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STELLA AMOJONG OMUNGA

Kenya,

Starting in Kenya’s urban slums, Stella is building diverse networks of support for young unwed mothers, to keep them healthy, educated, and integrated into society.

This profile below was prepared when Stella Amojong Omunga was elected to the Ashoka Fellowship in 2005.

INTRODUCTION

Starting in Kenya’s urban slums, Stella is building diverse networks of support for young unwed mothers, to keep them healthy, educated, and integrated into society.




THE NEW IDEA

In order to change the way society responds to teenaged unwed mothers, Stella is systematically working with key stakeholders—parents, doctors, friends, and teachers—to ensure that these girls don’t fall through the cracks. Teenage mothers are rejected by East African society; families disown pregnant daughters, nurses treat the girls disdainfully, and schools expel them from classrooms, closing the doors to further education that might help them regain a foothold and ensure a viable future for themselves after childbirth. This treatment not only hurts the girls and their futures, but it also does not prevent pregnancy: despite numerous campaigns to prevent pregnancy among unwed girls, teenage pregnancy continues to be a huge problem. Essential to the success of this effort, and Stella’s ultimate goal, is to change society’s perception of pregnant teens in order to improve sexual health education and stop the rising pregnancy rate. Stella has developed several interventions—including counseling the girls, training health workers, helping parents accept their pregnant daughters, and influencing the school system—aimed at changing mindsets toward unwed teen mothers and mothers-to-be and providing these girls with educational and occupational opportunities during and after pregnancy. Each locus of support reaches girls on a different level, to address issues of health, education, and financial and emotional support. In this way, Stella is best able to rebuild what has traditionally been taken away from girls as soon as they learn of their pregnancy.




THE PROBLEM

For unwed teenagers, pregnancy is the girl’s burden, and it carries life-altering consequences. In many parts of East Africa, the shame of pregnancy is extreme, and pregnant girls often have no one—not teachers, not parents, not even peers—to confide in or seek help from. Abortion is illegal in Kenya, forcing many girls to seek out underground abortion practitioners, who operate under abominable conditions and whose “procedures” often result in serious infection and even death. Girls who carry their child to term lack support, guidance, and access to appropriate health care. As Stella has observed, the prevailing attitude of nurses and doctors to these girls is one of disdain and judgment rather than support. For this reason, many girls avoid doctors, preferring isolation and risk to proper attention from medical professionals—attention that might mean avoidance of anemia, prolonged and obstructed labor, or any number of other complications.

In Kenya, and in East Africa as a whole, teenage pregnancy typically results in the girls’ formal expulsion from school. There are few attempts to reintegrate girls after they give birth, or to provide them with further educational and occupational opportunities. Lacking marketable skills, many girls end up on the streets.

A few years ago, the Kenyan government introduced a national sex education plan, but it was met with sharp criticism and has been all but abandoned in schools. Now, parents assume kids are getting the appropriate education in schools; teachers assume that parents are talking to their children about sex. There is not a culture of openness about the topic, which further prevents teenagers from gaining the information they need to make smart choices about sex.




THE STRATEGY

Stella seeks out points of intervention through the people that have the strongest influence and the highest leverage in a girl’s life. She also prepares unwed mothers to best take advantage of new opportunities by offering counseling and guidance and enabling pregnant teens to pursue education and occupational goals after the birth of the child. In this way, Stella is changing the formerly bleak fate of these girls, and showing society what is possible. Working in the slums of western Kenya, she has formed a network of community volunteers to gather information from the community, learning about pregnancy when it first happens, and to step in with guidance, support, and information. Working first with the girls themselves, she and her team of volunteer women in the slum areas in which she works offer emotional and health counseling, help girls connect with the appropriate medical care, and help restore relationships between them and their families. This raises their self-image and prepares the girls to look beyond childbirth.

Stella’s program opens up possibilities for social inclusion and economic viability through further education and occupational training. However, first she must ensure that they can return to the classroom after childbirth. To this end, she works with teachers and school administrators to save a seat in the classroom for these girls, and aims to return 40 percent of unwed teenage mothers to school. The more successful her girls are, the more Stella can prove that there is value in investing in young mothers. Stella also helps the girls set up small businesses that allow them to sustain themselves: she offers a one-week crash course on how to start a small venture—grain sales, weaving, crafts—and helps to set up a four-week apprenticeship with local businesspeople to further their training.

Another essential node of support in the network are doctors and nurses, whose attitudes about unwed mothers discourage teenagers from seeking appropriate health care during the months leading up to birth. The problem here has two dimensions: the first is strictly clinical, as pregnant girls need medical attention and information that will allow them to carry their child to term; absence of care during these critical months often leads to health complications. The second dimension of the problem is less tangible but equally problematic: doctors and nurses convey an attitude that discourages teens from seeking help. Doctors and nurses could help the situation tremendously, but fail to do so. To address these problems and realize a shift in attitude among doctors and nurses, Stella has set up informal gatherings among health care professionals, letting them know of the consequences of their actions, nonactions, and attitudes on this vulnerable patient group. Importantly, she brings on doctors who can be allies and works through them to bring about a shift in attitude and behavior.

Perhaps most importantly, Stella reaches out to parents, counseling them to accept their pregnant daughters. Once girls become pregnant, they are often thrown out of their houses or do not notify their parents at all; this cuts them off from an essential source of emotional support. Stella provides the girls counseling and a place to stay if necessary until the parents are approached or notified for the first time. Parents that sit on Stella’s board accompany girls to talk to their own parents, helping explain that pregnancy is not a social death sentence for the girls and their families, and enlists them in supporting their daughters in this challenging time. Stella offers the parents training in positive parenting, and to prevent more cases of early pregnancy, she also advocates for more open communication between parents and daughters on reproductive health issues.

A shocking reality for pregnant teenagers is abandonment by their peers and friends. Stella works within schools to form advocacy and student support groups that aid in prevention efforts, work to open lines of communication about sex, and help girls during their pregnancies. These clubs, comprised of mostly girls, but boys as well, provide an essential forum for discussion and support. Through the clubs, she has distributes information and education materials relating to safe sex, including posters, booklets, and handouts. She plans to establish a reproductive health youth center that will provide training, counseling, and other services to young people, and a community trust fund from which unwed mothers can draw in times of great need.

All of these activities first aim to change behavior, with the ultimate goal of shifting cultural perception and judgments about young unwed mothers in Kenyan society. Stella coordinates all activities through the Advocates for Single Teenage Mothers’ Rights and Empowerment, a membership organization that includes parents, teachers, and church and community leaders. The program currently runs on donations by parents, teachers, and others who realize the importance and potential of the work she is doing, and she is seeking donor funding as well. She has also helped the girls in her program to set up a bakery that is generating some revenue for the project. Her staff is entirely volunteer, and she relies on her board—made up of doctors, nurses, parents, religious leaders and a town chief—to help her reach the critical stakeholders. She furthers her capacity through strategic partnerships with organizations such as the WHO to create information materials and the Red Cross to train peer educators. She is also establishing a partnership with a legal organization to provide legal advice in cases of particularly young girls getting pregnant.

In one year, Stella has spread from one to all three major slums of Eldoret and is now planning to go to rural areas, where people have even less information about reproductive health, as well as to Uganda and Tanzania. To replicate her model, she is introducing it to other established organizations, particularly those addressing women’s issues. She is currently working with four other organizations to implement the idea.




THE PERSON

Stella was eleven years old when she learned of menstruation. A classmate, who had begun having periods, had no idea what was happening to her body. She was terrified; no one—not her family, not peers, not teachers—had warned her that she would bleed once a month, that it was a normal part of growing up. Curious and concerned, Stella went to her aunt, her caretaker since the death of her parents, for an explanation. The aunt beat Stella until she was unconscious. Menstruation, and any topic relating to reproduction, was forbidden, not to be discussed.

In 1993, when Stella was in secondary school, her closest friend, Emily, learned that she was pregnant. The girls reasoned, correctly, that if the school administrators found out, they would expel Emily. If she went to her parents, she would be thrown out of the house. Stella advised her to seek the counsel of a teacher, which she did. But the teacher, whom Emily approached in confidence, alerted the school’s headmaster and summoned her parents. Expelled from school, rejected by her family, Emily turned to a back-street abortionist for help. But complications arose from the surgery, and three days later, she hemorrhaged, dying on her way to the hospital. Stella felt anger and a very personal sense of loss, but she also realized that thousands of girls suffer a similar fate, that Emily’s case was not an isolated one. It was a societal problem, and called for a societal solution.

In her early 20s, after completing a two-year certification program in information technology and marketing, Stella took a job at a doctor’s office. During the two years she worked there, she saw and treated slum girls who came in for medical examinations after having undergone abortions. Most lacked basic information about reproductive health and pregnancy and STD prevention. In her informal talks with the girls, Stella found out that most feared going to the government health centers because the staff was hostile and judgmental. Stella’s life in the slums of Kamukunji further exposed her to the complex societal forces that put young girls at risk, and confirmed her resolve to respond.




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