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THE REPORTER POPULATION CONNECTION

Volume 44, Issue 1 February 2012

10 Million Child Brides Each Year, Having Children, While Children


President’s Note

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ast fall, as world population soared past 7 billion, I traveled to 21 colleges and universities across the nation, giving up to six presentations on each campus, reaching thousands of students. During each talk, I showed the photograph from Afghanistan (on page five of this issue) of 11-year-old Ghulam Haider with her 41-year-old soon-tobe husband. The reaction was always the same: stunned disgust. Many college students have sisters around that age who are busy doing normal kid stuff: attending school, playing sports, and just hanging out with their friends. If a man in the U.S. tried to marry an 11-year-old girl, he’d be arrested. Rightly so, and good riddance. Ghulam Haider dreamed of being a teacher. That hope has likely long vanished—replaced by the horrors of marital rape. When a child is involved it’s always rape, whether it happens in Afghanistan or right down the street. Ghulam’s story is just one of the 7 billion human tales on our crowded planet. Stories like hers matter greatly. The world’s future depends on how we treat our children who are, after all, tomorrow’s adults. By treating girls with respect, we change the climate for women—who are still treated as mere possessions in many parts of the world. Today there are more young people on earth than ever before. Some benefit from stable families, decent health care, and good education. But hundreds of millions live in a world of desperation and danger. For many young girls, even the simple act of walking to a nearby well is fraught with peril. A woman

in South Africa is more likely to be raped than she is to learn to read. A quick glance on the Internet reveals stories beyond my worst imagination. At Population Connection, we focus on universal access to affordable voluntary family planning. We face obdurate opponents. Some are tribal leaders in remote village huts. Others are never-married men wearing Vatican robes. Still others are members of Congress whose suits come from Brooks Brothers, but whose ideas are straight out of the 12th century. It’s hard to believe we still face such implacable forces, but we do. They never relent. Neither can we. Our commitment to family planning is powered by a singular notion: respect. We respect women. We respect couples. And we respect our precious planet. We can meet the population challenge by providing the tools and information people need to make thoughtful, informed choices. A better world begins by giving children what they need: love, security, and a chance to succeed in life. Amidst all the challenges, one happy fact: when child survival increases, couples generally choose to have smaller families. “Win-win” scenarios are welcome in this difficult world. When women and couples plan and space their children, everyone comes out ahead. Except for those who want to impose medieval notions on the rest of us. Their loss is the world’s gain.

John Seager john@popconnect.org

Help Make the Population College Connection

It’s going to take an extended, concentrated effort to achieve population stabilization. That’s why we need the next generation. We’re already active on more than 100 college campuses, and we’re expanding our outreach. You can help. Just email Lee Polansky at lee@popconnect.org or call her at (202) 974-7702 if you know of opportunities for us to make presentations on any campus across the country. There is never any fee or other cost involved since reaching young people is central to our grassroots mission. The Reporter — February 2012


The Reporter Volume 44, Issue 1 February 2012

Board Chair Marianne Gabel President and CEO John Seager Editor and Designer Marian Starkey Contributors George Fominyen, Rebecca Harrington, Molly Melching, Stacie Murphy, Shauna Scherer, John Seager, Alex Starkey, Marian Starkey, Anna Tomasulo, Pamela Wasserman Overpopulation threatens the quality of life for people everywhere. Population Connection is the national grassroots population organization that educates young people and advocates progressive action to stabilize world population at a level that can be sustained by earth’s resources. Annual membership includes a one-year subscription to The Reporter. Annual membership, $25. All contributions, bequests and gifts are fully tax-deductible in accordance with current laws. The Reporter (ISSN 0199-0071) Population Connection 2120 L Street, NW, Suite 500 Washington, DC 20037 (202) 332-2200 (800) 767-1956 (202) 332-2302 fax info@popconnect.org www.PopulationConnection.org www.PopulationEducation.org www.Worldof7Billion.org http://twitter.com/popconnect www.facebook.com/PopulationConnection

Cover Photo

A pregnant 15-year-old with her older husband, who is a migrant worker in Mumbai, India, meet with The Veerni Project. They were wed when she was ten, in his village near Jodhpur. The Veerni Project focuses on women, girls, families, and communities in the desert areas around Jodhpur, India, with medical, educational, nutrition, and community development programs to bring about change in their communities. Photo: Rose Reis, Courtesy of Photoshare

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Urban Family Planning in Dakar, Senegal

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From Poverty to Matrimony: Early Marriage in Rural Nepal

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Change From Within

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From Child Bride to Senegal Rights Crusader

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Editor’s Note

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Letters to the Editor

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Pop Facts

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In the News

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The President’s Circle

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Population Crossword

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Washington View

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Field & Outreach

By Marian Starkey

By Anna Tomasulo By Molly Melching

By George Fominyen

30 PopEd 32 Cartoon 33

Editorial Excerpts

Printed on recycled paper

www.popconnect.org

February 2012 — The Reporter

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Editor’s Note

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ampaigns against anything from HIV to breast cancer to genocide in Darfur have benefitted from celebrity support. Sometimes it takes well-connected people to champion a cause in order for significant funding and technical contributions to materialize. The Elders—a group of global leaders brought together by Nelson Mandela—has stepped up to be that advocacy body for the abolition of child marriage.

girls who become sexually active and give birth before their bodies have fully matured. In fact, pregnancy-related deaths are the leading cause of mortality for 15-19-year-old girls. In Amhara, a region of Ethiopia where child marriage rates are extremely high, more than two-thirds of married girls have sex for the first time before their first period. In Nigeria, a quarter of married girls give birth before age 15.

Girls Not Brides—a new global partnership to end child marriage—was created by The Elders and announced at the Clinton Global Initiative Annual Meeting in September. Several large foundations have been involved from the start and more continue to join. The partnership aims to have at least 150 members running programs in at least 20 countries by December 2012 and to raise $3 million for activities to end child marriage in priority countries.

Demographer John Bongaarts calculates that if the average age of childbearing increased by five years, future population size could be reduced by 15-20 percent. This hints at the effect that ending child marriage could have on future population size. If girls were allowed to finish their educations before marrying and becoming mothers, they would have fewer children over the course of their reproductive lives.

Child marriage is defined as the marriage of a person before she—it is usually girls who are married very young—is 18 years old. The practice is most common in sub-Saharan Africa and South Asia. Owing to its large population and the prevalence of the practice, India sees 40 percent of the world’s child marriages. In Mali, where we have a pilot Population Education program with the Peace Corps, 71 percent of women are married before they turn 18. Niger has the highest rate in the world, at 75 percent. Girls are married off young for a variety of reasons—most related to poverty, cultural and religious custom, and reverence for virginity. Often, the bride and groom do not even know each other. In Bangladesh, where the median age at marriage for girls is 15, four out of five girls first meet their husbands at their weddings. Parents who wait to marry their daughters risk the possibility that their daughters may have premarital sex, shaming their family for generations. Once girls are married, however, they are under much pressure to prove their fertility, even though they may not have completed puberty. Child marriage has serious health consequences for young 2

The Reporter — February 2012

Desmond Tutu is hopeful that we will see the practice of child marriage end in our lifetimes. “I am confident that change can happen very quickly. No woman who has had the benefit of staying at school and marrying later in life can inflict child marriage on her daughters. We can end child marriage in a generation.” Perhaps, with sustained interest and investment, we will.

Marian Starkey mstarkey@popconnect.org

P.S. If you would like to learn more about child marriage after reading this issue of The Reporter, TrustLaw has a hub of articles, videos, and infographics at www.trust.org/trustlaw/womens-rights/child-marriage. National Geographic published an article about child marriage in the June 2011 issue, with photos by Stephanie Sinclair, whose work is featured throughout this issue of The Reporter. See the article, photos, and a video at http://ngm.nationalgeographic.com/2011/06/child-brides/gorney-text.


Letters to the Editor

Send correspo

ndence to mstarkey@popc onnect.org. Letters are also accepted via postal mail. Le tters may be edited for clar ity and length .

From my viewpoint, your work may be the most important contribution being made for the future of the world. The one thing we do not need is more people. Somehow we need to stabilize our population with fewer children. The world is starting to see the necessity of limiting population. You at Population Connection are carrying the flag! Tom Stuelpnagel Avila Beach, California Member since 1989 I enjoyed your Editor’s note in the October issue of The Reporter and have been noticing that most turmoils and troubles in the world have a common denominator: POPULATION EXPLOSION. Keep up with the good work! Olgard Dabbert, M.D. San Diego, California Member since 2011 Thank you for the work you do to educate people about the issues surrounding overpopulation. Christine Mulholland San Luis Obispo, California Member since 1993 Your otherwise informative chart (“A Quick Trip to 7 Billion”) stated in its chronology that in the 1820s “Lowell, Massachusetts, America’s first planned factory town …” Despite Lowell’s many (and uniformly unconvincing) efforts over the years to claim that title, the indisputable fact is that my hometown of Paterson, New Jersey was this nation’s “first planned” industrial town. Paterson (a.k.a. “The Silk City”) was founded in 1791—30 years before upstart Lowell—by none other than Alexander Hamilton. Together with other industrialists (including the farsighted, but alas long-forgotten Tench Coxe), Hamilton founded the Society for Useful Manufactures. www.popconnect.org

Attn: Marian St Population Co

arkey

nnection 2120 L St., NW , Ste. 500 Washington, D C 20037

Indeed, the first industrial strike in the U.S. took place in Paterson in 1792—when deer were still grazing in what would become Lowell, Mass. Thanks for the great work that you and your staff do in a world which needs your efforts more than ever. Edward S. Hochman New York, New York Member since 1978 The poster is really elegant, very informative. It’s going to grab the kids’ attention. I’m just sorry I have to pick which side to hang up. Bill Mikolay Environmental Science teacher, Freeport Senior High School Sarver, Pennsylvania As I watch the various problems humans pose to each other and the planet, my belief that population expansion (of an exponential nature) is the direct or indirect cause of most, if not all, such problems intensifies. My father, a biophysicist, once did a statistical paper on the effects of population increase. The results of his paper were indeed frightening, and I believe we are beginning to see them fulfilled. Thank you for your continued work in this area. Daniel Hunt Woodland, Washington Member since 2007 I read with interest the latest issue of The Reporter. Russell Smith Managing Director, Parity Projects London, United Kingdom February 2012 — The Reporter

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Pop Facts Said Mohammed, 55, and Roshan Kasem, 8, on the day of their engagement in Chavosh Village, Afghanistan on September 10, 2005.

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The Reporter — February 2012

Maya, 8, and Kishore, 13, pose for a wedding photo inside their new home the day after the Hindu holy day of Akshaya Tritiya, or Akha Teej, in Rajasthan, India on April 29, 2009.


Photos by Stephanie Sinclair/VII. See more of her work at www.stephaniesinclair.com/childbrides

Faiz Mohammed, 40, and Ghulam Haider, 11, sit in her home prior to their wedding in the rural Damarda Village, Afghanistan on September 11, 2005.

t Every single day, it is estimated that more than 25,000 girls under the age of 18 are married. t A girl under the age of 15 is five times more likely to die in childbirth than a woman in her twenties. t When a mother is under 18, her baby is 60 percent more likely to die before its first birthday than a baby born to a mother older than 19. t In the developing world, one in three girls is married before the age of 18; one in seven before she is 15. t As a consequence of their physical immaturity, an additional 100,000 girls each year live with the disability of fistula resulting from obstructed labor. —The Elders, http://www.theelders.org/child-marriage

www.popconnect.org

February 2012 — The Reporter

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In

the

News

New Study Finds Link Between Injectables and HIV Infection A new study published in The Lancet correlates a doubling of new HIV infections with the use of the contraceptive injection, Depo Provera. The study, led by researchers at the University of Washington, involved 3,800 couples in Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The study participants were discordant couples (in which one partner had HIV and the other did not). The data was collected for an entirely different study, which the researchers cite as one of the weaknesses. About 12 million women ages 15-49 in sub-Saharan Africa, roughly 6 percent of all women in that age group, use injectables—either Depo or the generic version of the drug. In the U.S., only about 3 percent of women use Depo. Injectables are popular in sub-Saharan Africa because they require that women get a shot once every three months, as opposed to taking a pill every day (and obtaining a new package of pills every four weeks). This makes birth control a much easier undertaking for rural women who have to travel long distances to reach a clinic. The method is also easier to conceal from disapproving husbands and other family members because there is no paraphernalia, i.e., pills, patch, or IUD strings. Couples in the study that relied on the injection for their birth control were slightly less likely to use condoms, but researchers accounted for this potentially confounding factor in their analysis. 6

The Reporter — February 2012

One theory for the elevated risk of infection is that progestin may cause a thinning of vaginal tissue in women, as it does in macaques, making it easier for viruses to enter and exit. This theory will be tested in follow-up research that is already being conducted. The World Health Organization is convening a meeting to share follow-up research on the study and to deliberate over whether to advise discordant couples against using injectables without condoms. This is a serious consideration in a region where hundreds of thousands of women are injured or die each year due to pregnancy and childbirth complications.

Mississippi ‘Personhood’ Amendment Defeated Residents of Mississippi voted in November against an amendment to the state constitution that would have defined a person as “every human being from the moment of fertilization, cloning, or the functional equivalent thereof.” Proposition 26 would have banned abortion with no exceptions, and because of its vague definition, it could also have banned IUDs and emergency contraception. Some worried that even birth control pills would be outlawed. Abortion is already a difficult service to obtain in Mississippi, as there is only one clinic that performs the procedure in the entire state. Dr. Randall S. Hines, a fertility specialist in Jackson, said of the amendment, “Once you recognize that the majority of

fertilized eggs don’t become people, then you recognize how absurd this amendment is.” Personhood USA is the group that pushed the amendment. Already defeated in Colorado­, where the group is based, in 2008 and 2010, their ‘personhood’ initiative was rejected by 58 percent of voters in Mississippi. Now, the organization plans to try to get the initiative on ballots in six new states in 2012: California, Florida, Montana, Nevada, Ohio, and Oregon. Personhood USA is also trying to get the Mississippi legislature to consider the initiative, even after it failed to persuade the voters of Mississippi. Anti-choice legislators have already introduced personhood measures in Georgia and Virginia.

HHS Secretary Rejects FDA Recommendation HHS Secretary Kathleen Sebelius shocked family planning supporters in December with her rejection of the FDA recommendation that emergency contraception be available over the counter (OTC) to women of all ages. Plan B, the brand name for emergency contraception, is currently available OTC to women 17 and older—the new rule would have expanded OTC access to women 16 and younger. No health secretary has ever overruled the FDA in its recommendations. And there is no medical evidence showing that Plan B is harmful to any woman of any age. Sebelius stated that the safety of using Plan B by girls 11 years old had


not been studied and that since about 10 percent of girls that age are capable of becoming pregnant, this would need to be studied before she approved the recommendation. Obama backed her decision, saying, “And as I understand it, the reason Kathleen made this decision was she could not be confident that a 10-year-old or an 11-year-old going into a drugstore should be able—alongside bubble gum or batteries—be able to buy a medication that potentially, if not used properly, could end up having an adverse effect. And I think most parents would probably feel the same way.”

Maryland Expands Medicaid Eligibility Women in Maryland who earn less than 200 percent of the federal poverty level— about $22,000 a year—are now eligible for free family planning and reproductive health care through Medicaid. The new law expanded free services to about 35,000 women in Maryland. The program will cost $2.3 million per year and is expected to save $20 million to $40 million by averting unintended pregnancies and reducing the state’s high rates of infant mortality and low birth weight—plights that are more prevalent for babies born as a result of unintended pregnancy.

Planned Parenthood Loses Contract to Religious Org The Shelby County Commission in Tennessee voted 9-4 to end a 30-year contract with Planned Parenthood, in www.popconnect.org

favor of Christ Community Health Services. The Title X federal funding that was once shared between Planned Parenthood and the county health department will now go entirely to Christ Community, an organization that does not counsel on or perform abortion. Christ Community said in its proposal that it would provide emergency contraception, but now that it won the bid says it will provide that service through a third party, due to religious objections. Planned Parenthood is protesting the county government.

San Francisco Crisis Pregnancy Centers The San Francisco Board of Supervisors voted 10-1 to bar crisis pregnancy centers from engaging in false advertising that implies that they offer a full range of pregnancy-related services. The two centers that will be affected by the ruling do not provide abortion or emergency contraception and they do not refer patients to clinics that do offer these services. They must be forthright about their refusal to provide these services in all of their advertising going forward.

Uruguay Moves to Legalize Abortion The Senate in Uruguay passed a bill in December to decriminalize abortion in the first 12 weeks of pregnancy. President Jose Mujica said that he will sign the bill into law if the House approves it after returning from recess in February. Abortion is currently legal only in cases of rape and threat to the woman’s life.

Women and doctors who violate the law face jail time.

Teens Using Condoms More The National Survey of Family Growth found that the percentage of teenage boys using condoms the first time they had sex was 80 percent, up 9 percentage points from 2002. Although more teens used a condom the first time they had sex, just 49 percent of girls and 66.5 percent of boys said they used one every time they had sex in the four weeks before the survey.

7 Billion iPad Apps National Geographic developed a free application, or “app,” which bundles their reporting on the 7 billion milestone in one place. It includes the articles, videos, maps, and photos that graced the print magazine and website over the past year during their exploration of what 7 billion inhabitants means for our world. Science magazine also developed an app around their reporting on the 7 billion milestone. The contents are mostly peerreviewed articles, but also include a video and some useful graphics.

20/20 Special Diane Sawyer hosted a special on 20/20 about child marriage and maternal mortality in December. All five clips can be viewed online at http://tinyurl.com/ PregnantAfghanChild. The fourth clip is about population and family planning. To read the original articles from which these summaries were taken, see http://tinyurl.com/PopConnectNews February 2012 — The Reporter

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The Population Connection President’s Circle Recognizing Donors for Their Generous Contributions of $1,000 or More a Year By Shauna Scherer

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native of the San Francisco Bay Area, Reed Maltzman first recognized the effects of rapid population growth when it began to change the quality of life in his hometown. He saw a connection between the declining quality of things everyone enjoys, such as beaches, and the number of people trying to enjoy them. Soon he realized that the population challenge was not just limited to his own small sphere, but it was a challenge worldwide—and it was magnified at the global level. Reed and his wife, Jennifer, became members of Population Connection in 2006. Now a seventh grade English teacher, Mr. Maltzman began his career in the corporate world. He graduated from Harvard and earned his MBA at Stanford. After finding success as a senior director at eBay, he shifted gears. He wanted to embark on a career that would be more meaningful—that would leverage his creativity and autonomy. He found that in teaching. “When you’re developing a child, you hope they’ll leave the world a better place. Being a global citizen, you realize you’re not alone in the world. In fact, it’s a slightly crowded world.” Not only does Mr. Maltzman bring his concern about global population growth to his classroom, but he helps his own two young children, Max and Zoe, to understand population pressures as well. When he reads the book Material World with them (a photographic journey showing the possessions of typical families all over the world), they observe that larger families have fewer possessions— something that sparks conversations 8

The Reporter — February 2012

We thank the Maltzman family for their contribution toward making the world a better place for everyone, everywhere. If you’re interested in becoming a member of our new President’s Circle, please contact Shauna Scherer, Director of Development, at sscherer@popconnect.org or (202) 974-7730.

As a member of the President’s Circle, you will have the opportunity to... about population, consumption, and sharing resources. Reed argues that for solving any important challenge—from childhood literacy to world peace—adding fewer people to our crowded planet would help. He imagines the positive changes that would occur for many millions of women with a stable population. With 215 million women worldwide wanting to avoid pregnancy but not using modern contraception, it’s clear that women bear the brunt of rapid population growth. Thinking of his daughter, Zoe, Reed says “We take for granted that she’ll be educated.” That’s not the case for many girls and young women in the fastest growing regions on earth. Combined with contraceptive access, girls’ education is an important deterrent to early motherhood. “Empowering and educating girls, and making the world a better place for women, that’s crucial.”

...Meet one-on-one with John Seager, President of Population Connection, as he travels the country talking to audiences about population issues. Take part in quarterly conference call briefings with Brian Dixon, our chief lobbyist on Capitol Hill, as well as with other key Population Connection leaders. Attend special receptions hosted by members of our Board of Directors and fellow President’s Circle members. We greatly value your participation as a member of Population Connection, as we pursue strategies to increase funding for family planning programs at home and abroad, educate children in the U.S. about population growth, and motivate more Americans to work toward population stabilization.


Urban Family Planning in Dakar, Senegal Reflections on the 2011 International Conference on Family Planning By Marian Starkey

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ustafa, the man selling sand paintings at Kermel Market in Dakar, was also a taxi driver. He offered to bring me around for the day so that I could see the sights of the city, an offer I was pleased to accept. While attending the International Conference on Family Planning, I had had little time to explore because of the busy agenda. Having lived in Senegal for three months in 2005, I had already seen many of the local tourist destinations, so I told Mustafa that what I really wanted was to interact with the people of Dakar. As we began walking to his car, I mentioned that I hoped to take a picture of a woman carrying a baby on her back, tied on with only a thin sheet of colorful pagne cloth. I told him that I would pay the woman who was willing to pose for me so as not to be intrusive or sneaky. He laughed and shook his head, but set off briskly on foot to find me an appropriate subject. After walking for only one block, he saw two women selling handmade dolls and bracelets. He asked them in Wolof whether they knew anyone who would be interested in my odd request and one of the women immediately jumped up and ran to where another woman was holding her baby. She leaned over, slung the baby onto her back, and tied her on tightly. Then she stood up straight and smiled. I hadn’t even gotten my camera out yet! I bumbled around, fussing with the settings, and then took a couple of shots. I gave her the 2,000 CFA (about $5) that we had agreed upon and then she did something unexpected. She untied the baby and told me to lean over. She and her friend then tied the wet (and now screaming) infant to my back! Mustafa was standing there, enjoying the scene, and took my camera from me so that he could snap a few pictures. With vendors and pedestrians looking on, this toubab (white person) scared the daylights out of that poor child. I quickly gave the baby back and the woman then presented me with one of her handmade dolls and two bracelets, as a gift. Mustafa toured me around the city for a couple of hours and then announced that it was lunch time and wondered whether I’d like to go back to his house to eat with him and his family. I eagerly agreed and we drove to the poor, sandy suburb of Diamaguene. Men were shoveling dirt and gravel onto a roof from the ground—an incredible sight—and huge speakers were blasting West African rhythms into the street in front of Mustafa’s home. He explained that there would be a wedding, www.popconnect.org

although I didn’t see a bride and groom, only a bunch of people sitting in plastic chairs, enjoying the music. Mustafa’s two daughters ran over with their tiny ice cream cones and shook my hand. He introduced me to his elderly father, who was one of the people sitting in the plastic chairs in traditional clothes and pointy white leather shoes. We went to Mustafa’s house, which was a couple of small concrete rooms set off a courtyard. One of the rooms was his bedroom, and his wife was inside tidying up, tucking sheets snugly around the edges of the bed. He had called her on his cell phone from the road so that she would expect us. She spread a cloth on the floor, and then excused herself to fetch the food. She returned with a large stainless steel bowl of thiéboudienne, the national dish of rice, fish, and vegetables. Mustafa and I ate cross-legged, with Senegalese music videos playing on the TV behind him, each using a large spoon to eat out of the same bowl. February 2012 — The Reporter

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Normalizing the small family through advertising. Billboards with different rabbit families (all with two children) were posted throughout Dakar. Imams in Guédiawaye, talking about their outreach work on family planning. Photos: Marian Starkey

The Conference

Held the week after Thanksgiving, the International Conference on Family Planning united more than 2,200 health providers, researchers, policymakers, advocates, and members of the media in their goal of achieving universal access to family planning. The Bill and Melinda Gates Foundation, along with more than 30 domestic and international organizations such as USAID, UNFPA, WHO, and the World Bank sponsored the conference. The 140 sessions offered something for everyone. There were workshops for training clinicians to insert implants and IUDs. There were software demonstrations for those in commodities procurement who make projections of the future demand for contraceptive supplies. There were panels for journalists and advocates on techniques to effectively communicate the importance of family planning. And, of course, there were dozens of sessions for sharing the latest family planning research. Enthusiastic participants sported name tags hung from lanyards of donated CycleBeads (a string of beads that can be used as an improvised calendar to track a woman’s monthly cycle). Africans from all regions of the continent, many wearing boldly printed tailor-made clothing, mingled with North and South Americans, Europeans, and Asians over coffee breaks on the lawn. Old colleagues reminisced about all the times their SUV broke down in the Congo and the year when they lived in tents in Darfur. Researchers who only knew each other by name met in person to talk data and methods. Practitioners compared notes about the popularity of different methods in their respective clinics and communities. Lunchtime roundtables allowed emerging leaders to pick the brains of high-level family planning professionals (I had lunch with the new Director General of the International Planned Parenthood Federation, Tewodros Melesse, a soft-spoken multilingual Ethiopian economist with nearly 30 years experience in reproductive health). 10 The Reporter — February 2012

Senegal’s President Abdoulaye Wade spoke at the opening ceremony. He committed $1 million for family planning in his first-ever public speech on the topic. His words were transmitted via radio and newspaper throughout the country. Artisans mentioned his speech while bargaining on the sales prices of fertility dolls and djembe drums at Dakar’s thronging markets. Taxi drivers gingerly expressed their support as we sped along coastal routes, with UB40—still a wildly popular band in Senegal—crooning in the background. Wait staff asked for more details about the conference and our purpose in Senegal each time they brought another fresh seafood dish to the table.

Family Planning Assistance in Action

I joined the staff of IntraHealth on a visit to two clinics that they support in partnership with the Senegalese Ministry of Health, through the Senegalese Initiative for Urban Health (ISSU). The Initiative is funded by the Gates Foundation and also works with USAID to satisfy the high unmet need for family planning that exists in poor urban regions of Senegal. The mission of the Initiative is to make family planning more socially acceptable and to expand and improve access to family planning, at the community and at the policy level. One means of moving toward social acceptability includes working with religious leaders to educate communities about family planning and its benefits. We visited a mosque in Guédiawaye, where we spoke with several imams (Muslim religious leaders) who serve as liaisons between the mosque and the community on family planning and its relationship with Islam. In fact, Islam does not prohibit or even discourage contraceptive use. Over 90 percent of Senegalese adults believe that God is the only one who should decide how many children a couple has, so the value of these imams cannot be overstated. The imams spoke of how they bring family planning information door-to-door and slowly change minds in this traditional Muslim society. Sheep


Women at a clinic in Guédiawaye. Women in Golf Sud attend a family planning demonstration. Photos: Nicholas Loomis

bleated loudly outside the mosque, and at one point an imam unlocked the door to shoo away some especially noisy children. As we left the mosque and returned to our shoes and the sandy streets of Guédiawaye, we appreciated the positive influence religious leaders can have in a highly devout place like Senegal. The fertility rate in Senegal has decreased to 5 children per woman, from over 7 two decades ago. But the speed of decline has been much slower than in other parts of the world. More than 80 percent of poor urban women do not use family planning, and this is the population that the Initiative attempts to reach. In fact, 34 percent of women say that they do not want another baby in the next two years, but they are not using modern contraception—the definition of unmet need. Family planning services through ISSU are free or very inexpensive and are distributed at clinics and through mobile outreach. Demonstrations are conducted regularly and they are well attended. As we were leaving the clinic in Golf Sud, a neighborhood in Guédiawaye, a nurse began a demonstration for a dozen women, many with babies on their backs. She described each method, holding it up to the nods of the women. The doctor at this clinic said that contraceptive use has doubled in his community since the clinic opened, from 7 percent to 14 percent. That’s still not high enough to have much of an effect on the community’s fertility rate, but it’s an encouraging sign of progress. A midwife and two nurses run the clinic in Fith-Mith, another neighborhood in Guédiawaye. We spoke with them in the courtyard, which serves as the waiting room for patients—who often wait all day to be seen because the clinic is so understaffed. We squeezed past a woman selling cashews and several tired-looking mothers with small children to tour the clinic. Two metal beds with thin mattresses and a makeshift incubator were all that the single delivery room contained. Next door, two young www.popconnect.org

women who had given birth the day before were resting. Their tiny newborns peeked out of receiving blankets and the mothers seemed pleased that we doted on them for a few extra minutes before moving along to see the room where records are kept. When we lobby for increased funding for international family planning, this is a perfect example of where that funding is spent. On real women who have a real need to plan their families. Building a clinic is a first step. Staffing it and securing a steady supply of commodities is next. Drumming up interest and support is the final, and perhaps most difficult, step. ISSU is doing all three.

Encouraging Developments

The Gates Foundation announced at the conference that it will spend $70 million a year on family planning. Melinda Gates says the cause is now one of her top priorities. The UK announced that it would commit an additional £35 million to family planning assistance. For the United States’ part, we’ll continue to fight against attempts to cut international family planning by the House leadership, while urging the Senate and the White House to increase funding to $1 billion. While eating lunch with Mustafa, we talked about my week in Dakar. He seemed interested in the fact that so many people had come to his city to discuss family planning. He said that he wanted another child because he was hoping for a boy, but agreed that it’s important not to have more children than one can support. I had to wonder whether the work of the imams I had met two days earlier had something to do with his attitude toward family planning. His amusement at the fact that I am married but have no children was an improvement on the looks of pity or sometimes disgust that I received when I revealed the same fact six years ago. Senegal is poised for change and Mustafa’s daughters have reason to hope for brighter days. February 2012 — The Reporter 11


From Poverty to Matrimony:

Sumeena Shreshta Balami, 15, cries as the wedding procession leads her to her new husband’s home in Kagati Village, Kathmandu Village, Nepal on January 24, 2007. Photo: Stephanie Sinclair/VII

12 The Reporter — February 2012


Early Marriage in Rural Nepal By Anna Tomasulo

www.popconnect.org

February 2012 — The Reporter 13


Twenty-year-old Sanani Balami stood in ankle-deep mud, pulled

up stalks of rice, and lobbed them onto drier ground. Sanani and her family are generating no significant income right now; they work in subsistence farming and face a large amount of debt for her husband’s travel and hospital bills.

Farming and household work are not new to Sanani, who has been helping to support her family since she stopped going to school at age 12, and her in-laws since she was married at age 14. We interviewed Sanani in her home on a steep hillside in Kagati village, about 20 kilometers west of Kathmandu. She lives with her in-laws in a mud hut with a corrugated metal roof and a “barn” attached on the side. The room we sat in was sparsely accommodated. There were no chairs or tables, no furniture apart from an armoire across the room. We sat on planks of wood near the door, so as to have some light. Her motherin-law switched between preparing wheat beer and crushing chili peppers in a big mortar and pestle. Sanani’s two children crawled into her lap. Early marriage is common in Nepal. The legal age for marriage is 20, but the median age at first marriage (according to the 2006 Demographic and Health Survey) is 17.2 for women aged 20-49. In 2006, the Nepali government reported that 60 percent of women in this age group were married by the age of 18. According to UNICEF’s Innocenti Research Center, poverty is a key factor driving the practice of child marriage. In a 2001 report, researchers explain that marriage is seen as a “strategy for economic survival;” a “way to protect girls and to provide some stability in situations where societies are under extreme pressure.” Sanani has long dark hair, pulled back into a messy ponytail. She was wearing a red blouse and skirt, and around her neck hung red and green glass beads. She smiled a lot. She kept checking her watch during the interview, aware of the work to be finished before nightfall. We noted during other interviews that people were reluctant to be away from their work. Nepal is one of the poorest countries in South Asia and ranks 138 out of 169 on UNDP’s Human Development Index. For the 2009 fiscal year, the World Bank reports that GDP per capita in Nepal was a low $470. Taking time to talk to reporters means taking time away from work, and time is money. 14 The Reporter — February 2012

From Poverty to Marriage Sanani married Shyam Balami at age 14. Shyam was 17 at the time. These ages are estimates; neither Sanani, her husband, nor her mother-in-law are sure of their ages. It is common for parents to arrange marriages in Nepal. One father from the Thami ethnic group explained that it is a parent’s responsibility to make sure his children are secure, via a suitable marriage. He disapproved of the idea that a young girl would leave home with a man of her own choosing. His disapproval stemmed not from some pernicious desire to see a young woman unhappy, but rather from the break with one’s culture and the risk of premarital sex or marrying into the wrong caste. He himself has a daughter-in-law whom he did not choose. While he displayed affection for her and the child she bore, he said that it is the tradition that a parent should choose a suitable wife for his son. When Sanani’s parents first spoke to her of marriage, she had been out of school for two years, busy with cooking for the family, working in the fields, and looking after her younger siblings. Her parents could not afford to send all six of their children to school. As she was the eldest, and a girl, she was asked to drop out to help support the family. Sanani admits that she likes school. However, she felt it was her responsibility to take care of the household. “How could I go to school when there was so much work?” she asked. UNICEF reports that in impoverished areas, such as Nepal, “a young girl may be regarded as an economic burden and her marriage…is a familial survival strategy.” We learned through interviews that girls in Nepal are seen as a liability because they have fewer economic opportunities and will inevitably end up contributing to another family. Her family receives no monetary returns, despite having provided for a girl’s basic and education


Sanani’s home in Kagati village; Sanani farming in the rice paddies near her house. Photos: Anna Tomasulo

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February 2012 — The Reporter 15


Sanani’s children, estimated ages 5 and 2, outside their home; Sanani and her daughter during the interview. Photos: Anna Tomasulo

needs. So the most a daughter can offer is domestic help or an advantageous marriage. Such was the case for Sanani. Her marriage helped both her family and her in-laws. When Shyam was a young man, he was told that he needed to take a wife to provide much-needed help at home and in the fields. Along with domestic help, Sanani brought offerings of an armoire and a large water vessel to her in-laws—her dowry, as is customary in Nepal.

Dangers of Early Marriage Despite the economic benefits some families receive through 16 The Reporter — February 2012

marriage, early marriage can have serious health consequences for young girls. In Nepal, there is pressure for new wives to demonstrate their fertility and to begin bearing children as soon as possible. But research from the United Nations Population Fund (UNFPA) shows that girls aged 15-19 are twice as likely as women aged 20-24 to die during pregnancy. One of the common health risks of early pregnancy is fistula. Because young women are not physically developed enough to deliver a child, they often face prolonged labor. During labor, the baby exerts pressure against soft tissues in the mother’s pelvis. This can cause some tissues to die, leaving a hole or a fistula.


Depending on the location of the hole, the woman may experience involuntary urination or defecation, which will affect her quality of life, unless she can afford medical care. Fistula exists in Nepal, but a more common problem seems to be uterine prolapse, which is when the uterus descends through the genitals. UNFPA reports 600,000 women in Nepal are affected by uterine prolapse. Among the causes of this condition are applying pressure during delivery, strenuous manual labor after childbirth, and giving birth at a young age. Some effects of uterine prolapse include pain during urination, difficulties during sexual intercourse, and social stigmatization.

Will the Practice Continue? When Sanani’s parents told her she was to be married, she was happy, although she didn’t know what marriage was. “I thought it was a sport or a game to play.” Despite not knowing how babies were made, Sanani became pregnant shortly after marrying, and delivered a son at age 16. Fortunately for Sanani, she delivered both her children without problems. Sanani’s mother-in-law, Suntali Balami, explained that children are a gift from the gods. Many families will keep having children until a boy is born. In Hinduism, boys perform the last rites, meaning that boys ensure a deceased parent’s entrance into heaven. This belief increases, again, a boy’s value.

for work, and that men are three times as likely to migrate as women. Most migrant workers travel to India, Malaysia, and the wealthy Gulf countries. Shyam Balami was employed in Malaysia as a painter. After only four months, he began to lose feeling in his right foot and right hand. He could no longer work, and his family had to send more money to bring him back to Nepal. We spoke with Shyam at the Natural Health Hospital in Kathmandu, where he has been living since June. The hospital seemed empty. As it was a Saturday, we assumed it was “closed” on the weekends. With no staff to help us, we found Shyam, resting on a chair on a balcony, surrounded by a group of friends and family members. Shyam needed the help of two men to walk to his room. His left leg moved flawlessly, but his right leg swung forward in a stilted manner. When we asked Shyam about his marriage, he told us he understood marriage to be finding a girl, having kids right away, and making sure the children were more educated than their parents. When we discussed the marriage of his children, he firmly stated that they would decide for themselves when to marry. But he quickly added a caveat: this could only happen if the family was living a better life.

We asked both women when they planned to arrange a marriage for Sanani’s daughter, a shy 2-year-old who clung to her mother throughout the interview. Both answered that she must finish school before she can be married.

It seemed clear that education and awareness campaigns against child marriage in Nepal have had some success. The Balami family was aware of the dangers of child marriage and hoped for a different future for their children. But to attain this, more than good will and education is needed. Economic opportunity plays a significant role in decreasing early marriage in Nepal.

“I don’t want her to face what I did. When I was to be married, I didn’t know what was going on or why I had to leave my family,” said Sanani.

As our interview with Shyam came to an end, we showed the young father pictures of his wife and children that we had taken that morning. A smile exploded across his face.

Suntali said that even if a boy comes asking for her hand, she would forbid the marriage until her granddaughter has received her education. Suntali answered our questions quickly, not wanting to waste time with reporters when they could be working in the rice paddies.

Tomorrow Sanani will sacrifice a day of work and pay for transportation to visit her husband in Kathmandu. The trip will worsen their economic situation and increase their dependency on agricultural work Sanani is able to do. It will also impact the future of her 2-year-old daughter.

Sanani and her in-laws were very concerned about their finances. Last year the family raised 150,000 Nepali rupees (approximately $2,100) to send Sanani’s husband to Malaysia for work. This is quite common in Nepal: the 2006 Demographic and Health Survey reports that 37 percent of households in Nepal had at least one household member travel within the last year

Anna Tomasulo’s reporting in Nepal was supported by the Pulitzer Center on Crisis Reporting, through a student fellowship partnership with Boston University. See all the related reports from her project Nepal: Married Before They Are Ready at http:// pulitzercenter.org/projects/nepal-child-marriage-traditiongovernment-education-economy.

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February 2012 — The Reporter 17


The message from the youth of Basse is clear—they want their rights surrounding marriage to be respected.

18 The Reporter — February 2012


Change From Within Photos by Lilli Loveday

Molly Melching has lived and worked in Senegal since 1974. She is the Founder and Executive Director of Tostan, a non-governmental organization that has developed an innovative model for development in which communities are leading large-scale movements for positive social change.

Youth Leading Movement for the Abandonment of Child Marriage in The Gambia By Molly Melching

I

n the Serehule village of Sotima, Tida Waaly warned the crowd against the dangers of teen pregnancy—only one of the harmful but very common results of child marriage. She urged parents to let their daughters choose their husbands and allow them to marry only after they turn 18. Adolescents from the Mandinka village of Bassendi performed a skit, which portrayed the sometimes fatal consequences of teen pregnancy. In the skit, a young girl dies in childbirth because her body is not physically mature enough to deliver the baby. While the animated acting during a scene in which the mother discovers her daughter’s pregnancy provoked laughter, the somber funeral song concluding the play clearly drove home the message that teen pregnancy poses severe health risks for girls. Within numerous ethnic groups in The Gambia and other parts of Africa, it is common for parents to arrange for their daughters to marry before the age of 18. Parents in Africa and beyond commonly feel pressure to marry their daughters when they are still children for a variety of reasons, including financial hardship, the opportunity to improve a family’s socioeconomic status, and the desire to prevent the health and social consequences of sexual activity outside of marriage. Tostan has worked in the field of human rights in Africa for more than 20 years. During that time,

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February 2012 — The Reporter 19


A female participant shares her knowledge of the importance of human rights and responsibilities—she talks specifically about the right to chose when and whom to marry. Displaying a banner about early pregnancy, boys and girls march through Basse making their message known to the wider community.

our comprehensive, non-formal education program has resulted in over 5,000 communities in seven African countries publicly abandoning the practices of female genital cutting and child/forced marriage. At Tostan, we believe that this success is due to the fact that we, as an organization, do not lead or impose change; rather, Tostan’s Community Empowerment Program (CEP) provides communities with relevant information, the skills to identify their goals for development, and the tools to implement change. Tostan’s CEP is a 30-month, human rights-based education program that provides a space for dialog during regular class sessions led by a local facilitator on human rights and responsibilities, health, hygiene, and problem solving. Participants have the opportunity not only to access new information on these topics, but also to discuss whether or not it is valuable and relevant to their community. It is important to note that this empowering education does not focus on only one issue, such as child marriage, but instead allows people to articulate a wide range of their needs and aspirations, as well as to discuss their values as a group. Equally essential is extending this process outwards so that people engage 20 The Reporter — February 2012

beyond the family and community level. We call this organized diffusion, whereby participants reach out to others in their own village and then travel to other communities to share new ideas and information with their social network. This both reinforces and extends the impact of their decisions. Just as in other countries around the world, young people in The Gambia are leading social change through a social networking system of their own. In October 2011, 170 Gambian youth from 73 Tostan communities organized the third annual Tostan Gambia Youth Caravan, a five-day awareness-raising campaign. The teens, all participants in Tostan’s CEP, traveled by bus to five villages in The Gambia’s Upper River Region. In each community, they hosted an event for all community members, complete with information-sharing, songs, and skits that drew attention to the various issues that young people face in The Gambia, including child marriage and teen pregnancy. On the final day of the caravan, the youth extended their message of human rights beyond local communities, bringing it to the doorstep of the Gambian government. As honking horns announced their arrival, the Gambian youth spilled out of six buses and assembled in front

of the Tostan office in Basse, the largest town in the eastern-most part of The Gambia. The atmosphere was alive with excitement. Groups of girls in colorful fabric skirts and matching t-shirts danced along the street while waiting for the festivities to begin. Participants unfurled large banners that read “Allow me to choose my husband when I turn 18” and “Child protection is a responsibility for all.” The youth attracted much attention and soon large crowds of onlookers gathered along the street to witness the joyful celebration. The teens chose to end their five-day journey with a march to the residence of the Governor of the Upper River Region to advocate for their human rights agenda in front of local leaders and government officials. The group began their march through the town of Basse accompanied by Tostan supervisors on noisy motorbikes, as a marching band of teenage boys played the Gambian national anthem. Upon reaching the Governor’s residence, the youth presented a manifesto as they proudly displayed their banners. Read aloud in English by participant Fatou Baldé, the manifesto called for action from community members, local leaders, and government officials to respect the human rights of Gambian youth.


In the village of Bassending, participants perform a drama about child/forced marriage and early pregnancy.

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February 2012 — The Reporter 21


170 youth took part in the five-day youth caravan throughout The Gambia—here they are arriving in the community of Perai.

Basse’s Assistant Governor, Mohamed Salu Diallo, responded to Fatou Baldé’s appeal with admiration and respect. Addressing the crowd of young Gambians, he confirmed his commitment to human rights, stating:

information, resulted in the organization of this event. The teens recognized that with their new understanding of human rights, democracy, and problem solving comes the responsibility to act in order to implement change.

a thing of the past. Community-led strategies where people themselves lead the movement for human dignity offer a tremendous opportunity for achieving positive social change thought impossible only 15 years ago.

“Human rights are undeniable rights and should be enjoyed by all, especially the youth who are our future leaders. Your manifesto has outlined key issues on the rights that correspond to the responsibilities of youth and their expectations from the government. We will do our utmost to support you as responsible youth since you are [the] cream of our future society.”

Of course, it takes more than just one event to effect lasting social change; however, combined with the government’s support, community engagement, Tostan’s ongoing education for thousands across this region of The Gambia, and increased public meetings and declarations to end these practices, the actions of these youth are truly powerful. The passion and determination of these young African leaders clearly indicate that wide-scale change is on the horizon. Through empowering education, this confident and resourceful new generation will join with community members to make harmful practices, such as female genital cutting and child/forced marriage,

Tostan’s mission is to empower African communities to bring about sustainable development and positive social transformation based on respect for human rights. Working primarily in remote regions, the organization provides holistic, participatory education to adults and adolescents who have not had access to formal schooling. Tostan’s program includes modules on human rights, hygiene and health, literacy, and project management. It employs community-led outreach strategies that engage program participants in their own and neighboring villages. Through this approach, Tostan has transformed the lives of millions of Africans. www.tostan.org

As participants in the CEP, these youth were empowered with the tools necessary to lead social change, which, paired with their passion to share important new 22 The Reporter — February 2012


From Child Bride to Senegal Rights Crusader Article and photo by George Fominyen

F

atou Diakhate seemed so young when she was given away in marriage that her husband, Mori Diarra, took pity on the 13-yearold. Diarra, 30 at the time, spoke to Diakhate’s father and arranged for her to stay in her family home until she was 15. It wasn’t long after she eventually joined him in Keur Issa, a hamlet in western Senegal, that she became pregnant. Forty years later, sitting in the courtyard of the matrimonial home, Diakhate explained how she went on to have 12 children. “In those days, when parents saw their children getting married they were very happy,” said Diakhate, now 55. “Since we girls were not educated, we were also happy to get married. We didn’t know early marriage was not a good thing.” Child marriage is widespread across subSaharan Africa, where it is often driven by endemic poverty and seen as a way of securing a girl’s future both financially and socially. It also benefits parents through the payment of a “bride price.” A recent study by children’s charity Plan UK found that 43 percent of girls in West Africa are married before their 18th birthday. Not only are they pulled out of www.popconnect.org

school, but many face early pregnancy and serious health complications.

Death Threats

Diakhate didn’t attend any kind of school until her forties, when she took adult literacy classes as part of a community program run by local aid agency Tostan. During the 30-month course, she and other women in the village learned how to read and write in Wolof, Senegal’s main language. They also studied reproductive health and learned about obstetric risks for still-developing girls’ bodies, including a common childbirth injury called a fistula that affects about 2 million women and girls, mostly in Africa. A fistula causes severe incontinence. Experts say female genital mutilation, common in Senegal, exacerbates those risks. “We realized there are lots of problems with child marriage and that it wasn’t good at all for girls to be married early,” Diakhate said. Diakhate went on to become a community leader, rallying the women of her village against child marriage on the grounds that it put girls’ lives in danger and denied them an education. She spoke to the village chief, the local imam, and the municipal councillor about the

women’s wish to see an end to the practice. But the men were not convinced. They accused her of corruption, saying she had been paid by Tostan to destroy their ancestral traditions. “I don’t get paid—I’m a volunteer,” said Diakhate, her face still clouding at the accusations all these years later. “They sent me death threats saying they would use gri gri (magic) against me.” Despite the hostility, Diakhate pressed on. After several months of talks with community leaders her resilience paid off when in late 1998 the entire community decided to abandon child marriages. Not a single child marriage has taken place in Keur Issa since. Several other communities in Senegal have also banned the practice. The latest is a cluster of 159 communities in the Fouta and Kolda regions, which also abandoned female genital mutilation. “As women and mothers we talk to our daughters…We advise them to go to school,” Diakhate said. “We don’t want them to suffer the same fate as us.” Reprinted with permission from TrustLaw, a Thomson Reuters Foundation news and information service on anti-corruption and women’s rights.

February 2012 — The Reporter 23


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25. Black and white cookies 29. Refuse

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24 The Reporter — February 2012

68

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By Alex Starkey

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Have you enjoyed doing the crossword puzzles that have been in the last three issues of The Reporter? Have they been too difficult? Too easy? Please share your feedback at mstarkey@popconnect.org!

S E 21

12

A woman in a village near Jodhpur, India, with her granddaughter who was married at an early age. Photo: Rose Reis, Courtesy of Photoshare

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February 2012 — The Reporter 25


Washington View

Mixed Outcomes in 2011; No Guarantees in 2012 By Stacie Murphy

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he last months of 2011 saw a flurry of activity around family planning issues, foreign and domestic. In terms of both funding and policy, the outcomes have been decidedly mixed. And in looking forward to 2012, it’s hard to imagine that changing. There is simply no getting around the fact that enemies of family planning control the House of Representatives. Under these circumstances, victory is not only about progress made, but also ground held. After months of negotiations, in late December, Congress passed and President Obama signed the Fiscal Year 2012 Omnibus Appropriations bill. The spending package includes a total of $610 million for international family planning—only $5 million less than FY 2011, but well below both the $769 million requested by President Obama in his budget proposal earlier this year, and the $1 billion urged by family planning advocates. The funding level for our bilateral programs (through USAID) remains unchanged. The decrease in funding comes entirely from cuts to our contribution to the United Nations Population Fund (UNFPA), which will receive $35 million for its programs, in contrast to last year’s $40 million. 26 The Reporter — February 2012

The decrease in funding to UNFPA and the level funding of our bilateral assistance programs might be disappointing in another context, but we view this outcome as a definite victory. The overall foreign assistance budget decreased by 5 percent, so maintaining the same level of funding for our primary family planning program is an excellent outcome. It is even more impressive in light of the fact that the Republican majority in the House of Representatives originally approved both a 25 percent cut to family planning and the total elimination of support to UNFPA. The House bill also included a provision reinstating the Global Gag Rule. Fortunately, strong opposition in the Senate prevented the Gag Rule provision from being included in the final package.

Domestic Issues

The Omnibus package also set funding levels for several of the domestic programs we support. The funding for President Obama’s Teen Pregnancy Prevention Initiative (TPPI) remained the same as in FY 2011, although $5 million of its $104.6 million will now be required to be spent on abstinenceonly programs. While this is far from ideal, here again, the outcome is a victory when compared to the outrageous recommendation of the House of Representatives. The House bill cut

funding for evidence-based sex education from about $105 million to only $20 million—and directed that an equal amount be spent on abstinence-only programs. Viewed from that perspective, a token expenditure on abstinence-only seems like a bargain to preserve funding for serious efforts. Not all programs were treated as favorably, however. Title X, the nation’s family planning program for lowincome women, saw its funding drop by $2.6 million, to $296.8 million—far short of the program’s actual needs. In the current economic climate, this cut will mean that fewer women will have access to needed services, at precisely the time when more women need help. Ironically, this is a cut that will actually end up costing money, since evidence shows that providing family planning assistance ultimately reduces the cost to the state from unplanned pregnancies. In mid-December, the Department of Health and Human Services (HHS) announced that emergency contraception (brand name Plan B) would not be made available over the counter to women under the age of 17. This announcement was an unprecedented rejection of the medical and scientific judgment of the Food and Drug Administration, which recommended wider over the counter


access to the drug. Currently, women age 17 and older may obtain the drug without a prescription by asking a pharmacist, while younger women need a prescription. The decision is deeply disappointing, since easier access to emergency contraception has the potential to reduce unintended pregnancies among young women. It is extremely unfortunate that the FDA’s expert recommendation did not prevail in this case. Women’s health advocates have called on President Obama to ask HHS to reconsider the decision, but at the moment there is no indication that he intends to do so. The Plan B decision is not the only significant issue facing the administration. As we reported in our last issue, President Obama decided in the fall to include the provision that birth control be offered without copays under all new health insurance plans as part of the Affordable Care Act. We also reported strong opposition to the measure by some groups. That opposition now appears to be a fairly serious threat to the new benefit. Although the original rule contained a clause that exempted some religious employers, several Catholic medical groups have petitioned the www.popconnect.org

administration to completely eliminate the benefit, on the grounds that it violates their freedom of religion. As a “compromise,” they suggest a greatly expanded exemption that would cover any employer with even tenuous religious ties. Experts estimate that such an expanded exemption could leave more than a million women without access to this important new benefit. Worryingly, there are signs that the Obama Administration may actually be considering such a plan. When this issue went to press, we had no further information about the likely outcome, and no sense of the timeline.

State Level Challenges

Capitol Hill isn’t the only place where opponents of family planning are having an appreciable effect. At the state level, the “personhood” movement plans to make 2012 an eventful year. Despite experiencing a decisive loss in Mississippi this November—arguably the most conservative state in the country—personhood proponents have vowed to keep trying. Currently, there are plans for personhood amendments on the 2012 ballots in Colorado, Georgia, Florida, and Ohio. Proponents have also attempted to get the initiative on the Nevada ballot, but were blocked by a judge who declared that the language of

the measure was too vague. Additionally, a Virginia state legislator has introduced a personhood measure there that stands a reasonable chance of passage, given the conservative makeup of the legislature following the November elections.

Looking Forward

Although the budget battle of 2012 has only just ended, the 2013 battle is already set to begin. President Obama will release his proposed budget in February. Since his past budget proposals have been very supportive of international family planning, we expect that the forthcoming proposal will be as well. We have renewed our call for $1 billion for international family planning, a figure that represents the United States’ fair share of the total cost of providing access to family planning for the estimated 215 million women in the developing world who currently have an unmet need. Our allies in Congress have joined the call, with 104 family planning supporters in the House signing a letter to Obama, urging him to include the $1 billion ask in his FY 2013 proposal. In the face of the kind of opposition we have experienced this year, and in this economic climate, such a strong show of support is extraordinary. However, although we have hope of a positive outcome, there are no guarantees. And in an election year, anything can happen. February 2012 — The Reporter 27


Field & Outreach

Forging Connections Through Film By Rebecca Harrington

L

ast fall, as the world reached the 7 billion population milestone, we began collaborating with Tiroir A Films, producer of the documentary Mother: Caring for 7 Billion. Directed by Christophe Fauchere and featuring an interview and voice-over by our own Brian Dixon, the film focuses on the rapidly growing world population and the implications of such growth for women’s health and empowerment, the environment, and social equity. This timely partnership paved the way for an invigorating season of lively film screenings and discussions with diverse audiences around the country. The film centers on the story of an American children’s rights activist, Beth Osnes. A cofounder of the organization Mothers Acting Up, Beth shares her journey toward understanding the importance of population stabilization. One of ten children in a deeply Catholic family, Beth’s ideas about population were largely shaped by her husband, J.P., who comes from a small family and strongly believes in practicing replacement—couples having a maximum of two children. Throughout the course of planning her own family, (Beth and J.P. have two biological children and an adopted daughter from South Africa), Beth came to

28 The Reporter — February 2012

appreciate the notion of population stabilization. In filming Mother, her outlook is further influenced by her experience of meeting Zinet Mohammed, a young woman from an impoverished Ethiopian village. Beth and Zinet’s paths cross when Beth is invited to join a focus group sponsored by Population Media Center’s Ethiopian office. Population Media Center is an organization that employs entertainment (and more specifically, serialized radio and television dramas) to educate listeners about reproductive health issues and to impel social change. Zinet, a listener, is one of several women in this focus group. Having grown up in an abjectly poor family of 12 children in an Ethiopian village, where women are expected to marry young and have many children, Zinet opted to challenge cultural expectations and her family’s history of poverty, and is working to complete her education, while also supporting her family through her work at the local family planning clinic. Zinet serves as the role model for her family, as the sole member to pursue an education and to avoid the perils of child marriage and early childbearing. Zinet’s circumstances further highlight for Beth the need for increased access to family planning and education as a means to

empower women, stabilize population, and reduce pressures on our overtaxed planet. Beth reflects toward the end of the film, “The course of population stability is going to come from millions of women just like Zinet, making these same choices. They need an education. They need some outside agent that’s [going to] help them empower themselves, and they need a voice.” We first screened Mother for an audience of 65 at the Gateway Film Center in Columbus, Ohio in September. The crowd enthusiastically participated in the discussion that followed the screening, and many signed our petition to Representatives Steve Stivers (R-OH/15) and Pat Tiberi (R-OH/12), requesting $1 billion for international family planning assistance. The participants were eager to discuss the film’s themes, both with our staff and with each other; many stayed for nearly two hours following the screening and discussion. Brandon Beck, an Ohio State University student, reflected, “Before the film screening of Mother, I didn’t have a clear picture of the situation the world’s population is currently facing. With the population of the world  now  over 7 billion, universal access to food, clean water, and other essential resources have become increasingly limited. With the


demand for important resources higher than their availability, it is clear that action needs to be taken to control population growth as soon as possible.” Our next stop was Seattle, where we screened Mother and led a discussion at an event hosted by the Wallingford Neighbors for Peace and Justice. About 70 people attended that evening’s weekly “Friday Night at the Meaningful Movies” series. The film provoked inspired discussion from the audience, which included teenaged through elderly participants, prompting a mix of thoughtful, outspoken, and at times colorful ideas about population issues. Many participants signed our petition to Representatives Dave Reichert (R-WA/08) and Jim McDermott (D-WA/07). The group’s organizers, committed activists who care about a wide range of social justice and peace issues—including population— were engaged and incredibly welcoming, and we look forward to working with them again. November brought us back to Columbus to host another event, this time on the campus of Ohio State University. One of our most valued collaborators, the Ohio State Global Health Initiative (GHI), helped us engage an audience www.popconnect.org

of 50 students, who signed our petition to Representatives Stivers and Tiberi. While in Columbus, we had the opportunity to meet with two Global Health Initiative members, who plan to organize in-district advocacy meetings with Rep. Stivers this winter. These students, who were inspired by their experience at the 2011 Capitol Hill Days event, are eager to apply their knowledge at their advocacy meetings to advance the dialogue on population and family planning at the local level. Katie Ferman, GHI’s Chair of International Volunteering, said, “GHI and Population Connection have formed a very close, energetic partnership over the past year and a half. Population Connection has given Ohio State students interested in issues of public health, global population growth, and environmental issues the opportunity to have a voice in national policymaking at the annual Capitol Hill Days event, and it is an opportunity few of us would likely have otherwise. GHI looks forward to working with Population Connection in the future to advance their fantastic cause, both on the national level in Washington and at the district level here in Columbus.” Our final film screening of the fall took place in early December, when we

Announcement! Capitol Hill Days will take place in Washington, DC from Friday, March 30 through Tuesday, April 3, 2012. For more information, please contact Rebecca Harrington at rharrington@popconnect.org or (202) 974-7738. traveled to Minneapolis to share Mother with medical students at the University of Minnesota. We cohosted the event with the university’s chapter of Medical Students for Choice—an international organization that works to ensure that reproductive health care, including abortion, is part of medical school curricula and residency training. We have had great success sharing Mother, and will continue to use the film to connect with members and supporters throughout the country. Producer Joyce Johnson said, “We are very happy to work with PC on the promotion of our new film Mother: Caring for 7 Billion. It was important for us to find like-minded groups like PC that also believe in educating people in a balanced and caring way about the problem of population.” For more information, and to rent or buy Mother, please visit the film’s website at www.MotherTheFilm.com. February 2012 — The Reporter 29


Girls’ Lives Around the Globe PopEd

By Pamela Wasserman

Teaching Our Teens About Child Marriage

An awareness of gender inequalities is key to understanding the fertility and economic trends that shape life in the least developed parts of the globe. Our PopEd Program has several teaching activities that examine the status and well-being of girls around the world. These are designed for use in middle and high school social studies classes that focus on world cultures, human geography, and contemporary global issues. For a new activity module, “A Girl’s Life,” part of our new World of 7 Billion curriculum, we used available online photo essays and videos of girls around the world telling their own stories on four aspects of their lives: school, work, early marriage, and pregnancy and motherhood. As illustrated in this issue’s articles, child marriage has devastating consequences for girls’ futures. It typically means the end of their formal education, early fertility, poor health, abuse at the hands of older spouses and family members, and a shortened life. In deciding how to present these sobering issues to young people, we looked for multimedia resources that would personalize child marriage, but also present hopeful signs that girls’ advocates are making strides to eliminate the practice. 30 The Reporter — February 2012

As part of the activity, students watch the online video, “Child Brides: Stolen Lives” produced for NOW on PBS. This hourlong documentary examines the lives of girls in India, Niger, and Guatemala, taking a close look at cultural issues that define marriage, pregnancy, and girls’ education in their local areas. The program also highlights how committed individuals and organizations in these countries have been working to empower girls and give them greater freedom to make their own choices about their futures. The worksheet that we developed to accompany students’ viewing of the video includes questions to gauge their comprehension and analysis of what they heard and saw, as well as opportunities to express how they felt about the girls’ stories. Students are asked to examine why child marriage persists as part of some cultural traditions, how this practice impedes a country’s development, and how it can be viewed from the perspective of human rights. Students are also encouraged to extend their learning about child brides and other issues affecting girls around the world through contemporary literature, such as A Thousand Splendid Suns by Khaled Hosseini and nonfiction works, such as Half the Sky: Turning Oppression

Two girls in their classroom in a village near Jodhpur, India. Both were married as young children but are striving to remain in school before their gauna, or date of effective marriage. Photo: Rose Reis, Courtesy of Photoshare

Into Opportunity for Women Worldwide by Nicholas Kristof and Sheryl WuDunn. Recommended essay topics on gender roles are also part of the lesson plan: • Why do you think the “traditional” role for women in many parts of the world has been subservient to men? If women do “hold up half the sky,” why are they often not afforded equal respect in many cultures? • Are women’s roles in our country different today than when your mother was your age? How about when your grandmother was your age? Talk with women of different generations in your family or community to find examples to support your assertion. Are there changes you would like to see in gender roles as you enter adulthood? • How does greater equality between the sexes contribute to a society’s progress? See the full lesson plan, “A Girl’s Life,” at www.Worldof7Billion.org. The poster, A Quick Trip to 7 Billion—described on the next page—can be purchased on the same website, while supplies last.


Teachers Rave About World of 7 Billion Resources

Thanks to the hard work of our PopEd staff, many more teachers are using Population Connection curricula in their classrooms this school year. In the October 2011 issue of The Reporter, we included our new two-sided wall chart, A Quick Trip to 7 Billion. Over 50,000 of these colorful, data-rich posters were distributed directly to social studies and environmental studies educators around the country over the past few months, and we continue to fill requests for more. “Such a wonderful resource that I can use in hundreds of different ways with different lessons.” ­–Brian Ade, Chicago, Illinois

“They’re great. I’d really like one sent here. Get it translated into Tamil. What do you think? We work creating awareness of climate change issues in teacher training colleges.” –Apeetha Arunagiri, India

“Thank you for the poster. It came at the perfect time. My students are doing a similar timeline as a project this week.”

–Marie Lamkin, Arlington, Texas

“Thank you for your materials. They are well thought out and very enlightening.” –Sandra Halpin, New Hartford, New York

“Beautiful piece—fantastic publication, I was very impressed.” –George Ek, Arvada, Colorado

During the fall, over 24,000 visitors from around the country and the world (over 4,000 of those on the Day of 7 Billion—October 31st) visited our website. Looking at a geographic breakdown of visitors, we found that more teachers from Texas visited the website than any other state, followed by California, New York, Minnesota, and Michigan. We distributed hundreds of posters at our exhibit booth at the National Council for the Social Studies (NCSS) Convention in Washington, DC in early December and spoke with many enthusiastic teachers who had received them through our mailing or as part of the October issue of Social Education, the magazine of NCSS.

W

ith a grant through the Minneapolis Community Foundation, we were able to send surveys to those teachers in Minnesota who had received the poster. Their feedback was overwhelmingly positive and 90 percent of the respondents offered specific ideas on how they intend to use the wall chart in their classrooms. Nearly a third of those surveyed had already visited www.Worldof7Billion.org to find teaching activities to accompany the wall chart. “Awesome website. The current Pop Clock was a nice touch.” “The activities inspired me to create a women’s issues course.” “I’m using many of [the activities]. Love the website!” “Have used ‘Day in the Life of School Girls’—excellent, and several others upcoming. Especially like how resources add detail.” “I have already used ‘7 Billion: Where Do You Stand?’ and ‘Food for Thought’ and enjoyed both.” “Each one inspires new thoughts about ways to present the population info we currently use.”

www.popconnect.org

February 2012 — The Reporter 31


Cartoon

32 The Reporter — February 2012


Editorial Excerpts

Philadelphia, Pennsylvania

Minneapolis, Minnesota

It’s hard to see how politics played no role in the Obama Administration’s decision not to let teenage girls buy the emergency contraception, morning-after pill known as Plan B.

If a life-begins-at-conception ballot measure fails in the Bible Belt state of Mississippi, where can it win?

Sebelius expressed concern that girls as young as 11 might not use Plan B properly. Her decision last week means Plan B will be available without a prescription only to women who can prove that they are at least 17.

That’s the question that backers of the southern state’s antiabortion “personhood” amendment should be weighing after voters on Tuesday soundly defeated the controversial, unworkable initiative.

Advocates have made a strong case for giving teenage girls easier access to emergency contraception because they may be more likely to need it. Proponents also noted that Plan B is sold over the counter in more than 40 countries.

No matter where this ill-advised initiative pops up next, voters should reject it. The measure pushed by the group in Mississippi would have outlawed abortion and potentially birth control pills, in vitro fertilization, and medical treatment for a woman having a miscarriage.

Quick access is essential. Plan B works best when taken within 72 hours of unprotected sex. The high-dose birth control pill can cut the chances of pregnancy as much as 89 percent.

And the Mississippi ballot measure’s failure supports another routine poll finding: Americans strongly support access to birth control, even if their church’s leadership dictates otherwise.

Sebelius said she worried that girls as young as 11 would misread the label. She and the President wrongly focused on the lesser likelihood of an 11-year-old wanting Plan B instead of on the much more common cases in which a 15-year-old will need it.

Trying to criminalize birth control not only revealed how extreme Personhood USA is, it raised broader questions about the aims of other anti-abortion groups. Do they also want to restrict access to contraceptives relied on by millions of American women? If so, they’re incredibly out of touch.

—December 13, 2011

—November 9, 2011

www.popconnect.org

February 2012 — The Reporter 33


Population Connection 2120 L Street, NW, Suite 500 Washington, DC 20037

NON PROFIT US POSTAGE PAID POPULATION CONNECTION

Your legacy...people and the planet in balance Have you considered leaving a legacy gift, ensuring that your commitment to zero population growth continues well into the future? By remembering Population Connection in your will or estate plan, you can make a meaningful contribution to stabilizing population and improving the quality of life for everyone, everywhere. We also offer charitable gift annuities, which provide guaranteed life income and significant tax advantages. We are proud to honor our legacy donors as members of The ZPG Society. For more information, please contact Shauna Scherer, Director of Development, at sscherer@popconnect.org or (202) 974-7730. Population Connection ZPG Society members Katharine and Julian Donahue, visiting Iguazu Falls in Brazil.

If you’ve already included Zero Population Growth (ZPG) in your estate plans, there is no need to change any language. We proudly maintain the name and the mission.

34 The Reporter — February 2012

February 2012  

The Reporter

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