I was born in La Paz, Bolivia, and I’m one of nine children – I grew up in a Catholic, Latino family that believed that the more children, the better. So it’s slightly ironic that much of my work is in the area of family planning!
I have had the honor of working in family planning and in reproductive health going back to the 1970s. I think I was fourteen at the time, and I worked with the Center for Development of Population Activities (CEDPA). That opportunity exposed me, at a very young age, to the issues that we are trying to address now. And that opportunity imprinted on me a desire to make a difference.
How, I ask so often, can we empower young women? How can daughters have what was denied their mothers?
Over the years, I have seen women all over – from Africa to Indonesia to Latin America – in need of family planning and access to contraceptives and also looking to improve their own lives.
I spent many years at ACCION International in the area of micro- enterprise, making capital available to women and men to create their own enterprises. I have spent many hours sitting with women, listening to the stories of their lives, and hearing how having a little bit of capital to be able to work and to be able to provide for their families really changed these women. They developed a sense of empowerment, of dignity – they had control of their own lives.
And it didn’t matter whether I was in Accra or Mumbai or Lima – even though all of their stories were different, when I asked these women what they wanted for their daughters, they all said they simply wanted their daughters to be able to have the education that they didn’t have.
There are 600 million young women in the developing world today, and so many pregnancies of girls under the age of twenty. The mortality rate for those young women is twice as high as it is for older women. How, I ask so often, can we empower young women? How can daughters have what was denied their mothers?
Clearly education is one piece of it, but there are many other ways in which we can take on that challenge of having young women become actors in their own lives. We must think about the issue of reproductive health not only as the delivery of contraceptives but as an issue that is interconnected to many other issues, including empowering young women.
We have made progress, no question about it. There has been a decrease in the number of maternal deaths in the world. But we still know that only 21 percent of women in developing countries have access to modern contraceptives. In my work as an undersecretary of state for civilian security, democracy, and human rights, this issue of reproductive health hits me between the eyes when I travel, when I meet people all over the world who suffer because of everything that has not been accomplished in this field – who suffer because despite how far we have come, we have a much longer way to go.
If I am in a refugee camp with Somalian refugees on the Kenyan border, what they want to talk to me about is reproductive health. Can it be made available to them? These are vulnerable populations. For them, access to reproductive health is one way to become less vulnerable. If I am in a place where security is the issue, this also becomes an enormously important issue. In Pakistan, I have been working – even before the floods – with the Pakistanis to help address the issue of water and to manage water in a more effective way, but when the Pakistanis project enormous population growth, their efforts to address water and its scarcity become far more complex.
Reproductive health is an issue that fuels the spread of HIV. That’s true for low- and middle-income countries, and it is the leading cause of death for women during their reproductive years. Reproductive health is also an issue related to environment, which is another area in which I work. When I traveled to the Arctic Circle, and I recognized the degree to which that part of the world is being affected by climate change, I began to see that women in all of our communities are going to be on the frontlines of addressing these issues. So you can go from the Arctic Circle all the way to the tip of the continent where I was born, South America, or to Africa, and you will see that these are the problems that continue to prevail.
women in villages and small towns in the countryside is done – and will continue to be done – by those women who may have not had a great deal of education. For example, traditional birth attendants. All those years ago, at CEDPA we trained women who were leaders in their countries. In Kenya one of the women that CEDPA provided training for was a woman who became a wonderful parliamentarian. She was a woman who fought for women in Kenya.
Later, when I went to Kenya to train traditional birth attendants on issues related to delivering family planning services, we went to the countryside with this same woman – who wore her head piece, looking quite regal – and everyone Indeed, whether we seek to fight hunger, improve health practices, or create microenterprises, no actor proves more reliable or is more determined than the mother, sister, daughter, or wife. In communities was so delighted to see her. Here was a group of traditional birth attendants – older women, some of them with no teeth, some of them very slim – and as I stood there with my friend, one woman around the world, it is the women who drive the family, the community, and the society toward a better future.
The scourges of our world, such as poverty, exclusion, repression, and illness, impact women both first and worst. All too often, women are the first victims of crisis. A disproportionate number of women are refugees, as I recently witnessed when visiting the Dadaab refugee camps in Northeastern Kenya near the Somali border.
Across the globe women are victims of gender-based violence, the most traumatic tool of war. And they are undereducated and disenfranchised compared to men in nearly every corner of the world.
As we elevate the issue of women’s health, we need to remember that the “heavy lifting” of making reproductive health available to who was very small and frail and elderly, with maybe two teeth and her chest wrapped, looked at my friend and she said, “I delivered you.” Our eyes widened. Beside me my friend grinned and clasped her hands over her heart. The older woman continued, “I was there when your mother gave you birth.”
It is these women – my friend, the birth attendants, that old woman who remembered – it is these women who are delivering reproductive health services. It is these women whom we are trying to empower. And it is these women who drive me in my work. With commitment, resources, and coordination, we can have an impact.