I recently made my way through the same Central African countryside as I traveled through two years ago with Population Services International (PSI), the global health organization for which I serve on the board of directors. This time, I was in Rwanda and the Democratic Republic of Congo (DRC) with the Center for American Progress' to investigate mineral mining in conflict areas and advocate for the ban of their use.
While the focus of this visit was different than my previous travel to the country, the situation I found on the ground was similar. I quickly realized that you can't separate health from mineral mining issues, or others related to conflict for that matter. In fact, they are part and parcel. In learning about mineral mining in eastern Congo, I was continually confronted with stories of women victimized by systematic rape and at risk of HIV, STIs and life-threatening pregnancy-related complications.
I think of Mutunzu every single day.
I met Mutunzu in a camp for internally displaced persons in conflict-ridden eastern DRC. She and her seven children have called their small, make-shift 6' X 4' dwelling in the camp home for the past two years. She has been raped twice by the Forces Democratiques de Liberation du Rwanda (FDLR), and though she doesn't dare tell anyone for fear of stigma, Mutunzu's young daughter Naomi, who nursed from her mother's lap as we visited, is a result of her most recent rape. Both of Mutunzu's parents and her husband have been murdered. The camp provides a bit of stability for Mutunzu and her children, but security is scarce from what I could tell. She tries to walk to the nearby fields to do some work, but the prodigious bleeding from her vagina impedes her ability to do so for long periods of time.
The complexity of realizing the Millennium Development Goals (MDGs), and particularly MDG-5, which aims to reduce by 75 percent maternal mortality and provide universal access to reproductive health care, relies on addressing family planning, reproductive health and yes, things like minerals and mining. If we are to hold up our end of the deal, we must look at the peripheral factors affecting the reproductive health of girls and women. Conflict is unfortunately one of them.
As Mutunzu shared her story with me, we sat in front of the U.S. packaging that served as her home's fragile walls. I wondered what else from my government - and others - are reaching the women of this community. It's been ten years since we agreed on the MDGs. In that time, we've seen progress in areas like education and child survival, yet progress toward the promise we've made to women around the world through MDG-5 remains low. More than 215 million women around the world continue to lack access to modern contraception. The result is 66 million unintended pregnancies each year, which lead to 19.7 million unsafe abortions and more than 340,000 pregnancy-related deaths. The numbers are both staggering and unacceptable.
Until we can stop the atrocities faced by so many women in areas of conflict and violence, we must protect them from the ill effects of such environments. At PSI we recognize that this means we need to support women (and couples) throughout their reproductive life cycles, through comprehensive contraceptive choice, maternal health, and prevention of sexually transmitted infections with strong linkages to other health areas. Mutunzu's story, and so many others I listened to, is tragic, but it also shows the many ways we can effectively disrupt cycles of poverty and exploitation through increased health investments in women and clear, strong action against issues like mineral mining which put women squarely at risk. A few things immediately come to mind: peer education; universal access to long-acting, reversible contraceptives; reproductive health products and services; HIV education; job training, to name a few.
As I write this, I recognize the need for a hopeful message. The reality, however, is that - despite efforts - we are not on track to achieve MDG-5. But, in this critical moment, there is tremendous momentum around MDG-5 and a desire to make good on our promise to woman like Mutunzu. But if we are to reach the goals set out in the MDGs, we must increase political will and financial investments. This week, PSI and other partners of the Dutch-funded Strategic Alliances with International NGOs (SALIN) will gather in The Hague to present promising results in their efforts to reduce maternal mortality and increase access to reproductive health care through the delivery of safe abortion and long-acting, reversible contraceptives in some of the most resource-poor areas of the world. The collaborative efforts made under this program shed light on the importance of partnerships between civil society and governments to truly utilize the proven, cost-effective tools we have - highlighting the type of leadership women in the developing world need and deserve.