the culture and expectations of Togolese, but the importance of spacing births is an idea that is easily grasped once it has been suggested.  Many people are eager to share their experiences with having too many children and their own bits of wisdom about the importance of family planning.  There are of course concerns about family planning and we receive many questions.

Most questions pertain to rumors and side effects of using hormonal contraceptives and other concerns about effects of future children and fertility, but there are also some questions that are a bit different.  The rumors people hear about using contraception can be amazingly bizarre and once they become comfortable people ask questions very freely. I have been asked by one man about his wife becoming a loose woman once she can have sex without the fear of having children, who would pay for the parents’ funerals if there were only a few children, having a child born with an IUD in its head if the mother uses that method, and whether or not I personally enjoy sex with a condom.

After our work is done each groupement insists on giving us a meal or drink as a thank you for giving our time.  After a long day I have been stuffed with food I can’t refuse, though at least it keeps me from having to cook that day   Thanks to another day of groupements that fabricate sodebe (the local hard liquor) I have returned home from work hung over for the first time in my life, granted with the heat it is very easy to become hung over.  All day long I was offered shots of liquor and to refuse would have been very impolite.  Thankfully, I wasn’t the one driving!

Having closely spaced births is a problem that is very common in Togo.  Without knowing how or why to space births many Togolese, particularly many of the rural subsistence farmers, suffer a huge burden by having more children than they can fully support.  Not using family planning can have a significant negative impact, not only on the family itself, but on society.  Family planning is one of those things that if used can make other behavior and development changes easier to accomplish.  Many of the Togolese I have spoken with recognize the problem and I hope will begin using family planning or talking about it with their children and peers. 

You may have notice that family planning and access to contraception has been a hot topic in the U.S. the past few months.  I don’t want to get political, but I just want to let it be known that according to Togolese law all women are guaranteed access to contraception and family planning tools.  It is true that in practice this may not always be the case… but seriously, come on U.S.

“About the most massively useful thing”

Some local ladies rockin' pagne.

If you have ever read Douglas Adams’ The Hitchhiker’s Guide to the Galaxy you know that Adams has said that, “A towel is about the most massively useful thing an interstellar hitchhiker can have. Partly it has great practical value. You can wrap it around you for warmth as you bound across the cold moons of Jaglan Beta; you can lie on it on the brilliant marble-sanded beaches of Santraginus V, inhaling the heady sea vapors; you can sleep under it beneath the stars which shine so redly on the desert world of Kakrafoon; use it to sail a miniraft down the slow heavy River Moth; wet it for use in hand-to-hand-combat; wrap it round your head to ward off noxious fumes or avoid the gaze of the Ravenous Bugblatter Beast of Traal (such a mind-boggingly stupid animal, it assumes that if you can't see it, it can't see you); you can wave your towel in emergencies as a distress signal, and of course dry yourself off with it if it still seems to be clean enough.” 

I think Adams may have been a little confused; I think he meant to say “pagne is about the most massively useful thing.”  Pagne [pon-ya] is a colorful cloth that many people in West African countries use to make their clothes and really use it for everything else.  My preference is for the good looking handmade African-made pagne called batik.

Of course I have clothes made of pagne, but I also have some spare pagne around for everything else in my life.  I use pagne for a sheet, for a towel, a wrap to throw on and walk around my compound, a cover for my couch, curtains, table cloth, a rag to clean up, a head scarf, and a baby carrier.  Pagne is an item I always pack when I am traveling.  It is so utilitarian I wonder how I ever functioned without it back in the states.  I suppose I had a dozen different things back home that served the function of this one item.  It’s nice to grab just one thing to do it all, maybe using pagne will be one of those things I bring back home with me.

Every Child Deserves a 5th Birthday

April 25^th is world malaria day, and along with Stomp Out Malaria April is blog about malaria month. 

Here in much of Sub-Saharan Africa malaria is the number one killer of children under the age of five.  In many regions of Togo malaria represents approximately 60% of all childhood deaths.  Eliminating malaria in Africa would represent an opportunity for thousands of children every year to celebrate their fifth birthday.

The effects of malaria reach far beyond the thousands of deaths it causes every year.  Everyday kids can’t go to school and people are kept out of work all thanks to malaria.  With cyclic fever, chills, vomiting, diarrhea, and malaise, who can blame anyone for not being able to head into work?  As a result, malaria endemic countries suffer huge losses in GDP and productivity every year.  Malaria is a serious illness with resounding consequences, but it is something we can ameliorate.

You say “well that’s tragic, but what possibly could I, someone thousands of miles away from Africa, have to do with combating malaria?”  Just knowing that the issue exists is a step towards eradication.  Did you know that the U.S. used to be endemic with malaria?  It was as or more prevalent in North America than malaria is currently in Africa, but with focused efforts we eliminated it from the continent.  The same can be done in Africa, especially with the new tools we have.

There are of course always opportunities to give charitably, there are continuously campaigns to distribute the highly effective insecticide impregnated mosquito nets, but you don’t have to give money to help the cause.  Just be aware of the issue, talk about it, and read about what is happening in the world of malaria and you can help make a difference, too.