Getting Tested, Knowing your HIV/AIDS Status Together by Rita H.

Rita Hawkins

Health 3 - Nyaruguru District, Southern Province

 “The children are our future.”

 Nothing rings as true as it does here in Rwanda. At the center of many volunteers current projects, including my own, PMTCT (Preventing Mother-to-Child Transmission) and CPN (Consultation prenatal) help community members both male and female learn about HIV/AIDS transmission, pregnancy, labour, delivery and breast feeding care. Through this education, Rwanda hopes to eliminate new pediatric HIV infections and improve maternal care, child survival and health in general.

            As a short background, PMTCT services first appeared in Rwanda in 1999 starting with a few sites and by 2009 had grown to 373 locations implementing PMTCT services. During the first visit, starting with a PMTCT session followed by a CNP appointment, both the mother and father to be are given a short counseling session about HIV/AIDS. The nurse will ask questions about the knowledge known and answer or correct with current information when necessary about the health of both parents and unborn child. The couple are then tested together and together given results the same day. The couple is able to ask questions and express concerns if any about HIV/AIDS and the next months leading up to delivery.

             As volunteers we see every day that there continues to be cultural attitudes that exacerbate the gender imbalance in Rwanda. Whether that is a lack of empathy towards patients coming in for family planning services or PMTCT/CNP visits without a partner, traditional gender roles are without a doubt present. However, providing behavior change communication skills and ideas, informing the community with help from the local community health workers, educating men, women and children in or starting these programs at health centers and promoting cultural exchange about a better understanding of the importance of testing can and will help with development here in Rwanda. The empowerment gained of knowing ones own status and that of their partners, I believe will provide progression in gender balance and the eventual elimination of HIV/AIDS as a serious problem. 

            It is an essential part of the PMTCT program to have both partners attend this appointment, by having both partners included it not only helps the health center monitor HIV/AIDS status in the community, but provides valuable education and reduction in levels of people living with HIV/AIDS in Rwanda as a whole. In 2010, 70% of all pregnant women had access to HIV testing during pregnancy and of that 81% of women were being tested with partners. A major hope for this program to eventually have 100% of women and their partners coming to be tested and educated about PMTCT and natal care. Good health is essential for individuals to progress and flourish, in PMTCT and CPN the health sector in Rwanda is able to help to empower community members to know their status and protect the future generations.

Sarah Doyle
ED2 - Bugesera District, Eastern Province

As many of you may have read in a previous post, GAD has been busy with a bunch of different projects. One of our initial projects was the “All PCV Gender and Development Survey” to gauge what local GAD issues PCVs see their community members face as well as what GAD related challenges PCVs face in their day-to-day lives. I thought I’d take the time in this blog to fill you in on what we found and what it means for the Gender and Development Committee.

GAD Survey Results

Education Summary

The majority of PCVs have 41-50% girls in their classes in both 0 level and A level.  As the grade level increases, many notice that there are more boys in the upper level classes and less girls.  Most also notice that in co-ed learning settings, the boys tend to speak more and participate in class while the girls remain more quiet.  Most chefs de classe are male.  The two greatest barriers to paying school fees are access to money/orphans who have to raise their money and daily/seasonal work.  For PCVs who work at boarding schools, 27.6% of PCVs notice that students pay 40,000-55,000 FRW for school fees annually.  For those who work at day schools, the majority of their students pay 3,000 to 5,000 FRW.  Most PCVs have after school programs that are led primarily by the teachers.  Most schools have girls volleyball, which includes 23.8% of PCV respondents, and boys football, which includes 28.6% of PCV respondents.  The majority of afterschool programs have shared materials, which 42.1% of PCV respondents found while there’s an even split of 26.3% of PCV respondents that say their schools have no funding or they’re uncertain of how after-school programs are funded.  For Education PCVs, we encourage them to incorporate GAD into their lessons and also to start GLOW (girls leading our world) clubs to encourage self-confidence and leadership amongst the girls. As for leadership in the classroom, many PCVs noted that there is a boy and girl chef de classe, but unfortunately the boy is given all the authority and responsibility. PCVs could encourage the girls to step up and take on some responsibility.

Health Summary

In health centers, 33.8% of PCV respondents believe that health centers provide an array of services which include: basic/community referral, malaria/tb screening, family planning/pre-natal care/baby weighing, ORS, other educational sessions, cooperate/work with NGOs, home visits  to HIV patients, malnutrition services, etc.  A slightly lower percentage of PCV respondents, 24.2% believed that the health centers mostly offered educational sessions for their community members.  44.8% of PCVs noted that the head of the health center is male but all the other workers there are female.  30.8% of PCVs also noted that the male staff tends to feel less empathy towards female patients than female staff.  This is a key difference observed between male and female staff.  The two biggest problems for community concerning health, according to the highest written percentages, 40% and 26.7%, are family planning/birthing practices and malnutrition, which is considered to be solely the woman’s responsibility.  If there are equal men and women coming to the health center, 80% of PCVs replied that they received general consults.  If there are only men receiving services at the health center, most are there for treatment of physical trauma. 

While if only women are receiving the services at the health center, 55.6% of PCVs believe that they come more often and receive a wide variety of services.  The two greatest barriers to community members accessing the health center are distance, which 34.8% of PCVs noticed, as well as 28.3% of respondents stating time of the year/daily schedule was the most problematic.  Inability to pay for Mutuelle de Sante (health insurance) is also often noted as a problem for many.

Economics Summary

For 39.6% of PCVS, their community members make money by farming where as a slightly lower percentage, 18.6% found that Rwandans mostly make money by teaching and as shopkeepers.  In each profession, PCVS found that some professions were more male dominated while others were female dominated.  Farming and co-ops tended to be female dominated while teaching, health center/school/church officials, and drivers where completely male dominated fields.  There was an even split between males and females for those who work in business or entrepreneurship.  36.8% of PCVs were also unsure whether there were more women than men in general in the work place.  The majority of respondents, 68.4%, did notice that as you move up the hierarchy in the work place, married women tend to get more respect than unmarried women.  Only 28.4% saw that marital status had little or no effect on the work place hierarchy. 

Family Relations

It appears that though the government is emphasizing the importance of good family relations and offering family planning services to anyone over the age of 15, the reality is that little improvement/access has been noted at the local level. Gender based violence and family planning continue to be a challenge for communities. Almost all PCVs noted that family planning was available, while a few lived in a sector supported by a religious organization that only provided natural family planning or did not have health facilities available. Though family planning is available, single women are not accessing it due to stigma and general embarrassment of sitting in the waiting room with mothers and married women. One PCV noted that in 2011, only 30% of the women receiving family planning services at Kitabi Health Center were unmarried women. Another PCV has had unmarried women come to his/her house at night saying that they want birth control off the books (NB: PCV is not providing it, but there is a demand). Whitney and Jacob were able to convince their HC to provide BC at general consults, so women didn’t need to wait in line or be embarrassed. The success of Whitney and Jacob could be a great venue change for other PCVs to encourage at their health centers so young women are not faced with embarrassment being their only reason for not accessing family planning support.

Gender-based violence (GBV) is definitely a problem that PCVs and their communities deal with. The majority of PCVs said it was a problem and about half of them have actually seen or heard instances of GBV. Though this is a big problem, it is almost never reported. One PCV noted that women don’t report it because the punishment for the husband is to pay a fine, which then takes away from the family’s funds, which affects everyone. Another PCV noted that the police only get involved when there is blood, which again is very rare. Though there are a few health centers and organizations involved with GBV projects and awareness, the vast majority of PCVs reported no public awareness committees or organizations at their site. A couple PCVs stated that they had done GBV training at their site, with Caitlyn Griffith willing to share more information. Since this appears to be such a problem at many sites, it might be good for GAD to put together a GBV training manual.

Sexual Harassment Experienced by PCVs

Unfortunately, sexual harassment is a big problem for PCVs. The majority of volunteers experience it a few times a month, while though not a significant number, others experience sexual harassment weekly and sometimes daily. Furthermore, nearly equal numbers have experienced both verbal and physical harassment, something that Peace Corps seems to be unaware of (probably due to the low reporting of such interactions to Peace Corps). PCVs try to handle this harassment in many different ways, with “distance” and “showing dislike” being the most common techniques used. A few also noted that they avoid interactions with men or make eye contact or appear too friendly in public.

                Though few people reported about how their community supported them, it is clear that there is a lack of support coming from the community (an omission is assumed to be a lack of community support). A PCV might have the chance to vent or talk to a few people they are close to, and sometimes a community member will speak out against harassment of a PCV, but many PCVs seem to handle it on their own or internalize it. This is further demonstrated by the fact that only fifty percent of those who experienced sexual harassment went to Peace Corps for support. One PCV said she did not report it because she was told that the only option PC offers to deal with such a problem is to change sites. Others said that they did go to PC, but only felt comfortable talking to specific staff members (Gloriosa and Dr. Laurent). Though not reported, many PCVs have stated how they feel only a few staff members are approachable, while the majority don’t understand the amount of harassment PCVs, especially females, receive on a regular basis.

                Though many people said they were unsure about what PC could do to better support them, an equal number said that there was a need for sexual harassment to be discussed further in training. There is a need for a clear delineation between appropriate and inappropriate behavior because often at site, people try to say it is their culture to touch a particular way or linger inappropriately. PCVs suggest that there be a discussion between PCTs and LCFs and PCVs to discuss appropriate behavior as well as coping mechanisms used by PCVs. Another also suggested (in the GAD project section) that Peace Corps should offer a sexual harassment and self-defense training. This PCV did one in the United States before starting her service and says that she is more aware of her surroundings and more comfortable standing her ground if she is ever put in an uncomfortable position. There was also the suggestion that headmasters and community leaders be made aware of what constitutes appropriate treatment of a volunteer and to make community members aware of it. Though harassment will probably be a part of a PCV’s service, there are things that can be done from the Peace Corps perspective to reduce its presence and help community members understand that “ihangane” is not an appropriate response.

Homosexuality and GBLT

Though many PCVs have not participated in a discussion about homosexuality, the majority has and has had to struggle with a very negative Rwandan opinion that refuses to recognize a person’s right to their own opinion/ideas. Many of them emphasized their attempt to share American culture and stories from home to show the presence of homosexuality and general respect of others, whether you agree with their choices or not. Though this is a difficult for PCVs to have with community members, many PCVs noted that Peace Corps often does not address it in trainings and there is no discussion about it amongst PCVs or staff. Others suggested that PCVs share their experiences and how they approached the discussion, as well as have PCTs participate in role plays to practice. In general, there’s a need for general awareness amongst Peace Corps staff and an exposure of PCTs and PCVs to the reality of how a possible homosexuality discussion could go and how it could be handled.

How we are using the results

As stated in the previous post about what GAD is working on, the survey results were key in future planning at our last GAD meeting. We decided to take the recommendations of many PCVs and put together a manual of lesson plans for adults. We have GAD members as well as other PCVs who offered to share their projects working on lesson plans which will hopefully be finished by our next meeting. We will also work closely with the Peer Support Network to find a way to support PCVs who experience sexual harassment or problems related to queer issues, so stay tuned as we iron out what that’ll look like. We will encourage future GAD committees to put out a GAD survey every few years to get current info about site-specific needs of PCVs which will help the committee to plan projects and support PCVs as best as we can. 

Flower Power and Operation Smile, by Lucy S.

Lucy Sung
ED 2 - Gicumbi District, Northern Province

The Education 2 group is known as the “Big Group.” We started with 70 doe-eyed strangers at staging, some were lost along the way, and we gained some when Niger was evacuated. I’m not too sure where we’re at but it’s fifty-something, which is pretty darn good.

A weekend before in Kigali, some of us were bouncing off song ideas that we would blast in the background as we walk into the plane and take off into the blue blue sky. We had several good ones, ranging from “In My Life” by the Beatles 

Or of course, “Africa” by Toto. 

Our Close Of Service (COS) Conference is coming up and perhaps a song for our last conference  would be “Should I Stay or Should I Go?” by the Clash. This is a thought on many PCVs minds: should I stay? Should I go? What should I do?

For me, I’m ready to go home. My projects are wrapping up, most of my students will be graduating, my shoes are tied. I’m working on my graduate school applications and with it, the inevitable soul searching and replaying memories in my mind. Two memories come strongly to mind.

GLOW Club

Josee (GLOW Club member) and and Flaviah (aka Flavour Princess, GLOW Club President)

For one the earliest lessons in my GLOW Club at my school, College de Rushaki, we talked about self esteem. I’ve been dying to get some creative expression out of these students so after a quick lesson, we did a fairly common exercise called Flowers of Power. In the center of each flower, students wri te their name. Then on each petals, they write an adjective about themselves and glue it to their name, their Flower of Power. I showed them an example that I made for myself. Lucy: smart, creative, caring, etc…

I instructed the students to first write their adjectives on a piece of paper and show it to me or the GLOW President, Flaviah, before getting markers and construction paper.

At first, there was some confusion. Lilianne, brought me her paper and on it she wrote:

I am a girl.

I have hair.

I have eyes.

I have hands…

“Lilianne,” I said. “You must think of adjectives, words that describe you, that you are proud of and is true. For example, Lilianne, you are very intelligent.”

Lilianne grinned and rushed back to her seat and continued to write. I monitored the students until I realized, some had taken the example flower I had made and were copying the words I had written.

“Oya! Oya! (No! No!) These words must come from YOU. From your mind and from your heart.” I took the papers of these students and made them start again.

Many students now had a great first draft and I began dispensing the craft materials. Lilianne comes back with her new draft.

I am intelligent.

I have eyes.

I have toes.

I have black hair.

I stifle a groan and sit down with Lilianne for round three.

Operation Smile

The best helper! She's 4 years old, was teaching her how to write her name.

In March, I volunteered with Operation Smile, an international organization that surgically repairs cleft lips and palettes.

First a disclaimer, any opinions said here about Operation Smile are opinions of my own and not of the Peace Corps.

There are many offices of Operation Smile around the world and the South Africa chapter did a mission to Rwanda. It was sadly ironic when I was posting up flyers in my village announcing the dates when a neighbor came up to me.

Neighbor: “Umutetsi wa college afite uwana w’ibibari. Yapfuye uyumugitondo…” The cook of the College has a child with cleft lip. He died this morning.

Me: Hari umuntu undi afiti ibibari? Is there another person who has cleft lip?

Neighbor: BENSHI! Bara hari! Many people! There are many people!

I’ve never seen Rwandans in the village with cleft lips so I was surprised to hear that it was very common.

During the dates of the mission, other PCVs and I helped to register incoming families, get their meals on schedule (which was very difficult), and advocate for the Rwandans to the foreign staff. I do not want to criticize the work of Operation Smile, because it is so important in more ways than one can imagine, but there was some nonsense that left many PCVs frustrated. It was then I realized how the PC experience is so different from that of a summer intern or expat working for some multi-acronymed organization. We called the staff asking for basins, heated milk, clean water, all sorts of items that would not come to mind immediately to someone who didn’t live in the village like us. We talked to the patients and their families, many of them subsistence farmers from the Southern providence. It was the growing season so we talked about the corn in our gardens and plans to plant beans next.

While groups of patients were taken to the hospital, the other PCVs and I stayed behind and assisted the best we could. Even while sitting on the grass, or coloring books, I was always asked the same question, over and over: “What causes cleft lip? What causes cleft palette?” The other PCVs and I asked the staff, consulted the ever reliable Wikipedia, and could only tell the Rwandans, “No one sure, but it is a combination of genetics and environment.” It is very difficult to describe genetics in Kinyarwanda, but we managed by saying family history and biology.

The Rwandans had their own hypotheses but one thing was for sure, for a woman to have a child born with a visible deformatity like that is ostracizing. There was a teenage girl with a baby, she was kicked out of her home and shunned because her baby had a cleft lip and palette. There were many mothers who were they by themselves, not because the father had to work or be somewhere else, but because they were alone, completely. No wonder I never saw anyone with a clef lip in the villages, they are hidden. 

 One afternoon, a middle aged man accused all women for being at fault for giving birth to child with a cleft lip, that the woman had sinned.

“A woman’s body is like a garden, and her garden was not taken care of,” said the man.

A weathered looking mama stood up from her plastic lawn chair. “Well, every garden needs a farmer to grow plants, and if the garden is not good, then it is also the fault of the farmer!”

Oh snap.

Blues and Roots, by Jeff M.

Jeff Monsma
Education 2 -- Kamembe District, Southern Province
fun fact: Jeff lives the farthest and hottest part of Rwanda near the Congo border. We see him once in a blue moon. He's known as "the Dutch Diamond" in his village.

Piano notes pulse towards the window and spill out into the night. I sent the kids home around eight and now have some time to myself. The day’s highlight: Ono—my five-year old neighbor, perpetual house guest, and adopted daughter—put on my -8 prescription glasses, walked cautiously to the center of the room, lowered herself to the floor, and exclaimed in blissful confusion, “Where am I?!” Now the only company I need is Horace Silver and some syncopation, that delicious idea that, while time marches forever on, it need not be divided into equally metered ticks. It is time, not pitch, which is the greatest governing factor in music and the primary plaything of any composer—of any artist for that matter.

            And here I sit, in Africa, rolling out hard bop’s interpretation on the passage of time. Gives a whole new meaning to bring that beat back. Fortunately for me, the beat has returned of its own accord, instead of being dragged across the sea, forever pounding against the chains that brought it to the New World, eventually helping to break them. Following its Garvey-esque journey, the beat has found that, back home, syncopation is alive and well. And everywhere. Hands, feet, guitars, pianos. I’m surprised the rain doesn’t fall on the off beats. While the sun rises and sets at the same time every day, year round, every other rhythm is unpredictable.

            This idea has an obvious foothold in music. My favorite days are when the power goes out during choir practice, silencing the tinny, synthesized drums from the keyboard and passing the task of time-keeping off to the choir at large. Here “Rwanda’s beat,” as our bass player once described it to me, comes out in its purest form. The choir continues, unphased by the absent instrumentation, and claps out the rhythm behind many of our songs, claps on beats one and three, with one more clap in triplet time following soon, but not too soon, thereafter. It is a simple counter-rhythm that is echoed in nearly every blues guitar or swing drum kit, albeit in different form. From this base, individual members of the choir are free to clap out their own rhythms as they see fit, often receiving a response in kind from another set of hands. The group continues to collectively measure and re-measure time as the melody comes in, sometimes call and response, sometimes all together. I do not mean to imply that this is jazz, far from it. Out songs sound no more like Charlie Parker than Mozart or Motown. This is simply where that music springs from, a place where rhythm and collective improvisation are held in a place of musical honor. But there is another place I’ve found where these concepts are even more pronounced.

            Prayer. A Rwandan prayer session is unlike anything I’ve ever experienced. In all this imported Christianity, it is one thing that comes from nowhere but the ground beneath me. Occasionally, prayers will resemble something from my own religious idiom, a leader intoning over the congregation, who silently push the singular call heavenward. However, more often than not, the practice is something else entirely.

            The elder’s baritone floats out over the congregation, slowly rising and falling, the bass setting up a motive, calling ears to attention. He continues, rising a little more here, adding some extra stress to his words there. Other members of the congregation join in, softly at first, brushes skittering over the hi hat and cymbals. The leader continues, both setting the pace and pushingit higher. More of the congregation, loudernow, as the piano starts comping and the melody becomes collective. The elder pushesfurther, addingspeedand emphasis to his words. The congregation followssuitaddingmore of their owncontributionsaswords, sounds, pileontopofeachother and spilloutthewindows. Fasterstronger, theoriginalmelodyhasdisappearedintothe symphonic cacophony asthecollectivelinescarryeachotherhigherthantheyAND A SHOUT RINGS OUT AT THE BACK, the soprano sax takes over as one of my senior five students (I still don’t get that much participation from her in class) is borne up by the surrounding sound to heights unseen. She takes over the melody and tells us what she sees, describes the view from atop this mountain of vocal momentum. She picksup her owntones and starts thecongregation in a new direction “Oh, imana nyiringabo…”

            Hold up. Imana nyiringabo? I’ve heard this phrase in church many times before, but suddenly it hits me. That translates to (more or less, I’ve talked to a few friends and can’t get a concise translation) “God of mankind” or “God who is greater than all men.” This in itself is not surprising, we have similar phrases in English, but it strikes me that the root word for “man” (-gabo) also carries through in Kinyarwanda. I once had a women’s studies professor underline my use of “seminal” in a paper, presumably as a gendered word. The root for seminal is, in fact, “semen” which is Latin for “seed.” Now, I made no mistake in my use of the adjective in my paper, and I highly doubt I would have received a higher grade if I had changed my wording to include some kind of ovulation metaphor. However, my cultural sense of political correctness kicks in as I see a familiar face speaking a different language. How deep does this gendered system flow in Kinyarwanda, what effects does it have? Unfortunately, my linguistic knowledge is far from sufficient to even guess at these questions. I do know that the roots for man (-gabo) and woman (-gore) are not inseparably linked as they are English, but -gabo seems to possess certain connotations, as the adverb “bravely” translates as “bya kigabo,” using the same root. I also realize that my probing is flawed from the start, using my own clouded, cultural microscope to analyze something I know not of. I still can’t help but wonder how deep the rabbit hole goes. It’s obvious that the categorization, the connotations, of “woman” and “man” are stronger here, more fixed. How much does language play into it? Does my student realize what she’s saying? If no, what would happen if she did? If yes, what could she do to fight it? How could she change the melody into a new take on Charles Mingus’ “Haitian Fight Song?” After all, these are not my songs to write. Rwandan women can borrow influences, infuse their own fight with far flung rhythms, which I can help provide, but the consciousness must be theirs.

            The prayer is winding down now, as Betty carries us back down from the heights she’s reached. The bass returns and brings us back home. I don’t know if God understood it all, but somewhere, Sarah Vaughan is smiling.

Calling All PCVs - We Want Your Stories!

Gelsey Hughes

ED2 -- Kamonyi District, Southern Province

Sexual harassment.  It’s a term we’re all familiar with.  We know it’s something that shouldn’t happen, but does.  We know that when it happens it’s serious, not least because it’s often a precursor to sexual assault.  We know we have a right to respond to it.  But what is sexual harassment exactly?  And what should we do about it when it happens to us?

Sexual harassment is defined as “unwelcome sexual advances, especially by someone with authority towards a subordinate.” This could mean any number of things, from personal questions of a sexual nature to direct propositioning or unwanted touching.  As Peace Corps volunteers, we’re uniquely vulnerable to sexual harassment. We stand out, we work alone, and we’re navigating a foreign culture where our idea of “unwelcome sexual advances” might not match local standards of inappropriateness.  On top of that, we’re struggling to be culturally sensitive, to adapt and integrate.  In our struggle to be flexible and tolerant, we can lose sight of our boundaries. 

We at GAD want to help PCVs identify and respond to sexual harassment.  But before we can start talking about best practices, we need to hear from you, the volunteers.  Have you experienced sexual harassment?  What happened, and how did you respond?  You can submit your stories by emailing me at gelseyh@gmail.com or by commenting on this story.  Help us support and empower you!

Fact or Opinion, by Chinelo N.

Chinelo Nwosu
Education 3 -- Bugesera District, Eastern Province

The first 3 months of my Peace Corps journey began in a small village, Taba, in the District of Kamonyi, in the Southern Province of Rwanda. Taba is where I went through training which included hours of language(Kinyarwanda), sessions of tech training for teaching the Rwandan Education system, Cross Culture and Health sessions just to name a few.  While this time was filled with exciting new experiences it was also had its occasional stresses. Just when those stresses were beginning to peak we were given the opportunity to put our training to the test. We were allowed to teach the children of the surrounding villages.  This was to give us practical training, it also helped with our confidence in the classroom. For some, like myself, this was my first time teaching in a classroom setting so I was extremely excited to be paired up with Zack one of our training groups very experienced teachers.

One day we decided to teach Fact and Opinion, our theme for the week was opposites.

“Good Morning class, today we are going to discuss  fact and opinion”, Zack said very loudly. After all the student repeated “Fact and Opinion” in a low mutter, they took out their notebooks and prepared to take notes on the subject. After giving definitions of both fact and opinion, Zack gave examples. “Rwanda is in eastern Africa.” It is a beautiful day today.” “I think Fanta Citro is better than Fanta Orange.” After every example Zack took a poll from the students whether the statement was a fact or an opinion. He also allowed the student to give their own examples, but before he turned it over to the students there was one last example “Men are stronger than women”. Right after those words left his mouth the class roared with students yelling “Fact. Teacher, FACT!” Even though taking a poll was not really needed because we knew how the majority felt, we still took a poll. While majority of the class felt that the aforementioned statement was a fact there were two students who quietly insisted that this statement was an opinion. As the student laughed at the two, Zack broke the news to them, “Men are stronger than Women is….. and opinion.” The class began to disagree yelling “Not. Teacher, NOT! ” “You lie me.”

After getting the students to calm down, Zack explained to them why it was an opinion. They did not believe him. So we decided as a team to introduce them to the wonders of….. Arm Wrestling! We showed them a demo. As Zack and I sat on either side of the desk as we quietly argued about whether or not he was going to let me win to prove the point. I won in both cases. To drive the point home we decided that I should have a REAL arm wrestle with one of the boys in class. The biggest kid (I believe he was in his late teens)  in class chooses to arm wrestle with me. By this time students were excited to see the outcome. The student and I took our seats and Zack prepared our hands in the correct position. Anticipation was building. I was hoping that I actually won so I wouldn’t look like a fool. I felt like I was on an afterschool special, I, in that moment was an example for women everywhere or at least that’s how I felt. Just as  Zack let our hand the Dean of Discipline (a female) walks in and beings to cheer me on.

After about a minute, it was over. I was the winner. The females were so excited, including the Dean of Discipline. As my right arm throbbed, I took immense pleasure in changing the way that not only the males viewed females but also how the females viewed themselves.

Community Health Workers by Alma A.

Alma Aldrich

H(T), Nyaruguru District, Southern Province

In the past 18 years, Rwanda has made incredible progress in the area of gender development and gender relations. The government has made a conscious effort to include gender into most of its programs in policies, including a Ministry of Gender and Family Promotion, and enacting gender quotas into almost all levels of representative government. Today, Rwanda has the highest percentage of women parliamentarians (56%) in the world. Critics of gender quotas and other government policies often argue these policies are top down and do not address issues on the ground.

As a community health volunteer, my primary work involves collaborating with my health center nutritionist, community health workers, and caregivers on childhood malnutrition. Sometimes, when mothers of malnourished children come in with clear evidence of domestic abuse, or tell me stories of their marital problems, I feel discouraged and inclined to agree with the argument that most gender policies in Rwanda are too top down.

More often, however, I am encouraged by the incredible work and resilience I see coming mostly from Rwanda’s Community Health Workers (CHWs). These women and men work daily to improve the health of all Rwandans, and in doing so are challenging and changing previously held gender roles and relations at the grassroots level.

Each village in Rwanda has four elected CHWs. Two are binomes (these two, by law must be one woman and one man), charged with overseeing overall healthcare of their neighbors. They are generally equipped with iron supplements, malaria medications, among other things. A third CHW is charged with maternal and infant health. This CHW advises pregnant women and mothers, and oversees child growth monitoring among other things. The fourth CHW is in charge of social affairs: a broad mandate which can include assisting in domestic disputes between husband and wife or checking up on orphan lead households. CHWs are often invited to trainings put on by local health centers, the Ministry of Health, and international NGOs.

The position of CHW is unpaid, but holds significant prestige and clout in the community. A large majority CHWs who work with my health center are women. I am filled with excitement and hope when I see these women --often older, with little to no formal education (outside the current health trainings they attend) -- lead health education sessions and growth monitoring in their communities. Men and women alike seek advice and assistance from female CHWs and acknowledge their expertise in the area of health. For their part, female and male CHWs discuss with me the obvious role of women as main decision makers in the household when it comes to health, and tailor their interventions accordingly.

While many cultural attitudes in Rwanda remain seriously gender imbalanced, I am confident that daily activities by strong female and male leaders, like Community Health Workers, are slowly changing the attitudes of all Rwandans towards a better understanding of the value provided by both genders in progress and development.