Archive for November, 2010

Nigerian Chronicles X- PPFA in Gboko II

Posted in Africa, Documentary | Photography, Nigeria, Non Profit, Recent Projects, womens reproductive healthcare on November 16, 2010 by tuschman

This is the concluding chapter in this series, and will focus on healthcare training and an AIDS clinic at the NKST church headquarters facility.  Some personal impressions will follow the visual presentations.

The NKST reproductive-health project recently upgraded a center for educating midwives and nurses on reproductive-health issues, particularly basic family planning, contraceptive technology, and post-abortion-care services. The NKST education course produces a large pool of skilled family-planning attendants, whose outreach provides basic healthcare services to the wider community. Below is a series of photos taken in the classrooms.

This next series are photos taken in an AIDS clinic at the NKST facilities.

In my last night in Nigeria, I met with Dr. Mairo Mandara, director of the Packard Foundation programs, to go through a debriefing session on my experiences during the previous 10 days. She is a very bright, energetic, determined and outspoken woman, someone whom I greatly admire. I consider her, Thank-God Okosun, and some of the doctors I met to be true heroes. It would be easy for them to move to Europe or the U.S. and have a much easier life, but they are completely devoted to improving the quality of healthcare for so many of their fellow citizens; their hard-work and dedication is truly admirable.

I told Dr. Mandaro that Packard had indeed made progress in bringing family planning and post-abortion-care services to many communities, and that this changing cultural norms represented no small task . Apparently, I had only visited 20% of the projects that Packard had instituted in northern Nigeria, so the work that they had undertaken was even more widespread and extensive than what I was able to document. Yet, I told Dr. Mandara, there is so much work that remains to be done. The birth rate had been reduced to approximately 6 in the communities where they were working (as opposed to 10 or 12 before), which is definitley a big step in the right direction; nevertheless, without further reductions and better educational opportunities for children, it will be difficult for these communities to attain an improvement in their quality of life, and they will continue to struggle with poverty.

I asked Dr. Mandaro how much the Nigerian government contributes to women’s reproductive healthcare programs, and her answer left me quite speechless — it was precisely zero. To make really lasting changes in a country the size of Nigeria, these successful programs must be scaled up; however, without government support, it will be difficult to deliver the necessary education and family-planning programs to the millions of people who need them.

If I ran a large foundation, I would insist that the government match my annual budget by at least 5-10 times. Of course, this is my personal blog and opinion and in no way reflects the policies of the Packard Foundation or the realities that they may contend with. But I find it shameful that the government of Nigeria does not contribute any funds or programs in family planning. Despite the handicap of working without government support, Packard has made a significant contribution to the well-being of many communities in northern Nigeria.

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Nigerian Chronicles IX- PPFA in Gboko

Posted in Africa, Documentary | Photography, Nigeria, Non Profit, Recent Projects, womens reproductive healthcare on November 8, 2010 by tuschman

So far I have been documenting family planning in Muslim communities in Northern Nigeria.  This next post brings us back together with Thank-God Okosun and PPFA’s activities in an evangelical Christian community in Gboko, Benue State. The NKST (Nongo u Kristi u k Sudan hen Tiv) Church, whose headquarters we visited, has 127,115 members distributed among 298 well established congregations. As Nigeria provides little to no health care service for its citizens, the church had taken over this responsibility by being a health care provider;  9 hospitals and 123 primary health centers are managed by NKST.

The highly restrictive religious bias against reproductive health issues is a serious cause for concern in Nigeria. Most religious organizations view issues of reproductive health, particularly issues of sexuality and family planning, as immoral. Seven years ago PPFA was able to partner with the NKST church in altering this cultural and religious perception. Family planning, sex education and post abortion care are now accepted throughout the church and the fact that the church has a well established network of hospitals and clinics has made this PPFA project an effective one for reaching a large number of potential clients.

We arrived at the church headquarters as a large thunderstorm was brewing. The church compound is quite large, encompassing schools for both primary and secondary education, as well as those that train nurses and midwives and support several clinics.

As is the custom, we paid an honorary visit to the head pastor of the church upon our arrival. I photographed him by dim window light as there was no electricity in the building.

PPFA and Packard also made an advocacy visit to the leadership of NKST church to honor Rev. Inyonogie in appreciation for his contribution to the achievements of the family planning project. Here he is pointing to a painting of the founder of the NKST church.

A recess at the primary school in the church compound.

In the church. congregants are singing hymns before the start of the official PPFA program.

Church officer organizing PPFA donated contraceptive commodities. The materials also include MVA kits and Misoprostol. Manual vacuum aspiration (MVA) is a fast and safe way to empty the womb using a large syringe and cannula. It can be used to help a woman who has had a miscarriage or abortion that was not complete. Misoprostol is also used for incomplete abortions or miscarriages.

Prophylactics that will be distributed to the congregants.

Since the community is rather self contained ample opportunities for reproductive health care counseling exist.

The program takes advantage of normal everyday activities to distribute condoms. Go to the seamstress to get a dress made or an alteration and you also get a lecture on birth control and some prophylactics.

Similarly, go to the hairdresser, get counseling and free prophylactics.

A couple obviously anticipating using their new contraceptives.

Patients waiting to see health care worker at family planning clinic.

At the clinic, a couple receives counseling on family planning and they choose a method.

The introduction of family planning into a conservative religious community is no small achievement; changing cultural perceptions is a formidable task and we have to look no further than our own country to see how difficult it is to make lasting change. Packard and PPFA have successfully partnered in having family planning become a totally accepted way of life in the NKST communities.

Nigerian Chronicles VIII- Social Networking

Posted in Africa, Documentary | Photography, Nigeria, Non Profit, womens reproductive healthcare on November 1, 2010 by tuschman

In a small village an hour outside Kano I was asked to photograph a large congregation of people inside a small courtyard. Apparently this was the beginning of a wedding ceremony where Traditional Birth Attendants take the opportunity to dispense birth control materials  and  engage in family planning discussions. My initial impression was that there were more birth attendants than guests, but it was only the very beginning of the  celebration.

Two experienced TBA’s from CEDPA ( Center for Development and Population Activities) were among the first guests.

Gathering of guests in the courtyard.

Traditional Birth Attendants gathered in one of the rooms adjacent to the courtyard. Frankly, I did not see much interaction between them and the guests. Perhaps they were planning their strategy, or more likely  just resting before the guests arrived.

A few scenes from the courtyard:

A retired birth attendant.

A retired birth attendant, her colleague ( also retired) and her granddaughter.

Male Peer Counselors visit the marketplace to counsel males on the importance of  family planning.

Finally, Pathfinder volunteers at a university in Kano dispensing information on AIDS prevention.

I will be completing this series of  with two new posts on PPFA’s work in a Christian community in northern Nigeria.