Stirring The Fire

One HEART continued – Students Taking Action

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When One HEART decided to begin its program to address maternal mortality with the indigenous Tarahumara  in Northern Mexico they contracted with Alisun Chopel to do a feasibility study for the program.  Alisun was a student working on her Masters Degree in Public Health at UC Berkeley.  She applied for an internship with One HEART got a scholarship to cover her expenses and headed for Mexico.  Alisun spent 2 months living in the Sierra Tarahumara meeting with the local health workers and Parteras (traditional birth attendants) to see what their needs were and how One HEART’s methodology could fit into the Tarahumara cultural context.  In doing so she not only gained an invaluable life experience, but fulfilled the requirements for her master’s thesis.


Suzy consulting with Tarahumara mothers

Alisun’s findings prepared the way for Suzy Messer another university student who is currently pursuing her Master’s in Public Health with a concentration in Maternal  Health through Boston University’s School of Public Health.  Suzy is now the Field Coordinator for the rollout of One Heart’s pilot program in Chihhuahua, Mexico and is using her work there to complete the requirements for her master’s in Public Health.


Suzy visiting villages in the Tarahumara

As I’ve been speaking around the country on women’s issues for the last few years, many university students have come up to me and asked how they could get involved.  Like most students they didn’t have money to donate but they wanted to do something.  One of the most exciting parts of the Stirring the Fire website is the call to action that offers a myriad of ways — like working with organizations like One HEART — to support women and girls around the world.

When you get a chance check out Take Action on our website with its searchable database of organizations.

One HEART continued – Miso

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For cross-cultural global health programs it’s critical to ensure that there is compatibility between the values of the program and the recipient culture.  Since most Tarahumara women live several hours or days away from the nearest clinic or hospital they suffer one of the highest rates of maternal mortality in North America.  Of course it would be ideal if the women were giving birth in clinics or hospitals but women hesitate to make the long and difficult trip–especially if labor has started.  They typically end up having their babies alone or with an untrained birth attendant.  Part of One HEART’s plan is to conduct a maternal health education program for the local Parteras (traditional birth attendants) and give them a few basic items like sterile blades to cut the umbilical cord.


Teresa, local Partera

Ninety percent of the women who die in childbirth do so because of postpartum hemorrhage.  Administering drugs like Oxytocin to women who are having postpartum bleeding causes the uterus to contract and very effectively stops the bleeding.  Unfortunately, Oxytocin has to be kept refrigerated.  Another very effective drug for post partum hemorrhage, Misoprostol, does not need refrigeration and is very inexpensive—therefore an ideal drug for the Parteras to have on hand.  Unfortunately, because ‘Miso’ can also be used to induce an abortion, it has not been allowed to be used in the heavily Catholic Tarahumara Sierra. 

Arlene Samen the executive director of One HEART traveled to Mexico City to see if she could get the ban on ‘Miso’ lifted in the Tarahumara Sierra if proper precautions against misuse were taken.  The Mexican authorities who have been extremely welcoming to One HEART are taking Arlene’s request into consideration.  If approved it will be a huge victory for the Tarahumara women and their families.

One HEART in Northern Mexico

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I recently returned from the Copper Canyon located in the Sierra Tarahumara in Northern Mexico where I was documenting the work of the non-profit organization One HEART as they address the high rate of infant and maternal mortality among the indigenous Tarahumara.  There are about 70,000 Tarahumara Indians—or Rarámuri—scattered throughout the Sierra living in natural shelters such as caves or cliff overhangs, as well as small cabins of wood or stone. 

The Rarámuri are best known for their tradition of long distance running up and down the steep canyon trails.  Some of their races, which they run in sandals or barefoot, last for days.  In fact the Rarámuri are hosting their annual Ultra Marathon on March 7th.  I was told that they hunt deer by chasing the animal until it drops from exhaustion.

The One HEART team was welcomed by the Rarámuri with one of their special ritual Yumaré fiestas which lasted all night.  Two goats were sacrificed and the women brought ceramic jars filled with tesguino (corn-based beer) that is consumed in many Rarámuri rituals.

  

Around 4 am I managed to get an hour of sleep before it began to get light.  Although the women did drink a little it was the men who really let their hair down. 

 

The music and dancing went on all night and as dawn broke it was mainly the women who were left standing. 

I have found that preconceived story lines almost always take an unexpected turn and this one certainly has.  If you have seen previous post on One HEART you are aware that I started working with them in Tibet.  This documentary which I originally thought would portray a successful approach to maternal mortality on the Tibetan Plateau now looks like it will be about the political and cultural hurdles one faces when trying to address issues like maternal and infant mortality in the developing world.  The Mexican Government is very receptive to One HEART’s work, however, the drug wars in Northern Mexico and cultural issues with the Rarámuri may pose special problems as One HEART tries to establish its program.  For cross-cultural global health programs it’s critical to ensure that there is compatibility between the values of the program and the recipient culture.  I hope to document the process One HEART goes through to become aware of and bridge the Rarámuri cultural beliefs and values with our western medical traditions.  I will continue to post more about the One HEART story as it unfolds.

Julia Bolz and Ayni Education International

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Hadia, Out-of-School Girls Program, Kabul, Afghanistan
Hadia, age 11                   Out-of-School Girls Program, Kabul, Afghanistan

By 2000, UNICEF reported that only 4 to 5% of Afghan children were being educated at the primary school level. Fewer still had access to secondary and university-level education.

According to the World Bank, “Since 2002, more than 6 million students and teachers have returned to school.” 

The organization, Ayni Education International, has certainly had a hand in the increasing education, especially for girls, in Afghanistan.  Featured this week in the Seattle Times, Ayni was founded by Seattle based Julia Bolz.

From Ayni’s website, “Our main project, called “Journey with an Afghan School,” began just months after 9-11 and the Taliban were removed from power in Afghanistan. It is a grassroots project to build and supply schools for Afghan children. 

With funds raised by communities across the country, we have defied all odds by building and supplying 19 new schools and repairing over a dozen others, serving about 25,000 Afghan students. We also have provided wells; distributed text-books, school supplies and athletic equipment; provided teacher trainings; and set up libraries, computer centers and PTAs. Most recently, we set up two teacher training centers, training several hundred teachers.”

As I continue to add to the “Call to Action” portion of a new website to be launched soon (www.stirringthefire.org) I am continually amazed by the extraordinary people like Julia Bolz that are making a difference.  Thanks Julia for your wonderful work!

Women, AIDS, and Children’s Disabling Burns

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In sub-Saharan Africa, 61% of all people living with HIV are women. Young women (15–24 years) are three to six times more likely to be infected than men in the same age group.*

Unfortunately, 800,000 Zambian children have lost one or both parents to AIDS, and others are left to care for themselves because their parents have to work in the fields.**

Severe burns happen frequently because a third of the world still uses open
fires for cooking, heating and/or lighting. Overcrowded living conditions, lack of proper safety measures, loose clothing worn by women and insufficient parental supervision of children are other factors.

Because AIDS takes the lives of so many parents, especially the women who are the main caretakers of children many more children are now suffering burns from open fires.

The story of Mateo represents the typical scenario.  He fell into an open fire while under the care of his slightly older sister.  Actually Mateo was one of the lucky ones, many children go untreated but he received help from Interplast partner Dr. Goran Jovic.

The Forgotten Global Health Crisis from Phil Borges on Vimeo.

I traveled with Dr. Jovic as he flew to remote villages around Zambia in his single engine plane to treat severely burned patients that would otherwise never receive treatment and remain disabled for life. 

Burns comprise half of Interplast surgeries, with 80 percent of them being performed at 12 Interplast Surgical Outreach Centers in nine countries. 

*World Health Organization
**Interplast

How can we help ensure our security here at home?

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When I read in the book Half the Sky (Kristof/Wudunn, [New York: Knopf, 2009], xx-xxi) that the Joint Chiefs of Staff now consider the education of women and girls important to our military goals in Afghanistan and Pakistan, and consequently to our security here at home, it gave me hope that US military thinking has evolved from the days of ‘Shock and Awe’.

The UN, UNICEF, the World Bank, CARE and other experts on poverty reduction like Jeffrey Sachs and Paul Farmer have indicated that the key to alleviating global poverty and its attendant ills (like fundamentalism and extremism) is by empowering women and girls. Yet today less than 1% of US foreign aid targets programs that empower women and girls. Evidently it hasn’t gone unnoticed that the countries we are having the most trouble with right now are countries that marginalize their females. Hopefully this realization by the Joint Chiefs will prompt some rethinking about the allocation of our foreign aid funds.

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Humaria,11, sells eggs on the streets of Kabul to help support her family. She has never attended school. Today the literacy rate for girls in Afghanistan is 15% in the urban areas like Kabul and .6% in the rural areas.

Fortunately, the citizen sector (non-profit organizations) are stepping up to fill this need. There are literally thousands of organizations providing micro credit loans and educational opportunities for women and girls or addressing the issues of maternal mortality, violence against women and child trafficking.

The big question most of us are asking is how can we help? In my next blog I would like explore how nonprofit models of giving are evolving to become more personal and transparent.

Interview – Rachel Lloyd, GEMS Founder

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Rachel Lloyd, founder of GEMS, New York City

Exploited and trafficked girls in the United States

According to the Department of Justice, over 100,000 adolescents are involved in prostitution in the United States.  Sgt. Fassett of the Dallas Police dept pointed out an obvious irony of this situation.  “If a 45 year-old man has sex with a 14-year-old girl and no money changes hands, she will probably be sent to a counselor and he will likely get jail time for statutory rape.   However, if the same man leaves money on the table after having sex with her, she will probably be locked up as a prostitute and he will probably just get a fine as a john.”

Last Friday I went to Harlem to interview and photograph a remarkable woman by the name of Rachel Lloyd.  Rachel is the founder of Girls Educational and Mentoring Services (GEMS) in New York City and has dedicated her life to the struggle to end sex trafficking.   Rachel herself a survivor from an alcoholic family in England dropped out of school at 13 and was recruited into the sex industry.  Like so many girls who end up on the streets she was raped and attempted suicide three times.  Eventually, she emigrated to the United States where she vowed not only to change her life but also to help empower girls and young women in need and fight for their rights.  She went back to school, first earning her GED, then a Bachelor’s degree in psychology and finally a Master’s degree in urban anthropology.

For more than ten years, GEMS has been at the forefront of the movement to end the commercial sexual exploitation of children, building a national reputation as the country’s leading resource on the issue. GEMS has trained thousands of service providers and professionals who come in contact with at-risk youth to recognize signs of exploitation and to intervene and assist young women in their healing and recovery. GEMS’ success is due in large part to Rachel’s compassion for and understanding of young victims, her ability to work with political and community leaders, and her desire to change perceptions of commercially sexually exploited victims.

Rachel told me that historically law enforcement in our country has punished the victims of the sex industry—the vulnerable and exploited adolescent girls that are coerced and trafficked into the trade.  She said that labeling and jailing them as ‘teen prostitutes’ instead of what they are–exploited and trafficked children– while ignoring the 30 to 40 year old men that sell and buy these girls has been a crime in itself.

I took Rachel’s  photograph on the street outside the GEMS small office and then conducted the following interview in her tiny cubicle while her energetic staff of young women went about their important and  revolutionary work.

Rachel’s interview really opened my eyes to the problem of sex trafficking—especially of children– here in the U.S.  Take a listen!

Akhi — Tangail, Bangladesh

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Akhi

Women Empowered has been my primary focus project for sometime now.  I am currently expanding the exhibition to include multimedia profiles of a number of the women.  The first that I have completed is the story of Akhi, who at the age of 13, was sold as a sex worker.  She has since accomplished the near-impossible task of gaining support from religious, political and social groups to create an organization to finally give sex workers’ basic human rights.

Fahima — Kabul, Afghanistan

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There are many who believe that the greatest handicap to development in Muslim Middle Eastern societies is the status and roles they give to women.  Nowhere has this been more evident than in one of the poorest and dysfunctional countries in the world—Afghanistan.   During the reign of the Taliban essentially all women working outside the home were fired; 7o% of the school teachers, 50% of the civil servants and 40% of the doctors were women.   You can imagine what eliminating women from the labor pool did to the function of Afghan society.  To make matters worse many of the women were widows because of the lengthy wars in their country.   These women were left with no way to support their families. 

FahimaIn 2005 I met Fahima, a teacher since 1985.  She was one of the thousands of professional women who lost their jobs when the Taliban came to power in 1996.  In defiance of the Taliban and at great risk to herself, Fahima opened a clandestine school for young girls.  At one point 130 girls were coming to her home each week to study math, science, and the local language, Pushto.  When the girls were asked why they were going to Fahima’s house they said she was their aunt.  Although harassed by the religious police and threatened with beatings and worse, Fahima continued operating her school for girls until the fall of the Taliban in 2001.

Fahima now helps girls catch up with the education that they missed out on during the reign of the Taliban. 

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Unfortunately, it is not news, that even with the fall of the Taliban Afghans still face severe challenges.  Most children work to help their family survive and few are able to attend school.  

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Humaria sells eggs as a street vendor to help her family survive. As with many families in Afghanistan, years of war have left them very poor. Only half of all Afghan children ages 7 to 13 attend school and typically boys are chosen over girls. 

“From acid attacks, murder, torching of schools and sexual assault, violence against female students is dashing the dreams of thousands of Afghan girls and women who are thirsty for an education that may help rejuvenate the fractured economy and society of their war-torn country.”  From Reuters, Jan. 2009. 

Dexter Filkins, a reporter for The New York Times, took a stand to help improve conditions for education in Afghanistan.  I highly recommend you read his wonderful story.  

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Nafisa was thrilled when she learned she was chosen to attend Salman-e-Fars, a new school recently opened for young girls in Kabul.  Girls now make up thirty-four percent of the student population in Afghanistan- a dramatic increase since the Taliban rule, when it was essentially zero.

Dr. Chandini Perera — Colombo, Sri Lanka

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In 2004, I began documenting the work of organizations whose focus is the empowerment of women and girls. After visiting dozens of projects and meeting hundreds of participants and staff around the world, I have also come to believe that the most efficient way to alleviate poverty and reduce population pressures in the developing world is to empower women and girls through education, economic opportunity and open discussions about rights.

Here are a few of the extraordinary women I have had the honor to meet. Women who have broken through a cycle of repression or cultural tradition that limited their well-being and that of their communities— women heroes, remote and mostly unknown, on the leading edge of a global movement toward social and economic justice for women and girls.

Dr. Chandini Perera
Plastic Surgeon

Chandini

I met Chandini in Sri Lanka while doing a film for the nonprofit organization Interplast. Interplast provides support for the victims of severe burns around the world. Chandini created almost from scratch one the most successful burn centers in Sri Lanka.

When Chandini first started working with burns at the main hospital in Sri Lanka’s capital, she was surprised to find that the majority of her severe burn patients were women. They claimed the burns were accidental. However, as she began to treat these women she could not help but notice that the burns followed a specific pattern.  The burns were typically on the front of the upper body, arms, neck and face. As she slowly gained the confidence of these women they confided to her that they had set fire to themselves. Realizing that these women needed more than just the physical treatment for their burns, she formed a team that included a psychologist, a rehabilitation specialist, and several nurse practitioners.

Chandini told me that 70% of her severe burn patients are the result of self immolation. I didn’t understand it. Why would someone set themselves on fire? It had to be the most painful way to die.

Self Emulation Victim
Self Immolation Patient

As I documented Chandini’s work and met some of these women I began to realize that this terrible problem had its roots in women’s social and economic injustices. Self immolation not only happens frequently in Sri Lanka and India but is prevalent in Bangladesh, Vietnam, Pakistan and Afghanistan.

Kumari, Colombo, Sri Lanka
Kumari, Colombo, Sri Lanka

Here is a multimedia piece about Chandini titled “Postcards from Heaven”.  She is currently working tirelessly to raise awareness and end domestic violence in Sri Lanka.