Naomy Ruth Esiaba Works for Change in Kenya

By Jane Maxwell, Hesperian Editor

On page 210 of A Health Handbook for Women with Disabilities, there’s a story told by Naomy Ruth Esiaba, a polio survivor and woman of great determination from Kisumu, Kenya. In her story, Naomy recalls how, despite strong beliefs in her community that women with disabilities could not (and should not) become pregnant, Naomy did just that. She very much wanted to be a mother, loved children, and was delighted to be pregnant. But when she went for a check-up, the doctor told her to have an abortion right away because her disability would damage the developing baby. Women with disabilities are often encouraged to have abortions, even in countries where abortions are illegal.

Though she was scared, Naomy decided to go through with the pregnancy. But she was afraid to go for any more medical check-ups and didn’t do so until she was quite far along. Fortunately, when she did go for her check-up, she saw a helpful doctor who assured her she was going to carry the pregnancy to term, and advised her to give birth in a hospital. Naomy carried her baby the full 9 months, and delivered a healthy, non-disabled girl. During a recent trip to Kenya, I was lucky enough not only to visit my long-time friend Naomy, but to be there when “baby” Ann was home from college to celebrate her 21st birthday!

Naomy was a key reviewer of A Health Handbook for Women with Disabilities, and brought the same determined spirit to that endeavor. She gathered 7 friends—all women with disabilities—who camped at Naomy’s house for several days, sleeping on mattresses on the floor while they did a thorough review of the early manuscript. During that meeting they decided to start an organization, Disability and Women Development Strategies (DWDS), with the mission of empowering women with disabilities by providing education and building collaborative networks.

When A Health Handbook for Women with Disabilities was published in 2007, Hesperian received a grant to give copies of the book to disabled women’s groups in Africa. We sent Naomy 30 copies (later, she obtained and distributed 28 copies more). When the books arrived, she and her 7 colleagues at DWDS brought 30 women with disabilities to Kisumu and held the first workshop of its kind in that region of Kenya, discussing information from the book and giving each woman a copy. Naomy told me that this gathering gave the women and girls who attended an opportunity to get to know each other and establish relationships. Out of that workshop, 10 more community-based organizations for women with disabilities formed.

Representatives from each of these organizations continue to gather once a month to discuss various disability-related issues. While in Kenya, I was fortunate enough to attend one of the monthly meetings where about 50 women with disabilities, many of them with Hesperian’s book in hand, participated in discussions about disability and human rights. Naomy stressed to the group that many policies giving certain rights to people with disabilities are already in place in Kenya, such as physical access to public buildings, and free health care. However, few disabled people are aware of these policies, so they do not demand the services they are entitled to.

There are now 102 women with disabilities registered with DWDS, and there’s no doubt that with Naomy Ruth Esiaba at the helm, they will be making their voices heard.

Partnership for Honduran Health Before the Coup

The current coup d’etat in Honduras and the suppression of democratic rights has made health work by many of Hesperian’s partner NGOs much more difficult. We are very concerned about their safety and the repression faced by the communities they serve. Here is a description of one kind of community health program sent to us prior to the coup.

These pictures were sent to us by Cornell University student Jessica Wagner. Jessica first heard about Hesperian while working with medical brigades in Honduras, where the health workers used Where There Is No Doctor to help them treat scabies and other illnesses.

Jessica is currently Vice-President of Partnership for Honduran Health, a group of students from Cornell University that helps plan and execute integrative, sustainable public health programs in communities in Honduras in partnership with a larger NGO, Salud Juntos.

For a class project at Cornell, Jessica and other students used Where There Is No Dentist
to plan an age- and culture-appropriate dental hygiene program for K-12 students called Sonrisas Saludables.  The program addresses dental health, the importance of brushing, and interactive games and activities, and they also distribute toothbrushes.  After the students establish the program, it’s handed off to community leaders who take over.  Sonrisas Saludables has been successfully implemented in two Honduran communities where more than 2,400 children have participated in the program and have received toothbrushes and toothpaste.   
 
Jessica tells us, “Your books and resources have been invaluable for our group and I have given the copy that I ordered as a gift to a woman in the community who is going to continue the program in the future.”

      
 

 
   

Asian organizations fight for the rights of injured workers

by Miriam Lara-Meloy

According to The International Labor Organization (ILO), about 2.1 million workers die every year worldwide from occupational accidents. That number does not include the workers who are injured, sick, or permanently disabled, or the many millions of accidents that are never reported. Because both companies and governments have developed a model of doing business that prioritizes economic gain over people’s lives and wellbeing, workers and their families end up bearing the brunt of occupational accidents. But workers in Asia are uniting against this model, saying, “No amount of money is worth a human life.” They have formed The Asian Network for the Rights of Occupational Accident Victims (ANROAV) to create a space for workers’ organizations to share their experiences and find ways to connect and support each other as they build an occupational safety & health (OSH) movement.

Hesperian became a member of ANROAV when we attended their annual meeting in Phnom Penh, Cambodia in September 2009. The main focus of this year’s meeting was asbestos, and the newly formed A-BAN, the Asian Ban Asbestos Network, led a workshop on work-related lung diseases, emphasizing that a world-wide ban on production, export, and use of asbestos and silica is the only way we can eliminate the risks they pose to workers’ health. 

Another group highlighted at the meeting was TAVOI, the Taiwan Association for Victims of Occupational Injuries. TAVOI led a workshop on how to support, organize, and seek compensation for workers who are injured or become sick from work. And the International Campaign for Justice in Bhopal called on us to renew our commitment for justice in Bhopal by staging protests in front of Dow Chemical offices in our countries on December 3rd, the 25th anniversary of the toxic gas disaster.

Although it was disheartening to hear stories of struggles against overwhelming odds repeated again and again, it was also compelling to learn about the steps—sometimes small, sometimes more ambitious—that groups and communities are taking to be leaders of their own health at work. Some groups are now training workers on how to recognize chemicals that can make them sick; others offer information on how to seek help when workers get sick; and others organize strikes to force companies to compensate workers who got sick on the job, and to increase safety measures to prevent more accidents.

As Sanjiv Pandita of the Asia Monitor Resource Center said, “a real, grassroots organizing effort, where workers become agents of their own change” is what will eventually change the conditions, policies, and laws that put workers at risk. And through its book-in-progress, A Worker’s Guide to Health and Safety, Hesperian is also supporting the effort to build a worker-led occupational health and safety movement. This book will assist workers in their struggle for safe work by providing information, in a simple, accessible format, about physical and social hazards at work. You can read and download parts of the book in development from our free downloads page.

Hesperian's Deborah Bickel on the revision of HIV, Health, and Your Community

The following is an interview with Deborah Bickel, a former member of Hesperian’s Board and now on staff as a writer, technical advisor and editor. Deborah has recently joined Hesperian editor Susan McCallister to work on a revised edition of Hesperian’s HIV, Health, and Your Community to respond to changes in the epidemic and possibilities for treatment since it was written.  

Q: What is the difference between HIV in the United States and HIV in third world countries?

In most countries outside of sub Saharan Africa, HIV enters the population through a particular high risk group such as sex workers, or IV drug users and stays relatively confined to that particular population and geographic region. But in Sub-Saharan Africa, when the AIDS virus first appeared, the region was severely disrupted by wars, armies in the process of demobilizing, and mass migration in response to wide spread scarcity in rural areas. This instability, fueled by decades of colonialism, systematic underdevelopment, and brutal poverty, pushed the epidemic out into the general population.

Recent Mozambican history gives a clear example of all these forces at work. In eastern Mozambique when the Civil War ended in 1992, peace keeping missions brought soldiers from areas where armies had an HIV sero prevalence upward of 35% that quickly passed into the soaring populations of young women coming to the capital, willing to exchange sex for money to support their families left behind in the bush. Men moved in large numbers to South Africa to work in the gold and diamond mines where they were not allowed to take their families. HIV raged through these migrant populations through informal sexual relationships and prostitution that sprang up around the mines. The men carried the virus home to their wives. When the men came home sickened by HIV, their wives tended them and they too began to die. The result throughout much of southern Africa was a growing burden of orphaned children left to fend for themselves with few resources. The huge loans taken on during the war were refinanced and “forgiven” through the World Bank at the price of radical cuts to public sector services such as health, social protection and welfare, the very services most needed by the vulnerable households supporting the newly orphaned children. This is in fact present day reality in many parts of Mozambique and other sub Saharan countries burdened by the AIDS epidemic. 
 
Q: Who is the intended audience for HIV, Health, and Your Community?

The book is very reality-based, and it’s for communities affected by HIV. It’s written for people living with HIV and AIDS, their families and caretakers, and health care workers, too.

Q: Why revise HIV, Health, and Your Community?

Since the book was first written and treatment has become more accessible, the paradigm has changed: we’re no longer counseling those with HIV and AIDS about how to prepare for death, but rather how to live with HIV and AIDS. In response to requests from readers and users of the book, we added a new chapter addressing the particular needs of children, those infected with HIV and those in vulnerable situations as a result of HIV and AIDS. We are adding sections on microenterprise, various community based responses, and building upon a popular chapter on grant writing and funding appeals.

Q: What are the politics of this book?

HIV, Health, and Your Community recognizes that AIDS has become a pandemic in places like Sub-Saharan Africa because of underdevelopment, chronic scarcity, gender dynamics and inequity—not because people are more sexually active. In fact in more than a few studies comparing number of sexual partners over a life span, Africans in countries with a high sero prevalence of HIV have fewer partners than their western counterparts.  Western efforts to promote prevention in the region have missed the mark by focusing only on individual behavior change and not addressing the roots of the high risk behavior; poverty and gender inequity that leaves women to trade on the most elemental currency of the sexual transaction.

Also, HIV, Health, and Your Community gives strategies that build upon traditional systems and faith based organizations that persist long after the retreat of colonialism. These approaches can complement emerging national systems responding to social and health needs. The book provides creative ways for communities to respond to the effects of HIV through protection of the most vulnerable members of affected communities. For instance, there’s a story in the book that provides an example:

In Malawi, in response to a critical need for support to the growing number of families taking care of AIDS orphans, a community committee set up a free children’s crèche (childcare). Built by the community, the crèche is housed on communal land in a structure with materials donated by the local mosque. Because a local food security program donates seeds and basic tools, the crèche has a kitchen garden that provides the ingredients for a hot meal program as well as a means to raise cash through the sale of surplus produce. The garden has helped children learn the basic skills of land management traditionally passed to them by their parents and in the communal kitchen they learn about food preparation and nutrition.  Older children and young adults can participate in regular afterschool games and activities, and the older children coach younger kids in soccer. The younger children help with crèche chores like cooking and cleaning and organizing activities. 

Recognizing the importance of what the children were learning, the committee decided to invite any family in the community to use the crèche, rather than opening it to orphans exclusively. Now all children, both those with parents and those without, have an opportunity to play and learn together, allowing children to grow up less conscious of the differences between orphaned children and those in intact households.

Q: Where will this book be most useful?

It is useful to communities all over the world, but especially to those in Sub-Saharan Africa, Asia (rural India in particular), and Latin America.

 

Johan van Lengen: "The Barefoot Architect"

Hesperian networks with many individuals and organizations committed to providing accessible, easy-to-understand resources that empower communities to thrive and grow on their own terms.  Among these is the author of the newest text on our Health and Empowerment Bookshelf, The Barefoot Architect.

As the environmental movement began to take off in the 1970s, Dutch-born Johan van Lengen left his job as an architect in San Francisco and moved with his family to Brazil.  Crediting the innovative Whole Earth Catalogue as an early influence, van Lengen set out to work with poor communities to build safer and more environmentally sustainable housing.

With his wife Rose, he founded TIBÁ (Bio-Architecture and Intuitive Technology), an institute in Brazil’s Mata Atlantica jungle that offers workshops on ecological building techniques. TIBA hosts students and community leaders to work on bioarchitecture projects and learn new methods, from creating grass roofs to building with adobe.  In doing so, they also hope to reframe peoples’ ideas of their home’s relationship to the surrounding environment, creating shelters that are natural and sustainable members of a community’s ecosystem, whether urban or rural. 

Early in his work, van Lengen recognized that people in poor communities often have little choice but to seek shelter in buildings that are poorly constructed, environmentally detrimental, and hazardous to their health. Open windows and gaps in house construction provide entry to mosquitoes carrying malaria or dengue; found construction materials and furnishings might contain finishes or other chemicals harmful to both the family and the community; cracks in walls and floors can encourage dampness and mold, leading to asthma and allergies; and poor indoor sanitation facilities can lead to serious health problems. 

Van Lengen believed that a written guide to ecological building, with language and diagrams that could be easily followed, would help communities looking to construct safe and healthy shelter and empower them to take on these projects themselves. Like Hesperian’s Where There Is No Doctor, The Barefoot Architect was originally written in Spanish while van Lengen was working in Mexico in 1982. Manual del arquitecto descalzo was a heavily illustrated guide to building simple, environmentally sustainable houses using both traditional and modern methods. For example, while encouraging people to use recycled modern materials like bricks and concrete blocks, van Lengen also notes that cactus juice is an excellent impermeable finish.  Diagrams are not only clear and easy to understand, but also include images of materials easily recognizable to communities looking to build with what they have on hand, including palm, straw, agave, bamboo, sand and clay. 

The Mexican government was so impressed, they bought 40,000 copies and placed one in every library in the country. The book went on to sell over 200,000 copies in Latin America. It has also been published in Portuguese, and is now available in English.
 
Containing a wealth of information about natural materials, design for energy conservation, and building for different climates, the author emphasizes using materials that communities may already have on hand. The book straddles the diverse array of climates in the Global South, from deserts to humid tropical areas, and offers constructive, accessible instruction on planning to build in locations both rural and urban, for structures intended to be permanent or for those that could move with a family to a new location. The Barefoot Architect also invites to the reader to consider their local environmental threats, offering insights on building in areas prone to floods, earthquakes and mudslides.  The book includes sections discussing small-scale energy production, cleaning and storing drinking water, and dealing with septic waste. Some of these topics, such as protecting community water, building toilets, indoor health hazards in the home, and waste disposal, are discussed in more depth Hesperian’s own A Community Guide to Environmental Health.

One of the world’s foremost authorities on environmentally friendly building design and construction, Johan continues to develop new ideas and reach out to new audiences. For more on Johan van Lengen and his projects, visit TIBÁ’s website at: http://www.tibarose.com/ing/news.htm.  Click here to buy The Barefoot Architect.

Learning about Electronics

By Miriam Lara-Meloy, Hesperian Writer/Researcher

Earlier this month, I had the opportunity to participate in the International Conference on Labor, Occupational, and Environmental Standards in Electronics Industries in Suzhou, China. Organized by Hesperian partner the Asia Monitor Resource Center (AMRC) based in Hong Kong, and the Suzhou University Kenneth Wang School of Law, this conference brought together activists, organizers, lawyers, occupational hygienists, and specialists to learn and share information and experiences about the current working conditions in electronics factories in Asia.

Sharing their stories and struggles at the conference were groups like SHARPS, the Supporters for the Health and Rights of People in Semiconductor Industries, which is part of Korean Institute of Labor Safety and Health (KILSH). They told us about the high incidence of cancer in chip manufacturing companies in Korea (mainly Samsung) and about many young workers experiencing chronic and spontaneous nose-bleedings, chronic headaches, various skin diseases, musculoskeletal pain and disorders, menstrual irregularities and miscarriages. Laura Sarmiento from the Workers Assistance Center talked about the unspoken government and business policy of “No Union, No Strike” in the Philippines and how employers circumvent workers rights by only hiring contractual workers. Richard Gutierrez from BAN Toxics in the Philippines described the skin rashes, sores, and chemical burns that workers endure in the electronics factories while employers refuse to supply them with protective gear, training, or safer working conditions that would minimize exposure. We learned about the struggle of workers in the Taiwanese WINTEK company (which makes flat-screen monitors and panels for Apple), who are protesting the unfair dismissal of 600 employees in December of last year and the subsequent salary cuts and forced overtime for the remaining workers. Kevin Li from Globalization Monitor told us about the cadmium poisioning workers have suffered, and continue to endure, from working in Gold Peak battery factories in Hong Hong and China.

The meeting culminated in the creation of a Working Group on Environment, Health and Safety of Workers in Electronics Industries, an international solidarity network that promotes corporate and government accountability in the global electronics industry, united by concern about the impacts of this industry on health, the environment, and workers' rights.

This conference was a great opportunity to hear about the reality of worker’s experiences in the electronics industry, and to make connections with these brave groups fighting for worker’s rights. These partners will be invaluable as we continue to develop our book-in-progress A Worker’s Guide to Health and Safety.  A Workers Guide to Health and Safety will present the physical and social dangers of working in factories all around the world in an easy-to-understand format, including information about the electronics, garment, shoe, and light assembly industries. It will incorporate solutions, ideas, and stories from workers groups, such as the groups we met during this conference, that have fought and won (and sometimes lost) struggles to help workers achieve better working conditions. We have finished a section of the book on work dangers in the garment industry, which you can download for free from our downloads page.