Nyagatare, Eastern Province
Life is all about access. Access to education, to the right networks for employment, to water, even to family planning. Generally speaking, fertility is often higher in poorer families within society for a variety of reasons. One of these reasons is a families income, and countries that have higher fertility rates often have a lower average income. Low incomes for families modifies the variety of economic opportunities that are possible. While Family Planning is not unheard of in Rwanda, many families at some point have to make a choice about who to send to school, and more times than not the family sends the male children to school and keeping the girls behind at home to help with the growing family.
During Pre-Service Training, in the sub site Karama, where I lived, there were trails of used condom wrappers up to an area known as "the rocks." From there it was obvious that teenagers were having sex even though no one in the community was talking about it. But it was nice to know that condoms were available to the youth that lived in the area. However that is not always the case in all areas of Rwanda. My village in Nyagatare is heavily religious. On Saturday's the town center is virtually shut down as the majority of villagers are 7th Day Adventists and are in church throughout the day. The village doesn't have a bar or a butchery as 7th Day Adventists do not drink or eat meat. There are a few boutiques that sell contraceptives but they are both operated by men. At the health center condoms are offered at consultations however the only nurses at the health center are men, and that might intimidate single women or secondary students from getting what is available to them. The weekly family planning consultations have wide support with the older women of the village, and the health center regularly gives out oral contraception or the IUD. But not all women attend these consultations. When I asked the midwife at my health center why more women don't come in to use these free services that are provided for them her response was that many might not know that they are available. Each village has one community health worker responsible for helping with family planning but one person per village can only do so much.
This brings me back to access. Access to education is extremely important. Especially education about ones own health and benefits. Luckily the Ministry of Education has just recently released plans for a nationwide secondary school sex education program. The logic behind the program is to try and curb the number of teenage pregnancies but also to inspire self esteem and teach about HIV/AIDS. This is a step in the right direction and hopefully one day all women and men will have the access they deserve to family planning.
