Ostensibly, my recent chat with Tamara Kreinin, executive director of Women and Population at the United Nations Foundation, was supposed to be about International Women's Day. And while it was, we also got sidetracked into talking extensively about Tamara's recent trip to Haiti. Her observations were too insightful not to share. (For more background on the issues faced by women and children in Haiti, read my interview with CARE President Helene Gayle here.) Here, Tamara talks about how the earthquake has impacted gender-based violence, maternal health and education for girls, as well as how the women of Haiti are increasingly taking matters into their own hands to improve their situation.
Cassandra: What are the current issues faced by women and girls in Haiti?
Tamara: The conditions for women and girls in Haiti before the earthquake were not good - probably the worst place in the world, or in the Western Hemisphere, to be a woman. Very high rates of maternal mortality, very high rates of illiteracy, and very high rates of violence. [In a crisis], things just take a turn for the worse. The most frightening of all is the gender-based violence and also a significant rise in teenage pregnancy. Because of the violence, we're anticipating a significant rise in HIV/AIDS, STDs and pregnancy as a result of rape, which will be heartbreaking.
I went to Haiti see what we had funded - we had raised about $4 million from the UN Foundation in general and nearly $800,000 from the UN Population Fund for a few things: maternity kits, solar lights and reproductive and maternal health clinics. Maternity kits have sort of a bit everything: a pad someone could use to give birth, sanitary napkins, contraceptives. Many of the health clinics had been wiped out. There were 200 nurses or midwifes before the earthquake and they were down to 75. We participated in building 10 clinics, which are still in the building process.
They [residents of tent camps] said the violence was just pervasive, and the thing that would help the most was solar lights. The women of the camps asked for the lights and to be a part of deciding where they go - they said, we go to the latrine at night and the doors are hanging open and we really need some safety through lighting. So I looked at the lights - the latrines are at the edge of the camp and you just see how they are the perfect opportunity for violence against women. The clinic is also at the edge of the camp, so the women had asked to have the lights strategically placed on their path.
What I heard that was most unsettling is that the crime against women is both of opportunity and targeted. Sometimes it was just someone walking by a bunch of girls or women; other times, it's that the men are watching a particular girl or women and target her for violence. Sometimes they're watching for months until they pick their moment.
We know that the response of everyone has been very poor: the police, the people running the camp. The women are really trying to protect each other by being there to scream for help, by cell phones, et cetera, and they said there is just no recourse. I think it is beginning to change. I think the UN is trying their best, when they run the camps or work with NGOs that run the camps, to make the safety of women a priority. But it's slow going.
--Can you give us some context for why violence against women emerges in these situations?
It's a confluence of issues. First of all, you have people who have lost their homes, so over a million people - no homes. Second of all, people have lost their livelihoods. You have a population of men who feel completely helpless and frustrated. And there are not places to go get jobs and no immediate recourse for building one's home.
In Haiti, you've got a culture where women have not been recognized. It's been said not only by me but by the general who was early on in command of the U.S. military that if you want to improve life in Haiti, you need to improve life for women and girls. They are very much marginalized and have not had advances in education or health or participation in government or leadership or [chances to become] economically wealthy. You have a situation where women aren't valued and that combines with men being frustrated and angry. The violence is really so much about rage and they're taking it out on women and family.
--Do you have long-term plans to deal with the consequences of the violence you mentioned, such as a rise in HIV/AIDS and teen pregnancy?
The UN Population Fund is working, first of all, on prevention. They have mobilized information and education on AIDS prevention throughout the camp. Somebody donated two trucks and they made them into something called a tap-taps, a colorful truck. They place youth educators on the trucks and at least condoms - even though it would be much more ideal to have a choice of volunteer family planning - and they ride around through the camps and educate young women and men. Many more camps have clinics in them and they are building more clinics and working with other non-profits to make sure the health care improves.
Haiti is a place that has always been in need of more family planning services. Globally, 215 million women want but cannot access family planning in order to space, time and plan their families. Out of that number, there are about 350,000 maternal deaths; conservatively, 32 percent could be prevented with family planning. It's quite heightened in Haiti. Their fertility rates are nearly five children per woman and they're living on $2 or less a day.
--How responsive to, and knowledgeable about, is the population to contraceptives?
It's a mixture, like in every population, so the education is really critical. The high illiteracy rate doesn't help. Then you go to access and services, and there aren't enough clinics, there aren't enough supplies and there aren't enough health care providers to talk to a woman or a couple.
--What else are you seeing?
The other sad thing is, in Haiti they're already at a disparity between girls and boys in terms of going to school. After the earthquake, [the disparity] is increasing. When I was there, a girl told me, 'In my family, when money is short, the boy goes to school and I either stay home or go to a less good school.' I think that's pretty pervasive around Haiti - the girls aren't having the same opportunities boys. That makes a big difference. An estimated 43 percent of households in Haiti are headed by women, so we really need employment opportunities for women and education opportunities for girls.
When I was there, the resilience of the people was also clear. As I looked around these tent camps, you look left and there are two women giving pedicures and manicures, and then a little further along, there's someone who set up a little hair salon. There are little markets everywhere, whether it's selling vegetables or beans or art. It's an impressively resilient group of people.
The women I talked to who are trying to prevent violence and protect other women and girls were very impressive and tenacious. These women are not giving up, they are going to try every recourse to find safety for their friends, sisters, daughters, granddaughters, and they are relentless.
--Is there an overlap in resources or planning for the Millennium Development Goals (MDGs) and your goals for the rebuilding of Haiti?
Absolutely, it's really one and the same. For the purpose of priorities in Haiti, MDG 5 around access to universal health care and eradicating maternal mortality are very critical. The UN Population Fund actually looked at what it would take to meet those goals and are estimating numbers of clinics, supplies for family planning and reproductive health visits, how many practitioners they would need, et cetera. Now, nobody is doing a good job meeting the MDGs, but before the earthquake they actually were doing a little bit better in Haiti. They are hopeful that they can get back to that.
--Having visited Haiti, what do you think is the biggest gap in how Americans envision Haiti today, and the reality on the ground?
I did a lot of work post-Katrina and I remember going down there and thinking that there was nothing to prepare me for the vastness of destruction. In many ways, Haiti was the same. A lot of the ruble has been removed, but there is still a lot of it and the streets are very hard to drive down. Getting across Port-au-Prince is really difficult. You do get out of some of the areas that were destroyed, you climb into the hills - Port-au-Prince is near the water, which is where most of the destruction came from - and you climb into the fancier neighborhoods and some things look pretty nice. But it's hard to imagine the absolute vastness of the destruction, the ruble and the tent camps.
The flip side of it is I don't think we fairly portray the Haitian people and their drive, resilience and creativity. There are certainly a lot of challenges with the government, but I think people want to roll that into saying, they must be lazy people and not very creative, when in fact I'm really impressed by the women and girls there.