How climate change is driving up FGM and early child marriage numbers in West Pokot

Dec 18, 2022

By Maryanne W. Waweru l maryanne@mummytales.com

One day, as Domtila Chesang was returning from her anti-FGM campaign activities in the remote village of Kotulpogh in Masol ward, West Pokot County in northwest Kenya, she spotted two young girls animatedly flagging down their vehicles. With darkness fast approaching, and it being a bandit prone area that is highly volatile, a worried Domtila, who was traveling in a convoy of two vehicles stopped.

“The girls said they were running away from their village and pleaded that we take them along with us. They were familiar with our work and knew we had visited their village that day and taken some young girls with us. Their parents had allowed us to enroll them in boarding school,” Domitila remembers.

Unable to leave the girls alone in the risky area, Domtila invited them to their vehicle. This incident would lead to one of the most heartbreaking moments in Domtila’s work as an anti-FGM crusader.

For the last nine years, Domtila has been tirelessly creating awareness about the harmful effects of female genital mutilation (FGM) or cutting, a harmful cultural practice that is deeply ingrained and widely practiced in West Pokot. FGM comprises all procedures that involve altering or injuring the female genitalia for non-medical reasons. The genitalia is cut with a razor blade or knife, oftentimes with no anesthesia or disinfectant.

Harmful effects of FGM

FGM has no health benefits and has serious implications for the sexual and reproductive health of girls and women. The UNPFA states that FGM’s immediate complications include severe pain, shock, haemorrhage, tetanus or infection, urine retention, ulceration of the genital region and injury to adjacent tissue, wound infection, urinary infection, fever, and septicemia. Some of these complications can be fatal. Long-term consequences include childbirth complications, anaemia, cysts and abscesses, keloid scars, damage to the urethra resulting in urinary incontinence, painful sexual intercourse, sexual dysfunction, hypersensitivity of the genital area and increased risk of HIV transmission, as well as psychological effects.

Outlawed in Kenya

FGM is regarded as a serious human rights violation for girls and women and towards this, Kenya has ratified several international and regional legal instruments that have become part of the Kenyan law as provided for in Article 2 of the Constitution. These include The Universal Declaration on Human Rights (UDHR, 1948), The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW 1979), the United Nations Convention on the Rights of the Child (UNCRC, 1989) and the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa (Maputo Protocol, 2003).

Kenya’s Constitution affirms the government’s commitment to protect and promote all human rights and fundamental freedoms, including those of girls and women. The Prohibition of Female Genital Mutilation Act (2011) states that it is illegal to practice FGM in Kenya, or to take someone abroad for the same. The Children’s Act, 2001 criminalizes subjecting a child to harmful cultural practices, while Chapter 63 of The Penal Code outlines offences under which circumcisers can be charged. Additionally, the Protection against Domestic Violence Act, 2015 classifies FGM as violence.

High FGM prevalence

Despite it being forbidden, FGM is still practiced in the country, varying across regions and ethnic communities. According to the Kenya Demographic and Health Survey (KDHS 2014), the national FGM prevalence rate is 21%. FGM mostly happens during the July – August and November – December school holiday seasons, where thousands of girls aged between 9 – 15 are circumcised. In many of these communities, FGM is a critical rite of passage and a pre-requisite for marriage.

In West Pokot, the prevalence rate is 74%, according to UNICEF. In this county, the prevalence rates are particularly high in Central Pokot, North Pokot, and parts of South and West Pokot sub-counties.

Domtila’s anti-FGM efforts in West Pokot through her organization I-Rep Foundation, in collaboration with those of other partners in both the public and private sector have led to significant strides over the years. Some families have abandoned the practice and sent their girls to school. At these learning institutions, the girls do not only receive an education but are sheltered from circumcision and marriage.

One of Domtila’s partners is her former boarding primary school. When she herself was young and living in fear of being circumcised and married off, it was this school that sheltered her. Domtila now spends time in her community encouraging parents and elders to educate their girls. Some allow her to take their daughters and enroll them in the school. That is the mission Domtila had undertaken on the day the two girls animatedly stopped their convoy.

Chebichii and her friend

The girls who had stopped Domtila’s convoy were both aged 14. They were ripe for marriage. Among the Pokot, a girl of good standing is one who has been circumcised. It gives her privilege in society. It is an integral aspect of womanhood. An uncut girl is shamed, ridiculed, condemned, and excluded from group peer activities.

Of the two girls, one had already been circumcised and was soon to be married off to an old man. The other girl, Chebichii*, was scheduled for circumcision the following month, after which she would be married off. Their fate had already been sealed. As they both didn’t want this, they had hatched a plan to intercept Domtila on her way back from their village, hoping she would rescue them. They wanted to go to school and have a better future for themselves.

“When we got to the school, I asked the matron to stay with them until we figured out what to do next, since we didn’t have the permission of their parents to enroll them. The following morning, we called the parents and informed them of the girls’ whereabouts. They asked us to return their daughters immediately as they had already betrothed them,” remembers Domtila.

But the girls would hear none of it. They were determined not to return to the village because they knew what awaited them. Once married, it would be impossible for them to go to school.

Chebichii’s mother

Seeing how adamant the girls were, Domtila tried to convince the parents to review their stance and consider the voices of their daughters and the desires they had for an education. But they would not budge.

In fact, Chebichii’s mother was the most adamant.

“She was a woman I was familiar with as she had already allowed me to enroll her 7-year-old daughter at the school. Chebichii’s mother had gradually been warming up to the idea of not circumcising her daughters, instead taking them to school. But on this day, she demanded that I return her first born daughter. She said the current circumstances had left her with no choice but to marry off her daughter.”

The ‘current circumstances’ Chebichii’s mother was talking about are the ravages of the drought, following patterns of failed rainfall seasons over the last four years. West Pokot county is one of the 23 worst-hit arid and semi-arid (ASAL) counties in Kenya, according to the National Drought Management Authority (NDMA). Lack of rainfall has led to dry seasons which have depleted water and grazing pastures, leading to the deaths of livestock which are the economic backbone of the Pokot. Additionally, failed crop harvests have aggravated the situation.

Desperate circumstances

As a result, many families are unable to meet their household food consumption needs. Some are now consuming two meals a day, while the most affected are living on one meal a day. Those who are worse off are surviving on wild fruits. This dire situation has led to families marrying off their young school-aged daughters, as the dowry paid for them is a much-needed source of income. Families that had agreed to stop circumcising their girls and marrying them off are now reverting to the outlawed practices. Marrying off their girls has become a form of survival, and this is the situation that a desperate Chebichii’s mother was trying to explain to Domtila.

“I have been waiting to marry off this girl. We have lost most of our livestock because of the drought. I have not been able to feed my family. Through Chebichii’s dowry, our family’s livestock will be replenished and we will eat again. Chebichii is my only hope for survival and I will not let you take that away from me. You can keep my younger daughter and educate her all you want, but you will not take Chebichii. If you insist on doing so, you will be signing a death warrant for me,” she pleaded.

Domtila says it was a difficult situation for all, but they were relieved when the fathers of the two girls gave in and allowed them to be taken in by the school. The fathers, both polygamous, said they had other daughters in the village anyway, so it would not be a big loss for them if the girls studied.

But not for Chebichii’s mother.

A Pokot woman’s burden of responsibility

Among the Pokot, it is the responsibility of the woman to figure out survival for her family. The man’s work is to marry several wives, with each wife expected to give birth to as many children as possible. It is her obligation to provide food and income for the family, which she does through livestock rearing and crop cultivation. Having many daughters means more wealth for the household through dowry, and having many sons means the livestock will be herded. Husbands rarely concern themselves with how the family is sustained.

Suicide threats

This is the desperation that Chebichii’s mother was trying to explain. Providing for her family depended solely on her. The drought had affected her livelihood and now, she desperately needed to marry off Chebichii. She had no back-up plans. Chebichii was her only plan.

“She said that if I didn’t send her daughter back home, she would commit suicide and that her death would be on me. I spent sleepless nights agonizing over the issue. Here were two girls, fighting for their rights and here was a mother, forced by circumstances to disregard those rights. It disturbed me,” says Domtila.

Domtila also risked losing the trust she had gained with parents in the community.

“At that time, the parents had released 36 girls to me, all of whom were in school. After Chebichii and her friend ran away, word had started going round that I was abducting girls who were ripe for marriage. All the inroads I had made in the community were being threatened. The issue tormented me in ways that I cannot describe,” she remembers.

Motorbike convoy

The following day, the silence at the school was disrupted by the roaring sounds of motorcycles. Chebichii’s mother had sent a group of men to pick the two girls. The riders quickly hauled the girls onto the motorcycles and sped off with them.

Sadly, Chebichii was circumcised soon after. She and her friend were then married off at the age of 14, ending their dreams of an education. Once married, a Pokot girl is expected to begin childbearing soon after.

If Chebichii and her friend had been allowed to stay in school and pursue an education, they most likely would not have been married off, with better chances of leading healthier, productive, and longer lives. Their prospects for securing jobs with good incomes would have been higher and it is likely that they would have built better futures for themselves and their families. Unfortunately, by being married young, their vulnerability to economic disadvantages as well as sexual and physical abuse, poor nutrition and maternal mortality had increased significantly.

Chebichii and her friend represent the plight of thousands of West Pokot girls who are either not being enrolled in school, or who are being withdrawn from school to be circumcised and married off as a copying mechanism to mitigate the effects of climate change.

The lack of rainfall has seen many men and women migrate to neighbouring areas, including Eastern Uganda in search for pasture and water, leaving their children behind. Girls are subsequently being pulled out of school to take over the domestic chores that include cooking, cleaning and caring for their younger siblings, as well as trekking for long distances in search of water and foraging for wild fruits to feed their siblings. This is according to Ambrose Merian Pyatich from the Umoja Development Organization (UDO), which is a community-based organization based in Kapenguria, West Pokot.

But it gets worse.

Self-circumcision

According to Pyatich, the girls left behind are exposed and vulnerable to various adversities, including sexual and gender-based violence. While out searching for water, some girls are being abducted by boys who are forcing them into circumcision and later marrying them.

Others are being preyed upon by idle boys in the village who convince them that since they are now out of school, their only hope for the future is marriage. To be eligible for marriage, the boys persuade them to first get circumcised. Fearing that they will miss out on both school and marriage, some desperate girls are going to extremes to get circumcised.

“The girls are grouping themselves and getting ‘clandestine cutters’ to circumcise them. When they cannot get one, they cut themselves,” explains Pyatich.

Sometimes, things go terribly wrong.

“Many times, they bleed excessively. When this happens, their friends frantically seek out village women who have specialized in the procedure –’professional traditional cutters’, traditional birth attendants (TBAs) or medics to save their lives,” he says.

His sentiments are echoed by Loram Samson, the Assistant Chief of Kalapata location, manning Lotukum sublocation who says there has been an increase in the number of cases of circumcised girls seeking treatment in private chemists when things go wrong.

“After these ‘botched circumcisions’, the girls’ are sneaking into chemists to get treated. We have heightened our intelligence efforts and are making arrests in such cases,” he says.

Ambrose Merian Pyatich from the Umoja Development Organization (UDO) based in Kapenguria, West Pokot.

Other people who are benefitting from FGM are circumcisers.

“For each girl she cuts, she is paid Sh1,000 ($8). If she cuts about 20 girls, then she fetches a good amount of money. Many are doing so because they too have been affected by the ravages of the drought and are facing harsh economic times. Even those who had abandoned this trade are secretly returning to it because they too need to feed their families,” Loram says.

Cattle rustling

Pyatich notes that there have been heightened incidents of cattle rustling. This is because karachunas (young Pokot warriors) raid other villages for purposes of topping up their livestock herd. Since a circumcised girl aged 9 – 15 years fetches more dowry, and with cases of child marriage increasing, it is important for the karachunas to engage in as many cattle rustling activities to increase their livestock count.

Landslides

Extreme weather patterns have also seen incidents of landslides in some areas of West Pokot, most notably in 2019 and 2020. These landslides, mostly witnessed in the Nyarkulian, Tapach, Batei, Weiwei, Lomut, Tamkal and Chesegon areas caused massive losses, including destruction of homes, death of livestock and damage to crops. Additionally, the landslides reversed great FGM strides that had been made in the areas.

According to Pyatich, many families had abandoned FGM, with elders having declared the areas anti-FGM zones. However, the landslides changed this.

“The elders thought they were being punished by their ancestors for abandoning FGM. They believed their forefathers were cursing them and since they didn’t want any punishment, they made a declaration that all girls and women be circumcised. Under the orders of the elders –whose word is final –a mass circumcision exercise of girls and women began. Hundreds of schoolgirls, university students, and even career women who had survived the cut were forcibly circumcised. Those who protested were threatened with banishment from the community, so they complied,” Pyatich says.

Breaking the law

Interestingly, most of the community members are aware that FGM is illegal, but it is immaterial to them. They can quote the entire anti-FGM law, but with the prevailing circumstances and the need for survival, the law is a secondary concern. To avoid being caught, they have changed tact about when and where they are cutting girls.

“They are doing so at night in the bushes, caves, riverbanks, border points, and even under the guise of religious meetings. For example, in 2019 in Alale ward, a circumcision activity was conducted under the guise of a ‘church youth camp’ for girls. By the time people got wind of what was going on and informed the local authorities, all girls – totaling 94, had already been circumcised,” says Pyatich.

Pyatich says that over 2,500 girls are at risk undergoing the cut this November – December 2022 school holiday and unless something is urgently done by the government and other stakeholders, they will be circumcised. Once cut, they will be married soon after, ending their educational ambitions.

Assistant Chief Loram says the local authorities are working diligently to prevent girls from being cut.

“We are constantly holding sensitization forums in baraza’s in the community, in churches, and other places where community members congregate. We are going from village to village, using caravans to create as much awareness as possible. We are also working with NGOs such as World Vision who are helping us tackle cross-border FGM activities with our Uganda neighbours. We have previously arrested those going against the law, and this helps deter those who may have a similar motive. However, we cannot overrule the fact that many are now forcing their girls into circumcision secretly. However, we will not relent and have intensified our intelligence efforts to ensure we curb these activities,” says Loram.

Loram Samson, Assistant Chief of Kalapata location, Lotukum sublocation in West Pokot county.

Domtila has also started an informal school in Kotulpogh village that is teaching young girls’ basic arithmetic and reading, as well as providing them with life skills education. The girls who are enrolled in the informal school will likely be integrated into mainstream schools. Domtila continues to lobby the government to build more schools in West Pokot, which will not only increase the literacy levels of girls in the community, but will offer them safe spaces that will help reduce their exposure to harmful traditional practices such as early marriage and FGM.

I-Rep Foundation has also been linking girls and women to various empowerment programmes implemented by different partners in the community, as a way of providing them with alternative sources of livelihood.

Will FGM be eradicated in Kenya by 2022?

Kenya, through former President Uhuru Kenyatta committed to eliminating FGM by the end of 2022. As it stands, this is unlikely to be achieved. This is because the effects of climate change are heightening the vulnerability of girls, leading many families in drought-stricken areas –including those that had reconsidered the practice, to turn to child marriage as a means of survival. Climate change is making an already dire situation worse.

Indeed, policies, programmes and initiatives addressing climate change in the country must also consider the disproportionate effects on girls and women, more so those in communities that depend purely on their environment for their livelihood.

*Name changed to protect her identity as a minor.

Do you have feedback on this article? Please comment down below or email me at maryanne@mummytales.com

Also read: PASHA, a mobile app to help fight FGM in Kuria launched

Also read: The menstruation experiences of women and girls with disability in Kenya

Also read: Why Kenyan teenage mothers do not return to school despite re-entry policy

Mummy Tales is a platform dedicated to women and girl empowerment. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

How society’s attitudes towards the sexual lives of women with disabilities creates problems

Maryanne W. Waweru

Nov 10, 2022

By Maryanne W. Waweru l maryanne@mummytales.com

For many persons with disability, they often must deal with the reality of a huge section of society that stereotypes them as people who have no sexual desires, are asexual and are not deserving of intimacy and sexual pleasure. In this article, I share the experiences of three women who have faced prejudice regarding their sexual health, on account of their disabilities.

Margaret, 27, is from Thika, Kiambu County. She holds a Diploma in Human Resources management and is currently unemployed. Margaret has a physical disability –she has short arms and fingers. She, just like other young, healthy women of reproductive age goes through the normal ups and downs of dating and enjoys an active sexual life.

To prevent an unplanned pregnancy or contracting a sexually transmitted infection (STI) from her sexual partners, Margaret alternates between using condoms and the morning-after pill –depending on the man she’s with at that time. She prefers these contraceptive options as they are affordable and easily accessible.

The shocked Pharmacy Assistant

Margaret recalls an incident where she once needed to purchase the morning after pill. She walked to a pharmacy in Thika town and found an acquaintance of hers behind the counter. When she told him she needed emergency contraception, his reaction baffled her.

“He was surprised by my enquiry, confessing to never having thought of me “engaging in that kind of activity” (referring to sex). He unashamedly told me that because of my disability, he thought I was a virgin and couldn’t believe that I was sexually active. While he had placed me high up in his moral bar code, the look on his face left me with no doubt that I had dropped down it with a thud. I felt disappointed in him because as a medic, he should know better,” says Margaret.

Also read: The menstruation experiences of women and girls with disability in Kenya

What bothered Margaret most is that if a well-educated professional healthcare worker could have such an attitude, what of the common mwananchi?

When the Pharmacy Assistant got over his shock and began dispensing the pill to her, Margaret decided to educate him.

“At that time, I was 22 years old and in college. I told him that I was a fully grown woman with sexual desires and with the need for sexual satisfaction,” she says.

The shopkeeper

That, however, is not the only person that Margaret has had to explain her sexual activity to –something she believes she doesn’t need to do in the first place.

“There’s a time I went to my local shop and while there, I received a phone call from my best friend. Since I knew it would be a long conversation, I proceeded to sit on a bench adjacent to the shop. I narrated to my best friend about my visit to my boyfriend’s place the previous night, and how I had returned home that morning. I was excited as I talked to her –it was nothing unusual, just the normal banter that excited girls engage in with their best friends.”

What Margaret didn’t know is that the shopkeeper had eavesdropped on the conversation. She found this out when she went to buy something from the shop a few days later, when the shopkeeper told her she had a burning issue she wanted to discuss with her.

“The woman told me that she had overheard my phone conversation with my friend and wanted to find out if it was really true that I had a boyfriend, and if I had spent the night with him. She told me that eavesdropping on my conversation had left her very disturbed as the details I had narrated about my boyfriend didn’t sound like things I was capable of. Disappointed, she said that she’d always thought of me as a ‘nice, innocent girl’.”

In response, Margaret told her that despite her disability, she was a young woman with a well-functioning reproductive health system, so there was nothing unusual about her having a lover.

“She herself was my agemate and already a mother, and I challenged her about why she thought it was odd that I too could be sexually active. I took time to help her understand that persons with disabilities can also enjoy sex. In disbelief, she asked me lots of questions about how disabled people have sex, which I was patient enough to answer.”

Belinda’s story

Margaret’s story is similar to that of 27-year-old Belinda, who is an amputee and sexual reproductive health and rights (SRHR) advocate.

One day, after a community outreach activity where she and her team had distributed condoms to youth, she proceeded to a health facility to enquire about family planning services. She still had some condoms left in her bag.

When her turn arrived to go into the nurse’s room, she stood up. The nurse was standing at the door. However, something unexpected happened.

“As I stood, I forgot to close my bag and so all the contents spilled out. Many condom packets scattered on the floor. There were several people in the waiting area and as I collected them from the floor, I heard the nurse yell out: “you want family planning, yet you’ve filled your bag with condoms?”.

Belinda ignored the nurse’s remark and after she had returned all items in her bag, she began walking to the nurse’s room. But she didn’t expect the next words the nurse said to her.

“Haiya! Na kwanza wewe ni kiwete! (and you mean you are disabled?) As she said so, everybody in the waiting area stopped what they were doing to look at me. I felt so humiliated,” Belinda says, a forlorn look on her face.

Belinda says that the derogatory words from the nurse alluded to the fact that as a person with disability, she was not deserving of sexual activity or family planning services.

Also read: Why I put my teenage daughter on the contraceptive injection

It is this kind of unfair treatment by healthcare workers that prevents many women with disabilities from visiting clinics to access sexual reproductive health services, Belinda says.

“When I have conversations with my peers, they tell me of the many times they have been addressed in demeaning manners by some nurses. They do not expect women with disabilities to be having sex, and it shows in their attitude. They don’t even try to hide it,” she says.

While stereotyping, stigma and discrimination are issues they experience on an almost daily basis from society, Belinda says that they do not expect the same from healthcare workers.

“Such negative attitudes expose many women and girls with disabilities to various risks such as unplanned pregnancies and STIs, including HIV. As a result, they end up procuring clandestine abortions, many of which are unsafe and have led to death or life-long health complications for them. Others end up having many children whom they cannot care for,” she says.

Who made you pregnant?

33-year-old Christine, a woman with physical disability from Nairobi, shares her experiences as well.

When she found out she was pregnant seven years ago, Christine was hesitant about going to the clinic because of her peers’ experiences.

“My friends with disabilities had told me that when they went for the antenatal clinics, some nurses would ask them ridiculous questions such as ‘poor thing, which man did this to you? Who raped you? Did you report it to the police? Has he been apprehended? Or ‘why did you go laying down with a man, yet you know your body is complicated? Now look you’ve gotten yourself pregnant. Who will help you? Was it a must for you to have sex? Why do you want to add the extra burden of a child to your family, yet you’re already a burden to them? among other unkind remarks,” she says.

Christine adds that many people, including healthcare workers, assume that women with disabilities’ sexual activities are not consensual. That they are always raped or forced into it. It is lost on them that they too desire intimacy just like able-bodied women, and most can have sex and experience pleasure without any difficulty.

Also read: The curious case of the ‘midnight lovers’

It is these anxieties that made Christine delay her first antenatal clinic (ANC) visit, only doing so when she was 25 weeks pregnant. The World Health Organization (WHO) recommends pregnant women to have their first antenatal clinic visit in the first 12 weeks’ of pregnancy.

What surprised Christine most though, is her antenatal care experiences at a public health facility.

“I had very good experiences all through. I found nurses who treated me professionally. I had expected to go through negative experiences, but I was pleasantly surprised when I didn’t. I even regretted why I had not started my clinics early,” she says.

Christine is however quick to state that her positive experiences do not negate the negative ones that other women with disabilities have gone through.

Nurse Dinah

Dinah Akeyo Odoyo, 48, is a Nursing Officer at the Ledinah Community Medical Center, located in Homa Bay town, Homa Bay county in Kenya’s Nyanza region. In a career spanning 24 years, Dinah has served thousands of women, offering a wide range of sexual reproductive health services. She has attended to hundreds of pregnant women –including those with disabilities, and helped deliver hundreds of babies.

Dinah says that while indeed there are cases of women with disabilities who have received negative treatment from some healthcare workers, she says they are the exception, rather than the norm.

“Working as a healthcare worker is a calling, and most of us do it with so much passion. Unfortunately, there are those who may have been forced into the profession and it shows in their negative attitude. Such healthcare workers extend this mistreatment to all people –whether they have a disability or not.”

Dinah says that negative labels by society towards people with disabilities hinders many of them from seeking reproductive health services.

“For example, when a woman wheelchair user comes for family planning services, people stare at them, and you can tell they are judging them. It makes them feel bad to the extent they avoid returning for services. This is the feedback they give me when I follow-up with them,” she says.

Also read: Managing periods as a visually impaired woman: Eve Kibare’s story

Dinah says that though she has not gone through specific training about serving persons with disabilities, she has over the years learnt how best to attend to them.

“Communication is usually the greatest challenge for me, especially with women who are deaf. When they come for services, I must be creative. For example, when I ask them about their last menstrual period, I show them something that is color red. When I ask about their breasts, I touch mine so that they understand. Sometimes I use pictures or draw diagrams in my notebook to explain something to them. I also write down my questions, then give them the sheet of paper to write back their response. For those who cannot read or write, most come accompanied by either their sister, mother, cousin or close female friend who is able to help us communicate.”

Dinah says that the situation is better now than it was when she started out as a nurse over two decades ago.

“There is a lot more information today about the sexual reproductive health needs for women and girls with disability, unlike in yester years. This is because there has been a lot of sensitization in different health forums. Additionally, nowadays you see women with disabilities in the media articulating their issues and concerns when accessing reproductive health services, and this helps increase our knowledge about how to serve them better.

Also watch : I Didn’t Think Women Living with Albinism Got Pregnant

Dinah’s recommendation is for society to be more sensitized about the needs and rights of people with disabilities. This is because the stigma starts right from home and extends to their environments including the neighbourhood, schools, workplaces and hospitals.

“There is need for a socio-cultural shift in our society that will improve our attitudes and views about people with disabilities. They should not be judged for being sexually active. Why should people find that strange? It is also their right to receive quality sexual reproductive health information and services without any form of discrimination,” she says.

Dinah also calls for more targeted capacity building initiatives for healthcare workers, considering that their attitude and skills have a direct bearing on the uptake of services by persons with disabilities.

“When we change our attitudes, people with disabilities will be confident and will feel comfortable enough to express their sexuality and seek respective services. Nobody should infringe on their sexual reproductive health rights,” she says.

Do you have feedback on this article? Please e-mail me at maryanne@mummytales.com or comment down below.

Mummy Tales is a platform dedicated to women and girl empowerment. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

My pregnancy loss story

Maryanne W. Waweru

Nov 10, 2022

By Maryanne W. Waweru l maryanne@mummytales.com

Roselynn is a 27-year-old from Kiambu county, in Kenya’s central region. Roselynn has a physical disability. She was born with a birth defect where her spine didn’t form properly, leading to complications in her limbs. The first three months of Roselynn’s life saw her undergo numerous corrective surgeries. She walks with a limp.

Five years ago, Roselynn fell pregnant, but she lost the pregnancy at six months. In this article, she shares details about that experience.

When she got pregnant, Roselynn says she found her days filled with a lot of anxiety and fear.

“I was young –only 22 years and in college, and with a disability. What would people say? How could I be busy getting pregnant, instead of studying? I feared what people would think of me. I also dreaded my parents finding out, as I knew they would be very disappointed in me,” she recalls.

Also read: Why I put my teenage daughter on the contraceptive injection

At that time, Roselynn was studying away from home, so she didn’t have to face her parents daily. It was only her boyfriend and close cousin who knew of the pregnancy.

Delayed first antenatal care visit

After Roselynn found out she was pregnant, she knew she needed to start her antenatal care (ANC) clinics, but she kept postponing her first visit.

“I had too much going on in my mind. There I was, a broke college student who depended on her parents for upkeep. My boyfriend was just as young, 23 years old and jobless. With a disability, I also feared I would be reprimanded by the nurses. I was afraid they would ask me too many questions which I would be unable to answer. I kept waiting for ‘the right time’ to start the clinic,” she says.

For a positive pregnancy experience, the World Health Organization (WHO) recommends that a pregnant woman starts her ANC visit in the first 12 weeks’ gestation, with subsequent contacts taking place at 20, 26, 30, 34, 36, 38 and 40 weeks’ gestation. ANC visits present important opportunities for the prevention and management of existing and potential causes of maternal and newborn complications.

Breaking the news to mother

Finally, after days, weeks and months of agony, Roselynn decided to break the news to her mother. She had visited her parents back at home. She texted her mother with the message: “I’m sorry mom, I’m pregnant”. Roselynn sent the message late at night.

Fearing the repercussions of her revelation, she left for college very early the following morning before anyone knew.

“Interestingly, the few times I would go home or when we were on a break from college, my parents never noticed my pregnancy. I worked very hard to hide it,” she says.

As expected, Roselynn’s mother was surprised by her daughter’s message.

“My parents could not imagine that I could be pregnant. It had never occurred to them that I was sexually active. They worried about the implications of my pregnancy as a young woman with disability.”

Going to the clinic

After she got over her initial shock, Roselynn’s mother asked her how far along she was. That was when it occurred to her that she herself had no idea. She had never attended an antenatal clinic, and so didn’t know how many weeks gestation she was. She decided to act.

“The following day, I went to the clinic for the first time. After being interrogated and examined by the nurses, they established that I was six months pregnant.”

One of the tests that Roselynn underwent at the clinic was ANC profiling, which ideally should be done in the early weeks of pregnancy. The ANC profile involves several laboratory tests on a pregnant woman, which are instrumental in identifying any underlying conditions or complications. This helps in providing early interventions where necessary. The ANC profile also helps to determine the mother’s blood group to establish the Rhesus (Rh) factor.

Also read: The menstruation experiences of women and girls with disability in Kenya

According to Mayo Clinic, Rh factor is an inherited protein found on the surface of red blood cells. Where one’s blood has the protein, they are Rh positive. If the blood doesn’t have the protein, they are Rh- (negative). The “+” or “–” after blood type refers to Rh positive or Rh negative. Having a Rh-negative blood type usually does not affect one’s health but can be problematic during pregnancy if the mother is Rh negative and the baby is Rh positive. In such a case (Rh incompatibility) the pregnancy needs special care.

After Roselynn’s ANC profile was done, she was informed that her blood group was O- (negative), something she was told she needed to be worried about.

“I had never known what my blood type was, and I didn’t understand what the nurses were telling me. They explained the rhesus incompatibility factor, but it was all jargon to me. They said I was lucky my pregnancy had survived that long as I typically should have miscarried earlier. That even though alive, my baby’s pulse was very weak. I was horrified by the information they were giving me,” Roselynn remembers.

As they gave her medication, they thoroughly scolded her about her delay in starting her antenatal care visits.

“They told me that had I presented myself to the clinic earlier, the ANC profile would have established that I was Rh- (negative) and I probably would have been given an injection to help me and my baby. When I asked them if they could give me the injection then, they said that it was already too late, that it would not help.”

The injection that the nurses were referring to is known as the Anti-D immunoglobulin injection, which is given to a Rh- (negative) woman if she presents with any complication in pregnancy, regardless of gestation. The injection is also given within 72 hours of giving birth.

Roselynn was released to go home but was advised to watch out for anything unusual and if she noticed anything, to return to the hospital immediately.

Bleeding

A few days later, Roselynn started bleeding.

“My cousin was staying with me then, and since the bleeding began in the evening hours, we decided we would go to hospital early the following day. By morning, I was so sick that I couldn’t walk, and we had to hire a taxi to the hospital. After the medics examined me, they asked who had accompanied me to the hospital. I told them it was my cousin –who was just about the same age as me. They instead asked for my mother’s number and asked her to come to the hospital immediately. From how they were behaving, I could tell something was terribly wrong but I chose not to concentrate on it.”

While waiting for her mother to arrive, Roselynn remembers the doctor opening a book and handing it to her. The article he asked her to read talked about the rhesus factor and its implications in pregnancy. As she read the article, Roselynn remembers merely reading words but not understanding their meaning.

It was only until she saw her mother walk into the room that her world fell apart.

“When I saw my mom, I just started crying. That’s when the reality of what was happening hit me. She didn’t need to say it. I knew my baby was gone.”

In the presence of her mother, Roselynn was informed that they had found no foetal heartbeat, that she had lost her baby. She was told that she had to deliver the baby immediately. After being induced, and many grueling hours later, she delivered her stillborn son. She was given the Anti-D immunoglobulin injection soon after.

Also read: How society’s attitudes towards the sexual lives of women with disabilities creates problems

Was it because of my disability?

Roselynn remembers her mother asking the doctor over and over again if she had lost the baby because of her disability.

“The doctor told her that the loss of my baby had nothing to do with my disability, but perhaps it was because of my blood type and that of the baby’s, which he said was Rh+ (positive).”

Roselynn delivered her son at six months, just days after she had gathered enough courage to break the news to her mother about her pregnancy and thereafter go for her first ANC visit. She keeps wondering if that delay resulted in the death of her son. What if she had not been afraid to visit the clinic in the early days of her pregnancy? Would her baby have been saved?

Roselynn says she is now more informed about what she needs to do in the event she gets pregnant again.

“It has been five years, but the episode is still fresh in my mind. I still mourn my dear son. I haven’t been dating seriously because most men I meet want to settle down and start a family, but I don’t feel ready for that –yet. I’m not sure I’m ready to get pregnant again. I don’t know when or if I’ll ever be ready. For now, I’m just taking it a day at a time.”

Also read: I Lost my Baby at 37 Weeks Pregnant. This is What Happened” –June Muli

After the interview, I asked Roselynn* if she needed support or counseling for women who have lost babies, to which she responded that she did. I referred her to Vivian Gaiko of Empower Mama, whose story you can read here.

If you too know of a woman who has lost a baby and needs support, please refer them to Empower Mama or empowermamafoundation@gmail.com

Do you have feedback on this article? Please e-mail me at maryanne@mummytales.com or comment down below.

Also read: The pregnancy and childbirth experience of an amputee woman in Kenya

*Not her real name.

Mummy Tales is a platform dedicated to women and girl empowerment. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

The menstruation experiences of women and girls with disability in Kenya

Maryanne W. Waweru

Nov 7, 2022

By Maryanne W. Waweru l maryanne@mummytales.com

For many girls and women of reproductive age, receiving their menses is a normal and healthy part of life. Most women menstruate for about two to seven days each month. On average, women experience over 400 menstrual cycles in their lifetime, amounting to a span of more than 30 years during which they actively menstruate.

While most are able to manage their menses hygienically and with dignity, this is not the case for many women and girls with disabilities, for whom periods can be a difficult time. UNICEF states that women and girls with disabilities face additional challenges with menstrual hygiene and are affected disproportionately by lack of access to toilets with water and materials to manage their period.

To understand the period experiences of women and girls with disability, I spoke to two Kenyan women –Rose Resiato who has a physical disability, and Angeline Akai who is blind.

Rose Resiato works as an Operations Manager in a missionary-based institution in Kajiado County, located in Kenya’s Rift Valley. She uses an assistive device called a leg brace for her mobility. The leg brace goes all the way from her heel to the upper thigh, providing stability for her pelvic area, hip and lower torso. With this device, she is better able to perform various functions such as walking, bathing, and dressing. Sometimes, Rose uses crutches for additional assistance.

Sanitary pad and leg brace friction

When she is on her period, Rose must first put on her panty, line the sanitary pad and adjust the leg brace before dressing up. One of the main challenges that Rose faces is that as she walks, the wings from the sanitary pad (mostly made of polyethylene material) that protrude outwards from the panty –rub against the leg brace, with the friction irritating her skin. By evening, Rose’s skin is often sore and bruised from this abrasion.

That’s not the only problem though.

“My walk with the leg-brace sometimes causes the pad to move out of place, leading to blood leakage to the panty, clothes, and some parts of the brace. It can be a mess,” she says.

Using tampons could be an alternative, but Rose has her reservations.

“Since the caliper in the leg brace pushes against the pelvic area as I walk, I fear this can cause the tampon to be pushed up my reproductive system. Even though it’s a farfetched thought, it is a fear that has held me back from using a tampon all these years,” says the 36-year-old.

While changing a sanitary towel at home is a comfortable experience for Rose, the same cannot be said when she’s at work or in a public toilet.

“For me, changing a pad takes a lot of time. By the time I remove the soiled pad, wrap it up and dispose it, remove the adhesive strip from the new pad, firmly press it onto the panty and ensure it is correctly in place, wear my panty and adjust the leg brace –all while ensuring I don’t mess myself –is quite a balancing act. This means I take a longer time than usual in the toilet, which can be particularly unnerving when there’s a queue of women waiting to use the same toilet,” she says.

Sanitary bins

Essentially, all female-used toilets should have a sanitary disposal bin in each cubicle for enhanced privacy. While there exist no-touch sanitary bins fitted with sensors that automatically open and allow one to dispose the used pad, most locally available sanitary bins require one to open the lid by pressing the pedal with their foot. In such instances, it can be difficult for women with disability such as that of Rose.

“For me, the leg I use for support and balance is the same one I’m supposed to press the pedal of the sanitary bin with to lift the lid. It’s not easy. This is a situation that forces many women with physical disability to lift the lid of the sanitary bin with their hands. This is unhygienic and can lead to infections,” she says.

It gets worse for women wheelchair users, or women with no hands or fingers.

“By the time a wheelchair user manoeuvres her body to change her pad (usually in narrowly designed toilets that are not disability-friendly), dispose it in the sanitary bin and dress up, there are high chances of her messing herself. She often needs to be assisted. For women without hands or fingers, or for those with spastic conditions such as severe cerebral palsy, how do they change and dispose soiled pads?” Rose asks.

For such women, Rose says they need the assistance of a friend, caregiver, or even stranger during their menses. Menstruation ceases to be an intimate, personal experience for them.

Sometimes, they may delay changing their menstrual product because of the complications of doing so, which can in turn lead to health complications such as toxic shock syndrome (TSS).

Sinks in high places

When it comes to washing up, Rose notes that some sink basins in toilets are out of reach for women wheelchair users and those with short stature. It becomes difficult when they need to wash their hands as not only are the taps with running water high above their reach, but so are soap dispensers where available.

“If such a woman has soiled her clothes and needs to wash up, she would likely need to seek the assistance of a stranger in the washroom, a colleague, caretaker, or friend to help her out. This is certainly not a comfortable experience for her,” says Rose.

Clean toilets for white cane users

Angeline Akai, 36, is a visually impaired teacher and disability rights advocate based in Kenya’s capital city of Nairobi. For women like her, having running water in toilets is a necessity.

“Blind and low-vision people rely heavily on touch, so we use our hands a lot. It is for this reason that we must be very cautious about the cleanliness of the sanitary facility and its environment. Clean, running water is essential in washrooms,” she says.

Additionally, most blind and women with low-vision use a white cane, a mobility device that helps them to scan their surroundings for obstacles as they move around.

“A white cane is our extended arm, and we strive to ensure that it’s always clean. That’s why we need water in washrooms, to enable us to wash the white cane especially in toilets whose hygiene is not up to par,” says Angeline.

Unhygienic washrooms, poor water supply, lack of adequate disposal sanitary bins and lack of gender-segregated toilets in schools or workplaces are some of the challenges that make women and girls with disabilities fail to show up at school or work during their menstrual cycle. This in turn affects the academic performance of schoolgirls and productivity for the working woman.

So, what are the solutions?

Research and participation of women with disability

Rose proposes more research on the menstrual experiences of women with disabilities. This research, she says, must be inclusive of the views and experiences of women with disabilities.

“Period product designers and manufacturers must have discussions with women with disabilities to be knowledgeable about their specific needs. It is important for them to understand that women and girls with disabilities have different experiences. We need them to listen to our feedback on menstrual products and suggestions. This will help them better understand what works for us and what can be improved on,” she says.

Angeline concurs, saying that women and girls with disabilities are often not consulted or represented in decision-making processes regarding period product development.

“Most products are designed with the non-disabled woman in mind. No one has ever consulted me or any other woman with disability I know about our experiences with menstrual hygiene products. We are always an afterthought –if at all we are thought about,” she says.

Disability-friendly sanitary products

To help ease the challenges women and girls with disabilities face, Rose suggests the production of menstrual diapers –something like kiddie or adult diapers.

“Preferably made of pure cotton material, they would be easier to wear and remove, and the friction problem I face would be addressed as they would not be made of polythene material.”

She also suggests a reduction in price of pure cotton sanitary towels as the ones in the market are very pricy. A packet of one brand of cotton sanitary pads retails at Sh415 ($3.4) for just nine pieces.

Menstrual packaging consideration for the blind

When buying sanitary pads, Angeline is never able to differentiate pads according to their sizes.

“I recently learnt that there are pads for light flow, normal flow, and heavy flow. All these years, I never knew there are these variations, including extra-long pads that are better used at night for a more comfortable absorbency experience. I always knew that all pads come in the same size!”

Angeline’s suggestion is for manufacturers to package sanitary pads in a way that blind and low-vision women can easily differentiate and pick out.

“They can consider packaging them in braille format. If this would be difficult for them to deliver on, they can consider having the size variations in different textures on the packaging that we can easily identify by touch,” she says.

Further, Rose and Angeline urge stakeholders to ensure that there are reliable and accessible water, sanitation and hygiene (WASH) facilities in all public and private establishments that will enable women with disability have a more comfortable experience during their menses.

“Running water in the taps, or tanks with clean water should be made available in all female-user washrooms. Further, soaps and sink basins must be placed at reachable levels for all women with disability, including wheelchair users and women of short stature,” says Rose.

Rose and Angeline, who represent the voices of millions of women with disabilities, say that access to WASH facilities should be included in institutions and organizations’ financial budgets. They allude to the fact that while the construction of ramps and modification of toilets to make them disability-friendly may require additional resources, they are nevertheless necessary in creating enabling environments that make women and girls with disability more comfortable and productive during their period.

Education

The natural, biological process of menstruation is compounded by taboos, myths, misconceptions, and stigma. It is particularly worse for women with disability, where negative assumptions see them left out of educational programs on sexual reproductive health issues, including menstrual health.

Angeline says that when she was in an integrated primary school, promoters from a popular sanitary pad brand would come to the school and educate female pupils about menstrual health.

“They would conduct visual demonstrations on how to use the pads. I am blind, so I would only follow the teachings by hearing. I missed out on a lot because afterwards, no one would ask if I had understood the information given or not,” she says.

Later, when Angeline transferred to a school for the blind, the situation did not improve as the same promoters would come to the school, give the pads to the teachers and ask that they distribute them to the girls, then leave. They never gave any menstrual health talks to the pupils, and neither did the teachers.

“All that I learnt about menstruation was from my peers –with some information being misleading and inaccurate as they too didn’t know much. Sexual reproductive health educational programs mostly target able-bodied populations. There is a lot we don’t know,” she says.

Also read: Managing periods as a visually impaired woman: Eve Kibare’s story

Angeline suggests having menstrual health information delivered in accessible formats right from schools to healthcare facilities.

“Disability-friendly education material should be developed, availed and stored in print and electronic (web-based and social media form) that are accessible. The material should be in braille, audio and visual formats (with subtitles and sign language interpretation), pictorial aids and sign language, among other presentations. This way, girls and women with disabilities will be better equipped with adequate and accurate knowledge on menstrual health,” she says.

Zachary Samson Kweyu, a sexual reproductive health and rights (SRHR) advocate and community health educator from Nyeri county in Kenya’s Central region says that increasing society’s understanding of menstrual health must be prioritized as it will help address issues of stigma and misunderstanding around it. This education, he says, must include males.

“Men should not distance themselves from the menstrual health subject. It is important for them to understand what girls go through during their menses and offer their support. In schools, some boys tease girls who have stained their clothes. Other male teachers are said to be unapproachable, creating fear in girls who wish to ask for permission during a lesson to go change their sanitary towel. This fear makes the girls stay longer with their pads, leading to leakage and staining of their clothes,” he says.

Affordability of menstrual products

The World Bank indicates that about one in three people in Kenya live below the international poverty line of $1.90 per day. The institution further states that persons with disabilities, on average as a group, are more likely to experience adverse socioeconomic outcomes such as less education, poorer health outcomes, lower levels of employment, and higher poverty rates than persons without disabilities.

Most persons with disability (PWDs) are unlikely to have active or viable socio-economic engagements to earn a living. The COVID-19 pandemic, associated lockdowns, commodity supply chain shortages and resulting economic crises only exacerbated the situation (Kenya National Survey for Persons with Disabilities (KNSPWD). Subsequently, many women and girls with disability –many of whom live in rural areas –experience financial constraints in accessing menstrual products.

Due to these economic vulnerabilities, the cost of commercial menstrual products can be prohibitive for many women. These products include sanitary pads, tampons, menstrual cups, and period pants.

Kenya has instituted several policies aimed at improving menstrual health and enhancing accessibility to menstrual products. These include the 2004 directive for the removal of sales tax on menstrual products, as well as the elimination in 2011 of VAT on imported menstrual products and the raw materials for their production. Additionally, the Basic Education Act, signed in 2017, mandates the government to provide free, sufficient and quality sanitary towels to every girl enrolled in a public basic learning institution.

In 2021, the Kenya Bureau of Standards (KEBS) issued a product standard for reusable sanitary towels. The standard outlines absorbency requirements, fastening mechanism, comfort and feel, skin sensitivity and odour, care and user instructions.

There is also the Kenya Menstrual Hygiene Management Policy (2019-2030) that is aimed at ensuring that all women and girls in the country can manage menstruation hygienically, freely, with dignity without stigma or taboos, and with access to the right information on menstrual health management, menstrual products, services and facilities, and to safely dispose of menstrual waste.

Government’s commitment

Additionally, the Kenya Environmental Sanitation and Hygiene Strategic Framework (KESSF) details the government’s commitment to ensuring provision of safe, adequate, disability-friendly, appropriate and affordable menstrual hygiene facilities for managing menstruation hygienically and with dignity in different environments including schools, workplaces, public spaces, institutions and emergency situations.

Despite these initiatives, Kenyan women and girls continue to face various challenges regarding their menstrual health. There are gaps between policy and reality. Tina Lubayo, a disability-inclusion advocate from Women and Girls Empowered Kenya (WAGE Kenya) says the government and its partners must be more strict in addressing these gaps.

“Addressing the challenges that women and girls with disabilities face during their menses requires a multi-sectoral approach by key stakeholders such as: the general public, government agencies (State actors), legislators, political, religious and community leaders, as well as members of the private and public sectors,” she says.

Tina calls for collaboration amongst all agencies in ensuring that menstrual health education, period products, sanitary services and facilities are all made with the disabled woman in mind.

“This will ensure that all vulnerable women and girls, including those in the most remote areas of the country are able to menstruate hygienically, comfortably and with dignity. It is their human right to do so,” she says.

WAGE Kenya is a community-based organization led by women. WAGE Kenya works with young people with and without disabilities to enable them to build their agency to self-advocate for the respect, fulfillment, and advancement of their human rights. WAGE Kenya implements activities and programmes in the informal settlements and rural areas of Kenya in collaboration with key partners and leveraging strategic partnerships between young people and adults.

The UN Convention on the Rights of Persons With Disabilities (CRPD), emphasizes the importance of mainstreaming disability issues and fostering disability inclusion in the day-to-day for sustainable development. Kenya, as a state party to the CRPD must do better in addressing the concerns of women and girls with disabilities on their menstrual health.

Also read: Why I put my teenage daughter on the contraceptive injection

Also read: How society’s attitudes towards the sexual lives of women with disabilities creates problems

Do you have feedback on this article? Please e-mail me at maryanne@mummytales.com or comment down below.

Mummy Tales is a platform dedicated to women and girl empowerment. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

Why I put my teenage daughter on the contraceptive injection

Maryanne W. Waweru

Nov 4, 2022

By Maryanne W. Waweru l maryanne@mummytales.com

35-year-old Salome* is a mother of four who lives in Nyeri town with her family. Her first-born daughter Kena*, aged 18 years, has a physical disability.

Kena has spasticity, a condition where an abnormal increase in muscle tone or stiffness interferes with movement and speech. At her age, Kena is unable to speak –her attempts to do so only yielding a few incomprehensible words. Kena is also unable to use her hands to perform basic functions. Spasticity is usually caused by damage to nerve pathways within the brain or spinal cord that control muscle movement.

A few years ago, Salome took her daughter to the family planning clinic and put her on a contraceptive injection, which she renews every three months. I spoke to Salome about her decision to do so.

“There is an incident that happened when my daughter was 13 years old that is forever etched in my memory. At that time, Kena was a pupil at a school near our house. I would walk her in the morning on my way to work, and when the school would close for the day at 3.30pm, she would walk home –a stroll that took less than 10 minutes.

One day, as was her routine, she walked home and as she was closing the door behind her, a man flung it open, banged it shut and began attacking her. My petite-sized daughter, who cannot scream or shout for help as her vocals are undeveloped, was unable to fight off the attacker.

Meanwhile, I was on my way home as my employer graciously allowed me to leave work early so that I could be home at around the same time my daughter arrived from school.

On that day, I arrived in the nick of time.

Pants down

When I opened the door, I was horrified by what I saw. Having overpowered her, he had stripped her naked and was holding her down on the sofa. The man had his pants down to the ankle and his manhood was erect.

Because I had startled the man, he bolted out of the house. Everything happened so fast.

After quickly recollecting myself, I rushed my daughter to hospital where thankfully, the nurses established that she had not been defiled. Kena was crying helplessly, obviously shaken by what had happened. I felt horrible, but nevertheless grateful that I had stopped the man from committing a horrible act.

After our release from hospital, we went to the police station and reported the incident. The man was nowhere to be found.

I knew the man

When I returned home, word had already gone round and my neighbours began apologizing profusely, informing me that the 31-year-old man who had attacked Kena was their nephew. A drug user, he had become a nuisance to his parents, who had then sent him over to stay with his uncle (my neighbour) in the hope that he would reform. I had seen him a couple of times in the estate, so he was no stranger.

When his parents learnt about what had happened and that the police were looking for him, they disclosed his whereabouts. They said he was better off in the hands of the police than those of the public –which was baying for his blood.

Sent to prison

We pursued the case in Court successfully, which culminated in his sentencing for charges of attempted defilement. The man is currently serving a jail term.

The incident created a lot of anxiety in me. knowing that I cannot always be with my daughter to give her round-the-clock protection, a strong, agonizing fear began tormenting me. Kena was growing up and becoming a woman, and this worried me a lot. What if a man took advantage of her in the one second my eyes darted away from her? What if she got pregnant?

Family planning for my teenage daughter

After stressing about it for a long time and realizing I would go crazy as it was impossible for me to be with her all the time, I decided to put her on a contraceptive. I talked to her about it, and I believe she understood. She was 15 years old then.

After our conversation, I took her to the family planning clinic where she was put on a three-month contraceptive injection. She gets a new shot every three months, and I’m the one to takes her to the family planning clinic for this. Kena is now 18 years old.

Kena receives her monthly period as usual and has never experienced any side effects to the best of my knowledge.

I believe putting her on a contraceptive was a good decision. She was only 13 when the man attempted to defile her. What if he had succeeded? I’m not saying that it will happen, and I’m not a prophet of doom, but knowing the immoral society we live in, if it were ever to happen that she conceives, I am certain she would suffer a miscarriage. This is because, as a girl with disability, her body is too frail to carry a pregnancy to term. I know she would suffer and I would be too pained seeing her in such anguish.

Her body cannot survive childbirth

Even if she were to miraculously carry the pregnancy to term, I doubt she would survive the childbirth experience. It would be too grueling and would batter her body to destruction. Also, who would take of the child? She cannot hold anything with her hands, and her walk is labored. How would she nurse and take care of a baby?

I have four children and with the harsh economic times we are facing, times are tough for my husband and I. If Kena were to have a child, I would need to stop working to care for both she and her baby. It is a risk that I cannot afford to take. That is why I decided to put her on contraception. That way, I know she is safe from getting pregnant. I cannot protect her from everything, but this is just one way of protecting her.

My secret

No one knows that my daughter is on contraception. I don’t think people would understand. I’m the only one who knows what I saw that day I walked in on the man just about to defile my daughter. It is a nightmare that I live with every single day.

If I were to tell people that Kena is on a hormonal contraceptive, they will judge me for it, yet I am the wearer of the shoe and I’m the only one who knows where it pinches most.”

Also read: The menstruation experiences of women and girls with disability in Kenya

Also read: How society’s attitudes towards the sexual lives of women with disabilities creates problems

Various factors predispose girls and women with disabilities to increased vulnerabilities. These include stigma, communication difficulties, challenges with mobility, neglect, social isolation, rejection, as well as the assumption that they are weak and dumb. This leaves them exposed and at higher risk for sexual and gender-based violence (SGBV).

While doing my research on this article, I established that sexual violence against girls and women with disabilities is a widespread issue, but yet, one that is hugely silenced. It is one that is heavily hushed within families, and sorted out ‘internally’. A very worrying concern.

Evidence shows that girls and young women with disabilities may face up to 10 times more violence than women and girls without disabilities. It also reveals that as young girls with disabilities enter adolescence, their risk of experiencing sexual violence increases. It is estimated that between 40 to 70 per cent of girls with disability will be sexually abused before they reach 18 years of age.

There is need for the development of evidence-based interventions and prevention programs that address the various vulnerabilities that girls and women with disabiliteis face. These interventions should among others, ensure that girls and women with disabilities are safe from harm, are able to report incidents of abuse, and that justice is served for their perpetrators.

Also Read: The pregnancy and childbirth experience of an amputee woman in Kenya

If you would like to report a case of SGBV against a child, please call the Childline Kenya helpline number 116. You can also call the National Gender Violence Helpline number 1195.

*Names changed to protect the identity of the minor.

Do you have feedback on this article? Please e-mail me at maryanne@mummytales.com or you can comment down below.

Mummy Tales is a platform dedicated to women and girl empowerment. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

Life-saving medical equipment to secure safe deliveries for Kenyan mothers distributed to six counties

Maryanne W. Waweru

Nov 1, 2022

Lifenet-q2 — Dr Queenter Oyato, Nairobi County's Head of Partnership Coordination.

By Omboki Monayo l omboki2725@gmail.com

Expectant Kenyan mothers and babies are set for safer deliveries in the wake of a major equipment and training boost targeting 24 facilities in six counties.

The development comes after LifeNet International partnered with the Nairobi County government, five other counties and faith-based health facilities to ensure the distribution of 39 pieces of vital medical equipment.

At least 24 facilities across six counties are set to benefit from the distribution of the equipment. The counties are Nairobi, Kiambu, Kajiado, Nyeri, Kitui and Kirinyaga.

According to the Ministry of Health’s SDG Progress Report of December 2020, the maternal mortality ratio, which is the number of women dying of pregnancy-related causes, stands at 342 deaths per 100,000 live births.

“Estimates by the Maternal Mortality Inter-agency working Group (MMEIG) indicate a reduction in Kenya’s maternal mortality ratio (MMR) from 353 in 2015 to 342 per 100, 000 live births in 2017. However, the annual 3.3 percent rate of decline in MMR was inadequate to achieve the target of 140 per 100,000 live births by 2030,” the report says.

According to the United Nations Population Fund (UNFPA), at least 80.6 percent of births in Kenya are done by a skilled health personnel. This has left a number of mothers exposed to the risks of dying while giving birth.

“Given the current annual births, this means that there are nearly 5,000 women and girls dying annually due to pregnancy and childbirth complications,” the UN body says on its website page dedicated to the country’s maternal mortality status.

UNFPA notes that vital improvements have been made in ensuring that more women deliver their babies in recognized health facilities, but points out that four out of every five maternal deaths are due to substandard medical care.

“While access to skilled birth attendance has improved from 62 percent to about 70 percent over the last seven years, over 80% of maternal deaths are attributed to poor quality of care,” writes the UNFPA.

Also Read: How health workers in Kibera are assessing sick children using a new digital health tool

LifeNet International is a health system strengthening organization focused on delivering high quality capacity building in medical interventions.

It also boosts health facility management to improve the service provision of essential services to under-served communities through partnership with faith-based health facilities.

Since 2009, LifeNet has been working with local, faith-based health facilities in sub-Saharan Africa to bridge the deadly gap separating existing knowledge, tools, and resources from the healthcare workers who need them to save lives.

Through its growing network of 375 facilities spread across Uganda, Kenya, Ghana, Malawi, Burundi, and the Democratic Republic of the Congo, the organization deploys life-saving and health-boosting interventions directly to healthcare workers.

It also assists health facilities to build their capacity and quality in patient safety, maternal, newborn and childcare, family planning, HIV/AIDs, NCDs, general primary care, pharmaceutical management and spiritual integration.

On October 19, 2022, LifeNet held a distribution event at the Mission for Essential Drugs and Supplies (MEDS) headquarters in Nairobi. The event was flagged off by Sarah Borger, who is the organization’s Vice President of Programs and Operations.

Speaking at the event, Ms Borger revealed that the initiative aims to provide 39 pieces of high-impact medical equipment to support 12 health facilities across 6 counties in Kenya.

“We are flagging off the distribution of life-saving medical equipment to the various facilities in six counties across the nation. This equipment will improve the quality of healthcare received at the health facilities and is expected to save and improve lives,” Ms Borger said.

Sarah Borger, LifeNet Vice President of Programs and Operations.

LifeNet so far has provided 88 pieces of medical equipment to 24 faith-based health facilities in 2022 alone.

The medical equipment includes maternity and delivery beds, AMBU bags, oxygen concentrators, resuscitation tools, blood or hematology analyzers, autoclave machines, infant and incubators.

Autoclaves are used to sterilize equipment used during the deliveries. In the process, they help to ensure the safe and healthy delivery by preventing infections like neonatal sepsis from endangering the babies’ lives.

Incubators are used to protect the delicate existence of babies born prematurely. Hematology analyzers are used in analyzing the mother’s blood for signs of anaemia and any other deficiencies that might threaten the delivery process.

The consignment also included specially designed delivery beds designed to make the process of giving birth as comfortable as possible.

Besides supplying medical equipment, LifeNet provides capacity building in clinical and management best practices, quality assurance, and supportive supervision.

“These interventions have worked together to boost the quality of healthcare facilities in sub-Saharan Africa and helped provide essential services which have saved thousands of lives of mothers and babies,” Ms Borger said.

She pointed out that maternal and child deaths in the region could be reduced by handling pregnancy and delivery with the proper education and equipment, adding that LifeNet was committed to making a positive contribution towards this noble goal.

“Most maternal and newborn deaths in the region are preventable with the right knowledge, skills, and equipment. This medical equipment, coupled with high-impact medical and management training that LifeNet provides, is critical in preventing maternal and newborn death and disease and providing quality healthcare to communities,” said Ms Borger.

“We look forward to all the lives that will be saved and are thankful for the opportunity to support health facilities to deliver high-quality healthcare,” she added.

Also read: PASHA, a mobile app to help fight FGM in Kuria launched

On her part, Dr. Queenter Oyato, who is Head of Partnership Coordination in Nairobi County, said that LifeNet is among the valued partners helping to improve the quality of its healthcare services.

“LifeNet is one of our valued partners in the efforts we are making to improve the quality of healthcare. It supports us through the provision of continuous medical education, training and capacity building as well as provision of medical equipment,” Dr Oyato said.

She explained that maternal and child health care is a diverse field that requires considerable investment in order to reduce maternal and child mortality while securing the best possible health outcomes for mothers and their babies.

Dr Oyato said the county’s growing population required an equivalent response in terms of health service delivery.

“Nairobi’s population is expanding rapidly and there is need for a corresponding increase in facilities, staff, skills, knowledge and equipment to cater to the people. When it comes to staff training and empowerment, we would benefit from having more partners involved in the process,” she said.

Dr Oyato said the county had trained its staff on the use of the modern equipment, adding that the partnership with LifeNet was boosting its capacity to reach more people by educating its community health volunteers to direct pregnant mothers to the facility for delivery and care of their babies.

“LifeNet is helping us to equip the facilities and also train the CHVs so that they can empower expectant mothers at community level to make healthy choices that include attending the required antenatal clinic (anc) sessions and delivering their babies at recognized health facilities,” said Dr Oyato.

She urged expectant mothers to attend the ANC sessions for advice and guidance on maintaining healthy pregnancy and going through a safe delivery process.

“Attending ANC sessions is very important for every pregnant mother. Here, we have trained staff that will offer the required assistance, detect and diagnose any possible health complications such as ectopic pregnancies, pre-eclampsia, anaemia and gestational diabetes. They are also skilled in guiding the mothers on what to do to deliver healthy babies. Mothers and their babies are in safe hands with us,” she said.

Also read: Why Kenyan teenage mothers do not return to school despite re-entry policy

LifeNet’s Kenya Program Manager, Edwin Nyakan, said his organization was a committed partner in the country’s quest to improve health outcomes for mothers and the babies they hoped to deliver in the country’s health facilities.

“We have always endeavored to support the Ministry of Health by transforming healthcare systems through the provision of holistic, and compassionate care to patients,” said Mr Nyakan.

He further expressed confidence in the continued partnership between LifeNet and the Ministry of Health and faith based organizations that operate health facilities in the country.

“We are committed to continuing into the future, with the Ministry of Health’s support. Our goal is to save and improve as many lives as possible through high-quality healthcare,” Mr Nyakan said.

Photos: Omboki Monayo

Do you have feedback on this article? Please e-mail: maryanne@mummytales.com

Do you work in an organization that has programmes for mothers and children that you’d like highlighted? Reach me on maryanne@mummytales.com and I’ll get back to you.

Mummy Tales is a platform dedicated to women and girl empowerment. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

PASHA, a mobile app to help fight FGM in Kuria launched

Maryanne W. Waweru

Oct 26, 2022

PASHApng — Photo source: Anti-FGM Board Kenya on Twitter.

A one-of-a-kind new mobile application, PASHA, has been launched in Kehancha, Kuria West, Migori County in a bid to stem the high rates of female genital mutilation (FGM) in the region.

The PASHA App will help in reporting and tracking cases of FGM in the County. It will also help in sharing information with relevant government agencies, including the Kenya Anti-Female Genital Mutilation (FGM) Board and other authorities.

How does it work?

Through the PASHA App, a person can send or share emergency alerts either in text or voice recording. The App can pick the person’s location, and it also gives one the option of remaining anonymous.

Once shared, the information is then received by authorities who will respond promptly and accordingly –depending on the alert received. The mobile application is free to those who will use it. It can be downloaded from Google Play Store.

Also read: Why Kenyan teenage mothers do not return to school despite re-entry policy

The PASHA App will complement existing mechanisms of reporting cases of abuse against children, such as the free Child Helpline number 116 and the National Gender Violence Helpline number 1195.

Kenya’s committment to end FGM by 2022

The launch is timely, coming just before the November-December school holiday, a season when cases of FGM hits the peak in Kuria. Government data shows Kuria community has one of the highest rates of prevalence of FGM in Kenya; affecting 84 per cent of women.

Also read: The 4 Year-Old Girl with Traumatic Gynaecological Fistula in Kisii

In June 2019, Kenya committed to ending FGM by end 2022. The enactment of the Prohibition of FGM Act, 2011 was also a key milestone in the campaign to end FGM in the country. However, despite the legislative and policy measures put in place to end the practice, FGM remains prevalent in certain communities.

The PASHA mobile Application has been developed by the Kenya Anti-Female Genital Mutilation (FGM) Board in partnership with UNICEF Kenya.

Also read: How health workers in Kibera are assessing sick children using a new digital health tool

Do you have a story or initiative you would like to share? Email me on maryanne@mummytales.com with the details.

Mummy Tales is a platform dedicated to women and girl empowerment. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

‘Sugar Free Jude’ —a new children’s storybook raising awareness on type 2 Diabetes in kids

Maryanne W. Waweru

Oct 4, 2022

A new children’s storybook – ‘Sugar Free Jude’ to promote healthy lifestyles and raise awareness on the early detection, prevention, and management of Diabetes for children and youth across Africa has been launched.

‘Sugar Free Jude’ is a story of a young school-going boy, Jude, whose daily life is affected when he is diagnosed with Type 2 Diabetes. Jude was able to manage his health condition with help from his family, friends and teachers at school and he became the advocate to fight diabetes in his school and community.

The book is aimed at promoting a healthy lifestyle and raise awareness on the early detection, prevention, and management of Diabetes from a young age.

Read ‘Sugar Free Jude’ storybook: https://bit.ly/3PsepSf

The book was launched by Merck Foundation, in partnership with African First Ladies. ‘Sugar Free Jude’ is available in English, French and Portuguese.

According to the World Health Organization (WHO), almost 70% of the African population living with Diabetes is unaware of their condition and about 45 million adult population have Impaired Glucose Tolerance (IGT) which places them at high risk of developing type 2 diabetes.

Also read: How health workers in Kibera are assessing sick children using a new digital health tool

Early signs and symptoms of Diabetes such as frequent urination, increased thirst, feeling tired and hungry, vision problems, slow wound healing, and yeast infections. In case one experiences any of these symptoms, one must consult a doctor and get tested. Diabetes management is a lifestyle change, those living with this condition have to eat healthy, exercise regularly, stop smoking, and limit alcohol, sugar and salt intake.

Merck Foundation has also released a related song in three languages: ‘No more Diabetes, Sugar Free’ in English, ‘Dites non au Diabète’ in French, and ‘Chega de Diabete’ in Portuguese. The songs talk about promoting a healthy lifestyle and raising awareness on the early detection and prevention of Diabetes.

Also read: “Kwaheri Sandy Footprints, Habari Hiking Trails” a new children’s storybook by Deborah Nabubwaya Chambers

Mummy Tales is a platform dedicated to empowering its readers on different aspects of womanhood and motherhood. Read more motherhood experiences of Kenyan moms here. Connect with Mummy Tales on: FACEBOOK l YOU TUBE l INSTAGRAM l TWITTER

“It’s my fault I got pregnant. I’d be overburdening my mother if I returned to school” -the story of a teenage mother in Kenya

Maryanne W. Waweru

Sep 27, 2022

In the informal settlement of Kibera, a young ‘mama fua‘ (laundry lady) earns an average of 50 shillings ($0.41) per load. A woman who is a bit older earns double that amount. Work is usually hard to come by and cannot be depended on as a regular source of income. The same job in the neighbouring middle-class Langata estate, would earn a woman between 700 – 1,000 shillings (($5.7 – 8.2). But it’s often impossible for a young teenage mother to get a job in such a neighborhood. The older mama fua women who work in the middle-class neighbourhoods guard these jobs jealously and cannot allow it. This, is what I was informed as I interviewed a few teenage mothers like Rukia, who is a mama fua.

How did Rukia, aged 18 years, end up as a mama fua?

*This story is part of a series of articles I’m doing on the issue of teenage mothers in Kenya and the reasons why they don’t return to school despite legal provisions for them to do so. Each teen mom I feature has a different and personal reason why she hasn’t returned to school. I hope you find the articles insightful. Today I share Beryl’s story. Be sure to read the other stories on Elsa, Dayana, Lavenda and Beryl. You can read the full long-version here.

By Maryanne W. Waweru

When she was young, Rukia*, who scored 240 marks in her Kenya Certificate of Primary Education (KCPE) aspired to be a lawyer. But that dream is long gone.

A fourth born in a family of five, Rukia lives with her family in Kibera. She was in Form 1 at a private mixed day school when she became pregnant. When her pregnancy became visible at four months, she stopped going to school.

Father adbicates financial responsibilities

Now that her son is 11 months old, has she thought of resuming her studies?

“Yes I have, and I know I can return, but it’s complicated. I was in a private school where my school fee was paid by mother, who does menial jobs. I felt horrible when I got pregnant as I felt that I had let her down. Even though our father stays with us, he does not offer any financial support and says it is my mother’s duty to provide for the family,” says Rukia who was abandoned by her 22-year-old boyfriend after she informed him of her pregnancy.

Rukia says returning to school will overburden her mother as she will not only have to pay the school fees but also take care of her son and his expenses such as diapers, clothes and food.

“My mother is already overwhelmed with paying for my other siblings’ school fees, so it would be unfair of me to ask her to provide for an extra mouth yet it’s my fault that I got pregnant,” she says.

Rukia now spends her days caring for her son and searching for ‘mama fua’ (laundry jobs) that earn her little money which she says can only cater for her son’s expenses. She wishes she could get someone to pay her school fees.

Teachers’ invitation to return to class

“My teachers told me to return to school after childbirth. But if I go back, how will my mother manage all the expenses? My school fees and the additional burden of caring for my child and feeding the extra mouth? If I can get help with the school fees, then I can continue washing people’s clothes over the weekend, and the money I make can pay for my baby’s needs without burdening my mother.”

At the age of 18 years, Rukia says she doesn’t mind going back to school where she left off –in Form 1, even though she would be studying with students much younger than her.

“The only thing I would not want to do is to return to my former school. I would like a school where people don’t know my past. I think I will feel judged if I return to my former school. I’d prefer to study in a school where other girls will not gossip me. A school where teachers will not use me as an example to other students, telling them not to be like me. I wouldn’t feel comfortable learning in an environment with such an attitude from the teachers,” she says.

What are your thoughts on Rukia’s story? Do you think she will be able to return to school someday? Feel free to share your thoughts down below.

If you work in an organization that deals with teenage mothers that you’d like highlighted, reach out to me on maryanne@mummytales.com

*Name changed for purposes of protecting her identity.

“The teacher would ask me to lie down and whip my bottom despite knowing I was pregnant. I would also be made to kneel down” -tales of a pregnant schoolgirl in Kenya

Maryanne W. Waweru

Sep 26, 2022

Why would a teacher, fully aware of his student’s pregnancy, still ask her to lie down on her belly and proceed to whip her behind thoroughly? Why would teachers ask her to kneel down during mass punishments, knowing the toll this would have on a pregnant student?

*This story is part of a series of articles on the issue of teenage mothers in Kenya and the reasons why they don’t return to school despite legal provisions for them to do so. Each teen mom I feature has a different and personal reason about why she hasn’t returned to school. I hope you find the articles insightful. Today I share Beryl’s story. Be sure to read the other stories on Elsa, Dayana, Lavenda and Rukia. You can read the full long-version here.

By Maryanne W. Waweru

Beryl* is a 17-year-old teen mom. Her son is 10 months. She had been dating her 21-year-old boyfriend, a mechanic, for four years when she discovered she was pregnant. At that time, she was a Form 2 student in a girls’ boarding school in Siaya county.

Beryl would experience nausea and vomiting which she couldn’t hide from her classmates and as her belly grew, so did the murmurs among her fellow students and teachers.

Soon, she was summoned to the matron’s office and a pregnancy test done. The results were positive. She was then taken to the school Principal, whom she describes as ‘a warm, elderly and understanding woman’.

“The Principal encouraged me to continue with my studies until I was ready to deliver. She told me not to worry, that I wouldn’t be sent home. She even called my mother and assured her of the school’s support as I studied,” she says.

Mockery from other girls

Reassured, Beryl was however not prepared for the taunts she would receive from the student community.

“The girls would talk behind my back. Whenever I walked past them, they would giggle and burst out in thunderous laughter. I would feel awful.”

Additionally, Beryl was expected to do everything else like other girls. There were no exceptions for her.

Beatings and punishments while pregnant

“All the teachers knew I was pregnant. Yet when it came to punishments, there was no consideration for my status. I remember when the chemistry teacher asked us all to lie down on our bellies, before thoroughly whipping our bottoms. I was three months pregnant then, but it didn’t matter to him. I thought I would lose my pregnancy that day.”

Mass punishments, which happened often, were dreadful experiences for Beryl.

“We would be made to kneel for hours, and this was very difficult for me. Despite the teachers being aware of my pregnancy, they didn’t care.”

Ridicule from teachers

It didn’t end there. Some teachers would make snide remarks that hurt Beryl.

“They would say things like: ‘there are some of you in this class who have decided to start doing things that only adults are supposed to do’. My classmates would start chuckling, while giving me side eyes. I would feel very bad.”

It reached a point where, when specific teachers would walk into class for their lessons, Beryl would walk out, because she knew they would make mean comments directed at her during the lesson.

Beryl reported these incidents to the Principal, who promised to talk to her staff. But things didn’t change and worsened as her pregnancy grew. At five months pregnant, and tired of the negative treatment from students and some teachers, Beryl quit school.

The Principal nevertheless assured her that the school’s doors were always open and urged her to return when the baby was old enough to be left under the care of someone. While grateful for this gesture, Beryl says that if she were to return to school, it would have to be a different one as she cannot go back to the same ‘mean’ teachers.

Beryl is grateful for her supportive parents who encouraged her to return to school when her son turned six months, assuring her they’d take care of him.

Unexpected turn of events

As Beryl was contemplating going back to school, albeit a different one, her son fell ill at five months, leading to his hospitalization. He was diagnosed as having sickle cell disease.

“My son doesn’t eat well and is often sickly. He takes doses of medication three times a day. The doctor said that due to his frail health and the nature of sickle cell disease, my son needs me round the clock if he is to have good health. If I return to school now, he will not receive this dedicated care and I could lose him,” she says.

Due to the numerous hospital visits, Beryl moved to live with her father in Nairobi, while her mother continues to live in Siaya. They support her with the baby’s expenses.

Adult education school

One time when she had taken her son to hospital, the doctor informed Beryl of a programme that would be able to take in her son when he turns three years. When enrolled in the programme the doctor said her son would benefit from free medication and education. It is this promise that Beryl has been holding onto dearly.

Once my son is enrolled in the programme, I believe I’ll be able to return to school.

“I’ll be 20 years old then. Maybe I will enroll in an adult education school as I will be too old to go back to a regular school,” says Beryl, who scored 306 marks in her Kenya Certificate of Primary Education (KCPE).

Beryl is a single mother, having parted ways with the father of her son. She left him after discovering he had other sexual partners.

“I was shocked when I found out that I wasn’t his only lover. For my own health and peace of mind, I ended the relationship,” she says.

No sex, no support

After she left him, he cut off all the support he was giving her. Despite knowing that his son is sickly and needs financial assistance, he’ll only support Beryl if she agrees to a sexual relationship with him.

For now, Beryl’s focus is on the health of her son. She is holding on to the promise of the doctor’s assurance that once her son is three years old and enrolled in the programme, she will be able to pursue her education ambitions.

What are your thoughts on Beryl’s story? Do you think she will be able to return to school eventually? Share your thoughts in the commets section below.

Also, if you work in an organization that deals with girls and young women that you’d like highlighted, reach out to me on maryanne@mummytales.com

*Name changed for purposes of protecting her identity.

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