SCANDINAVIAN GENDER ROLES

By Yvonne Bekeny in Finland
Gender equality in the Scandinavian countries is a given and manifest reality in almost all aspects of socio-political and economic life in that part of Europe. Family policies are gender sensitive oriented and parenthood policies are instituted such that gender relations are significant at least on the symbolic level. The extent to which this happens in actual sharing of tasks between mothers and fathers is still a question to be researched? Child rights including the rights to provision and care by both parents have been instituted. Scandinavian policies have undergone changes over the years to ensure fathers opportunities to take care of their families (Eydal, B. 2008). Although the mother is ‘the primary parent…the father can be a visiting care assistant’ (Lammi-Taskula in Ellingsater & Leira, 2006). Transferring part of parental leave is negotiated by the parents with no explicit suggestion to change the status-quo of gender relations. The mother’s primacy in childcare remains unchanged. Norway, Sweden and Iceland, have a more clear-cut orientation in promoting father care and roles sharing between women and men in infant care. Lammi-Taskula states tht ‘Finland and Denmark on the other hand have vague positions in striving for gender equality in promoting father care’ (Lammi-Taskula in Ellingsater & Leira, 2006). Fathers take only a small portion of the whole parental leave period in all Scandinavian countries. Nonetheless, these gender balanced duties seem to be conditioned by socio-economic factors in the countries rather than by policy claims. There is a variation within the countries themselves and within the nature of employees; white-collar, blue-collar, minority, well-educated parents all have different views about sharing of duties equally over childcare. Lammi-Taskula maintains that “for large numbers of Nordic parents, unverified assumptions…about economic consequences of equal sharing of parental leave as well as cultural conceptions of gender and parenthood, especially motherhood, hamper negotiations both in the family and in the work place. Unreflected, unequal gender relations are naturalised and remain unchallenged” (Lammi-Taskalu in Ellingsater 2006).
These observations raise questions of the nature and limits to gender equality that the Scandinavian countries can declare. This idea is even more illustrated in the Norwegian context where parental leave arrangements are usually classified as policies enhancing gender equality. However, parental leave can be ambiguous with regard to gender equality objective, both regarding policy rationale and policy impact (Ellingsater in Ellingsater & Leira 2006). National variations of parental leave arrangements actually reflect different purposes, and generally are geared towards encouraging women to stay at home and promoting gender equality by supporting mother’s employment rather than shared responsibility in childcare. This idea is further substantiated by Boje (2006) who posits that even if mothers in all Scandinavian countries have taken up employment in large numbers, the traditionally gendered pattern of responsibility for child care remains in the large majority of families. In his article, he observes that although Denmark and Sweden seem to have the most equal division of caring responsibilities, even ‘the strong political commitment to equality has not fundamentally changed the gendered division of childcare. ‘Progressive and women friendly policies concerning work and family might modify the prevailing gender order but more profound changes can only be accomplished through comprehensive changes in norms and values concerning gender roles ( Boje in Ellingsater & Leira, 2006). Hence, looking at the above analysis it can be said that the question of gender roles in childcare in the Scandinavia is almost still a myth and in as much as the state would want to achieve gender equality in almost all spheres of life, the issue of gender equality in childcare is still a challenge to these states. Eydal (2008) remarks that if this myth could become a reality pretty soon, the new generation of children born in the family where both parents take care of children, will be the ones to break the vicious cycle of gender inequality.

Gender Training Workshop 2009

By James Achanyi-Fontem
Coordinator-WABA Men’s Initiative
Email: camlink99@gmail.com
The 5th annual WABA-FIAN joint gender training workshop takes place in New Delhi, India from the 6th to 9th July 2009. The training will be delivered by two experts in gender promotion strategies from India and Malaysia, Renu Khanna and Paul Sinnappan.
The joint training workshop aims at enabling some 25 advocates from the breastfeeding and food rights networks to raise awareness and sensitivity on gender issues. Resource persons for lectures and conducting exchange sessions will focus on the gender challenges to breastfeeding and food rights issues. WABA and IBFAN have supported the participation of 12 persons involved in the breastfeeding protection, promotion and support movement.
The World Alliance for Breastfeeding Action, WABA and the Food First Information and Action Network, FIAN, expect the participants to be well sensitized on the concept of gender and gender mainstreaming, after equipping them with tools and skills of gender analysis by the end of the course. The course participants should be able to enable others in their respective regions and countries to develop gender analysis of breastfeeding and rights to adequate food after the training.
This will be realized through the application of gender concepts and tools, and the development of gender sensitive strategies and work plans. Within the context of the training, participants are expected to be able to differentiate between sex and gender, recall dimensions of gender as a system, enumerate and list gender aspects of breastfeeding and rights to adequate food. The men and women should be able to list men’s role and responsibilities in appropriate infant feeding and promotion of rights to adequate food by the end of the training.
Themes to be treated within the week-long workshop include gender and sex, gender as a system, gender aspects of breastfeeding and rights to adequate food, gender analysis frameworks, economic and political contexts of women, men’s involvement, role and responsibilities, gender mainstreaming and gender indicators.
The participatory training methodologies include exercises, games, group discussions and presentations, role plays, experience sharing by participants and others. While Renu Khanna has a Master’s degree in Business Administration from the faculty of management studies from Delhi University, India with over 25 years of experience in health care management and organization development in health organizations, Paul Sinnappan has for the past 10 years been involved in conducting gender training for men in the credit unions, cooperatives, micro credit programmes and non-governmental organizations, NGOs, in Malaysia and South East Asia.
The joint WABA-FIAN gender training workshop initiative began with the introduction of gender concerns by the donor agency, the Canadian Cooperative Association, CCA. Since then, the International Cooperative Association, ICA; the Asian Confederation of Credit Unions, ACCU, and the Asian Women in Cooperative Development Forum, AWCF have become partners in the process of integrating gender in cooperatives in Asia and Pacific region.
The joint WABA-FIAN gender workshop initiative started in 2004. Other resource persons for the training are Flavio Valente of FIAN International from Heldelberg, Germany and Laskshmi Menon from the Association for consumers’ Action on Safety and Health Centre, ACASH, in Mumbai, India. Lakshmi is a consultant to WABA and was also the former co-coordinator of WABA’s Gender Working Group.
WABA’s gender programme goals include:
1. The promotion of gender awareness among breastfeeding advocates and mainstreaming of the gender perspective in breastfeeding advocacy and programmes.
2. The promotion of collaboration between the breastfeeding movement and the women’s movement, in order to strengthen the common advocacy goals of both movements; and to undertake joint advocacy, education and training on women’s rights, health and breastfeeding.
3. To increase participation of men in domestic work, child care and provide breastfeeding support, to raise men’s awareness on women’s rights and reproductive health issues. For more information, click on www.waba.org.my

Gender Equality Promotion

Strategies for Promoting Gender Equity in Developing Countries:
Lessons, Challenges and Opportunities
By James Achanyi-Fontem, Director of Publication, Cameroon Link,
Email: camlink99@gmail.com

Gender Equality Situation Analysis

Women are key to the development challenge. Throughout the developing world, women are at a disadvantage at household, community and societal levels. Within the household, women have less access to and control over resources and limited influence over household decisions. Beyond the household, women have limited access to communal resources, are under-represented in public decision-making bodies; have limited bargaining power in markets and often lack opportunities to improve their socioeconomic position. Therefore, efforts to reduce gender inequality are required on multiple fronts.
Gender mainstreaming has been associated with more failures than successes. While there have been some positive gains to gender equity in the thirteen years since the adoption of the Beijing platform of action, a number of factors - including the challenging policy environment within which gender mainstreaming processes operate, inadequate resources allocated to this work, institutional features that have blocked change, and the way in which gender mainstreaming processes have been implemented contributed to the overall failure of gender mainstreaming,
While advocates of gender mainstreaming envisioned both institutional and social transformation, in practice, bureaucracies have not proven to be effective agents of social transformation, Gender equity should be pursued in creative ways through the elimination ongoing feminization of poverty in the global economy as women workers constitute the driving labour behind export production and rural-urban migration.
The next step will be the scaling up of transformative programming to create a larger global movement, involving non-governmental, multi-lateral bodies, and donors, in order to create a forum for sharing knowledge of male-oriented programming and gender equality. Several remaining challenges include extreme poverty, lack of interest in fighting for gender equality, and bureaucratic hurdles to participating in the political process.
A larger conceptual frame work is needed, which links empowerment, rights and mainstreaming in all social spaces in order to advance the discourse on gender relations and achieve greater gender equality. Considering the realities of women’s , men’s and children’s daily lives in a developing country context, where gender relations are influenced by poverty, insecurity, impunity and patriarchy is also important.

Setting the context

The evolution of the main approaches to confront gender inequality is similar when women in development (WID) with gender and development (GAD) are compared, especially as each approach arose in a different historical context. How development strategies in general and strategies to promote gender equality in particular have evolved depend very much on the limitations and opportunities available at different points in time.
At one time, there was a desire among development practitioners to find a different model for promoting gender equity that encompass a broader, more multicultural approach and one that took men into account. At the same time from 1975 to 1985, women’s organizational capacity around the globe had increased dramatically, bringing a new set of voices from the developing world into the debate. Women’s groups developed their own projects, and were backed by various international donor agencies, including many private foundations. This explains how GAD came about as women’s activism was becoming an international force in response to a very different set of challenges and opportunities.
The projects and programs initiated under the GAD label were not all that different from earlier WID efforts. Women-specific projects usually seen as WID inspired, remained following the shift to GAD, in part because many cultures separate women’s and men’s activities. Gender mainstreaming was promoted as likely to be much more effective than the women-specific projects and WID offices associated with the WID approach.
Some advocates felt that mainstreaming could marginalize women’s programs and that disbanding gender units within donor agencies risked losing the ability to keep a focus on gender within aid bureaucracies. Moving beyond the WID-GAD enabled advocates to devise creative ways to promote gender equity, instead of simply responding to current trends.
Whether private firms can be influenced by gender equity considerations depends on local contexts and the particular role of civil society organizations and increasingly gender-sensitive legal systems. Unfortunately, civil society organizations are no longer perceived as representing grassroots energies.
In the major trend, it is believed that the new emphasis on climate change may create opportunities for environmental feminism to advance, while third trend has been the shift from the redistribution politics to identity politics, which has caused academic feminists, pays less attention to equality.
Grounded in feminist theoretical frameworks and intended to make mainstream institutions agents of social change, gender mainstreaming, refers to a wide set of strategies and processes. The Economic and Social Council of the United Nations (ECOSOC) defines gender mainstreaming as the process of accessing the implications for women and men of any planned action, including legislation, policies or programs in any areas and at all levels. The strategies of making women’s as well as men’s concerns and experiences an integral dimension of the design, implementation, monitoring and evaluation of the policies and programs in all political, economical and societal spheres, so that men and women benefit equally, but that the goal of gender mainstreaming is gender equality.
Gender mainstreaming is neither a clear agenda for institutional transformation nor a clear agenda for gender transformation and social change. In practice, gender mainstreaming has often involved adopting a gender policy, creating a gender unit to work on organizational programs, mandatory gender training and increasing the number of women staff and managers. In the worst case, gender mainstreaming has been used to stop funding for women’s empowerment work, and to dismantle many of the institutional mechanisms such as women’s units and advisors created to promote women in development in the name of integration.
In some regions like Africa, women have made striking gains in elections to local and national government bodies, as well as in entering public institutions. Girls’ access to primary education has improved and women are increasingly entering the labour force. Access to contraception has also become much more widespread and violence against women has been recognized as a human rights issue and has been made a crime in many countries.
Decreased government spending on social sectors, tightened macroeconomic and fiscal policies, privatization of state owned enterprises and basic services, and liberalized trade are some aspects of the policy environment that have had harmful effects on women. Government reform efforts have focused on administrative and fiscal reforms while neglecting to consider ways in which institutions can better support poor women and address accountability failures. With regard to resources, investment in women has been the lowest priority.
In terms of implementation, gender mainstreaming efforts such as gender training, organizational development efforts and planning for gender equality often have no clear connection to change that is meant to occur on the ground. Until now, strategies to promote gender have accommodated to institutional cultures and agendas, which are uneasy with notions of social transformation.
Some instrumentalized strategies are gender equality objectives broken down into advocacy for girls’ education due to the link with fertility reduction and micro-credit schemes targeted towards women due to the high development payoff. During the execution these programs, the fundamental feminist vision of social transformation is not very clear. It is necessary that gender advocates should frame mainstreaming objectives in practical terms in consideration of the strengths and weaknesses of particular kinds of bureaucracies. Another challenge is measuring progress. Tracking relative contributions to different goals within the same project is difficult, and it requires social impact analysis during the design phase of the project and sophisticated tracking mechanisms and gender disaggregated data to examine program impact. The way forward is to get a range of diverse strategies all termed gender mainstreaming including policy reform, advocacy, capacity building, analytical frameworks, and program development and monitoring systems to be disaggregated and analyzed in terms of their particular gains and failures. This would facilitate strategic thinking about what particular institutions are well positioned to accomplish and what they can be held accountable for. Civil society including women’s organizations and networks should be motivated to work for change, if commitments have to be achieved.

New Avenues for Change

The global economy has produced not only the feminization of poverty, but the “feminization of working poverty“. Though more women participate in today’s workforce, the great majority occupies low-status jobs and is unable to lift themselves out of poverty. More women take jobs in the informal economy that lacks job security, benefits or protection. Around the globe, women are working in export processing sites, as domestic workers, as street vendors or as suppliers at the bottom of a multinational supply chain.
With this situation, grassroots strategies are needed to address problems related to the fact that women are used as a source of cheap labour as part of an economic development strategy, while labour standards around the world are declining. International migration is another economic development strategy that has implications for women. Offering cheap labour as an anti-poverty strategy is insufficient to generate economic growth.
Women often leave their families to become domestic workers abroad, leading to the breakdown of the family and other social problems. International migration can also be detrimental for the women who migrate. This can be addressed by encouraging them to become part of the labour movement, because this allows women workers to monitor the conditions of their own workplaces and make sure people are being treated fairly.
Global networks give women more power to negotiate contracts with their employers. It is important to include men when addressing concerns of women in the global labour markets. In particular, men can play an important role in addressing the sexual exploitation of women. Truck drivers in Cameroon are taught about HIV/AIDS in conjunction with groups like the Women’s Gender Empowerment Councils in Bonaberi-Douala. These truck drivers drive across the Chad and Central Africa Republic borders, have different sexual partners or engage in other risky behaviour.
An alternative solution is the engagement of men around issues of reproductive health and gender equality. Men as Partners (MAP) works as increase men’s awareness of reproductive health issues and increase men’s support for their partner’s reproductive health decision. This can also stimulate men to take active stand for gender equality and against gender=based violence.
This is because there is a clear mandate around the need to work with men and boys to achieve gender equality that has been recognized by numerous international conferences and declarations and supported by women’s organisations and the women’s movement. One of the main driving factors of this mandate is the recognition of how gender inequalities fuel the HIV/AIDS epidemic.
Men are conceived of in some positive ways as financially independent, providers, husbands and fathers, but there are also negative and harmful messages about what it means to be a man. These include withholding emotions, exerting power, using violence, not asking for help, having multiple sexual partners, risking taking, substance abuse, violence, misogyny and homophobia.
Increased political, economic and religious fundamentalism has lead to the development of rigid norms of expected male and female behaviour. The concept of working with men and boys is to question some of the more detrimental constructs of masculinity and explore alternative attitudes and actions.
Men with more traditional concepts of masculinity are shown to be more likely to report physical violence towards female partners, to be involved in delinquency, to have a higher number of sexual partners, to experience sexually transmitted infections and to use and abuse alcohol and drug.
However, these traditional and harmful constructs of masculinity can be challenged and replaced with alternative models, which promote equality and lead to improvements in health for both men and women.
Another angle is the gender-neutral programming, which is common in large-scale HIV prevention programs. These programs promote HIV prevention, but unfortunately make no room for a discussion of how abstinence, monogamy and safe sex are experienced differently by men and women and the realities of men and women’s lives in a cultural context.
On the other hand, gender-sensitive programming, takes into account that men and women have different realities and that different strategies are often required reaching men and women. Gender-sensitive programming often includes design features that make services more male-friendly.
Transformative programming takes on negative societal messages about what it means to be male and female, and challenges those in an attempt to create a more equitable society, which supports healthier behaviours in the future. Challenging the direct cause of gender inequality, harmful gender socialization, makes it possible to address the spectrum of health issues, including gender-based violence, HIV, reproductive health, family planning, men’s role in maternal health, issues of fatherhood and care-giving, and issues of violence.
MAP’s programs consistently ask men to talk about equitable relationships and men’s role in promoting gender equality and challenge men to create a new masculinity that involves taking a stand against gender based violence in the community. Most programs have focused on reaching out to men individually or in small, intensive group settings, forcing them to consider what it means to be male and how notions of masculinity may have a negative impact on their societies. These strategies have been successful in changing individual attitudes, knowledge and behaviours and the next step would be to expand to the societal level, where there can be a greater, more sustainable impact on gender socialization.
Transformative programs on gender equality should move beyond the workshop approach to support men when they return to a patriarchal society where there is often not sufficient support for new concepts and constructions of masculinity. Community action teams led by men who have been through the workshops should be put in place to go out and communicate and engage in community activism around gender issues.
A clear challenge of taking this work to scale is building the capacity of organizations and social institutions in order tom attain sustainability. Individuals must confront their own issues concerning gender and identity before they can challenge the broader social situation. This requires significant time, effort and support.
Gender programming at the health level is focused on improving the quality of services and making them more accessible to men. This requires large scale media campaigns and new or reformed policies and legislation. The public sector should be engaged with increased funding to promote gender equality.
It is through the involvement of the public sector that more work will be done to address the broad socioeconomic conditions that can influence men and their behaviours. If men are unable to provide for their families, they may feel disempowered in their role as men and resort to some of the more harmful constructs of masculinity, which include dominance over women, use of violence and risk-taking behaviours.
Many men who have gone through critical reflections of gender have come out on the other side espousing more gender progressive attitudes, and engaging in more protective behaviours. Networks that bring together various organizations, such as non governmental, multi-lateral bodies, and donors create a forum for sharing knowledge of male-oriented programming and gender equality.
Action plans should be conceived which incorporate elements like women’s empowerment, strengthening productive capacity of women and supporting women’s psychological, social and reproductive health. These efforts get women feel more encouraged to speak and voice their opinions.
Previously, women were engaged in domestic activities, which were unremunerated. Women’s productive activities have generated new sources of income, which have increased women’s economic autonomy. Cameroon Link has trained women to speak out against domestic violence and assisted women who suffered from abuse.
Before this training, women were less interested in the politics of the community than in having their basic needs met. Only after women’s basic needs are addressed does the organization introduce other themes such as community participation. Productive activities of women are done with respect to the cultural identity of Cameroon, which is Africa in miniature, drawing on indigenous knowledge.

The Way Forward Gender Equality Promotion

The way forward is to work out a larger conceptual frame that includes empowerment, rights and mainstreaming in all social spaces, putting into consideration the realities of women’s, men’s and children’s daily lives. It should be noted that, in the developing country context like Cameroon, gender relations are influenced by poverty, insecurity, impunity and patriarchy. As such, achieving gender equity requires a stronger and diverse but unified voice for change; greater accountability and increased, targeted resources.
Currently, the accountability framework consists of several agreements at the global level, such as the Convention on the Elimination of All Forms of Discrimination against Women, the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa, the Beijing Platform for Action, the Millennium Development Goals and the Universal Declaration of Human Rights.
Other the other hand, gender equality is not just related to human rights, but also women’s empowerment and specific measures are needed to respond to existing inequality and to champion the empowerment of women in order to increase women’s opportunities and capabilities. Women’s empowerment also requires mainstreaming the gender equality agenda in institutions and processes in a way that transforms social values that have sustained gender inequality.

Challenges
Development Approaches

This tends to separate development issues from concerns over investment, foreign policy and security. Current development approaches are increasingly top-down, focusing on policies, institutions, and processes, without an adequate focus on community empowerment and social movements and as such do not have a large impact on people’s everyday lives. The centralization of power and resources has negative implications with respect to gender equality, because in the parliament, government cabinet, chief courts or among elders of the clan, where power is defined and decisions are made, there is a dearth of women’s participation.

Limited access to resources

Gender equality requires equal access to services and infrastructure such as roads, electricity, water, and communication tools. Without access to such resources, women with tremendous knowledge and skills, expertise and passion are not given an outlet to use their knowledge and skills, keeping them at a disadvantage. Technological tools enable women to use their time, energy and expertise more efficiently.

Poverty, Violence, Disease & Patriarchy

Gender equality cannot be achieved as long as women live in insecure environments, whether due to an abusive partner, militia or a threatening neighbour. It is important that development practitioners should shift focus from poverty reduction to wealth creation. By focusing on poverty reduction, women are viewed as subjects of poverty rather than as producers and generators of wealth. Women’s arts and crafts should be adequately valued as a reflection of their knowledge and skill.
The governments should offer support to women for their role as caregivers and nurturer, rather than treating them as subsidy providers for basic social services such as health. All women, whether rich, poor, working or housewives should participate in decision making spaces, academic and research institutions, advocacy and public awareness initiatives, political debates, the private sector and within households as a collective voice for change.
The voice of leadership at international and national level is also needed to call for greater investment in gender equality and women’s empowerment. Advocates of gender equality must seek greater accountability through legislative and policy strengthening; reform and harmonization, resources and an end to impunity; political governance and greater private sector investment and responsibility.
More public resources are needed to make strategies to promote gender equality successful. Mobilizing greater resources for gender equality requires a system of taxation that does not overburden the poor and gender-responsive budgeting. From all that has been said, it is understood that the fight for greater gender equality is strong and women simply need proper mechanisms for financing their initiatives for equality and rights.

Gender Sensitivity Guidelines

The World Alliance for Breastfeeding Action, WABA has designed guidelines for Gender sensitive materials, that can be used for advocacy and communications. Make use of them and give us your feedback.
1. Statements/recommendations should be broad to cover all women, whenever relevant. Use the term "woman" rather "mother", unless the context is specific to a mother. Eg. All women are entitled to good nutrition. Unless you want to make a specific point that pregnant and breastfeeding mothers in particular need additional nutrition and support.

2. Use gender neutral terms like "humankind" or "humanity" rather than "mankind." Avoid references to bis. Use s/he, for example. This point is even more relevant in Latin based languages as most nouns are gendered, masculine and feminine. Use the plural form when it is ungendered.

3. The content should always respect women's basic rights to food, health, security, development, personal integrity, informed decisions and other rights spelt out in the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and other international instruments. There can be cultural sensitivities to issues around women's right to sexuality and reproductive rights, although W ABA ' s Gender WG stand is that aIl women' s rights in CEDAW, the International Conference on Population and Development (ICPD) and Beijing Platform of Action should be protected and supported.

4. Consider the woman's situation (context, background) when "making demands on her" –eg. avoid using words like "should", "must", "ought to". General remarks like "Women should breastfeed" can be seen as insensitive if their situation, which prevents them from breastfeeding, is not considered. Rather talk about supporting women to breastfeed.

5. Avoid stereotypical portrayal of men and women in terms of social beliefs, norms of expected behaviour, sexual division of labour, access and control to resources decision making and power differentials. Note this especially in illustrations (images, photographs, etc).

6. Are the messages in the materials directed only to women or also to men? Where relevant, ensure that the messages also address men as a means to ensure their involvement and to recognize their rights and responsibilities. Being gender sensitive means that you recognize the entitlements, roIes and responsibilities ofboth men and women.

7. Ensure that we don't only talk about the father when we refer to men's role in chld care and domestic work. With changing family structures, the men involved can be a partner, friend, brother, etc. and not just the husband or father of the child.

The World Alliance for Breastfeeding Action (WABA) is a global network of individuals and organisations concerned with the protection, promotion and support of breastfeeding worldwide based on the Innocenti Declaration, the Ten Links for Nurturing the Future and the WHO/UNICEF Global Strategy for Infant and Young Child Feeding. Its core partners are IBFAN, LLLI, ILCA, Wellstart International and ABM. WABA is in consultative status with UNICEF and an NGO in Special Consultative Status with the Economic and Social Council of the United Nations (ECOSOC).

Maternal Health Protection

Maternal Care In Emergencies
By James Achanyi-Fontem
Pregnancy-related problems that women face are many, and, in most cases, unpredictable. Some of them lead to death or permanent injury. Social, political or economic factors should not be allowed to deny a woman her fundamental right for a healthy pregnancy and childbirth. Reducing maternal deaths is therefore a matter of rights and an urgent priority. That is why every family needs to be encouraged to make savings in advance preparation for emergencies. Fortunately, modern medicine has the capacity to handle most of the problems in health facilities.
Both mother and baby stand to benefit from treatment at a health facility. Some treatments at the prenatal stage have the benefit of preventing children from being born with complications and defects. In the home delivery story presented here, the placenta retention could have resulted in death.
Zinkeng got married and soon became pregnant, but did not go for pre-natal consultations in a health facility as one would expect and at the ninth month labour started at home. She was delivered by a traditional birth attendant successfully to a baby boy but the placenta did not come out thereby causing bleeding profusely. The Traditional Birth Attendant (TBA), accuses Zinkeng of infidelity, believing that this is the reason the clan gods and ancestors are bringing punishment on her by causing the placenta to be retained. This belief is common in most Cameroon rural traditional communities. Fears of infidelity are usually confirmed by divination. When the placenta is retained, there is no other verdict but guilt.
During a routine visit, a community health nurse comes across Zinkeng and her intervention saves her life. Subsequently, the nurse advises the traditional birth attendant and Zinkeng’s mother on the importance of antenatal and postnatal care, insisting that even though they risked denying Zinkeng the essential prenatal care, she must receive postnatal care.
During labour, Zinkeng cried out her sufferings and asked that she should be taken to the hospital, but the mother-in-law told her that it was no hospital matter. She asked her to confess her unfaithfulness to her son, and the placenta will come out. In her words, “You certainly know that our gods hate infidelity on the part of a woman.”
Sounding angry, feeble, and sobbing, Zinkeng replied that “I have not been unfaithful to your son. Which man in this community have you ever seen me with? I’m not a rotten woman. Please, stop ruining my good name and take me to hospital before I bleed to death.” By the tradition of some of these less educated parents, there is not justification but the fact that retaining the placenta clearly confirms her unfaithfulness.
The nurse had asked the expectant mother, Zinkeng, be taken to the hospital immediately there are any signs of labour, but the mother-in-law, who is a TBA would not heed to the advice, because according to her, she is a qualified TBA. But the nurse asked her to say, what was needed now that the baby is born, but the placenta was retained.
The TBA did not know what to say. And the nurse added that this is where there is a difference. The problem has nothing to do with infidelity. The nurse decides to help Zinkeng suckle her baby but the TBA refused, protesting vehemently, “No, no, no! We can’t suckle the baby boy on the first milk (colostrums). It’s bitter milk and the colour is not good.”
The TBA added that it had to be expressed and thrown away to allow fresh, clean milk to form, which is the good for sucking milk. Apart from that, both mother and baby should be bathe first, she went on.
The nurse realising how ignorant the TBA was, started explaining that the first milk that mothers in the village term bitter milk is the best for the baby. It is God’s own immunization against diseases. She invited the TBA and other relative present to just watch her!
As the TBA continued her vehement protest, the nurse told her of the Chinese proverb, that “One who says that a thing cannot be done should not interrupt the one doing it. You see how vigorously the baby is sucking? Now, hold the placenta and pull it gently and let’s see what happens.”
As the placenta came out, the TBA was surprised and a reluctantly said, Hmmm … With a sigh of relief, Zinkeng said, “Thanks, nurse!” Where diviners were ruining my life, reputation and marriage, you came to mend my soul and preserve my chastity.
The nurse on her part said, “Let all thanks go to God.” Zinkeng reported later that she was feeling dizzy and the nurse told her that with so much loss of blood, it was natural to feel dizzy. She was told to drink a lot of fluids and that a meat-based broth would be good, because she also needed iron.
Zinkeng was immediately taken to a health facility and was told not to get out bed until she felt better. Those who went visiting move away to talk about other matters and to give the new mother time to rest, as they arranged for transportation to the health facility.
What really happened?
When the nipple is stimulated through the sucking, it produces a substance in the body, a hormone called oxytocin. This hormone causes the muscles of the woman's uterus – the bag where the baby was growing – to tighten and contract. When the uterus tightens like this, it helps the placenta to separate from the uterus so that it can come out as it should.
The mother of the Zinkeng did not take the daughter to the hospital as advised because the labour took them by surprise. If she had been attending a health facility regularly, healthcare providers would have been able to figure out her due date, an estimate of the day her baby would be born. Most babies are born within two weeks before or after their due date. The labour wouldn’t have taken them by surprise.
The partner needed to put aside some fund for pre-natal, post-natal and emergencies. He did not secure any funds for the above. The role of TBAs is very important within the communities, but some of the complications of pregnancy and childbirth cannot be handled by Traditional Birth Attendants! Only health facilities have the necessary tools to handle most complicated situations.
Postnatal Care
Here’s what happens with prenatal visits. At a woman’s first prenatal care visit, healthcare providers counsel her on the importance of proper nutrition, diet, and exercise. They ask the woman about her health and her partner’s health; they identify any medical problems; they weigh her and check her blood pressure, and they check a urine sample for infection. The Traditional Birth Attendant cannot take these precautions.
Postnatal care is equally important in ensuring good health for mother and child. In the first few days after delivery, when her breasts begin to produce milk, she can have engorged or swollen breasts if care is not taken. She’ll also need to know how to prevent cracked nipples. There is a lot to know about. Simply let the mother access the nearest health facility.
Later Prenatal Visits
In later prenatal visits, the health providers measure the woman’s belly to see how the baby is growing; they check her hands, feet and face for swelling; they listen to the baby’s heartbeat; later on, they feel her abdomen to assess the baby’s position. They also ask the woman if she has any other personal concerns bothering her.
For more information, write to camlink99@gmail.com or click on the following link- http://cameroonlink.blogspot.com

Antenatal & Postnatal Bank

Antenatal & Postnatal Bank
The need to save money for antenatal and postnatal care
By James Achanyi-Fontem, Cameroon Link
The people of Bangwa in the south west region of Cameroon observe specific gender roles. Roles such as pounding in a mortar, grinding on a stone, fetching water and gathering firewood are considered feminine roles, if it is not milling palm oil or tapping palm wine. A man seen performing any of the above roles is mocked as being tied to the apron strings of his wife. It is in light of this that Pa Ndi, coming across her son pounding fufu, feels disgusted. She raises the alarm, attracting neighbours down the hills to the scene. The Assemblyman of the area steps in to calm the situation, and takes the opportunity to advise Atemnkeng and his wife Abangawoh to save money in preparation for the woman’s maternity needs.
What has not been found out is why some traditional customs frown on a male pounding, especially as food is food\and when it is consumed; it turns into the persons who eat it. Kinsmen and women, neighbours of Bangwa Community who were invited to come and witness the scene described it as an abomination of the century. Atemnkeng and his newly married wife, Abangawoh were echoed as having exchanged sexes, he now the he-woman pounding fufu, and she the she-man being the director of kitchen business.
On the other hand, these young educated persons take the scandal by their parent as an embarrassment. Abangawoh tries to learn from her mother, what they have done to warrant the community’s embarrassment? She knows that their village regards pounding, grinding, and carrying of firewood as feminine roles, and the biological mother, sniffed her out doing the unexpected. Though educated, Abangawoh see the embarrassment as a betrayal.
Many were driven to the scene by curiosity, though they knew that it was risky following a mob. Everyone wanted to see things for themselves. Atemnkeng’s mother caught him pants down, pounding fufu for his new bride, Abangawoh. She was mad that her daughter-in-law is subjecting her son to what she sees as a feminine role.
Apart from the young couple that did not see anything wrong in sharing roles, every other persons in the village believed the old lady was totally right. Some described the scene as a bad precedent well and that soon their wives will begin to order them about. They will not only have to pound fufu, but grind millet while humming a song – the men will have to go to the bush for firewood.
As the taboo spread, a community health worker arrived to address the crowd: “My dear fathers, mothers, brothers, and sisters, it is good community spirit to respond spontaneously to alarms. But this particular call is not a call of distress. It’s a slight domestic affair, requiring exclusive family settlement.” It was with these simple terms that the community counsellor invited the crowd to retire to their activities and leave the rest to him. Pa Ndi, Atemnkeng and Abangawoh were left alone.
The community counsellor told the three that because of the generation gap, the youth and older neighbours sometimes misunderstand one another, but that such misunderstanding could still seek a remedy.
He added that dialogue solves misunderstandings better than tears. No one should have told the couple that sobbing is uncharacteristic of Bangwa men. Abangawoh rather proved to be more hardened because she did not wail.
The counsellor added that, if spouses are not willing to show flexibility to each other, their marriage won’t hold. He advised that in any relationship as intimate as marriage, there must be sharing of responsibilities.
In most cases, it is difficult to settle a conflict without an intruder in African context. As the dialogue continued, an enlightened female counsellor came in and did not allow the story to be reported. She got part of it while going to the market and decided to visit the family of Pa Ndi. She told them that the days are gone when women had no voices. The dominating attitude of men must change, and bring women too into decision-making processes.
This is when Abangawoh came in with her explanation: “Your counselling said it all. Guided by it, we shared responsibility for pounding fufu, each according to his ability, for the entire family. My husband has the energy to pound, and I the skill to shape the result in the mortar. Which of the two roles is more risky? What if the pestle crushed my fingers? I would have only one hand left for the rest of my life. How would I live in a community like …
African village communities are very fussy about gender roles, but it is difficult to find any roles that women can play that men can’t, except women’s biological role of carrying a baby in the womb, which is God-given. It is important for couples to learn that people do not have to interfere too much in others’ marital affairs.
Though Abangawoh lauded the advice of the counsellor who did a good thing advising her husband to do what most men do not do in their community, which is sharing responsibilities with the spouse, she used the opportunity to ask for more rights. There was one entrenched attitude left that the counsellor needed to advise Atemnkeng to change for the better.
Atemnkeng doesn’t want to sit with her partner to discuss anything about their mutual welfare. He takes decisions affecting both of them alone. Abangawoh saw the need for them to save money so that she could visit the antenatal clinic regularly. The need was coming faster than …
This got the counsellor to pick some of the points puts forward to extend the dialogue into creating the antenatal and postnatal bank. He admitted that Abangawoh raised important points, especially as it isn’t easy going through pregnancy for nine months. Pregnancy has specific health needs. So does delivery. You must have money on hand for any eventuality. Though maternal health services are now free of charge in Cameroon, couples should set aside funds in case certain drugs or supplies are out of stock at the health facility. Also, there can be complications and the expectant mother may need to be taken by emergency transport to another hospital.
Though the couple are poor, they have the means to save a little from time to time to meet the needs of pregnancy and childbirth. They will need to make advance arrangement for transport, and will also have to buy supplies for delivery. Pregnancy and childbirth are family affairs. The expectant mother herself should be a central player in decisions relating to her own care.
Working occasionally for a wage and saving it is one way. You have poultry, goats and sheep. If you raise more animals, you can sell some to add to your savings. Your farm crops can also give you some money during the selling season. With a little seed money, there are many income-generating activities that you can engage in.

Caring & Protecting AIDS`Orphans

AIDS Orphans: Care, Protection and Education
James Achanyi-Fontem,
Cameroon Link
Worldwide, more than 14 Million children under the age of 15 have lost one or both parents to AIDS. Many of these children become responsible for the care of younger brothers and sisters. Some even become homeless and are forced to beg for food and money to survive.The arrival of Dr. Neal Rosenburg and Dr. Donna Taliaferro in Cammeron to research on HIV-related stigma with nursing students was symbolic of the fact that a child is born through the effort of love between a man and a woman. Gender promotion, as such has an important role in caring for children.
The following article is intended to help you understand the importance of having a will and designating a guardian for dependent children, so that if their parents die, the children will be provided for, and sisters and brothers can stay together. Cameroon Link also touches on the importance of keeping orphans in school.
This story is the summary of a recent discussion on how AIDS affects children, especially children who lose both parents to this disease. The statistics are shocking. Fourteen million children under age 15 have lost one or both parents to AIDS. What happens to these children? Sometimes the very worst — they are separated from brothers and sisters, forced to leave school and find work, and sometimes must even live on the streets and beg just to survive. But does it have to be this way?
Ngwibeteh knew that her sister was going to die, but still, it was a shock when she received the news. Linda died of AIDS. Her boy friend had died two years before of AIDS and the mother died of cancer. This is where the new challenge started as two children, a girl and a boy were left behind.. What would happen to Grace and Linda's children?
Julie had no choice as she has to take care of these children and her own two children. They are now like her own children, and she can not abandon them. But how is she Julie taking care of two more children, when she hardly has enough to feed our own?.
Not very far from their residence is a home where a girl down the road lost the mother to AIDS. She had to leave school because there was no money to pay the school fees! The last thing said about her is that she is living and working on the street. Julie. I does not want her niece and cousin to end up on the street.
While others thought otherwise, that the situation seemed hopeless, Julie knew that the best place for her elder sister’s children was with her and the husband, where things would be familiar and the children would be cared for. But at the same time, they have a problem. How can she and her husband possibly support two more children? They needed help and the help does not seem come from anywhere.
Cameroon Link on hearing about the sad case, visited Julie to discuss the will left behind by Grace, since cared for her children as a single parent. Unfortunately, nobody in the family knew that there could be a will, even though she had house estate.
Incidentally, though Grace was too preoccupied to tell the sister, she left her will in the hands of the chair of their credit union. She asked the credit union to help her execute the will when she passed away. At Cameroon Link that's one of the things staff organise counselling on, because most people are very worried about what would happen to their children if they are not there. Cameroon Link understands the importance of education for the future of children and assist in planning for HIV orphans, and this is one of things that came out of the will left behind by Grace and Linda.. They wanted their children to stay in school and this was put in their wills.
Apart from that Grace left her house and a small piece of land to her children. She wanted the sister Julie to hold the property in trust, and manage it. She hoped that, with access to her land, Julie would be able to support the children.
This is how the whole idea of convincing people to write their wills when they fall sick all started in communities covered by Cameroon Link. Those who do not know how to write wills contact the counsellors for guidance. Making a will is one way to protect children in the future. Family heads are advised to find a lawyer, a paralegal, a community leader, or a volunteer who can help you write a will. Making a will can allow children to stay together, to stay in school, to keep their family property and land, and to ensure a better future.