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From VHT to Male Champion: Nelson’s Mission to Create Positive Change in His Community

Nelson, a Male Champion trained and empowered under the Promise II Project-DFPA, stands as a beacon of hope in his community, earning commendation for his tireless efforts. Nelson has embarked on a mission to sensitize people on the importance of gender equality while fearlessly speaking out against Sexual and gender-based violence (SGBV) and other gender-related injustice.

While the inclusion of women remains paramount in advancing Sexual and Reproductive Health and Rights (SRHR) and gender justice, the engagement of men and boys is equally essential for achieving lasting change.

In the countryside of Kyabigambire Central, one Sunday Nelson is breaking stereotypes by assuming the proactive role of a male champion, advocating for SRHR and gender justice. Dismantling the notion that SRHR and gender equality are solely women’s issues.

Serving as an influential role model who is challenging harmful gender norms and stereotypes within his community.

Sunday Nelson’s dedication to this cause goes beyond mere advocacy and awareness rising; he immerses himself in the community, actively engaging men and boys in crucial conversations about gender issues and empowering couples and families to embrace gender equality and justice. He has demonstrated that supporting gender equality is not only beneficial but also essential for creating healthier and more equitable societies.

Drawing from his past experience as a VHT, Nelson transitioned into his role as a male champion, now collaborating with local leaders to challenge traditional notions of masculinity that perpetuate harmful behaviors and attitudes. His unique ability to navigate through complex issues with compassion and understanding has earned him praise and admiration from those he has helped.

By redefining what it means to be a man, Nelson has encouraged other men to embrace values such as mutual respect, consent, accountability and equality, reaching accountability and collective action.

In an interview with me, Nelson stated;

I’m passionate about creating change in my community. I believe sensitizing communities on gender equality and SGBV is key to fostering positive change, sparking meaningful dialogue and action. As a committed male champion, selected by the community, I’m engaging men in discussions about gender issues to strengthen families and communities. The Promise II project has been a turning point for me, offering training and fostering personal and professional growth. I’ve undergone a remarkable journey of growth and advancement.”

As Nelson continues to make a positive impact in his community, his story serves as a testament to the transformative power of dedication, compassion, underscoring the importance of community empowerment, mobilization, and meaningful participation. Meaningful participation from men and boys is crucial for challenging and dismantling patriarchal structures that perpetuate inequality, discrimination and denial of services. By actively involving men and boys in advocacy efforts, male champions emphasize that achieving gender justice is a collective responsibility that benefits everyone.

“With Nelson’s and the LC’s support, my wife and I successfully addressed our recent marital issues. Our disagreements had resulted in violence, but Nelson’s guidance helped me become a better husband. The positive transformations are now evident in our home.” – stated one of the beneficiaries.

Stereotypes have long permeated our perceptions of gender roles and responsibilities, often relegating men to certain societal expectations that limit their ability to engage in issues such as sexual and reproductive health and rights (SRHR) and gender justice. One of the primary reasons for involving male champions in advancing SRHR and gender justice is their unique ability to resonate with other men. Research indicates that men are more likely to listen to and heed the advice of their male counterparts.

By Fatiha Nkoobe

Communications Officer,

Center for Health, Human Rights and Development (CEHURD).

Fighting a Monster that Guards My Community’s Gate

A story of a GBV male champion Samuel Muhumuza from Hoima District, Uganda trained under Promise II project (DFPA).

“Of course, I’m a man. How can I be seen cooking or doing any home chores meant for women?” – Sam

Samuel Muhumuza is a Gender-Based Violence male champion from Kigorobya Northern Ward, Hoima District. His passion of being a Gender-Based Violence champion is derived from his personal experience and the trainings he has numerously had with Center for Health, Human Rights and Development (CEHURD). In my interview with Sam, he passionately shares how he finds it prestigious to do the kind of work he does and how he never wishes to go back to his previous life of being a politician.

“I knew I was a man. Certain gender roles weren’t for me however much they were affecting me. How could I be seen cooking? I would rather die of hunger than cook for myself or for my children even in the absence of their mum. But this narrative changed”. Says Sam

When change knocked Sam’s door, he embraced it and he’s now impacting his community. In Sam’s home, gender roles are shared amongst individuals be it male or female, and he does this openly so that his community can be able to pick a leaf from him.

“I have cows at home, with no herds man. My wife and I share this role. I also collect water for my family, and I have never lost my hands since I started doing so”. Says Sam

As a Gender-Based Violence champion, Sam has had to go head-to-head with some of his notorious cultural norms that spark of Gender-Based Violence. Much as he does his best to change his fellow men’s mindsets in his community, at times he’s looked at as a person trying to erode away his culture. Among the Alurs where Sam grew up from, women are not supposed to eat with men, they instead serve them, sit down and await on them as they eat until when they get done. After the man has gone, then a woman can eat after. Furthermore, a woman has no right to say no to sex if a man requests, regardless of her health condition. Cultural norms in Sam’s community are highly respected and this is something Sam has to deal with each and every day. He fights a monster that happens to safe guards his community.

Sam comes from a community where some people still believe that Gender-Based Violence cases happen in homes because of sorcery, woman’s delay to open the door for the man returning home past midnight is a sign of disrespect and all these can spark-off a fight. But as a champion who has gone through trainings, he clarifies to his community the major causes of Gender-Based Violence and breaks the myths and misconceptions around it.

In spite the criticism towards Sam’s work, he never stops what he does because it gives him a lot of joy. One of the things he proudly delights in is being able to reconcile breaking families through mediations. He even goes further to offer himself as a surety to suspected fellow men of Gender-Based Violence, with hope that when they’re out, he will talk to them and they change. This is a bold move, right? And surely, at least the two men he has stood for have not disappointed him.

“Much as fighting Gender-Based Violence is tedious and resolving its conflicts take a while, it is a worthwhile experience and this gives me pride and joy” – Sam says.

Sam therefore calls upon cultural leaders to join the mantle of putting an end to Gender-Based Violence and the government to be intentional on sensitizing communities on the dangers of Gender-Based Violence, since illiteracy and cultural norms happen to be the leading causes of Gender-Based Violence. He also urges other fellow men who have embraced change to be extemporary to others as he has been to his community.

 

By Faith Nabunya

Communications Officer,

Center for Health, Human Rights and Development (CEHURD)

The Unfulfilled Commitment; Eight years since the government committed to providing menstrual health products to girls

A UNESCO report indicates that in Sub-Saharan Africa, approximately 1 in 10 girls misses school during their periods due to stigma and discrimination. On average, a menstruating girl loses 13 learning days of school every school term. Additionally, an estimated 23 percent of adolescent girls aged 12 to 18 drop out of school following the onset of menstruation. 

Girls in Uganda face a multitude of challenges in managing their menstrual health. Alarming statistics on school dropout rates among menstruating girls underscore the urgent need for intervention. The absence of menstrual hygiene supplies in schools stands as a major barrier leading to many girls missing out on education, due to period-related challenges 

Along with other challenges; including inadequate infrastructure and limited information/awareness, the scarcity of essential supplies like sanitary pads is a critical issue that has not received adequate attention. Social stigmas and cultural taboos surrounding menstruation further exacerbate these challenges, making it difficult for girls to seek the support and information they need.  

Well knowing that economic disparities have exacerbated period poverty, with only the privileged able to afford menstrual products. The less fortunate often resort to desperate measures, including risky behaviors to raise funds for pads. Young people often depend on their parents for these supplies, who are already burdened with numerous responsibilities. High levels of poverty worsen the situation, as the price of a pad ranges from 3,000 to 9,000 shillings, an amount that could cover part of school fees for a daughter in some regions. This disparity undermines the fundamental goal of ensuring equal opportunity for all, as girls face unnecessary barriers that hinder their educational advancement and overall well-being. It is imperative that governments and stakeholders prioritize initiatives that address menstrual health as a core component of women’s rights and empowerment. 

It’s been eight years since the government committed to providing menstrual health products to school-going girls, a promise outlined in the 2016–2021 Manifesto of the ruling National Resistance Movement (NRM) government, with the objective of addressing school dropout rates and supporting menstrual hygiene, dignity, and the well-being of adolescent girls in primary and secondary schools. However, this pledge remained unfulfilled by the end of the term. 

The implementation of the pledge was anticipated in the Financial Year 2017/2018; however, the initiative has remained only on paper, eight years since President Yoweri Kaguta Museveni made the pronouncement. In April 2020, First Lady Janet Museveni, Minister of Education and Sports, announced plans for a sanitary pad manufacturing factory to distribute pads in schools nationwide at no cost. However, this plan is yet to materialize.  

As we mark Menstrual Health Awareness Month, I take this moment to remind the government of this important commitment outlined in the 2016–2021 Manifesto of the ruling National Resistance Movement (NRM) government. Every May of each year is Menstrual Health Awareness Month, an opportunity to create awareness on MHM and amplify/challenge key issues on periods, among them the unfulfilled pledges on MHM. This campaign culminates into the commemoration of International Menstrual Hygiene Day celebrated 28 may. May is the 5th month of the year, and the average length of menstruation is 5 days every month. 

Whereas Uganda has demonstrated commendable efforts in advancing women’s empowerment and leadership through various policies, programs, and affirmative action measures, there remains a notable gap in addressing menstrual health management among girls, which directly impacts their ability to compete equally with boys in education.  

Investing in menstrual health for girls is not only a matter of health and hygiene but also a critical step towards advancing toward an equal future. While strides have been made in promoting gender equality and empowering women in other areas, the critical issue of providing adequate support for menstrual health has often been overlooked. 

Menstrual Health Management (MHM) should be promoted as a critical aspect of gender equality and women’s rights. We have to ensure that menstruation is not a barrier to education, work, or participation in society. Menstrual Hygiene (MH) is a key and a fundamental concern that specifically touches on the existence, productivity, performance, and well-being of girls in school. 

Whereas the legal framework in Uganda is alive to maternal and reproductive health rights, like Articles 30 and 34 of the 1995 Constitution of Uganda which provides for the right to education to all persons of Uganda and imposes the responsibility of providing children with basic education on the state and the parents, Uganda in its aspiration to provide maternal and reproductive health services for girls and women and specifically on Menstrual Hygiene, still faces social, economic, and cultural challenges leaving a lot to be desired. 

It is imperative that MHM is recognized and promoted as a critical aspect of the broader movement towards achieving equality and justice for all women and girls. The inability of girls to compete on a level playing field with boys due to menstrual health challenges – highlights the urgent need for targeted interventions and policies. By implementing comprehensive menstrual health programs in schools and communities, we can ensure that girls receive the support and resources they need to manage their periods effectively, stay in school consistently, and fulfill their academic potential.  

Recognizing that Menstrual health is a critical aspect of women’s empowerment, particularly for adolescent girls, as it directly impacts their education, health, and overall well-being. By advocating for comprehensive MHM policies, we can contribute significantly to breaking down barriers that hinder gender equality and women’s rights globally. Promoting Menstrual Health Management (MHM) is not just about managing periods; it is about promoting gender equality and women’s rights on multiple fronts. Addressing access to menstrual health management products for school-going populations is a crucial step towards improving overall MHM. 

Menstrual Health Management (MHM) should be promoted as a critical aspect of gender equality and women’s rights. We have to ensure that menstruation is not a barrier to education, work, or participation in society. Menstrual Hygiene (MH) is a key and a fundamental concern that specifically touches on the existence, productivity, performance, and well-being of girls in school. Finally, I want to state that, access to essential supplies is a matter of equity and social justice, as many individuals, particularly in low-income communities, cannot afford basic necessities. Let’s help girls to realize their full potential and participate equally in society. 

Menstrual health management remains a time-consuming challenge for girls, hindering their academic success. 

 Fatiha Nkoobe, the writer is a Communications Specialist and Activist, working with the Center for Health, Human, and Development. 

nkoobefatiha@gmail.com 

The fight against Obstetric Fistula in Uganda: Progress made but challenges remain 

According to the United Nations, Obstetric fistula is a hole between the birth canal and bladder or rectum, caused by prolonged, obstructed labour without access to timely, high-quality medical treatment. This abnormal opening leaves women and girls with a constant leakage of urine, stool or both, and often leads to chronic medical problems, depression, social isolation and deepening poverty. Ninety percent of pregnancies involving fistula end in stillbirth.  

Obstetric fistula continues to affect the lives of thousands of women in Uganda. This debilitating condition leaves affected individuals with chronic incontinence and often social isolation.  

The National Library of Medicine (National center for Biometric information) highlights that in Uganda, the current lifetime prevalence of vaginal fistula symptoms is estimated to be between 16.3-22.5 per 1,000 women of reproductive age. This translates to an estimated 140,000 – 200,000 women and girls living with fistula in the country, with over 1,900 new cases occurring annually. 

The United Nations estimates that at least two million women live with fistula in developing countries, with 50,000 to 100,000 new cases occurring each year and these numbers represent only those seeking treatment. Women and girls in Africa, south of the Sahara, are mostly affected by fistula as well as other illnesses from sexual and reproductive health causes. 

The Ugandan government has taken important steps to address this issue. In 2011, the country enacted the National Obstetric Fistula Strategy (2011/12-2015/16) which aims to guide the implementation of prevention, treatment and re-integration activities for obstetric fistula. This has led to increased awareness, training of specialized fistula surgeons, and the establishment of dedicated fistula repair centers across the country.  

Strategic partners in Uganda have also followed suit and have been seen to implement the government’s strategy. The Kingdom of Buganda forexample is also dedicated to raising awareness about obstetric fistula among mothers in the central region. To achieve this, the kingdom collaborates with key hospitals in Buganda, such as Kitovu Hospital in Masaka District, to establish necessary infrastructure and provide support. The Kabaka Foundation, a prominent organization within the kingdom, actively participates in these efforts by organizing an annual Kabaka Birthday run which focuses on fistula awareness, among others. These events serve as a platform to educate the community and garner support from both local and international sources to fund initiatives aimed at preventing and treating obstetric fistula. 

The Terrewode Women Community Hospital – Soroti District, under the leadership of Executive Director Ms. Alice Emasu, has made a significant difference as well by saving the lives of more than two thousand (2,000) women suffering from fistula over a span of five years. We need to see more of such initiatives to create a significant impact. 

However, despite these efforts, challenges remain. The New Vision publication by Umar Kashaka on 8th May 2024 highlights the worry of the Uganda Ministry of Health on the rising backlog of fistula cases. In this article, the Assistant Commissioner of Clinical Services in the Ministry of Health Dr Alex Wasomoke is quoted to have revealed that approximately 1500 fistula operations are carried out in a year but 1,900 new cases are reported annually, leaving a backlog of over 400 cases unattended to. He also noted that each fistula patient needs $400 (1.5m) to undergo surgery and this is a direct affordability concern and a barrier to access of quality care services. 

An article authored by Ndyaye and published in the Daily Monitor on May 20th, 2024, reveals that Uganda currently only has 25 surgeons specializing in fistula repair, a shocking revelation considering the immense demand for such services. These skilled providers have successfully treated thousands of fistula cases, restoring dignity and hope to women and girls who had lost all. However, the demand for fistula treatment remains largely unmet, leaving countless women unable to access these life-changing services. 

Women living with obstetric fistula encounter a multitude of challenges across various aspects of their lives. Physically, they struggle with urinary and/or fecal incontinence, which can lead to skin issues such as rashes and sores, as well as complications like foot drop. Fertility concerns, post repair surgery often plague these women, with uncertainties about their reproductive capabilities and fears of recurrence during future pregnancies. Psychologically, they face disruptions in social relationships, potential divorce, and the potential heart-wrenching loss of their babies through neonatal death. 

The stigma, discrimination, and resultant isolation from their communities contribute to feelings of depression and low self-esteem. Economically, women with fistula experience a loss of livelihood, becoming heavily reliant on family members for support, and struggle to afford necessary treatment and transportation to healthcare facilities. Socially, they encounter challenges such as impaired marital status and responsibilities, limited participation in community activities, and various forms of discrimination based on health, disability, marital status, education, and socioeconomic standing.  

Despite these hurdles, many women can successfully reintegrate into their communities post-repair, although relationship issues and fertility anxieties often persist. It is important to address the holistic needs of women with fistula, encompassing physical, psychological, social, and economic support, to facilitate their complete recovery and successful reintegration into society. 

Underlying social factors such as poverty, gender inequality, child marriage, and limited access to quality maternal healthcare continue to drive the persistence of obstetric fistula in Uganda.  Addressing these social factors through multi-sectoral interventions is crucial to achieving the goal of ending fistula by 2030. 

On this International Day to End Obstetric Fistula, we therefore call upon the government and all actors to renew its strength towards this cause. Increased investment in prevention, treatment, and rehabilitation services is needed, along with empowering women and girls, challenging harmful social norms, and strengthening the overall healthcare system. Employing a comprehensive rights-based and multisectoral approach, at large, can finally place obstetric fistula to the history books in Uganda and beyond.  

It is very possible to change the status quo and impact society positively. 

 Compiled by Jacqueline Twemanye, Communications Department, Center for Health, Human Rights and Development (CEHURD). 

Embracing Women’s Health, Navigating Menopause in the Workplace

In Uganda, the pursuit of gender equality has seen significant strides in recent years through several initiatives aimed at empowering women in various aspects of life. Initiatives such as the Gender and Equity Certification Program and the National Gender Policy underscore the commitment to addressing gender disparities. However, it is noteworthy that there is a gap in policies explicitly targeting menopause as a workplace challenge.

It is thus essential to shed light on the often-overlooked journey of women in the workplace, especially as they navigate the unique challenges posed by menopause. Contrary to common belief, menopause isn’t exclusively an issue for older women, it can impact women below the age of 40 (pre-mature menopause), significantly affecting their professional and personal lives. This silent transition demands understanding, support, and an inclusive workplace environment to empower women during this critical phase. 

The Hidden Struggles: Menopause brings forth a myriad of challenges that can impact a woman’s physical and mental well-being, potentially influencing her overall job satisfaction and performance. Common symptoms include hot flashes, mood swings, sleep disturbances, and cognitive changes. These challenges not only undermine a woman’s confidence but also disrupt concentration and impact her ability to handle stress effectively. 

The Working Woman’s Dilemma: The workplace, traditionally structured without considering the specific needs of women experiencing menopause, can inadvertently amplify these challenges. Despite the prevalence of menopause among women, it remains a topic often shrouded in silence and stigma. Many women feel hesitant to openly discuss their experiences, fearing judgment or discrimination in the workplace. This lack of awareness and support perpetuates a culture of silence, hindering women from seeking the help and accommodation they need. As women increasingly play multifaceted roles, balancing career aspirations with societal expectations, the impact of menopause on their professional lives becomes a pertinent aspect to consider.  

Efforts to promote gender equality should expand to encompass policies that address the specific needs of women navigating menopause in the workplace. Recognizing and accommodating the challenges posed by menopause aligns with the broader goal of creating an inclusive and supportive work environment where women can thrive across various life stages, ultimately contributing to a more equitable society. Incorporating menopause considerations into existing gender equality policies can further enhance the overall well-being and empowerment of women in Uganda. 

Special Message to Women: let us celebrate not just our achievements but also acknowledge the unique journey many of us navigate through menopause. It’s a phase that may bring physical and emotional changes, impacting both personal and professional spheres. Remember, you are not alone on this journey. Embrace open communication, seek support, and prioritize self-care. Recognize your strength and resilience as you navigate these changes at the workplace. Advocate for your needs, and let’s work collectively to foster understanding, empathy, and positive change. You are valued, empowered, and deserving of a workplace where your well-being is prioritized.  

Examples of Workplace Neglect 

Temperature Control and Comfort: Many workplaces are not designed with consideration for temperature control, comfortable seating, or adequate lighting. This oversight exacerbates symptoms like hot flashes and fatigue. It is important that employers invest in creating a comfortable and supportive workplace environment. This includes adjustable temperature controls, ergonomic seating, and adequate lighting to accommodate women experiencing symptoms like hot flashes and fatigue. 

Flexible Work Arrangements: Some employers fail to provide flexible work hours or remote work options, making it challenging for women to accommodate varying energy levels and the need for extra rest during challenging times. Employers are encouraged to introduce flexible work hours or remote work options to allow women to manage their workloads effectively while dealing with fluctuating energy levels. 

Limited Education and Awareness about menopause: Many workplaces lack educational programs about menopause. This absence of understanding among colleagues and supervisors contributes to a lack of empathy and support for women experiencing these challenges. Workplaces may consider prioritizing implementing educational programs about menopause. This not only raises awareness but also fosters understanding among colleagues and supervisors, encouraging empathy and support. 

Limited Wellness Programs: Some workplaces lack comprehensive wellness initiatives addressing the physical and mental well-being of women going through menopause. This includes insufficient access to counseling, support groups, and fitness programs. Companies should incorporate comprehensive wellness initiatives addressing the physical and mental well-being of women experiencing menopause. This includes providing access to counseling, support groups, and fitness programs. 

Communication Barriers: In workplaces where open conversations about menopause are discouraged or not facilitated, women may feel isolated and unable to express their needs and concerns without fear of judgment. Encouraging open conversations about menopause is crucial. Creating a platform for women to express their needs and concerns without fear of judgment fosters a supportive and inclusive workplace culture. 

Creating a supportive environment for women experiencing menopause is not just an empathetic gesture; it is a workplace necessity. Advocacy for policy changes and the implementation of supportive measures is crucial to ensure that women can navigate this phase without compromising their professional growth. 

Together, let’s embrace women’s health and create a workplace where every woman feels valued, understood, and empowered to succeed.  

With solidarity,

Compiled by Nakalembe Judith Suzan, Community Empowerment Programme, CEHURD.