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From an Obstetric Fistula survivor to an advocate for girls rights: a journey shared by thousands of girls and women in Mozambique

12 December 2018

Opinion-Editorial

Andrea M. Wojnar, UNFPA Mozambique, Resident Representative

The ability of girls and women to control their own bodies is fundamental to their empowerment. Protecting and promoting reproductive rights – including the right to decide the number, timing, and spacing of children – is essential to ensure women’s freedom to participate fully in society. However, girls and women in developing countries continue to face systemic disadvantages, often rooted in societal norms that foster widespread gender inequality and gender-based violence in all its forms.

On a recent trip to Zambezia province in northern Mozambique, I met Joaquina, 16, who was pushed by female relatives to marry an older man because “she was the pretty one.” Joaquina quickly became pregnant and after a lengthy labor, she contracted obstetric fistula, one of the most tragic complications of childbirth. A hole between the birth canal and bladder or rectum caused by prolonged, obstructed labor without medical support, obstetric fistula leaves the mother continuously leaking urine and feces, and often leads to chronic medical problems, abandonment, depression, social isolation, and deepened poverty.

Worldwide, an estimated 16 million girls between 15 and 19 years old give birth each year, with 90% of those adolescent births occurring within marriage (Girlhood, Not Motherhood, UNFPA 2015). Child marriage is a human rights violation and a form of violence that denies girls their childhood and puts them at risk of early pregnancy. Childbirth at an early age is associated with increased maternal health risks.

For years Joaquina didn't know her condition had a cure, nor did her husband, who left her. Despite her suffering, she still participated in a local youth parliament where, after sharing her story, someone encouraged her to seek treatment.

Now Joaquina feels like a woman again and advocates with other girls to protect and prevent themselves from early marriage and pregnancy. Joaquina, as a mentor in the Rapariga Biz girls empowerment Program, is using her voice to influence change. Her dream is to become a teacher who influences the next generation of girls to make healthy and informed choices.

As a mother of two daughters who are being raised to demand and express their full human rights, I feel proud of Joaquina as if she were one of mine. She is using a horrific personal experience to inform others about the dangers of early pregnancy. I am pleased to be a leader in the United Nations Population Fund, UNFPA, that works tirelessly to ensure youth sexual and reproductive health and rights worldwide.

Rapariga Biz is a joint UN-program financed by the Kingdom of Sweden and the UK Department for International Development, that aims to empower 1 million girls and young women in 2 Mozambican provinces, 70% of that age group, by 2020. The program brings together Mozambique government officials from the highest levels, civil society, UN agencies, the media, and communities to ensure that adolescent girls have access to education, health services, life skills, and human and legal rights knowledge, primarily through peer-to-peer mentorship. Initial results are demonstrating enormous decreases in early marriage and pregnancy amongst participants.

Rapariga Biz also benefits from the U.N. Global Programme to Accelerate Action to End Child Marriage which targets 10-19 year olds at risk of child marriage or already in union, in 12 countries. UNFPA in Mozambique supports the implementation of other similar projects like the Kingdom of the Netherlands funded My Choice program in a third province, as well as the European Union-funded Spotlight Initiative to Eliminate Violence Against Women and Girls, which aims to accelerate prevention and response to sexual gender-based violence and early marriage in three more provinces.

Through these and other programs, we are positively influencing the lives of youth by accelerating efforts to reduce early and unwanted pregnancies. By working together to research local contexts, ensure legal protection, build government and civil society capacity to prevent and respond to violence against women and girls, Joaquina and her peers, will be well placed to make significant contributions to Mozambique’s development.