Teenage refugees ignorant about sexual, reproductive health

Adolescent Girls and Young Women (AGYW) constitute a major segment of young people (below 35 years) who comprise more than 80 per cent of the refugee population.
Due to inter-related factors such as broken families, community, school and health care structures, AGYW in refugee camps are systematically deprived of sexual and reproductive health (SRH) information and services provided by family/community and institutional (health care systems) respectively. Hence, they are vulnerable to teenage pregnancy and HIV/Aids.
“Yes, I have a boyfriend,” reveals Nilan Botende, 14, with her eyes half closed minutes into the interview when I inquire about her personal life.
Her English is sketchy and sometime an interpreter has to chip in for her to understand the question. She is more fluent in Lingala and Swahili. “I just want to be with someone,” Botende says, upon further inquiry.
Botende is one of the refugees who escaped from the DR Congo militia violence in 2018 and together with her family settled in Arua District in northern Uganda. Later, the family moved to Kampala and settled in Kirombe Village, Nsambya Central Parish. Here, they could work and earn a living.

The talk
However, as a teenager, Botende and her five siblings did not get time to talk with their parents about sexual reproductive health issues and neither did they interact with others in the same age bracket in places where they settled due to language barrier.
“I started getting my period after we reached Uganda,” she says. Asked if she at the time knew what the development meant, Botende says: “My mother just cut small pieces of cloth for me to use as pads. I had not been told about menstruation until my period started. Even after giving me the ‘pads’, my mother did not tell me anything else,” she says.

Education impact
Worse still, in DR Congo, the 14-year-old had stopped in Primary Six in which class, she says, they had never been taught about sexual and reproductive health. She could not continue with her education in Uganda since she hardly speaks English.
“I have just learnt recently that you can actually get pregnant and maybe sickness when you have unprotected sex,” she says.
But even then, she did not get this information from her parents but rather, from an organisation that brings together teenage refugees.
“Initially, I did not know anything [about pregnancy and HIV]” Bondete affirms. Even the time when her parents have found the opportunity to discuss the topic, it did not happen. One of her sisters got pregnant while in Kampala and a family meeting was called but “we [the young ones] were chased away,” she says.
Bondete’s family stays next to a slum and the 14-year-old girl, who still has dreams of returning to school and becoming a lawyer one day, has to brave repeated seduction from men.

Tradition
Jane Maninga, 16, is another refugee who fled with her family from the DR Congo’ Bukavu city in 2014 due to civil unrest.
Not different from Botende, Maninga also says her parents have never talked to her about reproductive health issues despite her vulnerability as a girl who dropped out of school in Senior Two before they left DR Congo in 2014 to settle in Mutungo Bbiina in Nakawa Division. She was 11 years then.
“I also have a boyfriend,” Maninga says without apology. Asked why she keeps a boyfriend despite being a minor, the 16-year-old responds: “That is a hard question.”
The sixth born in a family of nine children says she had no idea what it meant when her period started except the sketchy explanation her mother gave then. “I did not know anything and neither did I have a clue about HIV/Aids,” Maninga reveals.
Even when her eldest sister got pregnant while they were still in DR Congo, she could not understand what her parents were telling the former and neither did they ask her to take caution. However, the teenager was already getting advances from men.
“A Ugandan and friend of my father used to disturb me, always inquiring if I had a boyfriend. All I could do was warn him to stay away from me since I feared that my parents would not believe me if I told them about his advances,” she says, adding: “I thought they would think I was lying, so I kept quiet.”
Micheal Mukholi, the programmes manager at National Association of Women Living with HIV/Aids in Uganda (NACWOLA), says both government and other funders should look beyond providing shelter and food for refugees, especially girls and women.
“You realise that women and girls get tired of living in camps and, therefore, become vulnerable the moment a man shows up. They want to go out there and leave in their own shelter,” Mukholi says, adding that the humanitarian aid should not be about giving clothes in camps but also counselling and information on several things such as reproductive.

Sexual and reproductive health
According to the World Health Organisation, sexual and reproductive health is a significant public health need in all communities, including those facing emergencies.
It is defined as a state of complete physical, mental and social well-being, and not merely the absence of reproductive disease or infirmity in all matters relating to the reproductive system.
SRH rights involve access to accurate information and the safe, effective, affordable and acceptable contraception method of their choice. One must be informed and empowered to protect themselves from sexually transmitted infections. And when they decide to have children, women must have access to services that can help them have a fit pregnancy, safe delivery and healthy baby.
Adolescent SRH services therefore, aim to provide information, education and health services to adolescents to help them understand their sexuality and protect them from unintended pregnancy and/or sexually transmitted infections, including HIV/Aids.

Statistics
More than 60 per cent of Uganda’s refugees are under the age of 18, according to the United Nations High Commissioner for Refugees (UHRCR).
Uganda is home to 1.1 million refugees with 90 per cent from South Sudan and the DR Congo, making Uganda the third largest refugee-hosting country in the world after Turkey and Pakistan. Statistics from UNHCR indicate that South Sudanese make up the largest refugee population in Uganda (985,512 people) as at June 2018, followed by refugees from the DRC (271,967) and Burundi (36,677). Another 70,988 refugees are from Ethiopia, Eritrea, Rwanda.