Elizabeth Pappoe – Marie Stopes Ghana team member
I enjoy maternal and reproductive health a lot, as women are special.
Without the co-operation of the communities we serve, we wouldn’t be able to reach nearly as many people as we do.
Many of the problems we see every day can only be tackled in a meaningful, long-lasting way when lots of people work together and commit to solving them.
Our clients face challenges that go far beyond visible obstacles such as poverty and geographical location. There are unseen pressures too, leading to high unsafe abortion rates and low contraceptive uptake - even in countries where these services are legal and freely available.
Because we build our teams around people who are from or near the communities they serve, they see and understand the real challenges first-hand.
Our community-based educators and health workers have a very real knowledge of the issues on the ground, as well as the context and the sensitivities, insights that are sometimes lacking from Western-based NGOs. They identify common issues such as:
Lack of sex education in schools and within families means that false information about abortion and contraception is rife. Sex and sexual health are often taboo subjects in conservative communities, preventing people from talking about it and seeking help. This is particularly damaging for young people who are discovering their sexuality and need someone to talk to.
In many of the countries we work in cultural and religious traditions restrict women’s freedom and movement, forbidding them from using contraception without their husband’s consent, or even leaving the home without a chaperone - often male.
Our work often takes us into communities that are suffering the effects of war, unstable political regimes, natural disasters and humanitarian crises. For example, in the midst of the Ebola crisis our teams continued to provide vital services to women in Sierra Leone and other high-risk countries.
In every community we work with we see untrained or unlicensed ‘quack’ doctors, ready to perform unsafe and illegal abortions, or push dangerous concoctions on their desperate clients. Their empty promises leave women disabled or, worse, dead - ravaging whole families and communities.
We know we can’t fix everything. But we're committed to making a positive impact on the communities we serve. Our approach has always been to take a holistic view of problem-solving.
It means working with individuals to meet their immediate needs, such as visiting women who are unable to leave their homes for services. Alongside this we work with community leaders, local authorities and organisations to tackle the root causes. For example by promoting the benefits of our services among faith leaders.
With their local knowledge and connections, our community-based staff are the best people to drive this approach.
We're committed to building trust and relationships with communities – without their collaboration it would be impossible to do our work.
“It’s my mission to help women to educate themselves, to know their rights. I want women to be independent, to have a say. I’m not going to stop, I think I’ve just started!” (Brenda, Marie Stopes South Africa)
Building trust with communities doesn’t happen overnight. It is forged through the constant communication and dedication of team members. Community health workers are vital to relationship building. They will go out into the community every day to meet people, talk about contraception and the options available to them, make appointments, distribute contraception, chaperone clients to clinics, promote upcoming outreach visits, and follow up with clients afterwards.
Around a quarter of our impact in 2015 alone can be attributed to distribution of low cost and high quality contraception through pharmacies and community based distributors. They are fully embedded into the community, and that means they don’t just switch off at the end of the day.
Working with the community can be challenging but relationships are particularly tested at times of crisis.
The 2014 Ebola epidemic was the most widespread and deadly outbreak of the virus the world had ever seen. It resulted in massive loss of life and many communities were understandably gripped with fear. This led to negative consequences for our nurses in West Africa, who continued providing services throughout.
Over the course of the next decade, we aim to reach an additional 120 million people with reproductive services. Our work with communities will be crucial to this – but we can’t do it without investment and dedicated people on the ground.
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