By Judith Bruce and Marie Assaad
Located on the outskirts of Cairo, Egypt, Mokattam is a settlement of 17,000 people whose livelihoods are directly or indirectly linked to the collection and sorting of garbage. From just after midnight until the break of dawn, family-owned trucks and donkey carts collect garbage along routes allocated to them by middlemen. Upon return to Mokattam each day, the garbage is dumped into the center of a family home where family members — mostly women and girls — quickly make crude divisions of recycleables, separating out paper, glass, clothes, and bones. This overwhelmingly arduous and unpleasant task typically absorbs 4 to 6 hours a day and is split into 2 sessions: one from 5 to 9AM and another from 4 PM to 1 AM. Working with bare hands and feet, knee deep in garbage, the women and girls must sort the vast volume quickly in order to leave the home free for other family activities.
In 1984, the Association for the Protection of the Environment (APE) was established as an Egyptian non-governmental organization responsible for managing a composting plant in Mokattam and initiating social development activities in the community. The organization specifically seeks to improve the livelihoods of Mokattam girls by introducing new skills, social identities, and income-generating opportunities. Groups of girls are taught rug weaving, paper recycling, and embroidery. Though a training schedule and work hours are established, they are flexible so that families can negotiate their daughters’ availability for garbage sorting and other domestic duties while participating in the program. APE’s interventions respect the close link between the girls’ economic roles, their social development, and their standing within the family.
As the program developed, APE focused greater attention on the connection between the "unmet needs" of adolescent girls and the longer-term maternal and child health outcomes seen in the Mokattam community. For instance, a 1989 study found that more than 50% of pregnant women were not receiving prenatal care and only 32% of all women were vaccinated against tetanus. Illiterate and disempowered mothers were less likely to receive adequate support during pregnancy and often did not attend to the health needs of their children.
In response, APE developed a health promotion scheme that employs girls — whom the project perceived as truly eager to learn — as health workers. Girls serve as agents of change in reaching families with newborns and young children while, at the same time, receive knowledge of how to protect their own reproductive health. Initially the health workers visited pregnant women and mothers of young children, however, the project organizers soon added a component to address the special health needs of girls ages twelve to twenty. Linking girls together — trained health workers and girls in other households — builds on a window of opportunity for girls between the age of twelve and twenty, before they marry and have children.
The adolescent health workers are selected from among the poorest families — typically garbage collecting families — and given a physical examination and appropriate treatment where necessary. They then receive twice-weekly, unpaid training (over a 10-month period) in primary and reproductive health care, which covers topics such as household sanitation, nutrition, the sequence of childhood immunization, family planning, appropriate care during pregnancy, first aid and home treatment of common ailments. Once they begin making household visits, usually three to four per week, they receive a salary of 70 pounds (US$ 20.67) per month. Despite the fact that nearly all the girls are circumcised, they are willing to carry anti-female genital mutilation (FGM) messages to the community because they have come to understand that FGM can be harmful to women’s reproductive, sexual, and psychological health. To date, several hundred young girls have been trained as community health workers with the financial and technical support of numerous organizations, including the World Bank, the Ford Foundation, Oxfam, the European Community, Catholic Relief Services, and the Egyptian government.
During its decade and a half of working in the community, APE has gained much insight into working with adolescent girls. Through focus group discussions aimed at evoking the girls’ views about their own future reproductive health and personal fulfillment, the girls expressed changed expectations regarding the quality of their future lives, their role in selecting their husbands, the establishment of a more equitable basis for the husband and wife relationship, a clear desire to continue learning and earning after marriage, and a well-developed sense of their responsibility as future mothers — particularly with respect to daughters of their own. Among some of the lessons learned:
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While successful economic programs must be adapted to the realities of the society, they must also seek to improve girls’ social position.
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In addition to the economic benefit, income-generation activities can "capture" girls for introduction to a wider range of social possibilities, including basic education and training.
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The key to making opportunities to work outside the home desirable and acceptable for girls is that they are located in the community and operate in such a way that does not compromise the girls’ social status (i.e. potential marriageability) or their vital contributions to their families.
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When appropriately trained, young female health workers giving advice about proper food, rest, pregnancy, and even family planning has proved to be acceptable and respected in the community.
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Mokattam girls as young as fourteen are capable of expressing nontraditional values and set out high expectations for their future marriages.
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For some girls, involvement in income generation or any other enrichment program requires both on-going negotiations with their families and flexibility on the part of program organizers.
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The value of the program to improve life skills, autonomy, and self-esteem of girls is often severely undermined, at least temporarily, within the early years of marriage because new brides occupy the lowest rung in the domestic hierarchy and are subjugated to the wishes of their husbands and in-laws. Efforts to support girls must continue through the early challenges of marriage and the birth of their first child.
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An important complement to any program that seeks to reconfigure young girls’ prospects are efforts to bring about new understandings of women’s rights and to encourage practical support of these rights by men within the community.
The initial results of this program have led the organizers to try to replicate it in Tora, a smaller garbage-collecting community. Another program currently in the planning stages will focus on men — youth, husbands, and fathers — and encourage their support of unmarried and married young women alike. APE views male involvement as critically important to closing what would otherwise be an increasing gap between the expanding aspirations of girls and young women and traditional male views of women’s rights and responsibilities.
The project has shown that adolescent girls, provided they have been well-trained and are perceived to be competent, can become effective community motivators by serving as paid providers of health information and services to families within their community.
Contact name:
Mrs. Yousriya Loza Sawiris, President
Association for Protection of Environment
Tel: 202-3033028/3015120/299
Fax: 202-3440201/3020277
Email: yousriya@intouch.com
