The BBC’s helpful history of International Women’s Day cites a 1908 women’s march in New York – which focused on the right to vote and better pay – as the first step in the formation of what is now a globally celebrated event. Inspired by the march, in 1909, the Socialist Party of America launched ‘National Woman’s Day’. Then in 1910, at the International Conference of Working Women in Copenhagen, a woman named Clara Zetkin suggested to 100 other women from 17 different countries that they make this ‘Woman’s Day’ an international affair. Sixty-five years later, in 1975, the United Nations officially started celebrating the day and 20 years after that, began setting an annual theme to focus attentions. The first UN theme in 1996 was "Celebrating the past, Planning for the future". This year, it’s "Time is Now: rural and urban activists transforming women’s lives".
I recently learned what ‘rural activist’ means through a conversation with Emma France, the global development and strategic engagement director of Africa-based NGO mothers2mothers, and why it’s so important to celebrate the women who fit that description this International Women’s Day.
Operating in countries such as Kenya, Malawi, Swaziland, Uganda and Zambia, mothers2mothers is a global leader in the efforts to end paediatric AIDS. In sub-Saharan Africa, 200 babies are infected with HIV every day and most of them contract the virus from their mothers during pregnancy, childbirth and breastfeeding. With modern medicine and antiretroviral drugs, as mothers2mothers points out, this is entirely preventable. But healthcare services in these countries are so dire (Africa has 3% of the world’s health workers but suffers 25% of the global burden of disease) that doctors and nurses only have a few minutes to give a woman her HIV diagnosis and explain all of the treatments, drugs and tests she must undertake in order to stay healthy. Add to those rushed, anxious moments the stigma of a woman taking an HIV diagnosis home to her rural community, and it’s easy to see why many women don’t return for the treatment they need to protect themselves and their future children.
This is where mothers2mothers comes in. The charity was founded in 2001 in Cape Town by Harvard-trained obstetrician and gynaecologist Dr. Mitch Besser, who, as Emma tells me, “was having to convey health and hope to women who were probably thinking ‘how could you [Dr. Besser] possibly know what it feels like to face the stigma of HIV, how can you possibly know what it’s going to feel like to go home and tell my mother-in-law who I live with, or my husband, that I’m HIV positive?’ So Dr. Besser came to the realisation that the people who could really help these women were other women who’d been in their position.” And so, mothers2mothers employs around 1,600 HIV positive women and trains them as frontline community healthcare workers, so that they can lead the way for other women in their communities who are HIV positive and educate them in how to protect their babies and look after themselves. “The beauty of our model,” Emma continues, “is that we are able to have a woman sit down with another woman, mother to mother, and say ‘I was in your shoes two years ago, I have HIV, my baby was born free from HIV because of mothers2mothers. Look at me, I'm well, I'm healthy, I’m thriving, and you can thrive too.’”
Emma tells me about a recent trip to Malawi where she met Martha, a community Mentor Mother working for mothers2mothers, who is exactly the sort of rural activist this International Women’s Day is celebrating. Malawi is one of the world’s least developed countries and an estimated 890,000 (9.1%) of its population between the ages of 15 and 49 are living with HIV. Some of the areas Martha operates in as a Mentor Mother are a five-hour walk away from the nearest healthcare facility. With just one doctor to every 60,000 people in Malawi, Martha’s work as a frontline healthcare worker is critical. Her rural activism means going out “on a rusty old bicycle” and actively looking for women in rural communities who are living with HIV – women who would otherwise have no access to health services or information – and delivering vital information about how to manage the condition and prevent it being passed on to their children.
“Martha had one particular client,” Emma tells me, “who was not under anybody’s care – she had not been accessing any healthcare facilities, and Martha supported her to visit these facilities for the first time.” Martha walked the five hours with that woman, who was pregnant with her fourth child, to a healthcare facility to start receiving treatment. “The woman’s first child was HIV positive but wasn’t receiving treatment, and her other children were not very well at all – all of their lives were at risk – but because of Martha’s determination to bring her to the healthcare centre, her fourth child was born HIV-free and all those children and their mother are now receiving support and care.”
Mentor Mothers like Martha not only support and inspire other women in coping with the emotional stress of an HIV diagnosis, they also help them practically get access to life-changing antiretroviral drugs. According to the charity, all HIV positive pregnant and breastfeeding women in Malawi, for example, are eligible to be put on these drugs, and an estimated 64% of HIV positive pregnant women now receive the treatment – up from 20% in 2009. Mentor Mothers help women get this treatment, finding them, physically bringing them to the centres and holding their hands through the process. Mothers2mothers commits to these women and their families long-term, encouraging them to keep on going for treatment and to continue taking their medication. Mentor Mothers also run programmes in early childhood development (see video below).
“Without mothers2mothers, the stigma around the virus would have stopped me from getting any treatment,” says Thobile Nyamane, who works as a Mentor Mother in her native Swaziland. The stigma in Swaziland was so bad that when Thobile found out she was HIV positive, she threw away the booklet she was given at the health centre. “I didn’t tell anyone,” she says, “and I didn’t go back to the health centre for two years until I became pregnant with my second child.” That’s when she was introduced to a Mentor Mother who helped her “overcome my fears about treatment and disclose my status to my family.” Thobile went on to become a Mentor Mother herself in 2015. “We visit the homes of HIV positive women twice a month to ensure that we provide the psychosocial support needed,” she says. “We make sure the mother is taking her medication and that the baby is getting immunised.” Now a mother of four HIV-free children, Thobile is happy to report that thanks to mothers2mothers, she is "living a healthy, happy and purposeful life."
Liako Serobanyane from Lesotho had a similar experience. Women in her community were hiding their HIV diagnosis from their families “for fear of being discriminated against. They were dying in silence,” she says. “When I was four months' pregnant I went to the clinic for my first antenatal care […] I was given a box with antiretroviral drugs that would last until the baby was delivered, together with medicine for the baby. Six weeks after my baby was born, I got her tested. I was over the moon when her test came back negative.” Liako was later hired by mothers2mothers and trained as a Mentor Mother. “I learned things I wish I had known when I was pregnant. My first week was both exciting and frightening. When I stood in front of a group of women telling them about my experiences with HIV, it felt like my heart would kick right out of my chest […] But then I saw how much they valued having me there and I realised I could give support and hope to women who would have otherwise lived in fear. I am living testimony that, given the right support and information, it is possible for every mother in the world to have an HIV negative baby and that there will one day be an HIV-free generation.”
Mothers2mothers has virtually eliminated mother-to-child transmission of HIV in the women they work with. “Only 1.6% of babies that leave our programme, leave with HIV,” Emma says. “The UN Aid considers anything less than 5% to be elimination.”
Mentor Mothers such as Martha, Thobile and Liako are the activists we are celebrating this International Women’s Day. “We talk a lot about wonder women at mothers2mothers,” Emma says, “and these women are standing on the shoulders of giants.” By training and employing (ie. paying) its Mentor Mothers, mothers2mothers’ impact reverberates through communities. “I’ve met Mentor Mothers who have funded the first water source for their families – they’ve literally dug a well,” Emma continues. “I’ve met women who are the first to be college-educated in their communities – the first to have driver’s licences. HIV status has become irrelevant as they achieve their goals. What matters most to these women generally is becoming a role model for their children, for their families, and for the women around them.”