International Women’s Day 2018

Every year I write about International Women’s Day – the day set aside to honor women, to highlight the critical role they play in all of life. From nurturing life at its earliest stages to nurturing families, communities, and countries, women are critical to human survival. Not only do women change the world within homes and communities, but they also change the world in their workplaces. But there are still huge changes that need to happen so that women can not only survive, but thrive.

The very first International Women’s Day took place in New York City in 1909 on February 28th. In 1917, the Soviet Union declared March 8th a national holiday. It is interesting that the first countries to embrace International Women’s Day were socialist and communist countries. (That, my friends, is an observation, not an opinion.)

Though I believe implicitly in the importance of this day at every level, this year I find it more difficult to write about. I feel curiously uninspired and not a little discouraged. It seems that we can’t even agree on Women’s Day, let alone anything else. Sometimes we women are our own worst enemies.

As I was thinking about this, I decided that today I would highlight a project that I have been involved in this past year and introduce some of the unique women who have participated in the project.

Let me give you a little history: I began my job working for a state department of public health nine years ago. I began in a consultant role, and three months later I was hired as a full-time employee. The program I work for is a federally funded women’s health program that focuses on breast and cervical cancer screening in underserved communities. Two years after I started I began asking aloud if we might think about doing a project with the Muslim community in Massachusetts. It’s a big, diverse community and I believed we had a lot to learn about the community. Every year I brought it up. Like a record that is scratched and broken repeating the same thing over and over I would say “What about the foreign-born Muslim community? What can we learn in this community?

A year and a half ago, we received funding to do an assessment on attitudes toward breast and cervical cancer screening in the foreign-born Muslim community. I was over the moon.

We finished the assessment this fall, and our next steps are working side by side with the community and taking what we have learned to develop community and health provider trainings.

This project has been a gift. In an era where Muslims are seen as ‘other’ and therefore suspect, I have had the privilege of meeting with Muslim women from many parts of the world. All of them were born elsewhere and most came here as refugees. I have met doctors from Syria, Algeria, and Iran. I have met public health professionals. I have met housewives and many in the service industry. Every one of them has experienced untold loss, and many can never go back to their countries of origin; many cannot go home.

There’s Heba, a brilliant doctor from Syria. She has embraced this project and opened her heart. She is a gifted teacher and watching her speak to her community is amazing. Besides this, she has a new baby boy and a four-year old daughter.

There’s Afsaneh. Afsaneh is from Iran and she is also a doctor. She too has welcomed the project, leading dynamic focus groups so that we can learn from her community.

There’s Houria from Algeria; Saida and Naima from Somalia; and Annam from Pakistan. All of them have offered their unique perspective and stamp on the project. They are diverse in age, culture, and views of Islam, but all of them care deeply about their communities and their faith.

Those of us who are working on the project have been received into the broader Muslim community with uncommon generosity and grace, sharing meals and conversation, brainstorming sessions and ideas. Although we could easily have been viewed suspiciously, we weren’t. Instead we were welcomed with arms and hearts wide open.

And we have learned so much. Women shared honestly and openly about their views towards women’s health in particular, and the health care system in general.

I’ve learned a lot in this project, but one of the biggest things I keep coming back to is that change takes time. For me, being bold for change meant being persistent in my request for time and funds to do this project. Being bold for change means humbly going to a community and saying “I don’t know enough. Please help me understand more.” Being bold for change means going out of your comfort zone and hearing another point of view, another side of an issue. Being bold for change means building bridges that connect, not walls that divide. All of this takes time.

Today on International Women’s Day, I celebrate this project even as I remember the bigger picture that shows me so much more needs to be done. Happy International Women’s Day 2018 – All is not lost. 

Building bridges means moving beyond my enclave of cultural comfort to a place of cultural humility and willingness to learn.”*

____________________

*from Between Worlds, Essays on Culture and Belonging

Cross-cultural Connection

Recently I went to an outreach center in a different part of the city, a few blocks from the subway and behind the mosque in Roxbury. This area is perhaps the most diverse area in Boston. Here people from all over the world find their homes in apartments and houses. Residents are from Somalia, The Sudan, Ethiopia, Iraq, Senegal, Nigeria, Ghana and many more places. A large community health center in the middle of the community attempts to meet a myriad of health and social needs of residents.

We have tried to outreach to this community with health education for about a year and a half. We partner with a community based organization who are part of the community and committed to working within to make it a healthier and better place to live. I love this group. They are smart and funny. They work hard to create safe places where health messages can be heard and understood.

Tuesday was a breast health education session delivered to Somali women. They were all over 50 years old so in the age range where the majority of breast cancer cases are found to occur. Through interpreters and funny stories, poignant re-telling of hard events and sharing of different cultural beliefs we went through the session page by page. Time stopped as we gathered in a hot room talking, listening, learning. Between trainers, attendees, and a colleague we were from Nigeria, Ghana, Ethiopia, Eritrea, Somalia, and America.

This is where I learn why certain myths about breast cancer exist – for they don’t come out of mid-air, rather they are based in stories and events. This is where I learn that the women present believe that trauma to the breast causes breast cancer. “We come from a place where there is war” says one. “And the soldiers take their guns and hit us in the breast to keep us moving. Then we get breast cancer.” We talk about this and I’m not sure how far we get. It will take more conversations, more events, more relationship building to convince them that this is not founded on fact, on evidence, but on story.

This is a world I love. A world where interpreters and native speakers gather with others and connect over a common cause. A world where it doesn’t matter that the session was supposed to take 45 minutes and it took an hour and a half. A world of women from different cultural backgrounds, where I in my western clothing and they in their Somali clothing, head scarves wrapped tight, could begin the long dialogue of understanding. A world where skin color varies from pale cream to glowing, dark brown and every shade between.This is a world that resonates soul deep. My heart was full of the joy of connection and belonging. This is a world I know. A world I love.

It’s times like these that the early mornings and occasional mediocre days of the working world fade into the background, gloriously overshadowed by cross-cultural connection and with this, contentment.

Readers – I want to connect you to an amazing resource today! A friend of mine from years past has started a service called Kids Books Without Borders. Gail grew up overseas in France with a British mom and an American dad. And she loved to read! She has collected over 2000 books! 2000 BOOKS!!! And she now extends this love of reading and books to those who live overseas. All she asks is that you pay the postage. This is what Gail says:

Does your family live overseas and enjoy reading?  I have collected over 2000 books, available to you. I will send you a box of books to a US address or directly to you overseas.  All books are free. If shipped in the US, postage is also free.  If shipped overseas, I ask that you pay half the postage. Check out my website and submit a request.  I will then send you my booklist, so you and your family can shop!  

Think Christmas! Think Books! And then contact Gail at kidsbookswithoutborders.wordpress.com

Broken Made Stronger

Today’s post is written by Brooke Sulahian. Brooke and I have never met, but every time I receive an email from her I stop and read it. Because Brooke has a passion and a mission: to see women who are suffering with fistula healed and whole. She began an organization called Hope for our Sisters, Inc. with a mission statement that is simple and enormous:

“Changing the lives of women, one woman at a time”

I hope this post by Brooke brings you both hope and a challenge. In fact, i would love for this post to generate funding for one more surgery! just $450.00 to give hope! You can read more about Hope for Our Sisters, Inc. by going to the website.

My heart broke in Angola, but it was not Angola itself. Abject poverty, lack of sanitation, and poor medical care options abound. However, Angolans display pride in late-night celebrations and the care invested in each basket made and produce sold. The paradox of pride and joy midst sadness and need.

My heart broke anew when I dove deeper into the realities of fistula, a medical condition caused by obstructed labor and/or trauma leaving women incontinent, resulting in isolation from family, friends and society, lack of dignity, and loss of hope. Lives destroyed.

My door was open. My first trip to Africa. I dreamt of this journey since reading about fistula in 2010. Friends and family supported me with prayers and financial aid. Yet, constant questions took residence in my mind.

Why was I going to Angola? I’m not a doctor. I don’t speak Portuguese. I am simply a wife and mom who said, “Yes”, when called to speak out for our sisters with fistula. Was that enough? Through God, Hope for Our Sisters, Inc., (HFOS), had been fruitful, but I still had questions. In the end, I went.

I traveled with three HFOS team members (Kristen and Paul Coats, Jean Campbell) to visit the Evangelical Medical Center (CEML) in Lubango and bush hospital in Kalukembe, where we fund fistula surgery. We hoped to meet fistula patients to enable us to more effectively raise awareness, help others find healing, and work to prevent this horrific condition. God surprised us as we met fifteen precious fistula patients! Through Audrey Henderson, nurse, fistula advocate and interpreter, we respectfully captured their stories through pictures and video.

Another surprise awaited us as Dr. Steve Foster invited us to watch fistula surgery. Ana* was first to the operating room. Filled with fear in a new environment and unable to speak Portuguese, what amazing courage it took for her to come to CEML. At 20, having lost her first child during labor, Ana* longed for healing from fistula. Joy replaced her fear as she took this brave step towards restoration.

Celia* developed a fistula after her sixth pregnancy. In December 2012, at 29, abandoned by her husband and damaged by fistula, she left her three children with family to travel all day to the hospital. As Celia* awaits healing at the Patient Village, she displays amazing resilience; smiling, laughing, and teasing with fellow fistula patients, living as one victorious.

Luisa*, 32, stays at the Patient Village of the state hospital in Kalukembe, the one remaining former missionary hospital of the 150 before Angola’s civil war. Abandoned by her husband in 2009 after developing fistula and losing her child, Luisa* arrived in December of 2010. After nine unsuccessful fistula surgeries, she remains hopeful. Successive surgeries often decrease the chances of healing, but Dr. Foster recently helped a patient become dry after eleven surgeries. There is hope. Luisa* and fellow fistula patient, Joaquina*, have become each other’s “family” as they await healing.

As for me, I returned with a broken heart. A cost we must all be willing to pay when pursuing justice and healing. An incredibly minor cost in comparison to that paid by those robbed by injustice, but a true cost nonetheless. However, it can make us stronger.

I return to America with greater passion as we continue to raise awareness of fistula. Since these sisters cannot afford to pay for surgery, HFOS’s donors and supporters enable us to fund free fistula surgeries. For less than the cost of a new iPhone ($450), the life of a woman or girl suffering from fistula can be physically restored, paving the way for social, emotional and spiritual healing.

160 fistula surgeries funded…many lives restored…more to come…

*Names have been changed to protect these sisters who so openly shared with us.

Brooke F. Sulahian is the President and Co-Founder of Hope for Our Sisters, Inc. For more information about Hope for Our Sisters, Inc., or fistula, please go to the website at hopeforoursisters.org or visit the Hope for Our Sisters, Inc. page on Facebook.

We Have Work to Do! State of the World’s Mothers – #SOWM

During my flood relief trip in Pakistan a couple of years ago I witnessed severe malnutrition among babies and toddlers. Break your heart malnutrition and hunger. Shout for joy Plumpy’nut solution in some cases. Moms and babies have my heart – probably because I am one and I had five. Getting a good start in life changes a generation and with catastrophes like floods and earthquakes, the chances of having that good start decrease.

For the past 14 years Save the Children has published an annual report on the state of the world’s mothers. The report is long and detailed, providing key findings as well as giving recommendations. The data includes information from 176 countries on the health of children, health of mothers, and economic well-being. Finland came in first and Congo came in last.

This year’s report was released yesterday. Here are just a few of the findings:

The birth day is the most dangerous day for babies world-wide.

More than a million babies die on the first day of life, usually from preventable causes. While great progress has been made around maternal/child mortality, newborns continue to be the most vulnerable of all with little progress made around their health and survival.

Three primary causes of death were identified.

These include complications during birth, prematurity and infections. For all three of these there are interventions that work, that are effective, that can change these statistics. The number of newborn deaths could be reduced by 75% if these preventive measures were put into place. That’s a staggering success rate!

The interventions cost pennies to put into place – from 13 cents a day to $6 a day.*

  • steroid injections for women in preterm labor (to reduce deaths due to premature babies’ breathing problems);
  • resuscitation devices (to save babies who do not breathe at birth);
  • chlorhexidine cord cleansing (to prevent umbilical cord infections); and
  • injectable antibiotics (to treat newborn sepsis and pneumonia).

This is a big deal. Give a baby a healthy start and you change a generation, one baby at a time. Where it stands now is a public health crisis. 

So what do we do? How can we help? If you’re pregnant you help by taking care of yourself, of your baby; by eating right and getting prenatal care. Others of us can pass this information on – if we live in countries that fall at the bottom of the list find out what we can do in both big and small ways. If we live in the United Kingdom or the United States – take a look! The United States falls 30th despite spending approximately 18% of its GDP on health care. This is just sad.

  • 1 of 2,400 women in the United States will die from a maternal cause. This statistic is the same as Iran.
  • In the United States 60% of newborn deaths occur on that critical first day of life.
  • The United Kingdom fares better but not great at number 22 on the list. 

Take a look at the report linked below and the Save the Children website. Learning about this is the first step in making a difference! I’ve also included a link to a Huffington Post article that has a great infographic you can share. Huffington Post infographic.

What do you think of the statistics and the low cost interventions? Have you had maternal child health experience where you have seen these interventions work? Would love to hear from you in the comments! 

Code Pink

October is breast cancer awareness month. In my work this is an important month. It includes legislative breakfasts, educational sessions, screening events, and op-eds for newspapers.

Despite the plethora of information on breast cancer there are times when the information gets lost in the shuffle of life. Messages that would best go from our heads to our health get lost. In an effort to change that I’ve posted an infographic on breast cancer. It’s a different way of looking at what may be old information.

My hope is that you will not only look but act — if you’re young make sure the older women in your life see and know the facts; if you’re older make sure you are regularly screened; if you’re a survivor, share your story! We need to hear it.

Make October more than pink ribbons – make it action!

Code Pink

Altering Body and Soul – A Guest Post

Blogger’s Note: Daily as I take the subway home I  see a little boy with brown-rimmed glasses walking with an older woman. He seems tiny for his age, oblivious to the adults around him, much the same as other children. The thing that distinguishes this child from others is the tube that comes out from under his shirt, stretching around his tiny tummy to his back and attached to a quart-sized bag. The bag usually has a bit of greenish brown liquid in it. I don’t know him, and I don’t know his situation but I do know that he is already living life differently than his peers. He lives with an altered body.

He is not alone — this essay by my cousin Janice Klingberg takes us into her world of living with an altered body.

More than 35 years ago, I made an irreversible decision that was to impact my life more than I really knew at the time.

I was diagnosed with ulcerative colitis at the age of 15 but tried to participate in school and other activities as a normal teenager despite the physical discomfort and perpetual worry about accidents. Living through my teens and into my 20s was challenging, but I was relatively good, I thought, at hiding the impact of my illness.

I was grateful that in so many ways my life took an ordinary path—college, teaching career, marriage and children. Despite this, after our younger son was born in 1974 my colitis went wild, in part because of uncertainty about his health. I couldn’t ignore this exacerbation or my new understanding that years more with the chronic condition would make me more vulnerable to malignancies—read that, cancer of the colon. Years earlier, though advised that I might want to consider surgical removal of the colon (total colectomy), I was not emotionally ready to take that major step. By 1975 I was almost relieved when I made the decision to move forward with the surgery and live the rest of my life with an ileostomy—an opening (stoma) on my abdomen through which feces is diverted.

After my recovery and with the loving support of my husband, I was determined to continue living well, but this time without pain or anxiety about toilet facilities. I’ve had to deal with other issues related to my redirected plumbing, but overall, I have been a much healthier person than I ever was before my initial surgery.

I have now lived with an ileostomy longer than I lived without one, and though it’s part of who I am, it does not define me. I have shared my journey with others facing the surgery in the same way people helped me wrap my brain around its long-term impact.

One of those individuals, a young woman my age, helped rid me of fears that I wouldn’t be able wear attractive clothing again and  suggested lifestyle changes that would make it easier for me to live with an ileostomy, something that was daunting for a 30-year-old.

Surgery where the body is altered has life-changing potential.

There were unexpected and positive side effects. The entire experience helped to refine my vocational direction– I knew that I wanted to be involved in something that would make life better for others and add meaning to my own life. Stewardship of my God-given skills and talents became even more important to me, so I plunged into the nonprofit communications and fundraising arena. Many dedicated professionals challenged and energized me over the years as we worked together to improve the quality of life for thousands of people.

However imperfectly I contributed to those efforts, I am grateful to have had many opportunities to be part of something bigger than myself; something that brings satisfaction and meaning to my soul.

We live in a world where body image is often skewed and the temptation to define ourselves based on our physical features is strong. As I look back I am grateful to be able to bear witness that life has gone on—indeed, even improved and become more meaningful—after the initial shock of waking up from surgery with my altered body.

On What Planet is This Women’s Health?

The magazine caught my eye – it had bright colors and screaming headlines, plus beautiful Kate Beckinsale was on the cover. And then I realized it was about Women’s Health.

I work in Women’s Health. Daily I present, write, research and talk to women about health; specifically breast, cervical, colorectal and cardiovascular health.

I know health. I know illness.  And the magazine cover below is not health. It’s a poor imitation and false representation of health.