Senegalese women struggle to maintain their health under the weight of debt and poverty

The fishing pier at Gol Beach in Senegal is usually bustling with life, as it is crowded with women waiting for the fishermen to return, their eyes fixed on the outcome of the day’s catch, to the point that the sea itself almost disappears behind the crowds, but the scene today is completely different, as calm prevails in the place, and the sand is covered with the remains of broken shells, and plastic bags extending to the edge of the water.

One night, a strong storm accompanied by unusually heavy rains struck the coast of Senegal, paralyzing the movement of the sea and preventing the men from boarding their small wooden boats, known locally as “pirogis.” It also flooded some homes, and the next morning turned into a day of isolation, as the women remained in their homes, busy cleaning up what the storm had left behind and arranging their damaged homes.

Hard life

Life in Senegal seems more fragile and more difficult day by day, as described by Adama Faya, a 29-year-old rural woman. She says: “It is as if an invisible hand is holding everything, so we can only wait.” Her husband works as a fisherman, but when he is forced to use artificial nets at sea, he returns with a small catch that is not enough to support their daily needs.

Adama works in a small local clinic in her poor area, and she is among the women who meet periodically with a team from MSI, an international non-governmental organization based in Britain, which provides family planning and safe abortion services in 37 countries around the world.

This organization visits the area once every two months to provide contraceptives to women, in an attempt to protect them from repeated pregnancies that threaten their health and exhaust their bodies. Faya asserts: “When a woman can organize her childbearing periods, she becomes more capable of working and becoming economically independent, without waiting for the sea to bring in or for the help of men.”

Reducing aid

But this vital artery has become threatened, due to the reduction in international aid. In the waiting room inside the modest clinic, women sit on simple wooden chairs, listening to the 28-year-old midwife, Amy Mbaye, who has been in charge of the health center for nearly 10 years, saying: “The women here are true warriors.”

Mbaye explains that most women in the region go through repeated pregnancies, up to nine or 10 times, often including miscarriages or stillbirths.

She lists the many health risks resulting from this, from severe anemia, to abortion complications, and even maternal deaths, and indicates that due to the criminalization of abortion in Senegal, many women resort to dangerous secret practices that threaten their lives.

Mbaye adds: “Everything here is connected to the sea. When there is no fishing, there is no life.” We ask the women to come for examination, and they reply that they do not have the cost of transportation, as the hunting is weak, and the house needs food.” She confirms that MSI is the only organization that continues to support the community despite weak funding.

poverty

In a country like Senegal, where more than 19 million people live in debt, poverty and limited resources, health care seems like a rare luxury.

The local clinic itself struggles to provide the most basic supplies. Medical gloves are scarce, and the building is dilapidated and water is dripping from the ceiling. However, it is the only refuge for about 28,000 people, including 7,000 women of childbearing age.

For her part, Kumba Deng, a 52-year-old restaurant owner, shares the same feeling of distress, as she says sadly: “In the past, we used to eat two full meals a day, but now, once is enough for us.” She points out that most of her customers are now asking for “Fundi,” which is porridge considered one of the cheapest foods, which she serves to men upon their return from fishing at sea.

Ding adds: “My town is on the way to more poverty. In the past, people ate whatever food they wanted, but now there is nothing.”

Ding remembers with nostalgia the days of the 1990s, when her fishing neighbors would generously offer her their fish for free. Now, she is forced to buy fish at high prices to prepare “thiboden,” the famous national dish of rice and fish.

Pregnancy regulation

Ding has seven children, each separated by only about nine months. She says that the successive pregnancies without a rest period had a negative impact on her health, as she began to suffer from high blood pressure and felt weak.

Shortly after giving birth to her youngest child, six years ago, MSI provided her with a contraceptive device. She confirms that without the organization’s help, she would have had to pay £20 for the medical consultation and the costs of the contraceptive device, which is more than she earns in an entire week.

Ding says: “My life has completely changed. I am now able to work with confidence. I obtained a loan worth 400 pounds to expand my restaurant, and I paid off most of it. I have become stronger, I cook more, and I sell more.”

anxiety

MSI runs a British-funded program known as “Women’s Integrated Sexual Health,” which is implemented in a number of African countries, including Senegal, Mali, Niger, Chad, Mauritania, and the Democratic Republic of the Congo, with a budget of 60.9 million pounds sterling, for the period between 2018 and 2024.

However, the program was negatively affected after the reduction of aid during the era of the previous British government, as annual funding decreased from 30 million pounds to only 6.7 million, which reduced the number of countries benefiting from 12 to eight countries, and the number of women benefiting decreased from two million women to only 200 thousand.

Currently, with the new British government announcing its intention to reduce the aid budget again in favor of defense spending, there is concern among the population in Senegal and the rest of the countries that the program helps about a darker future.

About the Guardian

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Resilience

The “Integrated Women’s Sexual Health” program, run by the NGO MSI with British funding, relies on the efforts of local volunteers in Senegal, who knock on doors to convince women and their husbands of the importance of pregnancy planning and the interval between births. But in a society that depends on the sea for its survival, it seems that its waves no longer leave women with only one option: to withstand the storm.

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Spacing between pregnancy periods

Faye wants a 3-year break before thinking about having more children. From the source

In Senegal, those responsible for the MSI program are active directly within the community, as they go from house to house among trusted community members, with the aim of searching for women who can benefit from the health services provided by the program. During these rounds, the team talks with women and their husbands to explain the health benefits of spacing during pregnancy, which is one of the foundations the program emphasizes to maintain women’s health.

Those in charge of the program point out that spacing out pregnancies helps women reduce the health risks associated with repeated childbirth. This seems extremely important, especially in light of the absence of health insurance or free medical care that women can rely on in the event of any illness. In some cases, group sessions may be held on the sidewalk to provide assistance, but the reality requires everyone to face health challenges on their own.

The young Senegalese woman, Adama Faye, says that she did not know about modern contraceptive options until she underwent a postpartum examination last week at MSI.

Faye has two children, a six-year-old and a three-year-old, and would like to have a three-year break before thinking about having more children.

After learning about different methods of contraception, Faye is now able to protect herself for up to 10 years using available methods. Although she does not currently work, she used to work as a maid in the past, and she hopes that contraceptives will help her find a new job opportunity, perhaps in the field of sales, as she says with confidence: “I am good at selling things.”

Faye bears the responsibility of supporting a large family, including her children, her mother, her brothers and sisters, in addition to supporting her husband.

Every day, 45 women and girls benefit from some form of contraception at the clinic, with most women choosing long-term methods that provide protection for several years. An additional 18 women and girls are also undergoing cervical cancer screening as part of the health services provided.

At the national level, the government of Senegal has set ambitious goals to enhance reproductive health. These goals include reducing the maternal mortality rate and increasing the percentage of women who use modern contraceptives from 27% to 46% by 2028, as part of a comprehensive plan to improve health care for women and enhance their ability to control the health of their families and their future.

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Financing gap

The issue of family planning in Senegal extends to improving quality of life. From the source

In his office in the Senegalese capital, Dakar, the head of the Department of Maternal and Child Health, Dr. Amadou Doucouré, confirms that there are plans to increase the resources allocated to this vital sector, but at the same time he points out that these local efforts alone are not enough, saying: “Even with the availability of local resources, we still need the support of partners, as ultimately it is about saving lives.”

For his part, the regional director of the British MSI, Emmanuel Diop, says that the reduction in international aid, especially that provided by the US Agency for International Development, has left a tangible impact in the country, as it caused a large funding gap, which prompted the MSI to intervene to try to compensate for this shortfall.

Diop adds that the US agency was responsible for providing the bulk of the supply chain of family planning and contraceptive methods, but the cessation of its support led to the depletion of large quantities of these vital methods in various regions. He emphasizes that the issue of family planning in Senegal is not only related to saving lives and protecting women’s health, but also extends to improving the quality of life, as it contributes to providing women time to work, produce, and build a better future for their families. He points out that a woman who has five or more children “should not be forced to give birth to another child in difficult living conditions,” stressing the importance of supporting women and empowering them to make decisions related to their health and family future.

. Adama Faya: When women can organize their childbearing periods, they become more able to work and be economically independent, without waiting for hunting or men’s help.

. The programs of the international non-governmental organization MSI, which provides family planning services, have been negatively affected by the lack of funding.