Keita: Family Planning is the Best Way to Fight Maternal Mortality

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Dr. Diene Keita PHOTO crdt: OSVALDE LEWAT

Barely months into assuming office as the United Nations Population Fund Country Representative in Nigeria, Dr. Diene Keita shared with Abimbola Akosile her experiences, vision and views on development issues in Nigeria, on the sidelines of an awareness creation programme held by the Ministry of Health in Abuja recently. Excerpts:

Can you just tell us a little about yourself?

I am Dr. Diene Keita, an economist and lawyer by training, 53 years old and the UNFPA Country Representative in Nigeria since July (2017). Before Nigeria, I was the UNFPA Country Rep in Democratic Republic of Congo. So, I have been privileged to serve in a big country and this is the second one and I am very thrilled to be here.

So, what lessons are you bringing from the DRC?

The lesson I am bringing from the DRC is two-fold; first is complexity and diversity. DRC is a very huge country and relatively well-populated, and yet DRC has the duality of humanitarian issues and developmental issues. So what I bring is really a good knowledge of how to implement diversity within what we do, especially socio-economic issues and family planning, as well as how to reap Demographic Dividend in such a complex environment.

What are your views and tips on family planning and the existing cultural, religious challenges?

I think UNFPA has this fabulous way of tackling family planning and really in doing such thing culturally. We all know that every culture, at least most of them, has issue with family planning. The only time all faith persons agree is when we have to talk about family planning, so for me the cultural approach is extremely important and yet the women and young girls’ empowerment is absolutely of essence because a woman or adolescent should be able to decide for themselves. At the end of the day, family planning is not about all these facing them, it is about giving the woman or adolescent the autonomy to decide the time she wants to have her family and the time she needs to work or rest or enjoy the health community life. So really for me, that is the stake and here in Nigeria due to the diversity it is something we are looking forward to work with.

We have a very dynamic government working on it; the Ministry of Health is doing a great job, but also the other ministries because that is why I like the approach of the demographic dividend; because family planning is not health matter anymore; it is absolutely not Let me give you an example, if 13-year-old young girl, is either married too young with an old man; you know what I call old man? A 30-year-old young man is an old man compared to a 13-year-old girl; he is powerful sexually; you see what I mean? Sexually, that can ruin that girl’s life because he cannot control his actions, then he can hurt her without wanting to. This was this fabulous Nigerian movie where this young man husband obviously didn’t know how to behave to have intercourse and his young wife was 14. She was so happy to be married. She was beautiful but she was young. But the way he did it; he raped her and the woman’s life changed forever. He didn’t do it on purpose or intentionally but that woman cried forever. But that is the reality; you don’t train young men to become men, you see what I mean? So if they don’t know how to approach the young women, it becomes a disaster and this is part of the critical, sensitive issue.

It is not about him coming or implement what general common sense says, because if that young man had known better, how to be more tender, that young lady, she wouldn’t have been scared. And if they had known, they would be in love today. We have so many stories about this. It is really about communication first, and as well intimate communication sometime, verbal and intimate communication. “Are you happy, are you fine?”. And he can be very crude; he doesn’t have to be very modern. And I think whatever you are, Christian, Moslem or traditional religion in this part of this world, we have that challenge of making people understand. Because if you take the priest of any Catholic Church, or master of any Quranic School, people forget, they are leaders, they are very well educated. I was raised in a Convent in Rome; I spent quite some time in a Catholic school, I am a Moslem so I know both religions very well. Even sometimes at home, I sing Christian songs because I was raised in it and the Christians were so courteous with my religion. When they go to the mass, big mass, I would go, but classes I would have my private Islamic classes with my Egyptian teacher.

You see, so I grew up in a world where religion was really connecting very well. My dad was the Ambassador to the Holy See so I could see the Pope every year, so I have a lot of respect for all religions; that is where I grew up. For me it is not a job; it is true belief that we can make a difference with respect to everyone. And that would be my big challenge here, because you need to approach people; you don’t want to hurt them, you just want to educate them. The meaning says quite a lot because it is very important. The only thing that is as important of health and in family planning is education. That is why we talk about a man of 30 years who cannot even approach a woman correctly; you know in the past centuries in Europe, if you read Europe history, young men were trained sexually by their dad; they would take them in an institution, elder women would let them know how to go about it. And now because parents don’t talk to their boys anymore, the boys go aside to talk to their friends, they go on YouTube and learn by themselves, and it can be very harmful. This is the kind of thing I think we should be working on.

When you are talking of education, is it formal or just sex education?

Thank you; it is everything. Of course, comprehensive sex education for me is very formal, but I am talking of all education. All education because you have the people who do not go out at school but would do something called the husband school, talking about the women interest, about how to behave and the income-generating activities, how to involve the men in it, kind of husband daily school, parenting school, how many parent like me, you have young adult at home, a 20-year-old, 18, you don’t know how to communicate, it is a challenge. They don’t even know how to communicate. I have friends of mine from the Western world, living in America, they would say, “I don’t talk to my boys, so stop talking to your boy”. So it is not only Africa that face that. So we need to educate parents, we need to educate everyone to better communicate. But as well formal education for the young girl is of utmost importance; if the young girl can stay at school longer than possible, she would, whatever happens, be better than if she doesn’t go to school, because the family wants her married, instead of being wasted or having unwanted pregnancy.

Can you talk about the Green Dot initiative that was launched recently in Abuja?

I think the Green Dot is a fabulous initiative; it was launched recently and it has created centres and reference places where people, young people can get the information they need vis-a-vis family planning issues and larger sexual reproductive issues and health issues. And I think for me, this is the first country I have seen it launched really nationally in Africa and I found that very impressive. I have seen it favours the young people but the Green Dot for me is something that is very promising and we will be supporting the government and the partners to expend as much as we can and most of it – our work – is to monitor the system, to get from the users how it went, are they happy, do they want something different, and that is the thing we can help the government do that because it is a magnificent initiative and for all of us, I think it is a beacon of hope that we will reach the last mile and the last woman or young girl or young man who needs information and products.

Female Genital Mutilation is still a recurring issue especially in Africa, what do you think can be done apart from the normal multi-stakeholder awareness creation; are there any other innovative ways of tackling this without conflict against the traditional systems?

I think it is important and education is always at the bottom of it but this time the education of parents, education of elders, just to know “don’t do that because it has no religious roots”. Religious scholars have confirmed that everywhere; I was Rep in the Islamic Republic of Mauritania you had Fatwa and it says this is not good, stop it! It was fabulous. So today it is really our traditional culture; religion has nothing to do with it. But very often in this part of the world we tend to put both together to be happy. There is a blurred line between religion and our traditional practices; when it is convenient we mix both and when it is not we take away. Whether you are a Muslim or a Christian, that is what we do and this is where we work with religious leaders now so they can help us clarify that this is not a religious recommendation. Because those that have female genital mutilation, thank God it can be repaired. But, why at the first place try to harm a young girl to make her believe that her sexuality is not the right thing? That changed the life of someone.

Although inequality is not limited to Africa, what do you think can be done to address the situation in Nigeria?

That is true; inequality is definitely not limited to Africa but what is really the challenge of Africa or the so-called sub-Saharan Africa – and Nigerian is one of the biggest or the kings of sub-Saharan Africa in terms of population – is poverty. If you take gender-based violence, you take female genital mutilation, they all find their base in poverty at some point. So the pro-poor policy that is being put in place by the government of Nigeria I think is really evidence-based mechanism to tackle all those harmful practices in the country. Because everything goes back to poverty; if these people have not access to simple healthcare, they have not access to simple school, and when, let’s see, you have a job as a man in a remote community; then you need money so you go. And then your family lives in another place; you couldn’t take them, what if near that let’s say is a big private enterprise, we have a round-out enterprise, a school, a health centre, then your women and family can come and access the services. If there are local jobs, informal jobs there, women can access and do their jobs. If you take fishermen for instance, they go and fish, but who smokes the fish? It is the women. So when the Ministry of Fisheries gives some subvention to the fishermen, they should give some to the women to be able to smoke the fish and sell it in the market. That is what I call gender-based budgeting, the budgeting sensitive to gender; it is very important. Sometimes they don’t and the pro-poor policy takes care of that, the genderisation of the budget will absolutely take care of education and health and then you can think about inclusive growth because otherwise the fishermen money would not be enough and you would have to look for other ways of supplementing the income.

So, if you tackle inequality, then you can also reduce the issue of poverty?

Exactly, and for us in UNFPA one of the main ways they contribute to the pro-poor policy is our work on census, population census. Because that population census allow us to know where the people are, all the schools are, all the medical centres are, and really give information to the government to be able to plan better their natural resources.

That is UNFPA, you assist in the conduct of the census; it’s not as if you carry out your own survey?

Definitely not; we assist government in the census. The census is what we call the Mother of the surveys. It is a national full-ownership; that is the most important data the government of any country can have to use. What we do is we validate the scientific portion of it, that is what the difference between population census and electoral or administrative census is, that are not scientific those are for other purposes. And the general population census is the most powerful tool so it cannot be conducted by anyone but the national government.

How do we put young people first in Nigeria and the rest of West Africa?

In Nigeria, that is the easiest thing to do; they are 70 per cent of the population under 30 and so that is easy. If you don’t work on that population, you are not working in Nigeria. And whatever we do, we have to put young people first. You know formal education goes for the adult, for the parent, but when we start working, any programme the UNFPA does here now will be our main focus. When I talk to women above 30, I tell them, you are not my target anymore, because you have done your children or you are doing them now and usually you know you are here to hear some advice to better your life and move on. But the one we take care of is the one from the 13-year-old to make sure you do it right, as right as you can do. Because this is it; even when you have it alright, it may not be right at the end because life is happening. Life is happening so we want to give chance to more people, more young men and women to have it as right as possible for them to make a choice available.

How do you tie that into harnessing of the Demographic Dividend?

It is easy, first we are just at the beginning of our programme; some part of our programme is implementing with the young people wherever I am and when we implement with other senior implementing partners we make sure that indicators related to the young peoples’ outreach is clearly mentioned in the way they reach out to them. Because this is the only way they have to build trainers because if you have a single group of 10,000, those 10,000 are the ones who can replicate the information. They believe in it and step it down and so even as a Rep, even I adapt myself to that. When I converse with the young people or even if you see the way I am dressed, I am always trying to be close to them and to identify with them. And to tell you as a matter of young adult, my son helps me a lot. Because this is my job and sometimes he tells me ‘Mama, you are taking this too far, or too much to heart’. I originally don’t care about that. He really helped me a lot, because if you don’t listen, he really trained me, coached me and today I am the one begging, please don’t forget your old mum just so that I can remain on track to do my job properly. He will say “Mama, you are too sensitive, we young people, we don’t do this”. And he tells me “if someone sends me a message I have to respond immediately.”

You see, we are not the same, so I learn from my son to be able to reach out to my target, and moreso the young people, because anytime he comes, I say “come, let’s go, observe, this is it, right?”. Because they believe in themselves and we are lucky; we are lucky to have population of fine, young people around the world. This generation of millennials, they are just fabulous; they just want us to give them room to express themselves. And for me, this is….now, we need to make a difference, and I think all government and Nigerian civil society are all agreed on that. And we have some things I hope they join us on the issue of family planning, to talk about the indicators, to dance, to play music and by peer group all day and ask those people to continue village after village. I did it in DRC, from East to West from North to South; I got sick and I reached out to more than 50,000 young people. And then my young people would continue without me; they had a class and they were practising in the airplane! We went to the naval harbour, the military harbour and you have all those young men in the military, I was the head and we said “you guys, come..” and we explained to them and gave them the commodities. They are men and they would go to see some women and these contact us.

I reached every single place because those young men are out there, nobody would reach them and they do very critical work. And we went to the Inga Dam of DRC, you have all those young men working there for hours with no contact and then they would go night and they would meet women in the bar. They were so grateful. So what we do is not that the fancy target we see in meeting, we go beyond that and I meet with journalists some times because we need everyone. When I travel by road, my car is full of materials, because wherever I stop at the gas station, I give something to people and I start talking because we are leading by example to create awareness.

The thing is, we are not fighting the youths and the young ones; we are just trying to ginger them, to bring out the best in them….?

Exactly; and the fact is the best are there. Sometimes they just need to control; they want to take over the world. But the problem about taking over the world; you need to take care of the people existing already. So we teach them as well how to be diplomatic enough to convince the adults “Let me do it; I can do it better than you”. You see, that is what I do when my son tells me “Mama, let me, I will do this”, I say “Go” and I have tested it and then I see. That is what we do. But we need them, “don’t because we give you space, you have arrived. Don’t abuse the privilege; don’t shout on government, don’t shut because you are not there.” So, really we educate them to respect what is before them; use what is before them to do even better, but politely with respect and convincing method to move forward.

So if the youth population of Africa, of West Africa or even Nigeria is adequately harnessed, they can help transform this economy and stop this migration to Europe?

The fact is, in 25 years, if Africa does it well, it will be only two ways around; only two ways that the economy stop, only two ways. Now you want to talk about migration because of what happened, but in 25 years, there will be two ways; either, two ways if we have trained our people properly, if we train them, we give them jobs, they will stay here, they will go nowhere because the potential here is amazing. And Europe will lack the right competencies, population-wise. They will come to find them here, just like they did for the dragoons and their time. Because, population, even if we slow down and we are not slowing down; people are just understanding here, yet the competencies will be here because this millennial generation from Africa, they are innovative and just innovating and they love their culture.

What you have said is very interesting because when people are travelling to the developed countries, it is the best brains that usually go; so if they are retained here….I am trying to grasp the implication…..?

You see what I mean, because, take Nigeria, from Nigeria, you take from Cotonou, Lome, Accra, Cote d’Ivoire, Conakry, Liberia, Sierra Leone, you have Nigerians all the way. The best architect in Guinea is Nigerian and he can speak my local language better than I do. You move from Nigeria, you stop in Accra, you do your business, the rest continue moving. And some of those Guineans that speak French, that speak local languages, they continue to Haiti with Guinean passport because we have no visa with Haiti, and then you are in America. And that is where they settle. You see what I mean, some stop. My architect in Guinea is from Nigeria, he has good condition, so the migration is so complex. But that is the power of this Nigeria; whatever Nigeria does well, it will impact on all the continents.

Not just West Africa…?

Never, because when you put your wealthy money is Ghana, South Africa and the rest of Nigeria are as dynamic as the wealthiest one. So they are bringing that efficiency everywhere.

That means if Nigeria can successfully manage its youth population, the ripple effects will……?

Exactly! The rest will be trained as well and as much because they will feel the competition and they will move exactly. That is why I am so excited to be in position of being in charge of population issues because it gives me unique life opportunity to be part of an exciting venture with the government and the partners to try to change, to bring a better positive change. Whatever success Nigeria is getting is from Nigerians; and us international partners, we are just here to support, and to put our story to the story of this fabulous country.

How do you see the Nigerian environment in terms of the culture and the development sector?

It’s exciting! For me, as the UNFPA, as the young people and as the elderly people because we need to take the UNFPA mandate is very huge; we even need to take care of women who cannot have babies. We tend to forget them, yes, yet they exist and they suffer a lot. So, for me here, we don’t, we can’t do everything, but if we can help the government and our partners help the government to instil the right impetus to achieve Demographic Dividend, I would have said I have achieved my mission in this country. For instance, my Lagos office, I want it to be the hub for the young people. Even the office setting would be changed. If we need to attract different kinds of people, young and old and entrepreneurs because we have a budget, you know those villagers around the water, when you go around the bridges in Lagos, you see young girls. I need to have young leaders to come, to sit, to network with me. You see, how can we then make them work? I have a young man, Nigerian, he does shoes, another one does other things, how can we have them, or build a work industry so that those young girls can get a job or something that can make something out of it so they can make some money? That is the kind of thing; to create dynamism and dynamics as much as we can. Because when you are secured about how you can live tomorrow, you will listen to me to give you the right family methods, family planning methods; but if you don’t have anything to eat, you are scared of violence in the neighbourhood; that brings pressure to the methods and inhibits your ambition. So prevention is key, while we prevent, we promote inclusive growth.

From my interaction with the youths in the course of my development work, I have found out that many of them are, beyond formal education, are acquiring skills…is it possible for UNFAP to assist them to polish their skills?

Absolutely! That is what I do, I have the format and I like that kind of development work because that is why I have a lot of implementing partners and I love the efficient ones because we can do things differently. And because I trust there are not only one way, there are several ways because the country is so diverse. Even small tiny Benin where I used to work, it’s tiny compared to Nigeria the giant, but there is no such thing as tiny; a leader is a leader. It is the same thing here; implementing partner of a small NGO is a partner because we can work together. I say look, I give you money for this but this is what I expect. They come out very well and usually they bring me so much visibility on what we do and what we can do differently. That will even give more root to why we are here in the country and why we should be helping people. Oh, yes, that is what I do and this is the beginning of this programme, my new programme, which is starting in January. This is the time for discussion and for implementing partnerships so we can know how to move forward. I am really open to discussion to see where people want to work and what they want to do. I am the Rep for Nigeria and I have both my priority areas and more than that. So if I believe as a Rep; I am a Chief of a Diplomatic Mission and if I need to have this part, I go and have that part. I am helping Nigeria; I may not have enough resources to cover as I wish, but if I have a partner who can take this and let’s do this and we have an impact, we can report on this, I would go running because I need good model I can show to government and say “look at what we are doing; let’s mobilise and do more”. So, those breakers of innovation, for me, that is what I need in Nigeria. I cannot teach this fabulous government anything; everybody is senior here and because I am senior too, I know that you need others to help you achieve your goals; because only team work can do that.

Let us do a little forecasting here as an economist. In the next two years what do you hope to have instilled or achieved in terms of development work here in Nigeria?

In two years, I would have very clear indicators for family planning; very clear set of indicators. As of today I am hoping to have the report of the family planning meeting we held here in Nigeria in September; from there our yearly objective for family planning. The other thing we make sure that gender-based violence in humanitarian setting, in normal setting, FGM we have the right set of indicators how to tackle them and what to tackle there, because I only believe in facts. The third one is how to apply demographic dividend in partnership with Nigeria on how to assist Nigeria to develop by sheer of good practices. We have both positive and negative demographic dividend and there is only a very fine line between them, but we are aware of the risks and we want the positive for Nigeria.

Lastly, are you excited to be here and to face the challenges of your position?

Not only am I excited to be here and to face the challenges but the position of Country Rep of Nigeria is a big one to have on your resume and it shows your organisation trusts you and the government, which must have done a good background check on you, has confidence in you. This is a big moment in my career of 27 years in the UN system. Family planning is the best way to fight maternal mortality and we are ready to fight maternal mortality because that is our linkage to the UN Mission. Also, Nigerian women are so dynamic and they have sense of pride and sense of achievement and I hope to learn so much from them both professionally and personally. I want to use my experience from the other countries where I have worked (including Niger, Burkina Faso, Burundi, Haiti, USA, Senegal, Ethiopia, Mauritania, Benin, and DRC) to do the best I can here in Nigeria.