Year: 2022

TURKANA COUNTY, Kenya – “I have never experienced a drought as bad as this in my life,” 28-year-old Akure Ewar told UNFPA. At seven months pregnant, she complains that she is hungry and often feels dizzy when going about her day. “The dry seasons have been progressively getting worse over the last three years, but our animals kept us going with milk and meat. This time, they have all perished and left us with nothing.”

Kenya is in the midst of the worst drought experienced in 40 years, following four successive failed rainy seasons. More than 4.3 million people are in need of humanitarian assistance, among them 134,000 pregnant or breastfeeding women who are reported to be acutely malnourished and in need of treatment. Forced to migrate in search of water, food and pasture, many are unable to access health facilities for critical maternal health care.

“Before the drought, our health facilities would record an average of 411 deliveries in a month, indicating a skilled birth attendance rate of 70 per cent,” explained Maiyo Elphas, a Loima Sub-county public health officer. “In November 2022, the number was down to 100 births recorded, which represents a very low rate of 24.6 per cent.”

Pregnant women fending for themselves

“Every woman, rich or poor, has a 15 per cent risk for complications around the time of delivery, but almost no maternal deaths occur in developed regions,” the World Health Organization states, explaining the importance of skilled birth attendance, meaning a childbirth assisted by a trained health professional, such as a doctor, nurse or midwife.

The rate of skilled birth attendance was already low in Kenya, a country with a high maternal death rate of 342 per 100,000 live births. But the situation is worsening dramatically for those affected by drought.

In Lochorepetet Village, 30-year-old Losikiria Kuya says she often has to go for days without food. She is a mother of three currently pregnant with her fourth, and is often unable to trek the 10 kilometers to the nearest health center for her ante-natal check-ups.

“Usually when it is time to deliver, my husband will take me to the center on a motorbike, but with him often gone in search of pasture, I have to be ready to fend for myself if need be,” she said.

Bringing care to rural women

The drought crisis is not only affecting women’s access to essential maternal health care; it is causing serious undernutrition among pregnant women, escalating risks to them and their future babies. In addition to affecting the development of a fetus, undernutrition also causes a number of problems for pregnant women, including higher risk of sepsis and death.

UNFPA and partners – including the Kenya Red Cross, International Rescue Committee and county health management teams – are providing life-saving sexual and reproductive health services through outreach efforts that bring services closer to those who need them most.

“During the drought season, we have been carrying out health outreach activities every two weeks where we offer ante-natal and postnatal services, family planning, nutrition and immunization services to the community,” Lobei Health Center Nurse Dedan Njagi told UNFPA.

An estimated 15 to 20 pregnant women receive care at each outreach visit. Community health volunteers – the backbone of the outreach teams – are also tasked with keeping track of the women to ensure that they deliver at a health facility under the care of a skilled attendant.

Worries on the horizon

The severity and exceptional duration of the drought is worsening an already dire situation in Turkana County, which was already reeling from locust infestations and the COVID-19 pandemic. Projections indicate the possibility of a sixth consecutive poor rainy season from March to May 2023, placing even more women and girls at risk.

UNFPA is appealing for $113.7 million for its Response Plan for the Horn of Africa Drought Crisis 2022-2023 to respond to women’s and girls’ escalating needs.

Source: United Nations Population Fund

Our guest today is Madam Therese U. Poirier, UNAIDS country representative in Er¬itrea. Madam Poirier has com¬pleted her three-year term and is leaving Eritrea on January 1, 2023. The interview focuses on her professional and personal experiences in Eritrea.

Thank you for being with us. Please introduce yourself to our audience

This is an honor that I don’t take for granted. Thank you very much. My name is Madam Therese Poirier. I am a Rwandese- Canadian and a mother of two. I have over 30 years of progressive leadership experience in interna¬tional development. I started my journey working with grass root community development in my native Rwanda. Later on I moved around many countries in Africa, Asia, Latin America and North America (Canada). Before join¬ing UNAIDS, I was working as a diplomat for the Canadian gov¬ernment working with regional and pan African institution. A decade ago, I moved to UNAIDS and worked as its representative in Mali, Malawi, and now Eritrea.

You have been in Eritrea for three years; how would you de¬scribe your time here?

What to say! What to say about Eritrea! It has been an incred¬ible journey and I am extremely grateful for the opportunity I have had to work in this beauti¬ful country. I have made lifelong connections with the local people and international community that I will always cherish. Here, I have learned so much about this country. Eritrea is making its own progress at its own pace. That is something you need to experi¬ence Eritrea. You need to be here to see how Eritrea is able to be on track to meet many SDGs, espe¬cially the one I am interested in, SDG 3. I have seen tremendous achievement. They don’t make noise but they are scoring tre¬mendous achievement. I am im¬pressed by the level of commit¬ment of the people and the civil society I have been working with. I describe my time here as an in¬valuable learning path and I will really miss this. The exposure al¬lows me to experience firsthand how a country with a vision can perform. And I am very grateful for this experience.

As a UNAIDS representative to Eritrea, what are your obser¬vations and impressions about AIDS in Eritrea?

Thank you for this question be¬cause it is one of the things that I would like to say from the bottom of my heart. I would like to com¬mend Eritrea for the partnership I have with the Ministry of Health (MOH).

They have made outstanding progress, especially in health sec¬tor. If we see the strong leader¬ship skills of all involved in HIV response, it’s really impressive. And somehow, it contributes to making my job easier and fasci¬nating. One of the things I really appreciate is how people work together. You know, the way in the UN, the different sister agen¬cies work with each other and co¬ordinate the response. The same way, the MOH works with other ministries to ensure that the re¬sponse is very focused and well-coordinated. That’s how I have got the opportunity to work with people from the MOH, Ministry of Education, Ministry of Infor¬mation, National Union of Er¬itrean Women, National Union of Eritrean Youth and Students, the National Confederation of Eritrean Workers. All of them are involved and I really appreciate the dedication of the team. That, I believe, is what led to achieving these outstanding results that we are seeing now. Eritrea is on good trend. According to statistics, in 2003, the prevalence [of AIDS] was 4.34; now we are almost at 0.5. This is a huge leap forward. We may not make noise about it but we know it’s a very big achievement. This is because of the multi-sectorial approach; the work of all the people involved is what makes this happen. There are 284 sites dedicated to HIV testing services. And all depart¬ments are working to ensure that everyone can be tested by pro¬viding equal access. People liv¬ing with HIV are involved in the planning and implementation of services and that is commend¬able. That is what the Global Fund appraises Eritrea for. This kind of working together and co¬ordinated response.

Have you travelled out of As¬mara? Are there experiences you would like to share with us?

I wish I could travel more. Un¬fortunately, I arrived during the covid-19 lockdown and couldn’t travel all over the country, but I managed to visit some zones and it was really interesting to see the beauty of the country, the sereni¬ty of the country side. I remember when I was going to Massawa for a site meeting. Passing through the mountains to Massawa, it somehow reminded me of my native Rwanda. I really enjoyed it and I always like to go to the health facilities and get firsthand experience and discuss with com¬munities. One of the things I re¬ally enjoyed, which would be my takeaway, is community mem¬bers working with a health facil¬ity staff to build the waiting room for pregnant women who live in hard-to-reach areas. This meant that pregnant women could come prior to their delivery and have safe delivery under medical su¬pervision.

This is a very good example of what Eritrea can teach others. I enjoy visiting the country side to see the marvelous landscapes and visit HIV testing centers. HIV testing services are incorporated in healthcare facilities, making them easy to access. For exam¬ple, a pregnant woman attend¬ing an antenatal clinic (ANC) has HIV tests conducted at in¬tervals. Currently, I can say 95% of women are attending ANCs, which is very good. Of course, we still have some women who don’t deliver in hospitals. That is something we need to keep work¬ing on to ensure that all pregnant women come to health facilities for delivery and checkups.

If I asked you to paint a verbal picture of Eritrea, what would it look like?

Thank you for this question. Honestly, the country will leave a lasting impact on me. You know there is this saying that the taste of the pudding is in the eating. Should I speak about the warmth of the Eritrean people? Kindness comes naturally to them. Walking around in my neighborhood even in late hours, I feel safe. This is something unique. You cannot do that in some countries. Even in Canada, there are some parts of the country you can’t feel safe to go to. Honestly, during my time in Eritrea, I found the Eritrean people to be very cordial and welcoming. I have made several friends at all levels. In addition to that, I have had some privileges to be invited at local homes for meals and local coffee ceremony! I struggle with the first round of the coffee, i.e. Awel (first), and the second because they are very strong. I really enjoy the ceremo¬ny and the coffee from the third round on. Moreover, the working environment in Eritrea is very friendly and I really appreciate the interaction that I’ve had with people in Eritrea as a whole. I’ve really benefitted from my stay. That is something I would take away with me.

How does it feel to depart Er¬itrea?

As I said earlier, in my career for more than 31 years, I have traveled in various continents. I stayed longer in some countries than others but one of the things I want to say is that it is never easy to prepare for this inevitable day, to say your goodbyes. Last week, I had a workshop with health workers and women living with HIV, preparing this country to eliminate the disease. At the end of the workshop, as we were say¬ing goodbye we were all crying. It was heartbreaking. It is tough to leave this country; I know how much I will miss my Asmarinos. I will keep the friendship I have started here and I will keep it for¬ever.

Any other messages you would like to put across?

My key message would be to my partners; continue to build re¬silient and sustainable system for health and strengthen your pan¬demic preparedness so that Er¬itrea stays healthy. You did well under the threat of Covid-19; you can keep doing well. I would also say keep raising awareness and eliminate shame about HIV be¬cause the stigma may hinder the response.

That’s how the media and oth¬ers could help combat HIV. Con¬tinue the push forward and gain more ground in fighting HIV, maintain the tremendous gain we have made. As I said, HIV/ AIDS prevalence among clients coming to HIV testing services has declined from 4.34 to 0.6 in 2021. So, there is a lot of hope for Eritrea. And my most genu¬ine wish is to see what Eritrea will be in the coming year or two years. It can become the first country in Africa to get the full international recognition of the elimination of mother-to-child HIV transmission. Botswana has got the bronze but Eritrea can go straight for the top without hav¬ing to pass levels. It’s my utmost hope that this continues so that in some years I hear that Eritrea is an AIDS-free country.

Source: Ministry of Information Eritrea