Sharing knowhow and joining forces towards Health for All
Contribution to the Annual Report 2016 of the MMI Network

Healthy adolescents - healthy societies

Healthy adolescents - healthy societies

Taking care of adolescents is an investment in a healthy, sustainable future. Doctors with Africa CUAMM is working on this major issue that is essential to current international policies to give attention to this young and often vulnerable part of the population.

“Many boats come to Gbondapi from Bonthe every week because on Tuesdays there’s an enormous market of fish and all sorts of goods. Pregnant women are among those on the boat to share the travel costs with the others going to Gbondapi. But instead of slipping in among the crowds of the market stalls, they come to the maternity waiting home where they will stay before the birth. One of these was a teenage girl named Aminata. At first, I’d thought she was there to accompany someone else. But then I took a closer look, and like all the girls I’d met, the look in her eyes spoke of how much she’d been through and showed a certain resignation. They were the eyes of those without rights, who consider having an attended birth the greatest privilege imaginable and go through a world of hardship to get it.

Seventeen years old. Seventeen years old, and, as I found out later, she’d already given birth seven times. This was her eighth birth; she was a girl who had become a woman and a mother at once and much too young. This girl, already a mother seven times over, but with only three children still living, took the long, slow boat trip. She went alone to an unfamiliar village, leaving her three children at home, and trusting those who told her that she’d find a bed and a meal for her in a faraway place. She’s doing well now, but I know Sierra Leone and our efforts there start with not just recognizing the rights of adolescent girls, but convincing the girls themselves that they have rights.” (Francesca Tognon, doctor, public health expert)

Leaving no one behind

We work every day in seven countries in sub-Saharan Africa. And every day we see women come into our health centers, having traveled many hours over great distances to seek safe childbirth in expert hands. Many are young or very young, girls under twenty who already have several pregnancies and births behind them. Consider that in countries like Mozambique, most marriages and pregnancies, 48%, take place between 15 and 19 years old, or that in South Sudan, child marriage even reaches 52%.

Given this situation, in 2010, a Global Strategy launched by the Secretary-General of the United Nations urged attention to the health and wellbeing of adolescents. Leaving no one behind - this is the commitment we have made for the coming years to close the gap between the global north and south, and often between areas of one country and at least diminish the inequalities.

Taking care of adolescents: from diseases of poverty to early pregnancy

Talking about adolescents has become a necessity and a true investment for a healthy, sustainable future. Adolescents make up a significant portion of society; there are 1.8 billion adolescents out of the world population of about 7.3 billion, and 600 million are girls. And their share is set to grow. It is forecast to rise from 18% in 2012 to 28% in 2040. But over half of the world’s adolescents, about one billion people, are estimated to live in limited resource countries, which increases the risk of being exposed to “diseases of poverty,” such as malnutrition and HIV/AIDS. In the case of young women, tied to a lack of sex education, there is also the risk of early pregnancy with consequences lasting the entire lifetime of the young mothers. In the words of Doctor with Africa CUAMM’s Director, Don Dante Carraro:

“We believe in the significance of safe motherhood, which means assistance throughout pregnancy, and it also means awareness. This is why we are working in seven countries in sub-Saharan Africa in order to raise awareness and provide HIV tests not only for future mothers, but for as many young people as possible to stop the virus from continuing to compromise the lives of thousands. Young women’s lack of awareness of their rights can expose them to violence and often to pregnancies in adolescence.”

CUAMM with adolescents in Sub-Saharan Africa

Because we understand the importance of this “vulnerable” part of the population, we make women, children, and adolescents the focus of our action. Our primary objectives are health education with special attention to sexual and reproductive health, providing pre- and post-natal visits and educating about contraception and HIV prevention. An excellent example is CUAMM’s work in Mozambique where clinics were founded specifically for youth and adolescents, called SAAJs: Servicios Amigos dos Adolescentes, which provide consulting on reproductive health, pregnancy, and HIV prevention.

Providing a service that goes beyond just treatment to include information and awareness raising is essential in a country that is high in the rankings of very young marriages (14% have not yet turned 14). The data collected show that out of the 8,300 girls who came to the SAAJs in Beira last year, 37% were pregnant.

In most countries where we work, there is a very high percentage of child marriage, which is tied to early pregnancies. When the body isn’t ready to handle a pregnancy yet, risks rise dramatically. The data collected by Doctors with Africa CUAMM in 2016 showed that most neonatal deaths were the children of teenage girls. The numbers for 2016 show this: in the Yrol Hospital in South Sudan, adolescent women (15–19 years old) were 20% of the total of the pregnant women who came to the hospital, 87% of neonatal deaths were children of adolescent girls; only one adolescent mother out of three had had at least one prenatal visit before the birth, and only 1 in 3 had a postnatal visit. The situation is similar in the other countries as well. This is where CUAMM acts to support the most vulnerable people, first providing assistance for safe childbirth and giving information and raising awareness in the communities about the importance of prenatal visits and attended childbirth.

For this reason, Doctors with Africa CUAMM not only provides treatment and care in different settings, including “maternity waiting homes”, where in the final weeks of pregnancy women come and wait for birth with the assurance of being assisted, helping to prevent complications. For instance, in South Sudan, our maternity waiting home received over 100 girls in 2016, preventing possible complications. A transport service was established for those who live far away to make it easy to use the service.

A commitment for future generations

Taking care of adolescent girls means acting on many levels, including social, health, and family spheres. This is the challenge set by international agendas and one that Doctors with Africa CUAMM has made its own. Recently in New York, we proved this once again at the conference Leaving No One Behind. Healthy Adolescents: Smart, Connected, Sustainable Practices, organized by Doctors with Africa CUAMM on March 23, 2017, at the headquarters of the United Nations, in partnership with Italy, Mozambique and Canada’s Permanent Missions. The conference was a chance for professional meeting and dialogue within the 61st Commission on the Status of Women and a chance to consider a vulnerable part of the population. Internationally prominent figures were involved, such as Zainab Hawa Bangura, a women’s rights activist and former Minster of Health in Sierra Leone, currently Special Representative for the UN’s Secretary-General on Sexual Violence in Conflict.

Investing in the health and wellbeing of adolescents lays the foundations for the health of society in future generations.

Doctors with Africa CUAMM
Doctors with Africa CUAMM was the first NGO working in the international health field to be recognized in Italy and is the largest Italian organization for the promotion and protection of health in Africa. Since 1950, we have been working to support the most vulnerable parts of the population with treatment and prevention programs. In villages, health centers, and hospitals, Doctors with Africa CUAMM develops long-term health projects, connecting different levels of care (community, i.e. villages; primary health centers where only basic services are provided; and hospitals, where complications can be managed to bring health to the remotest corners of Africa.

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