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Clare and I

14 years ago today it was a chilly December morning in Barrio Candelaria, San Salvador. I’d spent the night before doing something mundane yet extraordinary… giving birth to a baby girl. She was still a little blue that morning, having had a tough time making it through to the light of day. Being born when you weigh 10.5 pounds is not an easy thing for a baby, or for a mother. But she was nursing and we had her wrapped up in a warm blanket and a little hat.

Niña Lita, my elderly midwife, stopped by around 7 a.m. that morning to bathe the baby, Clare, in the customary rose and rue to ward off any evil spirits or bad vibes.  She had come back early in the morning rather than waiting till later because she was concerned about us. The night before she was worried that neither of us would survive. She didn’t say so of course, but it was clear from her eyes and the lines of concern on her face as she helped us through the short, 4 hour labor.

I had gone to work on the 13th, the last day before Christmas break. My stomach was so big it was hard to eat or breathe. The baby was taking up all the possible space in my abdomen. I grabbed the bus home as usual, made dinner, read my son his bedtime story, and got ready to sleep. Around 11 I felt the first labor pains and called Niña Lita. She had attended me with my son Daniel (see my 18 years post) and had been coming around every month to ‘sobar‘ me – massage my stomach – and check in on how I was doing. I’d been to the ‘real’ doctor a few times also, but the pervasive medical approach in El Salvador at the time was a mix of fear and pharmaceuticals and that wasn’t my thing. So my pre-natal care was pretty infrequent and I was mostly just going through the motions.

As with Daniel’s birth almost 5 years earlier, I had decided to have my baby at home in the small room attached to our bedroom. We didn’t have the money for me to go to a private hospital, and the public hospital horror stories had me turned off. I wanted a natural birth with my family nearby. I wanted to breastfeed immediately and keep the baby close at all times – things that the public hospitals didn’t promote at the time.

Niña Lita arrived around midnight with her daughter A., a registered nurse who owned a hair salon down the street (and who had a mafioso for a husband – I learned last time I was in El Salvador that A. and her husband are in prison.) She made me some cinnamon tea to help speed up the labor, and I promptly threw it up. It was freezing in the house and the power was being funky so we relied on the flickering lightbulb and kept the candles handy. My mother-in-law was next door, I later found out, awake and vigilant, lighting candles to la Virgen and on her knees praying for a safe birth. She later said she’d had a bad feeling. My husband and Daniel were in the next room, dozing off and waiting.

Labor came hard and fast, but then the pains stopped despite the fact that the baby hadn’t arrived. She had crowned but she was stuck. I looked at Niña Lita, in pain and wondering what was happening. What was I supposed to do now? I wanted her to fix something, to make it better. She worked her calm magic, carefully reaching inside and untangling the baby’s umbilical cord from around her eyes and her neck. Random and harried thoughts marched through my head as I waited. Wondered. Time stopped and everything was silent. Then she gave me a penetrating look. ‘Tenés que empujar mamita. You have to push, mama.’No puedo, I can’t.’ ‘You must.’ There were no longer any labor pains to help me out but I managed. Finally the baby was born and relief set in – until I propped myself up a little more and looked down between my legs. A big baby. A girl. Her chubby body from the neck down was a beautiful rosy pink…. but she was still. Her entire head was bluish purple, her eyes swollen and puffed closed. Oh God. She’s dead.

Not possible. Not happening. Why? Why am I so stupid and stubborn? Why did I insist on having a baby at home?! This can’t be happening.

A. stepped back from attending me. Niña Lita bent down somberly. She rolled the baby onto her side and tapped her back gently while she murmured some prayers. The baby started to cry. ‘Una niña,‘ said Niña Lita with her crinkly smile. ‘Una bebecita gordita. Ay, que hermosura, que hermosura. What a beauty.’

A. cradled the baby while they cut the cord and cleaned her up. She was a bit scary looking, with her blue face and head attached to a chubby, healthy, pink body. Niña Lita put a little white hat on her and swaddled her up and gave her to me. She immediately started nursing and the fear left me. I knew she would be OK, despite her funny looking blue head…. it was about 5 a.m. and the sky was just starting to lighten.

My husband had come in from the bedroom to see the baby and pay the midwife. He had no idea of the tragedy we had just avoided. I heated up some water and took a bucket bath – I was exhausted and shaky. I crawled into bed with him and my son and Clarita, relieved.

My parents-in-law came over early to see the new baby and word spread quickly through the Barrio. My mother-in-law held her and gave thanks to la Virgen Maria. The night before she had promised that the baby would be a child of la Virgen, and that she would keep the tradition of celebrating the 12th of December – the feast day of La Virgen de Guadalupe. The visit to bathe Clarita left Niña Lita feeling relieved also. ‘Estaba bien preocupadita mamita,’ she said, ‘I was very, very worried.’ We got the scale from the corner store: 10.5 pounds. No wonder, we all thought. No wonder.

Clare and her dad

The following day we took Clarita over to get her first vaccines and her foot prints at the local health unit. ‘Where was the baby born?’ ‘At home.’ ‘En casa? ohh.’ ‘And how old is the baby?’ ‘2 days.’ ‘2 months you mean?’ ‘No, 2 days.’ ‘A baby of this size? Are you sure? Let’s weigh her. 5 kilos?’ They looked at me suspiciously. They looked at each other. Clarita was big, healthy, pink and strong. I was in good shape with no belly sticking out. I wasn’t wearing socks and didn’t have cotton in my ears as would a normal Salvadoran woman who had just given birth. I was very obviously a white woman. The baby looked very Salvadoran. ‘Would you like to have an exam?’ ‘No.’ ‘I think we should examine you. We need to examine you.’ they insisted. I realized they didn’t believe this was my baby. I agreed to the exam… certainly I didn’t want anyone accusing me of child trafficking. I passed the exam and went home for my 40 days of rest…. Well, actually I didn’t get that, but that’s another story.

Birth was only my first big scare with Clare. There were a couple other times that I thought I was going to lose her.

When she was 9 months old I took her to the clinic to get her MMR vaccine. I was walking home with her, and after a couple blocks her skin began to mottle. Then she fainted. I rushed back to the clinic with her, knowing that she was having a bad reaction. The doctors were nowhere to be found. The nurses were slow and bored. They thought I was overreacting. ‘She probably was scared of the vaccine.’ ‘No, this is something else. She didn’t even cry when she got the vaccine. She’s having an allergic reaction. Please can you do something?’ ‘The doctor isn’t here yet. Sit there and he’ll be in.’ ‘No I need something now. Do you see her? She needs something now.’ Eventually one of the nurses took us into an examination room and gave her some Benedryl while they searched for a doctor. Luckily the Benedryl worked, and she was fine. It felt surreal walking out of the clinic into the warm sunshine, birds singing.

Once she was feverish and dehydrated and the hospitals were closed. We had to wait until the next day to take her in. Meanwhile my mother-in-law took her to a traditional healer. Trying to leave for the doctor, then, we had a huge family fight because my in-laws said the healer said that Clarita had to stay inside because any air blowing on her would kill her. My husband and I wanted to get her medical attention as soon as possible. It escalated into a rift that was difficult to subsequently repair between my husband and my father-in-law. An argument of tradition vs ‘modernity’. Quien crees que sos, con tu esposa chelita y tu título de bachiller? Who do you think you are with your white wife and your high school degree? Crees que sabes mejor que tus padres? Do you think you know more than your parents?

My mother-in-law always counted on la Virgen to keep Clare safe and sound, and though I am not religious, I’ve always taken great comfort in her ability to pray.

14 years later Clare is still a survivor. She’s smart, strong, independent and beautiful. Beginnings always shape things and Clare’s beginnings shaped her. They shaped me. They shaped all of us.

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For the past couple years, I’ve been supporting the Youth Empowerment through Arts and Media (YETAM) project in 6 African countries. One of the best things about being involved in the project is the opportunity to work with some incredible people who are developing the program strategies and implementing YETAM on the ground.  Bedo, the child media program coordinator in Plan Mali, is one of those people I’ve been lucky enough to work with.  He’s kind, gentle, thoughtful and soft spoken yet solid in his opinions and knowledge. His face totally lights up when he’s working with the youth. He has clear vision and gets things done, writes excellent reports, and isn’t afraid to clarify things if he’s not sure he’s understood correctly.  It’s been a real pleasure working with him. On Friday, Bedo told me about some of the short-term positive results that the Mali team is seeing in the YETAM program there, which I’ll summarize below. Photo: Bedo in December 2008 at the Social Media for Social Change Workshop in Kenya.

YETAM
The YETAM project aims to help youth develop their skills to communicate, educate and advocate at local, national, and global levels about issues impacting on their lives using the arts, traditional media, and new media tools.The project methodology consists of hands-on workshops and activities where youth can improve their communication and analytical skills in order to effectively raise their viewpoints and enter into dialogue with families, peers, community members, decision makers, and the general public. Youth go through a process of participatory mapping, discussions to prioritize their key themes, topics or issues. Then they learn to use arts and media to get their messages across to those that they want to engage in helping them find solutions. To date the project is being implemented in 6 countries in Africa (Senegal, Mali, Cameroon, Rwanda, Kenya and Mozambique).

YETAM in Mali
In Mali, around 60 children and youth in a community in the Kati District have been involved in the YETAM project for about a year and a half so far.  In an initial workshop, the youth raised a number of issues through participatory mapping. They researched, investigated and developed opinions on these issues further through song, poetry, theater, photo and video, and later in the process, prioritized their most important issues:

· many children do not have birth certificates
· rural exodus
· violence at school
· excision (female genital cutting).

Integrating YETAM into school curriculum
Following the prioritization of their topics, youth began an education effort around the 4 themes with the local population and local authorities from their village and surrounding villages. As part of this effort, six school teachers were appointed by local school authorities to support the youth and supervise extracurricular activities around the youths’ 4 themes. They were trained by local consultants and Plan Mali staff on participatory methodologies using arts and media as participation tools.

During this training, teachers learned to adjust their teaching styles and to address the 4 topics not as lessons taught in the classroom, but as information sharing and advocacy topics through drawings, poetry, crafts, dance, and theater. New students joined the small arts groups according to the type of activity that they were interested in.  Students who had been involved longer supervised and trained newer students and helped integrate the program within the school.

In addition to the arts, youth and adults worked together on several short drama films. One of these was about female circumcision. It discusses the medical complications of circumcision in a married woman during her 1st birth. The complications were due to excision, done in infancy, and resulted in vesico-vaginal fistula. Rejected at first by her husband, the woman is eventually accepted after the husband’s becomes aware of the existence of appropriate care (free in Mali) and the commitment made between spouses at marriage.

Engaging the public and local authorities through arts and media
Through the training workshops and the production of the different arts and media materials, youth were able to form their own opinions, messages and ideas for solutions to the issues that they had prioritized.  They organized a public event in the community where they performed their drama, songs and poetry pieces, showed their film, and held a panel with local authorities to discuss how to improve the four areas that they had identified.  Photo:  youth performing a drama piece in the village.

Short term results to build upon
According to Bedo, “Integrating the YETAM methodology with the school environment enabled teachers to learn to address and manage issues with children and youth in a participatory way. The education methods have changed and the student / teacher relationships have become less tense, especially when it comes to discussing subjects such as violence at school or practice of female circumcision.”

Bedo explained that “the introduction of the ‘violence in school’ theme by the students initially caused some frustration among teachers. At first, they felt directly targeted. But when we integrated the teachers into the process, their frustration dissolved and trust began to grow between students and teachers because teachers are discovering another way to teach and discuss sensitive issues – they are behaving as coaches.”  Bedo also said that since the discussions took place at the school, the education authorities have become more interested in the topics and the project.

“At the community event,” said Bedo, “the mayor declared that the council was taking all steps to ensure that all children have birth certificates.  He also addressed the migration of young people from the rural to the urban areas, saying that one of the main reasons is lack of employment. He promised to create jobs to reduce the mass exodus of young people.” Photo: Children interviewing local authorities.

One of the most extraordinary things that happened as a result of the youth’s education and advocacy, according to Bedo, was that “the village chief also made a pronouncement….  He announced that ‘The practice of female circumcision is part of our traditions. As it has adverse consequences on the health of women, I have decided to end female circumcision in the village.’”

Teachers are engaged
Teachers have been happy with the new ways of teaching and the integration of the YETAM project within their school curriculum. One teacher told Bedo that “there have been developments in many areas, especially in the areas that teachers and students developed together – birth registration, rural-urban migration, female circumcision and violence at school.”

The teacher explained that the youths’ messages have extended to parents and those who practice these phenomena.Those who practice circumcision have pledged they will stop it. Corporal punishment is now prohibited by school rules, because we now know that violence undermines the intelligence of the child. The teachers have agreed to end it. They are ready to make every effort to pass the message of awareness among their colleagues so that together we can make every effort to end school violence….”

Youth see concrete results
Participating children also commented that they think that there have been improvements due to the project’s integration into the school. One 14 year old participant in the project said “With this new formula of YETAM, the suffering of children through corporal punishment in schools and the harmful practice of female circumcision has decreased. Before, we children, we could not stand before the public and parents to discuss the subject of female circumcision, but now we can do it. This has greatly reduced the practice of female circumcision. In our village, many people practiced circumcision, but now they say they will stop because they have learned from our messages about the harm it causes.

Another participant, who is 12 years old, commented that “with YETAM, teachers have ceased to beat us in school. Many of our schoolmates have their birth certificates. We are noticing an improvement in our situation.

Next steps
Bedo says that given the positive impact so far of the project, they will ask school authorities to institutionalize an annual special day for each of the 4 topics.  They will continue to support the work that the youth are doing and try to involve more youth, teachers, community volunteers and surrounding villages in this type of project.  Plan Mali also has plans to conduct a participatory assessment with stakeholders to evaluate the project so far and learn how to improve it.

Within the next month or so, the overall project website will be complete, and the maps, art work and videos of all 6 participating countries will be uploaded so that youth can connect with their peers in Africa as well as share ideas with youth in non-African countries.  A curriculum for teachers and youth groups based on the arts and media work that the youth have done around their priority topics is in the works and will be available for schools in the participating countries.


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Before I left for Cameroon, I had started doing a little of my own research via blogs and Twitter to learn a bit more about ICT4D in the Cameroonian setting. I wanted to get a feel for what the situation was so I’d be more in tune and also to see if there were any potential partners or people on the ground who I could learn from or link with Plan Cameroon. In the end, I was able to meet with Mambe Churchill Nanje the founder of http://www.afrovisiongroup.com/ and a partner on http://www.villagediary.org/, a project of the LINK-UP development group. Photo: Mambe Churchill Nanje of AfroVisioNgroup.

Since I’m coming from a non-profit and child rights background (at Plan International), and since we are looking into ICT4D as an enabler and facilitator for existing program work, and since much of our work centers on HIV/AIDS, memory books, birth registration, participation and child protection, I especially like the idea behind village diaries. This is some really interesting stuff on several fronts. The mission of the Village Diary project (summarizing from their website here) is “to enhance access to legal, social and health services for orphans, vulnerable children and widows experiencing different forms of abuses. It also serves as a platform to track the cultural and historical background of families and villages.”

By supporting the establishment of marriage licenses, birth certificates and last wills and testaments and providing secure access to digital backups of these documents to authorized case workers, Village Diary aims to alleviate the problems that arise after the death of a leading family member. Village Diary also collects stories by women and children to provide a forum for making change and at the same time offers a window into community life.

Village Diary does this by operating an online database that documents and shares cases of abuse of women and children for education, research and advocacy purposes, establishing institutional partnerships to enhance legal, social and health services and facilitate access of such services to orphans and women, strengthening existing support networks for women in the community, and recording cultural, environmental and historical changes of the people and villages involved in the project.

So on top of being involved in some very cool projects, Churchill is also a very cool guy and it was great to have the chance to hang out with him and a few friends on Saturday in Yaounde. Thanks, Twitter (and ourman, billzimmerman, and downeym!). I’m looking forward to seeing where this guy is in a few years, as he has some fantastic ideas for IT in Cameroon.

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As part of our mobiles for outreach and data gathering training last week, we went out to a community about 20 minutes away from the hotel today to hear Silla, the district civil registrar, talk about a project that Plan Kenya is supporting that aims to modernize the birth registration process. Plan Kenya is looking incorporating mobile data gathering and outreach into the project, so it was a good opportunity to test data gathering. We tested the Nokia Data Gathering Software using a form that the team had created earlier in the week based on the paper forms that the District Registrars office uses. It all worked just fine. Photo: Silas from Kwale District, and Petri, Director of the Nokia Research Center in Manaus, Brazil.

Silla is really an expert on birth registration and anything that has to do with it. He can quote you just about any law related to the subject in great detail. Currently, for registering births, people have to go to the sub-registrar/assistant chief’s office which can be quite far. Once there, sometimes there are not enough actual registration forms and they just give the registration information to someone who writes it in a school notebook. Later when they have more forms, the information is transposed to the official form, and sent along for processing. It can take awhile for processing, and people have to return to the sub-registrar’s office personally if they want to find out if it’s ready. The district is quite large, so they may have to travel up to 100 kms sometimes to go into check, and the certificate may not even be ready yet. Photo: Silla schools us on civil registration and explains why the district wants to modernize the process.

I talked to Ali M and Ali K (‘the Ali’s’ as we call them, since they are pretty much inseparable) who both work with Community Based Organizations (CBOs) that are participating in the birth registration project. (They were both at the video training with me last month here also). They explained some of the main reasons that not having a birth certificate makes life difficult:

If children don’t have birth certificates, they cannot get passports obviously, but that is the least of the issues. They cannot attend secondary school without one, nor can they benefit from any type of social service or insurance. Kwale district has a very high incidence of child marriages, yet if there is no birth certificate there is no way to prove in court that a girl is too young to be married. Other kinds of abuse also cannot be proved as child abuse. Without proper registration, the district does not get its fair share of the national budget because it’s not clear how many people are actually there. Photo: Ali K and Ali M – real leaders and innovators in community development.

As the Ali’s explained, if Kwale District is successful in incorporating SMS’s, mobile data gathering, and mobile outreach into the birth registration process, not only will they be the first district in Kenya to do it, but Kwale will be the first to even computerize the birth registration process. A couple ways they want to use mobiles are to provide a phone number that people could SMS their registration number to and find out if their certificates are ready or not, thus avoiding a long trip into the district office for nothing. They are also thinking of shifting the actual data gathering from hand written (carbon paper with several copies) to mobile data gathering and computerized data storage. In any case, a full project is being developed and piloted that will automate much of the current time consuming processes.

I remember when I lived in El Salvador and the municipality changed from hand written logs to computers. You used to have to go really early in the morning and wait in a huge line to get a number. Then you waited again till they called your number, went up and gave someone your information. That person would give your information to someone else who would look up the name/date, etc. and after an hour or 2, they’d call you and give you a little piece of paper with your record number on it. From there you would go wait in the cashier line to pay a fee for the copy of the certificate. Then you would go to another line at another window and give that number to someone else and sit down again for another few hours while that person would go into the archives books (bound books of hundreds of records) and find your certificate for you (birth, death, marriage, etc.). They’d make a copy and then it had to go to an official somewhere to authorize the copy before they’d give it to you. So basically you had to get there around 7 a.m. if you wanted to get it the same day, and it was a whole day affair.

Around 2000, they got a computer system in and modernized the process. I went in to get a copy of a document, and I clearly remember the security guard laughing at me because I looked at the certificate twice in shock when I paid my fee and was handed the actual certificate after about 30 minutes.

If the Ali’s and the Kwale District are able to get the equipment and set the project up, it could mean huge time savings for people and translate into greatly increased numbers of parents getting birth certificates for their children. The Ali’s have already taken the idea to a national level meeting and have other districts interested in their idea. Hopefully Kwale pulls it off and the model can be nationalized once any kinks are worked out! Photo: Mwenda and Ali, Kwale district CBO members.

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