Promoting Youth Friendly Health Services Among young people

Malawi should address the issue of unwanted pregnancies among young girls who are dropping out of school because of pregnancy. Heartrendingly, most of them do not go back to school after delivery as they dedicate their time to raising their babies and most are held back by the fear of how their schoolmates and teachers will treat them.  The issue of teenage pregnancies in Malawi has also led to unsafe abortions among the youth. 

As a way of putting an end to this, young people should be practically accorded their right to sexual reproductive health and family planning services. Furthermore, the policies that are aimed at promoting young people’s sexual and reproductive health should be operationalized without much ado because the issue at hand requires immediate action.

Investing in young people’s sexual reproductive health will greatly empower them so much that the youth will remain healthy, attain their education and realize their goals in life.
Young people have the right to make informed choices about their sexual and reproductive health, including the number, timing, and spacing of their children and the right to the highest attainable standard of health.

All young people, regardless of sex or marital status should have access to sexual and reproductive health services, which includes access to safe, effective, affordable, and youth friendly health services of their choice.

There is also a need to facilitate the process of encouraging peer education which also helps young people to obtain clear information about sensitive issues pertaining to sexual behavior, reproductive health, STIs including HIV and AIDS. Provision of youth friendly health services in tertiary education institutions and workplaces and other places where young people congregate is also viable and cost effective 

The youth in Malawi need to increase their knowledge base on current and relevant information about sexual reproductive health.

Of late, behavior change campaigns for young people have also been neglected and the consequence of this has been strongly felt in all parts of the country and that is in both rural and urban settings.

The government and non-governmental organizations need to maintain and develop effective monitoring systems of such initiatives to inform programing and improve service delivery.

On the other hand, when all is said and done, my fellow young people should also know that the onus is in their hands. No matter what the government and NGOs will do, the youth themselves are key to this. A lot of money, time and resources have already been spent on the promotion of young people’s sexual and reproductive health and  rights but the youth themselves are also to blame for not being active.

YFHS and Social Economic Development of Young People

“I have a 2 year old child and living positively mainly because I had no access to HIV”, these are words that were spoken in a discussion whereby young people were debating the importance of accessing Youth Friendly Health Services (YFHS). The narrator of this heartrending account, a youth worker from Mangochi district, told me that the girl continued to explain that she firmly believed that if she had access to YFHS about 3 years ago, the turnout of events in her life could have been different.

When a certain youth worker who was facilitating this session told me about the statements, I felt that the whole nation failed this young girl big time. Why would someone grow from childhood to adolescence without knowing critical issues about sex and sexuality? As I have always argued, parents and older relatives also know that they are supposed to discuss such matters with young people. Every adult realizes the need to discuss SRHR issues with a growing up young person. However, shyness forces people to continuously curtail such important sessions until it becomes too late to so. The consequences are so dire and at times irreparable. 

I for one believe that older citizens as well as duty bearers should know that they are also to blame when the country is registering increased cases of unintended teen age pregnancies and shockingly high prevalence rate of HIV and other Sexually Transmitted Infections (STIs).    We need to acknowledge our failure to protect innocent young lives as it is our responsibility to ensure that the young people are going into the adult world which they are conversant with and prepared for.

It is illogical to leave things to chance and expect that young people will one way or the other know about their sexual reproductive health. If one does not take that initiative to discuss SRHR issues with a young person who is growing into adolescence, the end result is that young person gets wrong information from their peers. Let me share with you what a group of adults told me about the most misleading SRH information they once got from friends and realise after some years that it was all a lie. Here are some of the misconceptions that were mentioned;

·       sleeping with boys or men helps a girl to get vitamin K

·       A girl can avoid conception by having a bath immediately after having unprotected sex

·       Infertility in men is caused by failure to undergo sexual cleansing during adolescence

These and many other factors are the reasons why allowing young people to access YFHS is the best option which parents and guardians of adolescent young boys and girls should choose. Young people’s access to YFHS will help everyone serve a lot in terms of time, money and other resources as problems that are caused by young people’s SRH challenges are costly. Furthermore, parents and guardians should accept that they are not experts in SRH. Sometimes, if parents or guardian are feeling shy or hesitant to discuss SRH issues with their adolescent boys or girls then they should let the YFHS Providers do the needful. Leaving the specialists to do the work is paramount in as far as prevention of SRH challenges which young people face is concerned.    

There is a need for all to know and understand that access to YFHS among young people is very key to social and economic development of young people. The welfare of young people and their lives in future is shaped by how their sexual reproductive health is taken care of today. 

Is Homophobia Responsible for Fueling the Risk of HIV among LGBTI in African Countries?

Barely nine months after the Court of Appeal in Botswana ruled in favour of registration of *LEGABIBO, the clergy in Malawi and their faithful took it to the streets on 6 December, 2016 in protest against legalization of same sex marriages in the country. The mass protests that attracted thousands of people in all major cities of the country were triggered by a proposal that the Members of Parliament should deliberate on whether same sex marriages should be legalized or not.  

My conversations with some of the people who exercised their freedom of expression and assembly to collectively remonstrate against the passing of such a Bill cited a number of reasons that ranged from religion to culture. However, my worry was that no one mentioned HIV/AIDS and other Sexually Transmitted Infections (STIs) and I wondered why?  

In my view, our biggest worry seems to be HIV/AIDS and the clergy as well as all citizens in Malawi really want to see the end of HIV. We all want to defeat AIDS but only a few are fully committed to the fight against its spread. Frankly speaking, the epidemic (AIDS) has devastated our lives in so many ways so much that it is among the common enemies that we all have. Now, this takes me to the issue of looking at those who have the highest risk of contracting and transmitting HIV who, according to UNAIDS are described as the Key Populations. These include female sex workers as well as Men who have Sex with Men (MSM). It is very ironic to note that the very same key populations are the ones who face a lot of difficulties when they want to access sexual reproductive health care services.  The LGBTI in general have the least access to prevention, care, and treatment services due to the fact that the society deems them as sinful as well as immoral. The stigma and discrimination that follows this kind of reasoning also stand in their way to access health services.

I am not saying what should be legalized or not but I simply want to express the feeling I have that the lack of a legal environment that supports access to health care services has implications on the spread of HIV.

HIV has caused enough damage already and the last thing we need to do is prevent other people from accessing information on how they can prevent contracting the virus or infecting others. I also believe that everyone needs health care services regardless of race, age gender or what have you. Young people who are LGBTI are two times more likely to suffer as compared to older people. This also means a good number of young people are not able to access prevention, care and treatment on such grounds and it is so sad that this is the only group in our country’s population that comprises leaders of today and tomorrow.

HIV messages should be tailor made to suit various groups of people in the society including sex workers and the LGBTI. I truly believe that we can fight AIDS with more than medicine. Raising awareness on how one can prevent contracting the virus or how to avoid infecting others is also the best approach. It is very hard for us to win the fight against AIDS unless all groups of people have adequate information.

HIV prevalence in most African countries like Malawi is shockingly high and it is very unfortunate the continent is the epicenter of homophobia and LGBTI is sadly Africa’s last taboo.  

                                                                                                                                               

 * LEGABIBO is an acronym for; Lesbians, Gays and Bisexuals of Botswana which is an association for the LGBTI community in Botswana.

The views in this blog are those of the author 

My first work experience

Written by ICS Volunteer, Elizabeth Mwale.

I first found out about this volunteer opportunity at the beginning of August 2016 when my parents told me about an advertisement that I was encouraged to apply for and sent off to YONECO by hand. After submitting my application I began to worry and was afraid of what the job will be like, how I could cope with other volunteers especially those from the UK?...So I decided to research through other previous volunteer's stories as well as additional information regarding the volunteerism itself.

A few weeks passed and I finally received a call back to congratulate me for getting through to the first set of interviews. This went really well and I went on to my second interview all the way in Lilongwe. When I arrived I was incredibly nervous and worried that I may not pass the second set of interviews. However, this proved wrong when a week later YONECO called me once again congratulating me and offering me a place to work in their team alongside other volunteers for three months. I was very happy after hearing this news and accepted instantly. I was so excited to meet new people and learn how to work well as a team as I had never had any opportunity before.

On the September 27 I arrived in Lilongwe alongside many other in-country volunteers and UK volunteers for an orientation session and preparations for the job. Whilst there, we were told to choose roles and I chose the role of community liaison. Something else I was worried about was how well I would be able to cooperate and communicate with the UK volunteers. My first day in the office consisted of learning how best to perform my role with my colleagues who would be taking the role on alongside me.

As time went on, despite the language barrier, I began to form an even closer bond with my two colleagues; Sarah and Anna whom were both UK volunteers, also allocated to the role of community liaison. Due to the UK volunteers not being fluent in my local language, I took on the responsibility of contacting the schools and communities in the local areas of operations. Although Sarah and Anna could not make the phone calls, they still had so much to offer by organising which schools and communities to get in contact with to arrange visits throughout the week.

One of the challenges we faced included being unable to get in touch with some targeted schools/communities due to the fact that their phones were often offline. This initially discouraged me and my colleagues. Nevertheless, we used this to motivate ourselves to push on and keep trying.

After a day of planning our session as well as booking many other schools for the same week; on Tuesday afternoon we arrived at our first ever Life Goals session. I was afraid that I would become be unable to manage speaking in front of a multitude of youths. However with the enthusiasm and team spirit, we were all able to achieve a confident, entertaining session. Six weeks down the line, I was now very used to my role and enjoy every aspect of the responsibilities that came with Community Liaison. I am also incredibly proud of the challenges I have faced and skills that I have developed such as being able to comfortably speak in public. Through the challenges that were faced in the first half of the placement that gave me courage for the last six weeks during my placement in addition to learning how to cope with other difficult tasks ahead of me. 

Now after this learning period am confident of doing more to my community through the role I played very much well. I am also happy as I have learnt some new skills and one of it being speaking confidently in public.

Development through the Lens of a Young Volunteer: Young People's Contribution towards Social Change

 By Eric Veeto Nyengani - Team Leader 

A life skills session with young people 

Sparing some time to volunteer with YONECO is the best thing one may think of in life. This could help bring answers to some of the questions we usually have.

Different organizations work in the communities where we come from, but it becomes very difficult to understand the impact of the work they are doing to the lives of people. Now YONECO in partnership with ICS, has answers to these and so many other questions and worries.

Knowing all the personal challenges which people are facing in the society may compel a person not to think of volunteering because they may be thinking that they will not meet their targets in life.

Looking back to my school life, my teacher in primary school used to say that nothing is achieved without being sponsored financially, and because of this I thought that volunteering was a waste of time. This was the case as I was focusing on achieving my goals in life, volunteering is not financially supported. Little did I know that volunteering can also have a huge and long lasting impact in achieving my personal goals.

As a community member now, I am fully aware of various negative perceptions about Sexual Reproductive Health and Rights (SRHR) and people to get accurate information to smash out these beliefs. Consequently; people, especially the youth, have so many unanswered questions and this also prevents them from finding ways of addressing various SRHR challenges in their communities.

People are constantly trying to understand so many things about SRHR. For instance;  before the YONECO - ICS Programme, both old and young people were asking questions like;

·      Where can I go and access SRH&R information in Nkhata Bay district

·      What can I do if am being abused or my friend is being abused?

·      If my first daughter has been impregnated due to unprotected sex where can I go to get help so that I can protect my second daughter from falling in the same trap?

·      As someone who lives in a rural and remote village, do I also have freedoms and rights?

YONECO - ICS volunteers have assisted a lot to provide answers to all the questions that are present in the community. Furthermore, the Tithandizane Toll Free Helpline number (116) has been widely publicized so much that communities are now able to report cases of abuse and other issues they face.

Our efforts also saw an increase in the number of young people and parents who were visiting  YONECO office in Nkhata Bay to seek SRHR information and counselling as well as some other l issues like the role of parents in the promotion of young people’s sexual reproductive health.

I am very hopeful that the answers that have been given to these communities will have a positive and long lasting impact on their lives as we are all going towards achieving sustainable development.

As an individual, I also benefitted a lot during my placement as a volunteer in Nkhata Bay district. Before we commencement of our activities, I also had my own worries an questions like;

·      Will I be able to stand in front of people to make a presentation and facilitate a session?

·      How am I going to understand the organization’s work in my community?;

·      Where am I going to get the office and field?

A life skills session with secondary school students in
 progress

These were some of the questions I had as an individual before I knew YONECO and ICS. My involvement in the ICS program responded to these personal questions which I had by providing answers. I managed to get responses for all the questions that I had.

I experienced this in my first three months as a volunteer when my knowledge was being sharpened and my understanding of situations also increased more than I expected.

However, challenges are always there that is life we just need to accept, being stressed at one point was one of the major challenges I faced in leading the team, coping up with emotions and stress was one of the life skills sessions we conducted in the second week of our placement. This topic contributed further to my understanding in a way that I learned useful management skills on how to deal with such situations.  

This has contributed to my personal development in a way that I understand that without even a single Kwacha {money} one can still develop his/her career. As an active citizen now, I see that volunteering is very rewarding - not financially as most of us expect. The rewards of volunteering are far much greater than what money can buy.  It is so gratifying to see how your contribution is changing people’s lives while you are also building your own self in the process.

The development of our society depends on how everyone will utilize the answers they got to the questions they had. One thing I know for sure is that; answers have been provided for community members to move forward towards the right direction.

Is World AIDS Day Worth Commemorating in Malawi?

HIV and AIDS has claimed a lot of lives in Malawi since the time it was discovered in the 80’s. The pandemic has negatively impacted on the world’s socio-economic landscape on top of making numerous children orphans some of whom have grown up but are still feeling the tweak of the vulnerability it caused them during their childhood days.

According to a report by AVERT; 10.3% of the total population in Malawi is living with HIV and young people who form over half of the country account for over 50% of new HIV infections.

The very mention of HIV sends shivers among many Malawians especially the youth and the whole concept of commemorating the World Aids Day is something they fail to grasp till today.

HIV and AIDS are terms that remind many people about the loved ones they lost as well as the stigma and discrimination which they or their dear ones suffered or are still suffering. Malawian society has not fully grasped the effects and dangers of stigma and discrimination that I perpetrated against people are living with HIV. Consequently, the on going stigma and discrimination is a thorn in the flesh towards the efforts of fighting against HIV and Aids.

Despite various interventions by the government, local and international Non Governmental Organisations (NGOs) and other development partners to deal with the two vices, stigma and discrimination based on one’s HIV status is still a menacing innocent lives of people in schools, communities and in work places. A number of people, including the youth, have lost their lives because of stigma and discrimination and this is a cause for concern.

On the other hand, Malawi has made commendable strides in the fight against the pandemic and this is a cause for celebrating such efforts.

This background justifies the need why the Malawi nation should join the rest of the world in celebrating the achievements that have been registered so far and look at ways on how to arrest the spread of the virus. The World AIDS Day also provides an opportunity for the AIDS servicing organisations, the private sector, the academia and the general public to seriously look at various issues surrounding the pandemic and collectively find solutions to such challenges that include stigma and discrimination.

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HIV prevalence rate for young people in Malawi is still on the rise. Young people make up to 60% of the national population and there must be more interventions to protect the future in a way that there must be much investment in HIV prevention programmes and much advocacy on provision and accessibility of quality Youth Friendly Health Services (YFHS).

Just like in many other countries, the World Aids Day in Malawi is marked by a national event with traditional dances, speeches and testimonies. This is a day whereby people reflect and build hope for tomorrow. We further remember those who died of HIV and AIDS and many others who contributed positively in the fight against the virus.

Even though the country has lost a lot of productive citizens because of AIDS, there is great hope for life, accomplishment of dreams so long as we provide care and support to those living with the virus while at the same time keeping the promise by ensuring that those living with HIV should avoid re-infection and infecting others with the  Virus.

An HIV free generation is possible.

By Timothy Bengo

My Journey as a Volunteer with YONECO, ICS and Progressio

 written by Elsie Gondwe

Sometimes one gets into the right things for the wrong reasons. This was I two months ago, after having finished my Bachelors degree in Medical Laboratory Science and awaiting my graduation, I wanted to make fast money. I wanted a good job and to earn whatever it is that I thought I really needed at the moment. Lucky enough my sister who resides in Nkhata Bay calls to say there is an opening at YONECO (in my mind I thought this could just be what I needed. Money!). So I got through the interviews and was successful enough to go for training (yay!)

That’s when we got repeatedly informed that this was neither a survey nor a job rather we were employed as volunteers. Members were not entitled to a salary nor allowance just a stipend to get by. I was shattered; this was not what I signed up for.

The in country training came to an end and time came to go back and welcome the UK volunteers to our respective partner organization. This interaction with the UK Volunteers was probably the first in my life. Don’t get me wrong, I do meet people from Europe and throw in a few hellos where necessary but the thought of working with not just one but twelve of them scared me (well, that’s how I felt at first).

They all seemed nice, I managed to introduce myself to the UK team leaders who were really friendly and open. As I went around saying hello, I realized that my sentence construction was failing to come out right. I even forgot a few grammars. Of course, I do know how to speak good English but I found myself struggling to get simple worlds out of my mouth. The fast ascent and slang of the UKVs made it hard for me to keep up and maintain a conversation. This was just the first day and I wasn’t confident enough to communicate. I kept on asking myself one question over and over again; 'what kind of a team leader will I be if I can’t express myself enough?' That day went by and so, the training came to an end.

We finally got to our placement - YONECO in Nkhata Bay. First week of work or rather first day being a Monday, we had a brief description of what the organization was about and what is expected of us in the next three months. We had further introductions among ourselves (volunteers). The UKVs had no time to waste and they went straight to planning, coming up with different posters and formulating ideas, assigning roles to members, reading through preceding placement files. They did a lot and these people are organized you have no idea. 

I was of the opinion that they will be playing with their phones and being idle - boy I was wrong. I was the one who looked lazy as I stood there looking at what they were doing. So I started making myself productive and chipped in where necessary to learn new things from them. That week passed with me learning new skills everyday from my fellow volunteers.

I learnt one thing about the UK volunteers, they always asked questions. They are never ashamed to show they don’t know something so they would rather ask than pretend to know- I salute that!

Elsie Gondwe at Kayapapaya receiving a bracelet from Erick Veeto  

Week two came so fast we started planning for field sessions. As an in country volunteer I thought I knew everything there is to know about Malawi. I thought to myself that this was a great chance to showcase how knowledgeable I am about my country. The different scenarios I came across in various schools and communities made me realize how less I knew about my country. This also oped my eyes to fully comprehend how much people needed our efforts to reach out and spread the word on HIV, STI, and teenage pregnancies and other sexual reproductive health issues. The situation in the communities we worked in compelled me to change my approach and perception of such sensitive topics. These issues are a major concern among young people and older members of the country. 

Having schoolchildren approach me after a session to just ask me a simple question made me smile. This came about because I knew I reached out and someone listened and I get satisfaction in the fact that, somehow, I have saved a life.

So it wasn’t about the money anymore, it didn’t matter whether I had to walk a long distance to get to work. I always looked forward to what I could do for the community on that particular day. To top it all, I had the most amazing team with me, team Umoza. The team was so inspiring and supportive. We could disagree at times and annoy each other but we always found a way out. No matter how angry one got, it was never permanent.

When I got the call to start work in my trained field in Lilongwe, all members were happy for me . I had the best support system a team leader and a member could ever get. I believe I inspired fellow in country volunteers to learn more and to gain experience and competence in the roles they chose. Even if it meant pushing and shouting - though that was never my intention. I wanted them to come out of this placement changed and motivated as they choose their various career paths.

A gift to Else: a bracelet labeled Team Umoza) 

My last day at YONECO was memorable. I hate goodbyes but I had to leave. The team took me to Kayapapaya for a cold one (soft drinks by the way this was and still is a dry program). The coordinator threw in a few farewell remarks. Then I was presented with a bracelet with words written vertically around it and the words  read 'TEAM UMOZA'  (I have never taken it off since I wore it ) good memories. But life has to move on, another chapter opened. I left YONECO a happy volunteer; the one-month stay changed my perception all together.