Photos for Millennium Development Goals for UN week Sept. 21-26 2014

I was asked by FHI 360  in collaboration with Women Deliver, Girls’ Globe and Johnson & Johnson to contribute some of my photos from my upcoming book: Faces of Courage to present during this year’s UN General Assembly opening session the week of September 22-26 in New York. They are creating an online campaign centered around the Twitter hashtag #MDG456Live to draw attention to how the development community is addressing women’s and girls’ issues related to MDGs 4, 5 and 6 at the UN General Assembly. I am very proud to be part of this effort. Here are a set of bookmarks that will be distributed:

 

 

 

 

 

 

 

 

Novartis Malaria Initiative

Malaria is one of the great scourges of mankind.

In 2011 and 2012, I traveled the world in cooperation with Novartis to document the impact that malaria has on people — and to show that,with the right combination of know how, technology, resources, and collaboration, malaria can be beaten.

Through my photographs I witnessed the amazing story of the Novartis Malaria Initiative.

This massive program has delivered 600 million antimalarial treatments to adults and children in malari-infested regions across three continents

The following link will take you on a remarkable journey, from the creation of the antimalarial active ingredients in China,
to the treatment of malaria patients in Africa and Asia.

http://www.malaria.novartis.com/malaria-initiative/onlinebook/index.shtml

I hope you enjoy traveling with me on this journey.

Teenage Pregnancy in Guatemala

In Guatemala, half of all young women marry before the age of 20. Only five percent of them use an effective method of birth control.
Forty-four percent of women become mothers before they reach 20; the proportion of young mothers is even higher among women without education (68 percent) and among indigenous women (54%). By the time they turn 30, many of these women have seven or eight children.
Although there is a federal mandate to provide universal reproductive-health education and healthcare , entrenched cultural norms and the
influence of the Catholic Church mean that very few young people receive it.

Early motherhood is recognized throughout the world as a factor that negatively impacts the physical, emotional, and reproductive well-being of young women, as well as the pace of a country’s development. In Guatemala, scarce economic resources limit the lives of most young people; an unplanned pregnancy adds further weight to their burden. Thus, it is imperative that young people have access to education regarding the additional social, psychological, and health consequences of teen pregnancy.
Stuart Schear, the former Vice President of Communications for Planned Parenthood, has written about a very innovative program that is directed at teenagers.
To quote from his blog, funding and technical assistance from Planned Parenthood supports “Tan Ux’il, a local youth organization active in the rural northern region of Petén. Tan Ux’il seeks to ensure that young people between the ages of 12 and 19 have accurate information about sexual health and birth control. The organization also advocates for health services for pregnant women.”  TanUx’il’s young activists also created a friendly clinic in a local hospital that caters to young pregnant teenagers.

The full waiting room of a prenatal clinic in a regional hospital in Peten Guatemala. The youth activist of Tan Ux’il lobbied for this youth friendly clinic and suggested that it be painted in bright colors.

A young pregnant teenager  waiting for her pre-natal exam.

This pregnant young girl is only 16 years old.

Her boyfriend was 24.

Gomber, a young DJ for Sexo Tips Radio, who shares tips about sexual health and birth control with her audience in Guatemala between playing pop songs.

Elmer, a founder of Sexo Tips Radio,  plays  popular music and answer questions from their peers about sex and puberty.

Some of the other teenagers of Tan Ux’il broadcasting their Sexo Tips radio program.

Dowry Abuse in India- Action India Women’s Support Group

This January, I documented the work of Action India, a grantee of the Global Fund for Women. Action India is involved in many aspects of women’s empowerment; one aspect of their work in particular, however, moved me the most: supporting women who have been victims of dowry abuse.
The Global Fund’s Anasuya Sengupta gave me the following overview:
“Dowry-related violence and death are simply one form of domestic violence that happens in India and around the world. Yet dowry abuse is a particularly pernicious form of violence, because it is closely linked to culture and religion. When they marry, women in many Indian communities take into their marital home ‘stree dhana’, or ‘women’s wealth’, which often consists of jewelry or clothes from her family. The value of the dowry has actually increased over the last few decades (in parallel with India’s economic liberalization) as a means of rapid economic gain. And the custom has even spread into communities that did not traditionally practice any form of dowry. For example, the dowry can now be found in some Muslim and indigenous (adivasi) communities, where the groom’s family traditionally paid a mehr or a bride-price. These trends have occurred despite the fact that the giving and receiving of dowry is technically illegal in India, although rarely enforced.”

The stories that I documented in India include horrific cases in which husbands and their family burnt women alive for not paying an ‘adequate’ dowry. One victim of dowry abuse whom I met was Nazia. She told her story to a women’s support group. We are in a tiny room no larger than 10 feet wall to wall. Women fill almost every inch of floor space. Most of them appear to have suffered physical abuse, and they have now gathered to support Nazia. It is hard for Nazia to speak; she is on the verge of tears, as if she has already used up all of her courage simply to come here. The support group is very important and encouraging, yet it’s hard not to feel disturbed by all the stories of mistreatment and violence.
Many perpetrators are literally getting away with murder. I asked an Indian woman who was traveling with me how this can be possible. She explained that people just make up excuses to make it seem as if the abuse and murders are all self-inflicted. For example, the family that hung their daughter-in-law could claim that the victim had felt suicidal and hung herself. Or if they badly burnt a daughter-in-law, people could claim that her sari caught fire.

Nazia is 21 years old. She has been married for two years. Her husband’s family demanded a motorcycle as part of the dowry, for which her parents gave 50,000 rupees(US$10,000) for the motorcycle. But this wasn’t enough, so the husband demanded a car. But the cost of a car was far beyond what Nazia’s parents could afford.  One day when Nazia was riding with her displeased husband on the new motorcycle, he pushed her off. His intent was clearly to kill her and cover up the murder as a traffic accident. She was seven months pregnant at the time.

After Nazia survived the “accident,” her husband tricked her into taking some medicine to help her recover. Instead of feeling better, she felt ill and went to the hospital, where she delivered a stillborn child. After Nazia was discharged from the hospital (which required her husband to sign some papers, apparently) he left without her. Nazia has been living with her mother for the past five months. She wants a divorce and the return of her dowry. She broke into tears shortly after I photographed her.

Shanthi had only one daughter named Kavita. When Shanthi marrid, her in-laws demanded 5,000 rupees. But she could only afford 3,000. For lack of 2,000 rupees (US$40) Shanti’s in-laws hanged and murdered her daughter, Kavita.

Kamalesh is a woman with a very abusive husband (note the scar underneath her eye). He is a drunkard and regularly beats her. She still lives with her husband but on a different floor of the house. The husband does not take care of her or her children, and Kamalesh has nowhere else to go.

A mother and daughter in a rural village, 70 km outside of Delhi. I believe the mother’s name is Indu and her daughters is Tinko. Tinko had suffered through five years of abuse. She is living with her mother now, who is very supportive.
Here is a recent article by a very well-known Indian journalist, Kalpana Sharma, which gives a strong analysis and overview of dowry-related violence and homicide in India:
http://www.thehindu.com/opinion/columns/Kalpana_Sharma/article2856945.ece

To quote from the article:
“The official figures of dowry deaths are obviously just the tip of the iceberg. A truer picture would emerge if we added the cases of young married women registered as having committed suicide.
Dowry has not disappeared. It has morphed. Seema Sirohi, in her interesting and relevant book Sita’s Curse, Stories of Dowry Victims (HarperCollins, 2003), gives this humorous yet apt description of dowry as it has come to be today: Dowry has become a bribe paid to a husband to keep the bride’s body and soul together. A woman is a mere conduit to a ‘good’ dowry – the
definition of ‘good’ being flexible and expandable. The boys are on sale and
there are few discounts in the marriage market. There is no ‘buy one, get
one free’ here. It is a transaction weighted against the woman. In fact, it is a sale where even after the price is paid, satisfaction is not guaranteed. And ironically, the sale is never complete with marriage – the buyer is expected to keep paying in cash and in kind during festivals, to celebrate childbirth, and to mark ritualistic occasions. Any excuse is good enough to keep the one-way street laden and moving with gifts.
The fact that women are still being burned for dowry in modern-day India should enrage us. Why are we accepting of this outrage, this insult to the sensibilities of all women? We should be burning dowry, not women.”

Planned Parenthood Global and Soccer in Kenya

(The following text has several contributors- primarily Joyce Ho, a Graduate Media Fellow from the Stanford School of Medicine and Leila Darabi from Planned Parenthood Global).

In Kenya, Planned Parenthood Global (PP Global) works with several local soccer leagues to integrate sexual and reproductive health education and services into their programs.

For many, expectations for their educational and career success do not extend beyond completing primary school. Some are already mothers. Joining an athletic league provides these young women with the chance to exercise, become part of a team, and have some fun. Evidence shows that young women who participate in team sports are more confident, stay in school longer, and set more ambitious career goals than those who never get to run across a field or score a goal.

Using their Youth Peer Provider model, PP Global’s partners train young people to become health educators and contraceptive counselors in their own right. Youth Peer Providers work closely with local clinics and are trained by public health experts to teach their peers how to avoid unwanted pregnancy and sexually transmitted infections, and to provide contraception to young people who need it. This peer-to-peer model circumvents the stigma and barriers that surround adolescent sexual and reproductive health services. In countries where talking to young people about sex remains taboo, Youth Peer Providers help their counterparts delay pregnancy, stay healthy, and stay in school.

We will follow two girls: Sylvia, who lives on in the Kilifi district on the coast of Kenya and Anne, who lives in an urban slum in Nairobi (names changed to protect their privacy).

In the Kilifi District on the coast of Kenya, HIV and teen pregnancy trap some of the world’s poorest and most disadvantaged adolescent girls in a relentless cycle of poverty. A local community organization called Moving the Goalposts (MTG) sought to address this issue by organizing a young women’s soccer league. By engaging these young women in physical activities that promote camaraderie, MTG helps its players build self esteem and leadership skills. The framework for MTG represented a unique entry point for reproductive health initiatives for these young women, to give them the knowledge and tools to protect their sexual health.

In 2011, MTG and Planned Parenthood formed a collaboration to build a sexual health youth peer provider program into the soccer league. Sylvia, age 22, is one of the first peer providers trained through the MTG and Planned Parenthood program in Kilifi. She plays on the older girls’ soccer league and teaches sexual health classes to her peers before games.

The unique quality of the peer provider program lies in increased access to the target population. Young people are hard to reach, especially in areas where enrollment in school is limited. Sometimes adults speak different languages from the younger generation, and oftentimes, youth shy away from asking questions about sexual health out of embarrassment or discomfort. Peer providers know exactly how to reach the ones they are trying to help – they know how to communicate effectively and lessons are safe places where girls can ask any sort of question and not feel embarrassed. Here, Sylvia demonstrates the proper way to use a condom while her teammates listen and learn.

A young woman in Kenya knows that if she gets pregnant, she will probably be forced to drop out of school and the course of her life will be unalterably changed, leaving her with very limited options.  Through MTG and Planned Parenthood, these soccer players are becoming empowered to take their health needs into their own hands. Sylvia, a star player on her team, understands the importance of this program, and thus devotes many hours a week to peer counseling and soccer practice.

The girls don’t live close to the soccer fields. Many players walk miles from the slums to the more well-kept neighborhoods where the soccer games are held, demonstrating their true dedication to the program.

Sylvia lives at home with her mother, the head of the household, who is proud to have such a responsible daughter who spends time volunteering to help her community. Sylvia has an older sister who is currently married with children, and Sylvia  wants to finish her education first before embarking on a similar life path.

Next year Sylvia plans to start classes at the local university. After finishing secondary school, she took time off to work and save up money, all the while debating whether college was within her reach. Sylvia’ experience with the team and the Youth Peer Provider program helped build up her confidence and plan for her future. This is in stark contrast to the future in store for many of her peers who haven’t finished secondary school and are already mothers. Sylvia has truly broken the mold, and unlike most of the young women who grew up in her neighborhood, she will make it to that next level of education. It is our hope that Moving the Goalpost and Planned Parenthood Global can continue to work together to inspire other similar girls to take ownership of their futures.

In Nairobi, PP Global partners with the Bravilian Queens, a nonprofit that organizes several teams in the newly established Nairobi Girls Soccer League. The program takes advantage of team practices, a time when a group of young women are gathered together, to provide basic sex education and answer any questions about puberty, sex, relationships and contraception.

Anne lives in one of the urban slums of Nairobi. To reach her home, one has to walk past an open latrine and then walk about 400 meters over a hill on a path littered with trash.

Here she is pictured with her parents and her younger sister.

Anne is not a Peer Counselor but one of the girls whose self-esteem is greatly benefited by her athletic prowess on the soccer field and her knowledge of her own reproductive health care needs.

Anne participates with great enthusiasm even though she does not have the funds to buy a pair of soccer shoes. She either borrows a spare pair when available or, in most cases, plays in knee socks and sandals.

Kibera

This past year I had two opportunities to photograph in Kibera, Kenya, which is the second largest slum in Africa and the third largest in the world. Even though I have witnessed poverty, the physical landscape of Kibera was, to put it frankly, quite overwhelming.

The population of Kibera is estimated at 1.1 million people, up from 700,000 ten years ago. There is no infrastructure, no roads, no safe drinking water, or sewers. Kibera is created from scraps of tin and mud. The photographs presented here were all taken on my way to do work assignments in the AMREF Clinic (for the Novartis Malaria Initiative) and in the Tabitha clinic (for Planned Parenthood). All of the photos are “grab” shots. Some were taken from the vehicle that we used to get to the AMREF clinic. The car I was in had to inch it’s way along narrow muddy streets barely wide enough for our vehicle. Outside my window, people were going about their daily life not more than three feet away.

On my second trip to Kibera we walked to the clinic, and I had to be very mindful of each step to be sure I wouldn’t slip and fall into the mud and refuse. It was rather uncomfortable for me to take photos in these circumstances, as I felt that people really did not want to be photographed. It’s not my normal practice to work under these circumstances, but I felt obligated to document these living conditions and to share them with the outside world.

The poverty in Kibera was overpowering. Any solutions for alleviating or improving the situation here seemed to be beset by incredible complexities. I was recently at a conference on global health and food security at Stanford University, where I asked an expert in this field about dealing with the poverty found in large urban slums such as Kibera. He admitted that they had not discovered any effective strategy to deal with it.

I am hoping that this post will open a forum for ideas that readers may have in improving the living conditions found in places like Kibera. My impression was that whatever was being done was not effective; of course, the healthcare provided in the clinics I visited was very relevant and made a real difference in people’s lives; but when the population of Kibera has grown by 50 percent in 10 years, larger-scale solution are needed.

Below are a small sample of some of the photos and to see the complete portfolio in a larger format, please go to:

http://www.tuschmanphoto.com/kibera_web

The first image is on the outskirts of Kibera.

There are a series of photos at the end of the portfolio on all the “hair salons”. I found it hopeful that even in dire poverty, people try to look their best and dream of a better future.

A few 2011 highlights

I had the privilege of working on some very satisfying and rewarding projects this past year. I documented the Novartis Malaria Initiative and a few of my photos were recently used in an ad for Novartis in the Dec. 19th issue of the New Yorker. Here is the ad and I have also included the two images uncropped.

I also had the privilege  of photographing a library of images for Planned Parenthood Global and here are a few images that were used in their Annual Report:

To see the full Annual Report, here is a link: (All the large double paged photos are mine with the exception of the one taken in the US).

http://www.tuschmanphoto.com/pdf/International_Brochure.pdf

On the local level I photographed an Annual Report for the Palo Alto Medical Foundation focusing on their oldest patients. Despite the stereotypes of old age, these people were very inspirational. The youngest person, in their late 80’s was a ballroom dancer and the oldest- and this was hard for me to believe- was 105 years old, lived in her own home, had just come back from a cruise and wanted me to help her buy a new computer!

Here is a link to a pdf of the PAMF AR.

http://www.tuschmanphoto.com/pdf/PAM035_Annual2011_lowres.pdf

Several of the images from this past year received awards in photography competitions.

The image of the Ecuadorian women below was awarded a fifth place award in the APA Something Personal Exhibit in SF this past January.

One of my portraits was nominated among the best in the portrait category of the

INTERNATIONAL COLOR AWARDS PHOTOGRAPHY MASTERS CUP. Photo is below:

And finally the following image was accepted into the One Life International Photography Competition. It was taken while I was documenting a girl’s education program in Rajasthan.

I also was fortunate to collaborate wit Gayle Peterson, a philanthropic consultant, on her new venture.

Click here to see the full muti-media presentation:

http://tuschmanphoto.com/Partners_for_Change_.mov

I will be posting stories from the work I did for Planned Parenthood and the Novartis Malaria Initiative. My next post, however, will be on the problem of third world urban slums, in particular, the slum of Kibera in Nairobi, which I had the occasion to visit twice this past year.