The International Planned Parenthood Federation (IPPF) recognised former African Union (AU) Commissioner for Social Affairs Advocate Bience Gawanas, who is currently the Special Advisor to the Minister of Poverty Eradication and Social Welfare, for her contribution to sexual and reproductive health and rights on 20 May 2017.
The IPPF hailed Gawanas as a champion of women’s health and rights in Africa for her role in initiating far-reaching campaigns such as the continental Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA), which the United Nations Population Fund (UNFPA) supports. In this interview with Emma Mbekele, the UNFPA Communications Officer, Adv. Gawanas shares her insights on the award.
EM: When you heard about the nomination, what went through your mind?
BG: “It was very strange. I was driving back from Maltahöhe and the driver was a bit tired, so we stopped on the roadside and then the phone rang. So, the person asked, “Is this Bience Gawanas,” and I replied yes. Then she said, “I’m calling to inform you that you have been nominated for an award.” I first said to her, “excuse me, wait a minute, what award?” And then she explained. I then asked her to call me back later, when I’m at home. So, she called back and she confirmed…
I was astonished because it happens at a time when we are really starting to talk about these issues, but mostly it was obviously also in recognition of the work that I did when I was at the African Union. It was a great feeling to know that the work one has done is being recognised worldwide. ”
EM: This must be a very special moment for you, your family and country. What does it mean to you personally, the country and the continent?
BG: “Well, for me personally it is about putting maternal and child health on the African agenda and that was surely a recognition. I also believe that what we really did at the AU through the adoption of the Maputo Plan of Action through the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) was great.
We then had a whole Summit of Heads of State held in Kampala in 2010, and the theme of the summit was Maternal and Child Health.
What we did was that for the first time we organised a moderated panel discussion where we invited the two heads of state including the then executive director of UNFPA, Thoraya Ahmed Obaid, who was one of panellist together with Yvonne Chaka Chaka and I. It was really great to see how the heads of state engaged with the issues. It was basically, a debate that lasted five or six hours into the night.
For the continent, because it is recognition of what the AU has really done in terms of putting maternal and child health high on the agenda. For my family personally, yes it is an honour for them. My kids will always say how proud they are of me. In fact when I went to receive the award I was together with my two children and my grandson. ”
EM: You are the mother of CARMMA. Do you think CARMMA has achieved what it was intended to achieve?
BG: “When I was at the AU, I used to work closely with Ms Etta Tadesse, former UNFPA Representative to the AU and the Economic Commission to Africa and I kept telling her that since I came to the AU we had worked very much on HIV, Malaria, TB and health systems strengthening etc. However, Africa faces the challenge of high maternal mortality rates and we need to do something about that. That’s how the discussion started and we were asking ourselves whether we should have a movement, or should it be just a campaign raising awareness about the issues. And so, that’s basically how CARMMA was born. In 2009, I presented it to the ministers of health in Addis and the campaign was launched.
The objective of the campaign was firstly to harness political will around the issue, and to make sure that it is an Africa-owned initiative, were we say it is a problem for Africa and how do we resolve that problem. By the time that we launched CARMMA, we already had the policy framework on sexual reproductive health and rights, which was adopted in Botswana.
Then the ministers decided they wanted to have a plan of action, and the Maputo Plan of Action followed that. But I was very aware that having this policy instruments, was one thing, the other thing was the implementation at the national level. So, that was the idea around CARMMA.
CARMMA was a campaign to ensure the effective implementation of the Maputo Plan of Action or other related policy documents. It aimed to raise awareness around the issues because what I realised was, once you start talking about maternal mortality issues, you put women at the centre.
You are addressing not only health issues, but addressing questions of gender i.e. is it because of the low status of women that this issue is not addressed; does the role of culture and tradition also contribute to that. And so, CARMMA, in a way is exactly what it is means; it looks holistically at women’s health. We wanted to believe that it was not a question of Africa not caring; it was maybe the way of doing things. And that is why CARMMA’s slogan was, “Africa Cares: No Woman Should Die Giving Life.” That was in 2009, and by the time I left the AU in 2012, many African countries had launched CARMMA nationally.
What we did in each country was to have the whole launch spearheaded by the minister of health, but we also made sure it should involve the United Nations agencies, and other international organisations like IPPF if they existed in that country, but also traditional leaders, religious leaders, everybody. It was mass mobilisation within countries.
Secondly, we also said to countries, should not only launch it in the capital cities. We suggested they must also launch CARMMA outside the capital cities, because that is where the problem is. High mortality rates in Africa affect rural women mostly because of access and delay issues. I was very heartened when I was travelling around to attend these launches. I remember in Sierra Leone as part of the launch, the government declared that pregnant women and children under the age of five years would receive free medical treatment. What also impressed me about CARMMA was the commitment made by health ministers; they drove the initiative forward and they gave recognition to their own organisations for having led that. In Malawi, the former president, H.E. Joyce Banda, also became the champion of the campaign in Malawi and turned around a lot of things.
Thus for me the greatest achievement was to mobilise support around maternal mortality issues. But as long as women are still dying we have not achieved the goal, and so I still hope that there is still that focus and that CARMMA has not died, and that it still continues.”
EM: Lastly, what are the projects that you’re working on at the ministry?
BG: “When I came back I was Special Advisor to the Minister of Health and Social Services and it was very clear where my personal interest lay, which was definitely on maternal health. As I was saying it is good to be back in the country because I was there when we were developing the policy frameworks. Now I am here, and I can at least facilitate the implementation of some of the things that we as a country have committed ourselves to.
The one thing that remained a concern for me is that we still had high maternal mortality and we had the issue of baby dumping, teenage pregnancies, and all those issues are challenges that we continue to face in Namibia. Illegal abortions, unsafe abortions, and I was so glad that our minister asked a very fundamental question, “in a country such as Namibia where contraceptives are freely available, why is it that women still risk their lives; why is it that we still face the challenge of teenage pregnancies?” We have called for a national dialogue on this issue, including issues of abortion. As you know, abortion is illegal in Namibia, except where a woman’s life or baby’s life is threatened or where it’s as a result of rape or incest.
We say that we really need to open up the debate, because as we are sitting here, next door to us abortion is legal. So even though we sit and talk and we condemn, those that can afford go across the border to South Africa anyway and they have their abortion. It was a debate that was on the table so many, many years ago. So, I fully support the minister that we should have a national dialogue on these issues. It is high time that we open up the debate again and then see what interventions do we need to have.
I think we need to also place great deal of focus on adolescents. We need to come face to face with the reality that young people are sexually active now at a much earlier age, so whether or not we like to hear that – and sometimes as parent we don’t want to assume that our children are involved in sex at that age. Unfortunately, it’s a reality that we need to discuss. I remember when the campaigns on HIV started, a lot of people still had difficulty dealing with the fact that it was sexuality transmitted and therefore you unfortunately had to discuss sex, whether you liked it or not. Basically, for me those are the challenges and the challenges that the Ministry of Health and Social Services has also set as priorities. So I feel that with this award I am really inspired to continue promoting sexual and reproductive health rights in Namibia.”