9 Women in Africa

Dana Perino reflects on her trip to Africa

Mar 2nd, 2010 12:53 PM UTC
By Chris Scott

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As you might recall, former White House press secretary and Fox News contributor Dana Perino was one of 9 women who traveled to Ghana and Sierra Leone with ONE in January. Today, she has a great piece at FoxNews.com reflecting on her trip and what she learned about the health and well-being of mothers in Sierra Leone.

Here’s an excerpt– you can read the full piece here.

You may have heard that going to Africa can change your life forever. That’s certainly been true for me on the trips I’ve taken there. Recently, I had the opportunity to travel to Freetown, Sierra Leone with the ONE campaign to learn more about maternal and child health, girls’ education and women’s empowerment in Africa. While there I got to visit the Aberdeen West Africa Fistula Center – and I’ve not been able to get it out of my mind since.

I’d never heard of vaginal fistula – I thought perhaps that was because I don’t have children of my own and so I wouldn’t necessarily know all the things that can happen in labor. But the women with me on the trip, many of them mothers, weren’t familiar with it either. For women living in poverty without proper medical care, however, they learn about it far too frequently and often at a very young age.

Vaginal fistula occurs from an obstructed or prolonged labor. Most women with obstructed labor need professional medical assistance before they deliver. But most women in Sierra Leone – and elsewhere – have no access to a doctor. They often give birth alone in their villages (one in eight women in Sierra Leone dies in childbirth). A fistula occurs when the pressure from the baby’s head pushes against the pelvic bone and causes damage to the tissue around the bladder and the rectum. That means that once the labor is over, women suffer from the damaged tissue that leaves an opening between the birth canal and the bladder. They are unable to control the flow of urine, and they often have difficulty walking after delivery; they suffer from horrible skin irritations and the smell is terrible. They often are shunned by their fellow villagers – with no explanation as to why it’s happening, they feel they’ve done something wrong and they live their lives in deep depression and shame.

Thankfully, through the generosity and dedication of the Aberdeen West Africa Fistula Center (AWAFC), many women are getting their lives back. At AWAFC, experienced surgeons are able to help a lot of women by repairing the fistula and then providing physical therapy for those that have difficulty walking or trouble with nerve damage and pain. They also receive a new dress and participate in a ceremony that celebrates their recovery. For these women, that might be the only time in their lives that they ever are celebrated.

Healthcare in Sierra Leone

Nine women joined ONE last week on a listening and learning tour through Ghana and Sierra Leone. Nancy Brady reports back:

Our final day of the trip proved to be a challenging and emotional day for our delegation as we examined Sierra Leone’s devastated healthcare system and confronted numerous obstacles for providers and patients alike. A consistent theme throughout our journey has been the association between healthcare and development. A strong healthcare system balances prevention and intervention strategies, provides healthcare education for citizens maintains an active workforce of healthcare providers and affords sufficient resources to confront illness and/or disease. In turn, a robust healthcare system can promote and maintain a sustainable workforce. Since the end of Sierra Leone’s civil war in 2002, the country has struggled to rebuild its healthcare infrastructure. Furthermore we examined some of the country’s most affected and most marginalized groups, mothers and children; and how to keep them both healthy and alive.

One immediate concern is the sheer lack of healthcare workers for the approximate 6.5 million people living in Sierra Leone. One obvious reason is that during its eleven year conflict most nurses and doctors fled the country in pursuit of security and prosperity. Today, doctors and nurses continue to leave Sierra Leone as salaries remain uniformly low while workloads continue to escalate. Despite the internal plea for healthcare workers to return home or remain in country, the country struggles to maintain its qualified workforce. One gross example includes the fact that there is one lone Pediatrician for the entire country. Another important healthcare indicator is maternal and infant mortality rates. Sierra Leone ranks among the highest (or worst) in the world. While the average woman carries six children, she also has a one in eight chance of dying during childbirth. The results are devastating.

For women of Sierra Leone, additional healthcare concerns center around access to care and lack of healthcare information. Many women residing in isolated and/or rural areas are unaware of the benefits of birthing in a hospital. Thus, they prefer home deliveries. However should a problem arise during childbirth, there may be grave consequences. Sometimes a woman may be located far from a suitable healthcare facility or left without transport. Should she secure those things and she arrive in time, fees in order to access life saving services may be prohibitive. In a similar fashion, some parents avoid or delay bringing sick children to the hospital because they fear costs, sometimes resulting in infant mortality. Children needlessly die from treatable, preventable illnesses such as malaria, pneumonia and diarrhea.

Over the past two days we visited organizations that are addressing the healthcare crisis with a particular focus on maternal and child health in Sierra Leone. Our first visit was to the Aberdeen Fistula Clinic. The clinic is one of few places in Africa that repairs obstetric fistula, a condition that arises usually as a result of prolonged and obstructed labor (usually lasting between 2-5 days) when emergency care is unavailable. It almost always results in stillbirth. Fistula is described as a hole or opening between the birth canal and one or more of a woman’s internal organs which results in a constant leakage of urine. Without surgical repair she will be unable to bear children. Many women suffer nerve damage and have difficulty walking after delivery. In addition to its physical effects, a woman may often face social ostracism by her community, abandonment by her husband and family, impoverishment, or depression and suicide. An estimated 2 million African women are affected each year. The Aberdeen Clinic is run by Mercy Ships in partnership with Engender Health, with support from USAID. We had the opportunity to meet with Terri Bilton, manager of the clinic and her staff who discussed the progress as well as the challenges ahead. In total, the clinic has carried out a total of 1558 obstetric surgeries and repaired many more lives. You can read more about the program here.

Here’s a video of Terri discussing Mercy Ships in greater detail:

The following day, we evaluated the challenges of maternal and child health with a visit to the Sierra Leone Institute for Child Health and Princess Christian Maternity Hospital. At the Institute for Child Health, we applauded the efforts of the staff which saw a reduction in children’s mortality rates from nearly 15% to 5% during the previous year. Hospital staff equates these findings in large degree to patient education and parents bringing their sick children to the hospital earlier. Hospital costs were also reduced and medicine and surgical procedures have become more affordable to patients.

We also visited the hospital’s maternity ward. Despite all efforts to encourage women to arrive sooner and avoid complications, the hospital still sees a significant maternal mortality rates. Just this week, the hospital saw a staggering five deaths alone. Overall while the hospital is making some improvements, it continues to face ongoing challenges including a lack of basic supplies like plastic gloves, medicine, and an inadequate blood supply to provide transfusions for mothers who suffer from hemorrhage or anemia.

Finally, we completed the day with a visit to a midwives’ training facility, located next to the hospital. The training facility aims is to build healthcare capacity Midwives undergo training for a period of 18 months. Following training and certification, midwives are dispatched by the Ministry of Health to various posts throughout the country. In order for Sierra Leone to address its debilitating healthcare infrastructure, training programs geared towards health workers are critical. Maternal and child health will be greatly affected by the reach and skills of its providers. In order to retain these trained professionals Sierra Leone will also need to systematically address salary and medical supply limitations in order to achieve the Minister of Health’s goal of dropping user fees for pregnant women and children beginning in April, 2010.

Dana Perino talks about trip to Africa on “Fox and Friends”

Jan 25th, 2010 1:49 PM UTC
By Chris Scott

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This morning Dana Perino, former press secretary for President Bush, joined Fox News’ morning show “Fox and Friends” to discuss her recent trip to Ghana and Sierra Leone with ONE. Dana was one of 9 women who joined the learning & listening tour to gain a deeper understanding of the development challenges facing sub-Saharan Africa. You can read some accounts from on the ground here.

Here’s Dana Perino discussing the trip:

Africa: My Home and My People

Nine women are joining ONE this week on a listening and learning tour through Ghana and Sierra Leone. Yvonne Chaka Chaka reports back:

The delegation that I have the pleasure of being a part of arrived in Sierra Leone last night to continue our Africa tour. This morning, we were joined at breakfast by officials from the United States Embassy and the Sierra Leonian Anti-Corruption Commission for a thorough briefing on the political, social and economic conditions prevailing in Sierra Leone. The first image that comes to one’s mind when you think of this beautiful country is probably out of the movie, Blood Diamonds, which depicted the civil war that was fueled by illicit diamond trading and resulted in the loss of so many lives. But in this now peaceful nation, we were told today that the population, after having suffered so much, no longer wants war and really just wants to move forward. But because jobs don’t exist, peace is fragile and external shocks like a refugee situation from neighboring countries could quickly plunge this country back into crisis.

In order to build on what has been achieved so far, governance structures are being put in place to ensure that gains achieved are entrenched. The Anti-Corruption Commission has been empowered to arrest and prosecute cases of governance abuses and they have already put away a few Ministers and the Head of the Revenue Commission. The President and the government need to be congratulated for successfully bringing to justice many of the leaders responsible for corruption. Sierra Leone is an example to the rest of the world of what can be achieved by good government and strong political will.

But serious challenges remain. For example, the fisheries industry in Sierra Leone is being devastated by illegal trawlers from China, South Korea and Spain! The long-term impact of their illegal trawling could be the destruction of the artisanal fisheries sector which could lead to a food insecurity issues as well as increased unemployment. This is what happened in Somalia where former fishermen turned to piracy in the absence of a means to maintain a livelihood.

Sierra Leone is also used as a transit point for smuggling illegal drugs to Europe and the United States and the drug routes are also being traced to Sahelian countries where the proceeds can go on to support many illicit activities.. Civil society must be strengthened, educated and supported so that they can come out and challenge corrupt practices wherever they exist.

Our group also had a great meeting with Sierra Leone’s resident, Ernest Koroma, who told us about his country’s strategic priorities focused around building basic infrastructure and creating an enabling environment for the private sector to flourish. I am also delighted, as a Global Health Advocate, that the President has approved the removal of maternal and child health-related user fees which will now make their access to healthcare free. This is wonderful and the donors need to support the implementation of this great initiative so that the resources will be there to support.

To better understand the policies that have been put in place to support the private sector, we went on to the Ministry of Extractive Industries to meet with the man at the helm of the country’s most important foreign exchange earning sector. Sierra Leone has so many minerals but just has not had the prevailing conditions for managing their resources efficiently. You have to be certified to operate in the extractive industry in Sierra Leone and the Ministry polices the industry to ensure compliance. There is now a legal framework in place to ensure the equitable distribution of revenue generated from minerals. The government is also mandating special attention to the communities where the minerals are found by building in strong rehabilitation requirements into the new mining contracts.

As an Extractive Industry Transparency Initiative (EITI) candidate country, Sierra Leone has incorporated the transparency recommendations into the country laws and they now publicly disclose receipts from their revenue proceeds. The new law also requires the mining companies to negotiate socially responsible projects with the communities they operate in before their license is approved. As you can probably imagine, the Ministry is under capacitated but doing their best. Diamond fields spread over a 20,000km area, almost over the entire country. There is 570km of coastline to protect from diamond and gold smuggling and borders with Liberia and Guinea are long and porous. But I am proud to say I noted the government’s commitment to progress in our interactions today and with the support of the international community they can do so much more.

In April of 2009, a group of jewelers were caught trying to smuggle 28 uncertified Sierra Leonian diamonds, with an average weight of about 40 carats each, into New York. They were seized at JFK airport but have yet to be returned to Sierra Leone. The United States government is doing their part to ensure that illegal diamonds do not enter their country and I applaud their action and encourage all other concerned countries to abide by these principles. Thanks to the Kimberley process, Sierra Leone’s wealth can be protected and will not continue to be taken away from its people. Sierra Leone has made huge progress in providing better healthcare and improved governance which is making life better for its people. Diamonds are a girl’s best friend and my group of girls will do all we can to support Sierra Leone’s best efforts to lift their country out of poverty and secure economic opportunities for all.

My First Trip to Africa

Nine women are joining ONE this week on a listening and learning tour through Ghana and Sierra Leone. Maureen Orth reports back:

For me, each day in Ghana has gotten better. Yesterday I met my first African Chief, or Nana. He was resplendent in a blue and gold kente cloth and he sported a five foot long gold pendant that would have convulsed any rapper—but then you notice the solid gold starfish rings. Nana donated the land for a rice cooperative that was mainly fueled by female labor. The men mostly stood around and watched as the women harvested the rice in ankle deep mud with machetes. The women also pulled out the threshing machine and carried the winnowed rice to the milling equipment. But what was great was that TechnoServe, a US NGO, had given this farm the tools to support themselves by teaching them how to increase yields and do the math that would allow them to pay back the loans they had borrowed to seed new crops. TechnoServe had not been back to this particular farm for the last eighteen months but the farmers had already saved in advance for their next bank payment. If you ask the women what they spend their increased income on, their first response is school fees for their children.

Soaring interest rates of up to 35% are a huge problem for small businesses in Ghana so saving is hard when profit margins can be completely eaten up by interest. We visited the business of Josephine who made small pieces of furniture and hand carved African masks. She told us that several years ago when she got an order for 200,000 units from Target, no bank would give her credit to purchase materials for a month. She was able to complete 70% of the order. But then she claimed the Chinese came along and ripped off her designs and the cheaper “made in China” models undercut her business.

The Chinese are everywhere in Africa. We met the First Lady of Ghana, Mrs. Ernestina Naadu Mills, a soft spoken retired educator who would like to establish a drug rehab center—in the last few years Ghana has become a transit point for drugs coming from Latin America on their way to Europe. She confided that the wife of the Chinese ambassador had given her $5000 for her proposed center. A Chinese company is also building part of a new highway leading out of Accra to the north near the seaport—a sub-contract they won from the U.S. funded Millennium Challenge Corporation. So the Chinese are quietly and firmly putting their stamp everywhere.

Last night we had a dinner with leading Ghanaian women and it was a treat to meet this well-spoken, charming group who talked about the same things professional women in the U.S. talk about—how to break through the glass ceiling, how to mount a political campaign, how to network and connect with one another. They talked about the need to get support in the medium range—not a huge grant for major efforts to combat aids or malaria, but $20,000 to begin a business. This is a country where it is a struggle to convince families even to educate girls at all. Boys still go first. Attitudes are beginning to change, however. Yesterday afternoon we visited Nyanyano Primary School of more than 700 girls and boys and were treated to a dance and mimed play acted out by the students in which the father refused to educate his daughter and banished her. Years later when he had been injured by the wastrel son he supported, he had to go to the hospital, only to be treated by his daughter, who had become a doctor! Watching the children act out throw themselves into this lively scenario in front of the whole school in the hot sun on a dusty platform with a drum accompaniment was really something. The actress on our tour, Connie Britton, said it was one of the most exciting pieces of theater she had ever seen. Later, Cindy McCain nearly got mobbed as she presented two soccer balls as our gifts. To these children a soccer ball is the equivalent of giving one of our kids a sports car.

Today we visited a truly remarkable school for girls, Nsaba Diaspora Community Senior High School, a boarding and day school established for girls from a region outside Accra where 107 girls sleep under malaria nets in immaculate surroundings and supervised by a top notch governing board of female educators who have also established an FM radio station to propagandize about the importance of female education. It costs $600 a year to go there, forty percent of the girls are on scholarship. One woman stood up and told us she sold wares on the street for years to save up to come. She is in her third year of high school and is 29 years old. The school requires that the girls crop their hair because the administrators do not want them diverted from their studies by worrying about their looks. We also gave the girls soccer balls and they were as thrilled as the boys had been yesterday. They have no sports equipment at all. In Ghana, a donation as small as a soccer ball can make a tremendous difference. South Africa singer, Yvonne Chaka Chaka, told the girls that she had grown up in Soweto and that her dreams and education—not to mention her talent—had saved her. When she learned the 29 year old only had one pair of shoes, she gave her a pair of her own and there were tears all around. After three days here, we know we want to support and help not only these admirable women of Ghana but women and girls throughout Africa.

Meeting the women of Ghana

Nine women are joining ONE this week on a listening and learning tour through Ghana and Sierra Leone. Maura Keefe reports back:

These women work hard, and their spirit amazes me. They come here because this farm is the key to a better future for themselves and their families. The transformation that is taking place in Ghana is not unlike the changes we have seen in the States. Women get a job and make money. They are able to invest this money, make small profits, and bit by bit, they gain greater control of their lives.

With greater productivity on these farms, the women are less vulnerable to the whims of the weather, not to mention changes in their government and personal lives. These women prove that they are successful in business, garner respect from their neighbors, and become leaders with the power to make improvements in their communities.

Interestingly, statistics show that women working on farms like these are likely to invest their profits well. Some studies estimate that women invest up to 90% of their extra income in their families, compared to only 30-40% for men.

On a national scale, women are key drivers of economic growth, particularly in the agricultural sector. The farm we saw today is funded through Technoserve, an organization that focuses on providing people living in poverty with access to productivity-enhancing tools like seed and fertilizer. Technoserve also works with these people to develop entrepreneurs and institute good business practices. Technoserve works with public and private-sector partners, including U.S. Agency for International Development and the Bill and Melinda Gates Foundation.

The rice farm we visited this morning is one of those projects. This partnership is enabling women with greater access to high-quality seeds, fertilizer, and training for their farms. Women actually produce up to 80% of the food produced in the developing world, where agriculture is the backbone of most economies. That means that these women, by showing up to farm every day, are not just feeding their families for the day. They are helping to pull their countries out of poverty and feed entire nations.

Studies show that if women were just given equal access to agricultural products like seeds, fertilizer, and training, agriculture yields could grow by over 20%. By investing in women in agriculture, the United States is stretching its dollars to fund sustainable development that is giving these people ground to stand on in the long term. With more funding for projects like this one, more women and their children would be going to school, receiving better health care, and, critically, would be helping their local economy grow—possibly the most important pathway out of poverty.

We also visited a school that is being funded by the Millennium Challenge Corporation and USAID in Nyanyano. There we were able to visit a few classrooms and met a wonderful group of committed teachers and administrators who were proud to show off their new facilities. Under very trying circumstances, these men and women are working everyday to ensure that young girls have the same access to education as young boys. In our classroom visits, it was clear that young girls are attentive students and active participants in their lessons.

Before we departed the village, we were treated to memorable performances by the students. First, the children entertained us with a four-act musical drama that told the story of the importance of educating young girls. The story revolves around a mother, father, son and daughter, all played by the children, and narrated by a student choir. The father refuses to allow the mother to pay for education for their daughter and throws the mother and daughter from his home, his decision has long-term consequences. He stays with his son who does not take care of the father in his old age, while his daughter continues her education and goes on to become a doctor. When the father becomes ill as an old man, he goes to the hospital only to be treated by his daughter. When the daughter recognizes it is her father she refuses to treat him and he begs for her forgiveness. It is only when the mother reappears that she brings the family back together again. The ONE delegation was delighted by the creativity and spirit of our young theatre troop and roared our approval!

An additional part of our send off was a poem read by a young girl names Joyce. Joyce, wrote a poem about the importance of empowering women. And, I have to say, it made me tear up. You cannot help but be inspired by the changes that are happening for women in Africa. I cannot do our young poet justice, but you can see her presentation in this video:

From education to agriculture, women’s economic participation is critical to long-term poverty reduction. I’m convinced that if all Americans witnessed what I saw today, they’d be moved to even greater action to make sure that the U.S. continues to invest in the women I met here at the Technoserve Rice Farmers Cooperative and through the Millennium Challenge Corporation.

Connie Britton Reports from Ghana

Nine women are joining ONE this week on a listening and learning tour through Ghana and Sierra Leone. Connie Britton reports back:

We started our day early with a visit with Ghana’s first lady, Mrs. Ernestina Naadu Mills. It was a wonderful way to kick off our week of this listening and learning tour and in particular, today’s focus on health issues. Despite major progress in the fight against poverty and disease over the past decade, the health of women and mothers remains one of the most pressing challenges in poor countries like Ghana. We were wholly impressed with “Madame First Lady” and her ideas and openness about improving Ghana’s government in her newly acquired role. Ghana is in the enviable position of having a relatively functional, effective, and peaceful government, and she hopes to make it even more so with her husband as president. Her comments suggested how, in Africa, if the governments can systemically help themselves, they will exponentially improve the lives of their people. Most important in accomplishing this, Madame Mills emphasized, is “education, education, education.”

Following our visit with the first lady, we spent the morning at Ashaiman Health Clinic, where money from the Unites States’ President’s Malaria Initiative is supporting Ghana’s campaign to reduce malaria rates by 75% by 2015. As is true across Africa, pregnant women and children are the most vulnerable to malaria and the least capable of fighting it. It was stunning to see the numbers of women who came to this center to educate themselves. Thanks to funding through PMI and other donors, the clinic is providing intermittent preventative treatment during pregnancy and also insecticide-treated bed nets to help mothers protect themselves and their young children from malaria. Still, the sight of a 25 year old woman lying on a cot, sick with malaria, despite the fact that she owns a treated bed net – left unused because it makes for a hot night’s sleep – was a reminder that this disease is still a danger and a killer, and emphasized again the imperative of “education, education, education”!

From Ashaiman we went to Tema Hospital to learn about their efforts to prevent mother to child transmission of HIV. Ghana’s total HIV rate of 1.9% is lower than many other countries in East and Southern Africa. The trouble here is the stigma associated with HIV, which is actually worse than many African countries, very possibly because the percentage of people with the disease is so low. We met a woman and her baby, both with HIV, who didn’t want to be photographed by our camera crew; she sells in the market and if she were “seen on TV” people would discover she has HIV and not buy from her. Still, the numbers of HIV-free babies born to mothers with HIV has been dropping here, a good sign in general that progress is being made in this country’s battle with AIDS. In Ghana, women make up 60% of HIV-positive adults. With help from the Global Fund to Fight AIDS, TB & Malaria, Tema is now offering treatment and counseling to HIV-positive women and mothers, all pregnant women are encouraged to get tested, and women who test positive are given drugs (depending on the stage of their virus) and their babies are given treatment once they’re born. Now the challenge is to get the men in to test, a much trickier feat. Again: “education, education, education”!

Today we met the most powerful woman in Ghana, along with many women who are leading the fight to demolish the impact of these diseases in Africa. But perhaps the most powerful and courageous women of all were the ones who were seeking education and treatment for themselves and their families. They truly have the capacity to change the landscape of this country.

P.S. Here’s a video of ONE US Executive Director Sheila Nix describing Day 2: