Empowering Young Women on Health Amid Boko Haram: An International Women’s Day Message from Nigeria

Empowering Young Women on Health Amid Boko Haram: An International Women’s Day Message from Nigeria

 {Photo credit: MSH Nigeria}Some members of the Amdo Health Club in Billiri, Gombe StatePhoto credit: MSH Nigeria

It isn’t easy being a woman–or a girl–in Nigeria.

I grew up in a little village in the North where the tradition was very patriarchal. But my family was quite revolutionary. My father, right from the beginning, supported all of his children to go to school. When he got ill, he told my mother:  ‘You must promise me this: If I’m not around, and you are forced to choose between who to send to school, always choose the girl. The boy will inherit the land; he will always have a livelihood. The girl, she is not allowed to inherit anything; the girl child needs an education to find a livelihood for herself. '

It’s the opposite of what everyone thought! This is how I learned to lead.

The girl child in Nigeria

For many girls and adolescents in my country, poverty, patriarchal traditions, or threats of terror limit her access to health information and care, as well as to support systems, education, and economic security. Last International Women’s Day, I shared some of the horrors the girls and families in northeast Nigeria face from Boko Haram: Boko Haram stole our girls, raided our villages, and killed and drove our health care workers away. Whenever there is civil disturbance, it is the women and children who suffer the most. They are the most vulnerable. As a result, women and children cannot access essential care, and Nigeria suffers some of the worst maternal and child health indicators in the world.

However, in the last year, the Nigerian government has made amazing strides at returning order and calm. The rates at which the bombs are going off, and the raids in villages, have decreased and quieted down. There are still some suicide attacks–where a girl is forced to wear a bomb and detonate it in a public market. And we still haven’t found the 200 Chibok girls. But, in the northeast, some schools and health care facilities have reopened, allowing children to return and health personnel to provide care. Displaced people are slowly coming back.

Empowering Adolescent Girls as Health Change Agents in Gombe State: Amdo Health Club

MSH worked with local partners to lead a pilot intervention with 30 adolescent girls (ages 13 to 19) at Government Day Secondary School, Tal in Billiri, Gombe State–one of the terrorized states in northeast Nigeria—for six months from 2014 to 2015. This program, known as the Amdo Health Club (“Amdo” means love in the local dialect) had a far reaching impact on the girls; for many it not only changed their lives, but also the lives of their sisters, friends, households, and communities.

At first, many of the girls were quite ignorant about their sexual and reproductive health. For example, many girls didn’t know about menstruation or that you can become pregnant during the first time of sexual intercourse. We not only gave them information, we built a support system where the girls could receive services.

We trained their teachers and collaborated with the Parents Teachers’ Association (PTA) and school principal—so the girls would not have to go far and to increase trust with parents and the community. We arranged places the girls could get support, including through community based organizations, such as Community Oriented Health Providers Association (COHPA), a collaborating civil society organization, and local government agencies.

Health workers in the facilities were also pulled in to provide guidance so that the girls were able to make informed decisions without feeling guilty. Sometimes, religious leaders and teachers acted as advocates regarding religion and how it affects sexual and reproductive health, helping demystify misunderstandings, myths, and rumors in such a way that there is no contradiction or conflict, and making it easier for girls and families to accept and adapt.

[The reproductive health coordinator addresses Amdo Health Club participants, parents, and others at a meeting.] {Photo Credit: Adaeze Umolu/MSH}The reproductive health coordinator addresses Amdo Health Club participants, parents, and others at a meeting.Photo Credit: Adaeze Umolu/MSH

The girls had opportunities to participate in collaborative creative processes—like writing a poem and story book (both published), illustrating posters, and writing and acting out a stage play—as well as volunteer and leadership opportunities. [See the book and listen to one of the Amdo Health Club girls recite the poem, “Down, down the road”.]

With that health and life empowerment, these girls now play a major role in owning their sexual and reproductive rights. They hold their own and even educate their friends, their families, and the boys.

Empowering Girls, Amplifying Health Impact

One girl was terrified when she first menstruated. She thought she was going to die, and cried all night. She didn’t tell anyone all night. The next day, she opened up to her friend at school, one of the 30 who had attended the health club lectures. Her friend told her, “Oh no, you’re just becoming a lady!” and taught her how to take care of herself. The girl then told her mom about what happened; now, her younger sisters will benefit from the health information and support.

Many of the girls became advocates, and are so enthusiastic about what they believe in that they continue to spread the message. The girls who volunteered at the health facility got the opportunity to get to know the health workers and how the systems work so they would not be scared of them, and could demystify it to their friends and family. Rifkatu, one of the girls who volunteered at the hospital, now uses what she learned to educate her parents, her siblings, and her neighbors.  ‘I can’t keep this to myself. I have to tell my other friends,’ she tells us.

Rifkatu has gone on to form health clubs in a few neighboring schools and also goes to religious groupings to talk to girls and boys about sexual and reproductive health issues. Hearing a confident young girl talking about what she knows is extremely powerful. This is increasing the number of people in her community who are accessing health services at the health facility.

Every time I repeat the story of Rifkatu, it makes me really proud that it was MSH who provided the initial information and health intervention and has reinforced our resolve to work with adolescent girls. Wherever she and the other girls go—and whomever they empower—the health impact is replicating all over again the work that MSH did. We hope to scale up and operationalize the health club program in other schools and states, for both girls and boys. We know that boys have a role to play, too, and it is high time they are empowered and feel responsible for their own actions.

[Members of the Amdo Health Club with leaders from MSH, the school, community, and other partners.] {Photo credit: MSH Nigeria}Members of the Amdo Health Club with leaders from MSH, the school, community, and other partners.Photo credit: MSH Nigeria

Envisioning Nigeria 50-50

My father passed on when I was in secondary school. My mother held onto his words, and ensured we all went to school. I wanted to go into medicine and become a doctor. My mother said, ‘If I can help it, I will support you.’ I became a doctor. And, I knew that I needed to fight for other girls to have access to health and education to be able to reach their full potential. 

This International Women’s Day is an opportunity for all to pledge to take a concrete step to help achieve gender parity ("Planet 50-50") by 2030.

To achieve a Nigeria 50-50, there must be frameworks for policies and systems that cater to the needs of women, girl children, and adolescent girls: that help women and girls achieve their ambitions; call for gender-balanced leadership; respect and value difference; develop more inclusive and flexible cultures; and root out workplace bias.

[Dr. Zipporah Kpamor is MSH country representative, Nigeria.] {Photo: Gwenn Dubourthournieu}Dr. Zipporah Kpamor is MSH country representative, Nigeria.Photo: Gwenn DubourthournieuRight now my government is working to better define this, especially for during times of violent conflict. There is a presidential committee that has been mandated to rebuild the northeast and MSH has been invited to be a part of that committee. MSH will focus on improving the health of women and adolescents through our fragile states strategy, using experiences from within Nigeria, as well as Afghanistan, South Sudan, Democratic Republic of the Congo, and so on.

This International Women’s Day, when each of us can be a leader within our own spheres of influence and commit to take pragmatic action to accelerate gender parity and health impact, I thank the Amdo Health Club girls, the teachers, and health workers, moms, dads, siblings, and friends, local partners, and more, who have the courage to learn, share, and lead on adolescent health. And, I thank my father, who saw, before most, that to empower a girl child is to truly empower a community and a world. Here’s to planet 50-50!

Dr. Zipporah Kpamor is MSH country representative, Nigeria.

For more information about MSH’s work in Gombe State, read the report or watch the video. Local government agency partners included: Gombe State Ministry of Education; Local Government Education Authority; Ministry of Health; Billiri LGA Maternal and Child Health Unit; Gombe State Agency for the Control of AIDS; and Local Government Agency for the Control of AIDS.