March 23, 2017

Family Planning in African Poverty (part one)

“No women meetings in village,” the chief asserts to me.  I translate here his broken West African French.

“Male village elders must be there.”  He concludes.

I am running a development program in a rural village in Cote d’Ivoire, five hours north of the Abidjan capital.

“What if only the female elders were there and report back to you and the other male elders after?”  I muster my sweetest smile.  I know he is partial to and fascinated by my western ways, but baffled by them as well.

“As you like it,” he concedes.  “But babies good”  He asserts, confidently.

“Oh, yes, we just want to space the babies, so that the men can get more rest.”  I flash another straight toothed white American smile at him.  He nods in surrender.

I have won this battle and it is an important one.  My colleague and I are initiating a family planning program in thirty six villages (eighteen of which we regularly visit).  It is part of a larger health care and small business program that we are operating.  Living and working in this West African community, we notice fairly quickly, the problems with the spread of AIDS and the proliferation of unintended pregnancies.

Since we are both women, we decide to initiate a woman-to-woman program to educate the local women on the merits of birth control for family planning and disease prevention, but, like most projects in rural villages, change doesn’t come easily.  The men in charge are nervous about western schemes to limit African populations and to empower women.

We are tinkering with loaded dynamite.  If the all-woman meeting is not a resounding success by the locals’ standards, then all our development initiatives will be regarded with suspicion, particularly ones that relate directly with women.

I was twenty three at that time and had so much to learn, which, living in the middle of an African jungle, I sure enough did.  Before leaving for Africa, I feared that I wouldn’t have enough knowledge to share with the people in my program, but having recently exited college — birth control  — now that I knew about.  I hoped I could empower the women to take control of their reproductive freedom as I had.

The meeting took place, and thanks to some enterprising kids on bicycles, bribed with an invitation to a home made American dinner at our place, word of the unprecedented woman only meeting spread across the community like the rainy season mud.  They came in droves.  Some walked over thirty miles, some caught rides in the back of passing trucks, mopeds or motorcycles and on top of buses.

We are astounded. We scramble to make room for all of the attendees.  The village female elders sit with us at a front table displaying posters about AIDS and breast-feeding amongst an assortment of condoms and tubes of contraceptive foam.

This was an historic moment, for our program, for the village, and for the women who dared to come that day.  For one hour we spoke to the women about the importance of spacing their children.  I had never spoken French in front of a crowd before but my roommate assured me that my skills were sufficient enough for the task.

“Children are a gift from God,” I begin in my best assimilation of West African French.  The opening scores rounds of approving head bobbing from a largely Christian crowd, though the northern and foreign Muslim woman seem to agree as well.

“Your ancestors practiced child spacing because the men had multiple wives.  The men would let the new mothers rest and care for the baby for a while before they would partner with them again.”  Again, more nods, especially from the elders.

We continue with a talk about the physical, economic and emotional merits of spacing children, and the importance of preventing diseases like AIDS hotly on the rise in their communities thanks to improved roads and visiting prostitutes from the city.

The most popular part of the meeting is the frank talk about the contraceptive devices.  Many questions ensue, and waves of giggles emerge when we passe around the condoms.  When we encourage them to open the packages and blow the condoms into balloons the fun really begins.  The laughter that erupts unsettles the village chief who peeks into the meeting.  I motioned to him that all is well and the women elders shoo him away.  I suppose no one had ever seen women having that much fun before.  The women’s laughter was a favorite topic for some time to come.

The meeting succeeded, and we achieved our goal: the women felt comfortable enough to talk about birth control and to ultimately handle the paraphernalia without too much embarrassment.  That was real progress for the community.  We started a door-to-door woman-to-woman birth control program (modeled after the Avon cosmetic concept except that the women selling goods were trained volunteers) and it worked.  While the men were in the fields, the women could comfortably and privately have all their questions answered and discreetly purchase contraceptives.

The meeting was favorably reported in the Abidjan newspaper which hopefully gave the idea to other communities in the country and I gave all the credit to the male village chiefs and local government officials (who had signed off on the event, but did nothing, of course but show up in the villages to show off their fancy western cars and gold jewelry).  I had quickly learned what it took to get things done in that community, and giving credit to local officials was a great way to succeed in important work.

What I couldn’t do that day is tell those women that they don’t even need to have a child if they don’t want them.  That was a message not to be told.  In a region where childless women were suspected of having a curse cast on them by some improper action on her behalf, how could a woman have any true reproductive rights?  When working in the developing world, though, you take the small victories where you can.

In a community where the mentally ill were chained to trees in the center of villages, where very few marriages existed, where young women were encouraged to be sexually active as soon as they reached puberty, where the concept of “love” and “romance” were silly western concepts that evoked confusion when witnessed in foreign films, and where women often conceded that they didn’t think they had  the right to refuse any man who made a sexual advance at them, or the right to ask him to wear protection, how much of a difference could we really make?

By introducing the idea to the women that they could control the spacing of their children, I’d like to think that we empowered the women in a small way.  By teaching them about the dangers of AIDS, hopefully we averted some senseless deaths.   But where a woman doesn’t feel that she had the right to say no to a sexually interested man, how empowered can these women really be?  It was heart-braking in many ways to witness their plight.

The women we saw the most, the neighbors who frequented our porch, the ones who sold us food and goods in the market, the ones who volunteered in our health care program and received small business grants, spoke at length with us, watched us and learned from us and hopefully were the better for it.  I certainly learned a great deal from them.  However, the end of the 1986 film “The Mission” comes to my mind where Jeremy Irons, an 18 century Jesuit Priest, wonders if the indigenous peoples in South America that they came to “save” wouldn’t have been better off if they, the missionaries, had never come at all.

How does a foreigner work with a vastly different culture not accidentally, sometimes, change it for the worse?  Development workers ponder this often.  Was it helpful for the women of an African village to witness the freedoms that upwardly mobile feminist women from America take for granted – freedoms that they may never gain?  I’ll never know.

Upcoming Posts:

  • Friday April 1st: Family Planning in African Poverty (part two)