Riiiingggg riinnggg !!!. It was the day before we broke off for the Christmas holiday, and I was winding up and almost ready to leave the office when a phone call came from 400 kilometers away. On the other end of the line was John, a Student Nurse and Sexual Health Educator for the Sexual Health Improvement Project (SHIP), who urgently wanted advice on how best to handle the ordeal of an 11-year-old girl who was raped by a man two years ago. The girl reported the abuse to her mother but she concealed the matter after receiving a bribe (money) from the perpetrator of the abuse. The mother warned the little girl never to tell anyone what had happened. “Sarah has just revealed this to me after she tested HIV+ during our outreach visit today. She is emaciated, weak and malnourished. I need advice on how best to handle this delicate issue,” John said in a poignant tone. As I listened, I found myself baffled both by the details of Sarah’s story and by the fact that her situation is all too common in Uganda: these are realities girls are grappling with in my community. I had to use all the means at my disposal to find a solution.
John goes to schools to conduct sexual health education to youth using informal, participatory and interactive methods. As coordinator of SHIP, it is my job to create activities to help young people like Sarah who confide in our Sexual Health Educators. We are now connecting Sarah to the local health facility for treatment and are getting in touch with the District Probation Officer (in-charge children’s affairs) to take up the issue. Setting the wheels in motion to get Sarah out of her predicament reminded me of the path I have taken to get here, and of all the reasons there is such an urgent need for sexual health education. Rape, incest, teen pregnancy, and transmission of AIDS are all serious problems in Uganda. I believe the only way to combat this situation is to address the cultural and social issues that cause them. I know that education is our most powerful tool to create a safer and healthier future for Uganda’s youth. SHIP’s vision is to have a society of healthy young people empowered to make informed and responsible decision regarding their sexuality. And with more than 60 percent of Ugandans under 24 years, we’ve got no time to lose.
Navigating Adolescence with No Adult Guidance
A girl is considered a woman in my community when she develops breasts. My personal experience in adolescence is that this transition stage is so challenging, yet punctuated with excitement, exploration, discovery and vulnerability. Adolescents experience a lot of surprises and fright because they have never been prepared for this stage of life. So how much can we blame them anyway when things go wrong? After all life is learnt and experienced by each and every person! Every adult has been through this transition in life and has had an experience of mystification, culpability, quandary …you name it.
My adolescence was filled with vacuums of information, because none of my parents ever talked to me about growing up. Friends told me about maturation, menstruation, and relationships with boys. Of course these were mixed messages. I grew up in a remote area, without TV; the small radio was only tuned in by my father for the news broadcast or his favorite music channel. I vividly remember the day my mother found me stealthily reading a Drum [fashion, music, relationships] magazine, she scolded and beat me. “So you have started reading this kind of magazines, do you want to get spoil….!” she shouted.
My mother’s rage is a typical scenario in Uganda, where discussing issues about sex between adolescents and parents is simply taboo. Instead, heaping threats on adolescents about issues of sex and relationships with opposite sex has only attracted the desire among young people to test the facts, discover and experiment.
Because of these cultural realities, it was up to me to make decisions on sensitive matters that none of my parents wanted to discuss. I have no sister, so I was confronted with big adolescence issues for which I had no solutions. At 15 years of age, one of the big boys in my class used to tease and abuse me (sensitive touches) but I did not know how to deal with this situation. I began hating school, my self esteem was affected, but fortunately he left our school. I went on being confronted by all sorts of unfair situations and thought the world just hated me. Inside me I suffered alone while the society was busy threatening me instead of educating me.
Making personal decisions as a young person can be a daunting challenge without advice, information and experience. All one is told is that having sex before marriage is an abomination and immoral. But this kind of information and parental threats are not effective in protecting youth from unsafe behaviours.
Studies show that by 18 years of age, 72 percent of girls in Uganda have had sexual intercourse. The reality is that adolescents are engaging in sex and we need to give them the right information before hand. Peer pressure motivates many adolescents to initiate sexual activity early, and financial transactions are a major component of adolescent sexual relationships. In fact, 31% of young women in Uganda report receiving money for sex. Being educated about the likely dangers and consequences of such acts can help them decide. While 20 percent of girls have their initial sexual encounter coerced or conducted under considerable pressure. Having the support of health professionals in the community can empower them to seek help in such situations.
As a grown up adult and mother of teens, I had never understood the dilemma adolescents go through until I began working with them through SHIP. Going into schools and communicating with young people in informal, participatory ways has given me new insight into their worlds. I realize today that having experienced the transition into adulthood is not adequate to make the adults/parents understand what young people are struggling with to become responsible adults.
Abused by their own ‘Shields’
My work with SHIP has brought me face to face with horrors that are difficult to comprehend, and has taught me stories like Sarah’s that are common in Uganda. Many cases of girls who are abused, defiled, and raped by relatives in their homes in the name of guardianship are reported daily. Daphne a young nursing officer and SHE, is passionate about integrating her skills in Sexual Health Education to her day-to-day work. Her experience in working with adolescents gives an insight into the glaring dilemma adolescents grapple with.
One of Daphne’s horrible experiences was when Rose, 17 sought a five-year contraceptive injection from Daphne at a health facility last year. Rose, from a poor family, a student under the care of her uncle in the Kampala divulged that her uncle was sexually abusing her. She had already conducted two crude abortions; the last one left her critically ill, so she wanted to avoid getting pregnant again. Rose was advised to tell her mother about it. “I told my parents but they say I should endure the situation (abuse) for the sake of completing my examinations”. Rose lamented in tears. Rose only feared pregnancy which is reprimanded by Ugandan society and did not think about sexually transmitted diseases/HIV/AIDS.
They Dare All Perils Abortion is illegal in Uganda and is punishable. I lost many of my own adolescent friends to abortion, others dropped out of school due to pregnancy. In 2011, Rhoda, 17 years old, was clandestinely brought and abandoned in the rural health unit in a critical condition by her friends. Rhoda had conducted a crude abortion that went bad and septic. This was an emergency, but post-abortion care services are not developed in Uganda. Rhoda had to be transferred to a higher health facility urgently to save her life. Rhoda was rushed to the hospital about ten kilometers away, however her life could not be saved.
Poverty and negligence a risk factor
The adolescents say one common reason they engage in sex is poverty and negligence. Parents are preoccupied meeting their own personal needs and have forgotten about the needs of their children. Parents think school fees is the most important thing in their children’s life and overlook nurturing them and providing sex education. Hope’s story is not uncommon: she was sent away from school to collect a book and pencil (costing 500/=) but her parents refused to provide. The Universal Primary Education programme requires that parents provide children scholastic material, food and uniform. Disappointed, she went home weeping knowing her future was doomed without an education. A businessman eventually lured Hope into sex and that continued since this kept her at school. Hope is now 12 years but has just tested HIV positive.
Hope’s terrible dilemma reflects the fact that parents still believe that children are the sole responsibility of government. Universal Primary Education is now compulsory, but the law is not yet in place to deal with parents who do not meet their obligations of keeping children in school.
Phina, now a nursing student and a sexual health educator for SHIP, has vowed to complete her education against all odds. She says her father promised never to educate a girl because her elder sister got pregnant while at school. He arranged a husband for her, a proposal she rejected outright. But how many girls can find the inner strength to take such a defiant stance? Her old, poor mother is toiling to get tuition fees to complete her nursing training. Phina’s personal experience is her motivation to work as a SHE to educate adolescents so that they don’t go through her experience. To help her succeed, I have created some time to mentor Phina. Talking to her on the phone at least once a week gives her more courage and motivation to achieve her goals.
Where do we go from here?
I am certain sexual health education needs to begin as early as 11 years given that children especially in rural areas tend to complete primary education at 17 years. Waiting until later ages in to begin sex education is a missed opportunity. Defilement of young girls is at an alarming rate. Last year over 63 girls in 30 primary schools in Ngora district who registered Primary Leaving Examinations either got pregnant or married.
Defilement cases in Ngora district are never concluded in the law courts because of bribery of police by perpetrators or cases are settled out of court. The burden of proof is left to the victim who cannot afford the expenses. One village community ganged against a school matron and threatened to rape her daughters if she dared pursue a defilement case with the authorities.
Coordinating SHIP has been an eye opener to me about adolescents’ sexual health. It is clear that young people do not have adequate information about what to expect as they grow up and how they are supposed to react. Adolescents have no one to listen to them. To combat this situation, SHIP goes into the schools to complement the [formal] efforts of the public education sector in sexual health education, which is not effective because it is delivered using the classroom approach. The vital role played by parents, teachers and community leaders in the lives of young people is recognised. It is my dream that one day every adolescent will be able to have the information they requires to make better and appropriate decisions about their sexuality. SHIP is working out an expansion program with the local members of Parliament to reach Ngora youths with these skills and information.
It’s no doubt that the current generation has been unfair to the next generation. They have relegated their responsibilities to none, and they are leaving the youth to their own fate. It’s critical that we educate young people about sexual health, about the dangers and consequences of unsafe behaviors. We must give girls the tools and empowerment they need to stay in school, seek help when they need it, and fight back against sexual abuse—and we need to do it now.
This article is part of a writing assignment for Voices of Our Future a program of World Pulse that provides rigorous new media and citizen journalism training for grassroots women leaders. World Pulse lifts and unites the voices of women from some of the most unheard regions of the world.