Blissless Matrimony

By Bethlehem Kiros

GOHA, AMHARA REGION-  For Serkadis Hunachew, her wedding, instead of a happy, blissful day,  was an utter source of anguish, an untimely and forced rite of passage. “I was crying when people were dancing and celebrating,’’ says the 13- year-old regarding her wedding ceremony that took place two years ago.

According to Serkadis, her tears were preceded by shock as she was completely unaware that she was about to be married until the very morning of the ceremony when they were dressing her for the occasion. To her, marriage meant tragedy as it would not only loot her of her childhood but also shatter her dream of finishing school and making something of herself. At first, she contemplated running away but later decided to stay in order to spare her parents the embarrassment. She says that the only comfort she had at the time was the possibility that the marriage could be annulled after the ceremony.

AMHARA_274_IMG_0662, Bindra
Serkadis Hunachew, 13, (left) is one of the thirteen children of a destitute farmer who gave her away in marriage, mainly to relieve himself from the responsibility of providing for her. Haimanot Gashu (right), 12, sits in a classroom with Serkadis where they are in 6th grade at Goha Primary School in Goha Kebele (sub-district)

As the day advanced and guests flocked to their house, the celebration and dancing escalated but Serkadis’ gloomy mood did not change: a situation that annoyed her father. “He hit me because I couldn’t stop crying,’’ she recounts. When a wedding day ends, the custom is for the groom to take his bride at the back of a mule to his own parent’s house but Serkadis, still very upset, refused to ride with him. “I rode with another boy from my village all the way to Ambessame,’’ she explains. Ambessame is the nearest rural town to her village and the seat of the Dera woreda (district) administration.

Though the wedding officially renders her married, it was not expected of her to commence her wifely duties, as the arrangement was to keep her under the custody of her parents until she is considered fit to run her own home. Hence, after she spent five days with her husband’s family, sharing a bed with his sisters, she returned back to her village, Goha upon the request of her parents.

The Ethiopian constitution clearly stipulates that in all actions concerning children, the best interest of the child should always take precedence. Moreover, the government has ratified international conventions that stand for the protection of the rights of children and various governmental and non-governmental organizations are working to support the abandonment practices such as child marriage that are clearly against the best interest of children. Yet, Ethiopia remains to have one of the highest rates of child marriage in the world. At the forefront, is the Amhara regional state where almost half of the female children are said to be married before they reach 18, although the regional government has adopted the federal family code that criminalizes marriage before the age of 18.

Poverty, which is the primary challenge of the region, is said to be one of the main driving factors for child marriage. Serkadis’ parents are also admittedly unable to provide for her due to their poor means of survival. “They told me that their main reason for marrying me off is their inability to send me to school anymore,’’ she says. When her parents say they cannot afford to send her to school, they are referring to the school materials, mainly notebooks that they are only expected to purchase a few times a year, (not school fees, as government schools are tuition free).

Second to the last of 13 children, Serkadis states that her family lives in extreme poverty that worsened after a large part of their land was apportioned among her brothers who have started their own families. “My parents have not bought clothes for me for a while and it is my teachers that even buy soap for me,’’ she says.

When she got back home after her honeymoon and they broke the news to her that she would not be going to school, her response was, “If I have to, I’ll move to the city, work as a house maid and earn my own income to go to school.” However, she might not need to go to that extent as one of her brothers, who recently heard about her marriage, invited her to live with him in Bahirdar city where she can go to school while helping him in his shop.

AMHARA_275_IMG_0685
Haimanot Gashu (center), 12, stands outside the Goha Primary School in Goha Kebele, Dera Woreda, Amhara Region, Ethiopia, 28 January 2015. Married at the age of seven, she is currently under a lot of pressure from her mother to move in with her husband, as she is now considered old enough to run her own home. She currently lives with her uncle and aunt.

Serkadis is considering taking her brothers offer since her father has informed her that she will move in with her husband at the end of the year. Despite the continued pressure from her family, Serkadis persists with her decision to take no part in the arrangement. According to her, she is so detached to the whole idea that she did not even make an effort to know the name of her husband. “What good would it do for me to know his name? I don’t want anything to do with him,’’ she firmly states.

Due to the wedding and the ensuing arguments with her father, Serkadis had to quit school during the year of the wedding but she managed to repeat the 5th grade last year and is now at the 6th grade. Before her father pulls her out of school again, she is planning to go to her school headmaster and ask for her school transcript so that she can go to Bahirdar with her sister who recently came for a visit after many years. “My sister was very angry at my father for what he did so she told me that she will take me with her to Bahirdar if I get my report card this week,’’ she explains. Once in Bahirdar, Serkadis will then decide whether she will stay with her sister or brother.

Her only reservation is leaving her mother behind. “My mother has heart problems, and it is me who always looks after her and the house when she gets sick,’’ she says. “But if they are planning to send me to my husband soon, I might as well go to Bahirdar where I can have a better future.’’

Empowering Girls – Empowering Humanity: Picture It!

As part of the Guardian interactive article for the 25th anniversary of UN convention on the rights of the child, we asked children across the country what rights were most important to them. Presented with a child-friendly version of the convention, this is what they had to say.

For the International Women’s Day celebration we selectively pictured the girls.

 Interactive Gallery, click on each image to enlarge and read story. 

 

Trilateral South-South Partnership in Water Supply and Sanitation kicked off

 

South-South cooperation High Level Seminar on Urban WASH and River Basin Management.
Group photo of South-South Cooperation High Level Seminar participants on Urban WASH and River Basin Management, 20 January 2015, Hilton Hotel, Addis Ababa.©UNICEF Ethiopia/2015/Ayene

ADDIS ABABA, 20 January 2015: Today, the Government of Ethiopia organized a high level event to launch a two year South-South cooperation programme between the Governments of Brazil and Ethiopia on water supply and sanitation in Addis Ababa.

Present on the occasion were H.E. Alemayehu Tegenu, Federal Minister of Water, Irrigation and Energy, H.E Kebede Gerba, State Minister of Water, Irrigation and Energy, Ms. Meseret Yetube, Director of Primary Health Services and Health Extension Programme at the Federal Ministry of Health, H.E. Ms. Isabel Cristina de Azevedo Heyvaert, Ambassador of Brazil to Ethiopia, Ms. Angela Spilsbury, Senior Health Advisor of DFID, delegates from Brazilian Government and members of the media.

The high level mission from Brazil comprised of a nine- person delegation to introduce innovative approaches to accelerate the One WASH national programme and address the three pending challenges namely urban sanitation, urban water regulation and watershed management.

His Excellency Alemaneyu Tegenu, Minister of Water, Irrigation and Energy and Chairman of the National WASH Steering Committee in Ethiopia began his keynote address by congratulating the Brazilian delegation who travelled a long journey from South America to attend the inception mission for the South-South cooperation programme. He also thanked the Government of Brazil for letting Ethiopian experts visit exemplary reality in their country within the urban WASH to learn from successful models for the development of Ethiopian towns.

H.E. Ms. Isabel Cristina de Azevedo Heyvaert, Ambassador of Brazil to Ethiopia on her part revealed, “This meeting is one of the main benchmarks of my five year term of office as an Ambassador given its strategic importance for the economy and social development. I really consider this to be chance to participate in a meaningful way of the improvement of the quality of life of people and especially women and children, the most vulnerable beings in the society.”

In September 2014, UNICEF Brazil and UNICEF Ethiopia with the financial support from DFID organized a high level delegation to Brazil led by the State Ministers of Health and Water, Irrigation and Energy. The objective of the mission was to get insights on how Brazil has advanced in providing Water, Sanitation and Hygiene (WASH) in urban areas given its rapid urbanization in the last 50 years, which reduced significantly child mortality. During this mission, the government delegates were impressed by the advances made in managing fecal, solid and liquid waste management in small and medium sized towns. Additionally, they learnt how effective regulation can ensure that low income families and marginalised households in urban areas are able to receive affordable water supply.

South-South cooperation High Level Seminar on Urban WASH and River Basin Management.
Ms. Anupama Rao Singh, UNICEF representative a.i. to Ethiopia giving a keynote speech at the South-South Cooperation High Level Seminar on Urban WASH and River Basin Management, 20 January 2015, Hilton Hotel, Addis Ababa. ©UNICEF Ethiopia/2015/Ayene

Ms. Anupama Rao Singh, Acting UNICEF Representative to Ethiopia on her part said, “UNICEF is looking at different technology options, and with the support of the Brazilian experts, we intend to pilot small scale, condominium, sewerage systems which can better fit the needs of small and medium towns in the country. In addition, UNICEF is supporting the development of the Urban Sanitation and Hygiene policy for a more efficient and coordinated efforts in making Ethiopian towns greener and healthier for women and children and the population at large.”

Through the DFID financed One WASH plus programme, UNICEF has been requested by the Government of Ethiopia to lead the development of a national integrated urban sanitation strategy. The South-South collaboration with Brazil will provide expert inputs to enable the finalisation of this strategy.

Ms. Angela Spilsbury, Senior Health Advisor of DFID announced that the UK Government will provide 106 million euros over the next five years to the One WASH national programme out of which, 22 million will be given to UNICEF to address the needs of women and girls in relation to water and sanitation, enhancing the engagement of the private sector and linking water resources management to climate resilience.

“Ethiopia would like to emphasize on enhancing partnership and development such as this since a national strategy on integrated urban sanitation and hygiene is being developed and hopefully ratified very soon”, said Ms. Meseret Yetube, Director of Primary Health Services and Health Extension Programme at the Federal Ministry of Health. “In line with this, the exchange visit we have been doing will definitely benefit our countries not only in the WASH sector but also in other walks of life”, she added.

The delegation from Brazil will visit four regions of Ethiopia in three teams. The first team will visit Adama and Gonder in Oromia and Amhara regions respectively and will focus on the establishment of independent water regulation for urban settlements. The second team, led by Dr. Samuel Godfrey, Chief of Water Sanitation and Hygiene (WASH) in UNICEF Ethiopia, will visit Tigray with the objective of establishing a “technology transfer” of condominium sewerage for high density population areas. And a third team will visit the Awash basin in the Afar Region to exchange ideas on water resources management. The output of this visit will be a two year collaboration on Water Supply and Sanitation sector between the Governments of Ethiopia and Brazil.

South-South cooperation is a term used by policymakers and academics to describe the exchange of resources, technology, and knowledge between developing countries, also known as countries of the global South. Over the past decade, Brazil´s South-South cooperation with Africa has been growing rapidly and this represents an exemplary initiative of trilateral agreement between the Governments of Brazil and Ethiopia with the support of UNICEF.

 

A Day in the Life of a Well-fed Child: Ethiopia

By Frehiwot Yilma

AMHARA REGION, 05 June 2014 – Kossoye Ambaras is a small lush green village within Wogrea woreda in northern Gondar where it is relatively cold. Amarech Ashager, a 28 years old mother of two, is used to the weather as she lived her whole life here. At the top of her daily agenda is making sure that her family, especially her youngest son, Metages Birhanu of 9 months, is well fed.

Like many of the residents, Amerech does not rise out of bed before 7 a.m., as it is too cold to leave the house. She begins her day by breastfeeding Metages and cooking breakfast for the rest of the household. Her husband, Birhanu Tagel, is a businessman and her eldest son, Muluken, 10, is a third grader. After saying ‘good day’ to Birihanu and Muluken, Amarech will cook breakfast for Metages. Since he was introduced to solid food only three months ago, Metages eats exclusively porridge. Preparing highly nutritious porridge for a child is a technique that Amarech has recently learnt. The base of the porridge, the flour, contains various grains and legumes. For breakfast the added ingredient besides the flour is an egg and minced cabbage. As well as cooking the food, feeding the child to achieve best results is also a discipline. Amarech has learnt to feed her child while also playing and talking to him to keep him engaged.

It takes a village to raise a child

Health Extension workers in Amhara region provide preventive and curative health service to the community
Health Extension workers in Amhara region provide preventive and curative health service to the community ©UNICEF Ethiopia/2014

Amarech and other mothers in the village get support from Health Extension Workers (HEWs) on how to properly raise their children. Today, HEWs Habtam Dese and Yeshiwork Tesfahun are weighing the children in the village to monitor their health and development. They too receive assistance from Gebeyaw Alamerew, the woreda Nutrition and Child Health Officer. In a typical session with a HEW, a six-month-old child will receive a vitamin A supplement, while those aged above one year will additionally receive deworming tablets. With the support of UNICEF, this has become a routine service in the woreda.

Out of 18 children weighed by the HEWs , 16 are in the average weight range. Amarech is one of the happy mothers to learn that her son, Metages, weighs 8.6 kilograms, well in the range of a healthy baby’s weight. “I am so happy that he has gained a few more grams since last time,” she says, smiling. After weighing babies in the community, Habtam and Yeshiwork demonstrate how to make a child’s diet balanced and about the importance of using iodised salt. As the child-friendly food preparation simmers over a fire, the two mothers, whose children’s weight was under the average limit, get counselling on how to improve their baby’s weight. Gebeyaw believes the woreda has come a long way. “In previous years, there were up to eight children per month in Kossoye suffering from Severe Acute Malnutrition (SAM), but this year there have been no cases,” he says. “This is because we monitor the children’s growth and give counselling and other packages of support to the mothers at the earliest stage possible, as we did with the two mothers today.” When the food has finished cooking, Habtam and Yeshiwork let the mothers feed the warm nutritious preparation to their children.

Bridging the nutrition gap before sunset

Amarech Ashager breast feeds Metages Birhanu, 9 months old
Amarech Ashager breast feeds Metages Birhanu, 9 months old © UNICEF Ethiopia/2014

The afternoons in Kossye Ambaras are usually foggy this time of the season. Amarech has subsequently decided to do her laundry the following day and so turns to preparing dinner as well as other domestic chores. For Metages, she has a new menu in mind: adding mashed potatoes and carrots to the porridge. She says she will also never forget adding iodised salt to the food. “Habtam has told us that iodised salt is key to a child’s mental growth. She also told us that we have to put in the salt after the food is cooked and out of the oven so that the iodine does not evaporate with the heat,” she says.

Habtam is one of 38,000 government salaried HEWs currently providing nutritional and other support to mothers and children across all regions of Ethiopia. Development partners such as UNICEF are committed to support this initiative. “Nations will face critical bottlenecks to economic growth if a large proportion of their working-age people’s IQ and productivity are limited by under-nutrition,” says Dr Peter Salama, UNICEF representative in Ethiopia.

As the day draws to an end, Amarech’s house becomes lively as the family come together and discuss their experiences. While breastfeeding Metages, Amarech tells her husband about the importance of investing in their children’s diet to ensure their healthy future. “I will feed my children a variety of foods so that they will have a bright mind,” she says with confidence. “And I will be happy if Metages becomes a doctor.”

On the recent Micronutrient Global Conference (June 2-6, 2014), researchers, policy-makers, program implementers, and the private sector has been discussing ways of overcoming micronutrient malnutrition. The forum has been held under the theme of “Building Bridges”, thus emphasising scientific advances and multi-sectoral programming on adequate micronutrient intake. Read more

Health Extension Workers: Key to Reducing Malnutrition in Ethiopia

Eneayehu Beyene and Tena Esubalew, helth extention workers Amhara rigion of Ethiopia.
Eneayehu Beyene and Tena Esubalew, Health Extension Workers in Delma kebele of Machakel woreda Amhara region of Ethiopia. Preparing their monthly report on community based nutrition activities to submit to the health. ©UNICEF Ethiopia/2014/Tsegaye

AMHARA REGION, 3 April 2014- Tena (meaning health in Amharic) Esubalew, 25, and Eneayehu Beyene, 27, are the heroines of Delma kebele as they have become the health confidants of the community. Delma Kebele (sub district), which is located in Machakel woreda (district) in the Amhara Region in northwest Ethiopia. Delma is a community 10 kilo meter from an asphalt road with a population of 4,733. As part of the EU funded Africa Nutrition Security Project (ANSP), UNICEF launched a community health programme (2012-2015) in 20 districts across three regions of Ethiopia to help the Government boost the nutritional status of children under two in communities like Delma where child malnutrition has been alarmingly high.

Key to the programme’s success has been the role of community Health Extension Workers (HEWs). From Delma, Tena  and Eneayehu have received intensive training with the support from UNICEF on nutrition so they can effectively carry out health extension duties.

“It is clear to us that three years ago no-one in this community could identify if a child was malnourished or not, this problem has been recently solved through the programme’s awareness strengthening on nutrition,” says Eneayehu

Breast Feeding-Tena Esubalew Health Extension Worker coaches Etenesh Belay positioning of the child for effective breast feeding
Tena Esubalew Health Extension Worker coaches Etenesh Belay positioning of the child for effective breast feeding Amhara rigion of Ethiopia. ©UNICEF Ethiopia/2014/Tsegaye

Eneayehu and Tena spend most of their days walking between households in Delma, visiting young mothers in the community and engaging them about the importance of child nutrition. They are trained to identify mild and moderate malnutrition and also growth faltering – based on which they provide age-tailored counselling. Additionally, they can diagnose if a child has Severe Acute Malnutrition (SAM) with or without complications. If a child is suffering from SAM with complications then the health extension workers will quickly have them referred to a health centre in the nearest town.

The health post where Tena and Eneayehu  work is  situated on top of a hill surrounded by open fields and grazing livestock. It is a busy hub frequented by the community’s young mothers, who are eager to learn about their children’s health status. The walls are plastered with graphs charting the health and development of the community’s under-five children. It is here that growth monitoring of all the community’s children under-two-years is conducted on a monthly basis and compared with World Health Organisation growth standards.

Breast Feeding-Yedeneku Aynalem 38 with her son Barkelegn 10 month
Yedeneku Aynalem 38 with her son Barkelegn 10 month, who is benefiting from community based nutrition Machakel woreda Amhara region. ©UNICEF Ethiopia/2014/Tsegaye

Yideneku Aynalem, 38, reaches up to a mud shelf in her hut and retrieves an illustrated booklet. “This is a very important document”, she says carefully opening the page to reveal a colourful chart. The HEWs have distributed  the materials printed with the support of UNICEF throughout the community to enable lactating mothers to track their child’s weight. Yideneku points to a graph and traces with her finger a green upward curve signifying the trajectory of a healthy child’s development based on optimum height and weight measurements. She explains with a smile how her 10 month old child Barkelegn Walelign’s growth has started to correlate with the green line on the chart. “I have been given the knowledge and it is now my responsibility to keep putting this learning into action so that my child can remain strong and healthy”, she says. Yidenku’s child is one of 270 children under-two years of age that have benefited from the EU-UNICEF supported package of high impact interventions in Delma.

The community results are encouraging: the rate of underweight young children has reduced from six per cent to one per cent in two years. “At the start of the programme, six children in the village were diagnosed with Severe Acute Malnutrition (SAM) – this year only two children suffered this extreme health condition”, says, Tena.

In Ethiopia, DFATD support improves community based child and maternal care

By Frehiwot Yilma

Paul Rochon thanks Misa Wondimagen, 25, Health Extension WorkerDERA DISTRICT: AMHARA REGION, 30 October, 2013 – It is early Thursday morning and Gibtsawit Health Post, found in a rural village of Gibtsawit Mariam located 42 kilometres from Bahirdar, is busy with patients. The small room is crowded with mothers who are there to check their babies’ growth; pregnant women having their antenatal care and men and women of the community who are receiving malaria treatment.  Today is a special day, because the health extension workers of the health post are welcoming Mr Paul Rochon, Deputy Minister of International Development, Foreign Affairs, Trade and Development Canada (DFATD) and Dr Peter Salama, UNICEF Representative to Ethiopia.

Misa Wondimagegn, a 25 year old health extension worker, supports the community in Gibtsawit village of Dera district with curative and preventative health and nutrition services.  Misa and her colleagues Meseret and Hagere are supported by the health development army (a network of one volunteer to five Households) attend the 13,366 population of the kebele.

Misa has been working at Gibtsawit Health Post for seven years. “It was just when I finished tenth grade that I had the opportunity to join the training for health extension workers. It was hard convincing people to allow me to monitor the growth of their baby and take my advice about what to feed their children,” she says.  “We travelled long distances to reach as many households in the village as possible.  In each of our visit we tried to improve the health seeking behaviour of the community and eventually encouraged them to go to the health post.”

Growth Monitoring and Promotion is the cornerstone in the Community Based Nutrition Programme.  It creates a platform for the health extension workers to contact the caregivers and check the nutritional status of children, detect growth faltering at early stage and provide counselling on Infant and Young Child Feeding practices (IYCF).

“Now, the situation has changed a lot: we have mothers who bring their children for check-up and pregnant women who come for antenatal care. The support we get from UNICEF and the Canadian Government has increased the variety of treatments we provide for the community. We have outpatient treatment for children diagnosed with severe acute malnutrition and for pregnant women we give antenatal care and supply iron –folate. We promote good Hygiene and sanitation and we also give treatment for common childhood illnesses like pneumonia malaria and diarrhoea for the community,” Misa explains with smile on her face.

Support in Action

Haimanot Andarge, 20, and her daughter Azeb Abraru, 23 month, relax at home in Dera Woreda in Amhara region of Ethiopia

Since 2007, the Canadian Government has been supporting UNICEF Ethiopia’s interventions in Child Survival with Vitamin A and Zinc Supplementation and Integrated Health System Strengthening as well as routine immunization. Dera is one of the 100 UNICEF supported districts implementing the preventive and curative nutrition interventions. It is implementing Community Based Nutrition (CBN), integrated with other Community Maternal New-born and Child Health Interventions (CMNCH) to prevent child malnutrition, focusing on the first 1000 days: the time between conception and when a child turns two years of age.

In August 2013, 1,247 children attended the monthly Growth Monitoring and Promotion session in Dera enabling Misa and the other 78 health extension workers in the district to identify nutritional status of the children, detect early growth faltering, help the caregivers visualize the status and counsel them on appropriate age specific feeding messages using the Family Health Card as a counselling aid and refer children for further care in a timely manner whenever needed.

Haimanot Andarge, a 20 year old mother of baby girl Azeb, is one of the many mothers in the district who got follow ups from Misa and her colleagues during their pregnancy. “Misa used to come to my house regularly ever since she knew I was pregnant. She gave me vaccines and other supplements which was important for my baby. And when my labour began my husband took me to the health post. Misa encouraged me to deliver at Hamusit Health Centre which referred me to Bahirdar Hospital in time as my delivery was complicated. My baby was delivered safely because the health post was in our village to identify my condition,” Haimanot remembered. Her eyes reflect her fear of what might have happened. “ Azeb, is going to be two this year and  Misa still follows up on her  regularly and gives me advice on what to feed her,” adds Haimanot.

Integrating approaches to combat malnutrition

Holding Plumpy'Nut produced in Ethiopia, Misa Wondimagen, 25, Health Extension WorkerOne of the challenges to the health extension workers was what kind of advice to give to families with low income, regarding additional food for their children. “Health Extension Workers usually explain to families to use variety of cereals, animal protein and vegetables. Those who have money would buy and others barter with what they have produced,” explains Ato Worku Endale, Head of the Dera District Health Office. “Recently we have been integrating the health extension programme with the agriculture extension programme to support farmers on what to produce and how they can support their children and family with variety of food items. In addition, the safety net programme that has been implemented in this particular community allows families with low income to be involved in the income generating activities.”

With the integrated multisectoral approach of the government of Ethiopia and the support of UNICEF and partners such as DFATD, the hard work of health extension workers like Misa and colleagues is paying off.

Revolutionizing treatment of Severe Acute Malnutrition (SAM)

The support from UNICEF and the Canada Government that started the preventive nutrition programme of Community Based Nutrition linked with provision of WASH facilities has helped reduce the number of children who are malnourished.  According to Dr. Peter Salama, the collaborative work of all stake holders, the availability of treating health posts within the community have made saving a child easier than ever before.

At the end of the visit the team eagerly waits to hear from Misa and her colleagues on their response to the fundamental question of how many children were lost to malnutrition recently.  “There were 27 children diagnosed with Severe Acute malnutrition in July 2012- August 2013. They were treated with the Out-patient Therapeutic Programme (OTP) and 20 have been cured and seven are still on follow up with good prognosis but we have not lost a single child,” Misa explained boastfully.
Group Photo: Joint visit of UNICEF and DFTAD

“It was not easy to change the attitude of the community. When we started, there was no one before us working with the community reaching every  household door to door. We started from nothing. But with the support of donors like  UNICEF and the Canadian Government, I cannot even remember the last time a child died in the community for the last four years,” Misa reminisces.

“It makes me realise that it was not for nothing that I worked so hard at the beginning. I have brought change in my community.” Misa concludes.