Bridging the reproductive health gap for girls in Nairobi slums

For many young women in Nairobi's crowded Kibera slum, life is fraught with danger in addition to the hardship they share with other residents of one of Africa's poorest neighbourhoods. They live in constant fear of violence, rape, sexual abuse, HIV/AIDS, unequal access to education, and excessive domestic responsibilities.

Fatuma, a secondary school student, says she can hardly step out of her home at night for fear of being sexually assaulted. "As a young girl, life here is not easy. Men are always after you. They try to pressure you into sex," she says. "Having a boyfriend is not a bad thing; the problem is what you do with the boyfriend. Most guys say having a girl without sex is like tea without sugar."

Fourteen-year-old Emily, who wants to be a lawyer, thinks a girl in Kibera can only forge ahead in life if she gets to know her rights and value as an individual by way of sex education. "I like being a girl, but I want to know my rights," she says. "I want to teach other girls their rights also so they can be respected."

BINTI PAMOJA

Both girls recently joined a new reproductive health education programme targeting teenage girls in the slum. Binti Pamoja (Kiswahili for "girls together"), as the project is known, uses innovative approaches to impart such information to teenage girls there.

The project is a component of a youth programme called Carolina for Kibera. It was established to fill a gap left by the absence of reproductive health education for young women, say co-founders Karen Austrian and Emily Verellen, recent college graduates who carried out a part of their course work in Kenya as exchange students.

Under the project, 28 girls aged between 13 and 18 are learning to explore the complex issues affecting their daily lives through activities such as photography, community drama, sports and HIV/AIDS peer group discussions.

Having learned the basics of photography with the use of disposable cameras, for example, the girls capture images to illustrate those issues, as well as events highlighting female leadership roles.

Karen says she realised that whereas official reproductive health outreach and education in the country are expanding, such services only cater for married women, thereby ignoring the unique set of needs relating to teenaged girls. "Reproductive health is there, but it is only targeted at married women," she told IRIN. "Younger women are expected not to have sex."

Emily said there was an absence of youth programmes specifically targeting teenage girls. Due to their emphasis on sports, those that existed tended to attract boys rather than girls. Moreover, girls often could not participate becuase of the weight of their domestic responsibilities.

Most youth programmes in Kenya, she added, also tended to have an overwhelmingly male leadership, which largely discounted the special needs of girls. "At their age, the girls have specific reproductive needs different from those of boys," she explained.

SEX EDUCATION POLICY

Meanwhile, the government's policy on reproductive education remains unclear and in Kenya, as in many other African countries, there is a lot of resistance to providing sex education in schools.

An education ministry official, who requested anonymity, told IRIN there was no sex education at Kenyan schools; instead, the ministry had introduced the less controversial "moral education", which only touched on general aspects of reproductive issues and HIV/AIDS. "We did not give up completely. We brought in moral education, and we hope to integrate it into the school curriculum," she said.

Experts say the negative attitude towards sex education, particularly among religious leaders, is problematic, especially since statistics indicate that the rate of new HIV infections is increasing fastest among young people. According to Cynthia Eyekuze of the Centre for Reproductive Law and Policy, the source of the negativism is the widely perceived notion that adolescents want "to run and have sex once you tell them about sex and condoms".

"The reality is they are having sex anyway, we've already said that, we all know that. In fact, if they're having sex, at least make sure that they know what exactly this entails, that they know the biology of it," Eyekuze noted.

Experience in Kibera and elsewhere in Kenya tends to support her view. The images captured by the Binti Pamoja girls portray aspects of gender violence, and the lack of reproductive health support, which in combination serve to render most of the young women in the slums very vulnerable to HIV/AIDS and other sexually transmitted diseases (STDs).

IMAGES

One photograph is of a six-year-old girl gazing out over a large dusty field with dilapidated corrugated iron-roofed shacks in the background. "The reason I took the picture was because the girl in the photo was raped by a 34-year-old man who was her neighbour, when her mum and dad were away," explained 14-year-old Marceline.

"The man always used to send little girls to the shop for milk, sugar and sweets. After they got back, he would invite them into his house, then rape them and give them money to keep their mouths shut," she added. Luckily for many other girls who might have become his victims, he was apprehended and subsequently jailed for 15 years.

Another image depicts a girl barely seven years old standing outside a rusted iron sheet structure, carrying a younger sibling on her back. The mother of these children is a single parent, according to Judy, the photographer. "In order to get food, she must go out and look for money from men," she said. "The kids are not healthy because the mother does not feed them properly. When they get sick, nobody looks after them, so they must take care of each other."

LIFE'S LESSONS

Now, armed with information on their reproductive health rights as well as communication and leadership skills, the Binti Pamoja girls say they are able to make momentous decisions on the basis of what they have learned. "Binti Pamoja helped me," says Rosemary. "If it had not been for the programme, I would be HIV-positive. I would not be a girl. I would have become a mother. Most of my friends who didn't join the programme are pregnant," she adds.

Fatuma says the programme is providing her with the opportunity of "building my life". "I don't want to mess up my life. My mother is working very hard to put me through school. My father is dead. I don't want to misuse my mum's efforts and end up staying in Kibera," she told IRIN.

Halima, who is about to enter secondary school after successfully completing primary school last year, agreed. "We were taught now to look men in the eyes and tell them 'no!'. Before that, it was difficult to say 'no', because men approach you with a lot of violence, so you lose courage."

Halima has seen a number of girls in her neighbourhood who contracted STDs and could already be infected with HIV due to a lack of sex education. She also cites the case of two classmates, both of whom died last year as a result of complications arising from unsafe abortions.

EDUCATION CHALLENGE

However, the greatest challenge for the Pamoja girls is education. Several know they may not even make it to secondary school, either for lack of fees, or blatant refusal by parents to keep them in school.

According to Zebah Atieno, 14, one of the most intractable problems affecting life in Kibera is the negative attitude towards girls' education. According to her, most people regard taking girls to school as a "joke". "In Kibera, most people say girls are not supposed to go to school," she says. "I don't see how we can survive without being educated. Parents should know that it is [a form of] violence not to take girls to school."

"Why is it that women are not given a chance to make their dreams come true?" wonders 18-year-old Maureen. "Instead of us doing what we want, we are forced to do what we do not want to do, and if we refuse, we are beaten to death by the men," she adds.

Rosemary, 16, in her photos, shows her anger at the heavy domestic chores imposed on girls, while their brothers go to school and play football. "You know, here in Kibera, boys say girls are the only ones who are supposed to wash the clothes, carry the babies and fetch water. If you tell a boy to carry a baby, he says: 'That is work for girls only.'"