Steps and leaps

2011 was a great year for VSI, a great year for women, and a great year for me personally.

VSI wrapped up research projects introducing life-saving misoprostol tablets in five countries, and in that process I had the opportunity to meet women and providers benefitting from our efforts in villages and towns throughout Africa — women and providers whose stories I’ve shared over and over with colleagues, friends and family who rely on me to bring Africa to life with the voices and photos of the heroes I’ve met there.

I met Maria, an elementary nurse in Mozambique, who told me in a calm voice with pain in her eyes about her own daughter’s unsafe abortion, and how she desperately wished she’d had misoprostol tablets to give her so she didn’t have to suffer.

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Precious Cargo

It was a hot and sunny day when we started out across the only bridge on the White Nile for over 1000km. The banks of the river were bustling with people bathing, washing their clothes, fishing, and offloading goods from small boats. After we crossed the river we headed down a dirt road toward our first destination: a Primary Health Care Center (PHCC) staffed by a trained community health worker (CHW). The old adage that “It’s the journey that matters and not the destination” held true as we hastily rushed down the dirt road narrowly dodging goats, long-horned cattle, and small children and women carrying water containers and bundled wood on their heads.

At one point in the road we noticed a traffic jam with an assortment of NGO land cruisers, minibuses, mototaxis, and curious onlookers piled around a beer truck stuck in a muddy crevasse in the road. Men with shovels surrounded the beer truck, desperately trying to dislodge the vehicle and its precious cargo. Apparently a church was being inaugurated in a village down the road and many dignitaries were attending, as it was the home village of a political bigwig.

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Bright Lights

I sit with the bright light beaming directly into my eyes and feel the dry paper clipped against my chest. The sharp metal objects poke and prod the inside of my mouth as if they’re searching for something that I missed. Overall it’s not a pleasant experience, but I know it must be done.

“So what do you do?” asks the dentist standing directly over me.

The instrument resting awkwardly against my tongue gives me a long moment to think about how to best respond.  Faces and names of our programs jumble in my head – Nafissa, Zamna, Monaisha, Robey.  These women are the real reason why I come to work on Monday mornings and why VSI exists.  We believe passionately in the power of women and their impact on the world.  I didn’t snap the photos hanging on our office walls and I’ve never met the women we feature on our website, but I can name them all – Lelti, Dilwara, Agnes - that’s what I do. 

I begin to describe my work at VSI in detail between the poking, gargling, and teeth cleaning.  I talk about miso and its medical use; I try and paint a picture of what life is like for rural women in Africa because as citizens in this country we could never fully understand the life-threatening challenges of a pregnant rural woman in the developing world.

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Four years...and memories to last a lifetime

Four years seems like a long time in retrospect, but fifteen hours feel even longer as I restlessly sit on a flight from Dhaka, Bangladesh to Los Angeles.  This will be my last trip overseas with VSI, as I prepare to leave the organization to pursue my PhD.  This last long flight allows me plenty of time to reflect on these past few years and the impact of this work on women’s health.

I first joined VSI four years ago when the organization was a much smaller operation and only had a few country programs.  I am honored to have had the opportunity to help build and support many of VSI’s misoprostol programs from the ground up.  Ghana and Bangladesh were such programs.

The first half of this last trip I spent in Ghana, visiting rural health centers where misoprostol tablets are distributed to women during antenatal care (ANC).  The counseling and misoprostol women are receiving while pregnant ensure they will have protection against excessive bleeding if they cannot make it to a health facility in time to deliver. In Bangladesh I traveled with partners and visited similar safe motherhood programs in rural communities.

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Change Starts with Small Steps in Kenya

The sun pounded down on us as we walked to the middle of Kibera, the slum area of Nairobi that up to a million people call home. My colleagues and I entered through Kibera’s market area, where long aisles of vendors in corrugated metal structures sell anything from fresh produce to clothes to electronics. My Kenyan colleague, planning some apartment renovations, stopped at a hardware stall to inquire about the price of paint. I stood by, letting their Swahili run into a stream of words my English-speaking brain couldn’t make sense of, and examined an overstuffed ring of paintbrushes hanging on the wall. A man lay down seemingly unconscious in the middle of the path a few stores away, mostly ignored by others. It seemed like a typical day in the second largest slum in all of Africa.

We continued on, reaching the area of Kibera known as Mashimoni, which means “holes” or “pits” in English. I hopped over a few muddy areas covered in shoe soles and cardboard. The sun’s heat intensified the smell of unidentifiable waste emanating from the ground. When we entered the courtyard surrounding Frepals Nursing Home, I gratefully stepped onto the concrete floor that was swept free of any debris and in the shadow of the roof’s overhang.

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