February 21 2006
Senator Henry was attending the conference as the guest of Her Excellency, Mrs Eki Igbinedion, wife of the Governor of Edo State, Nigeria.
It is a great honour to be here at the Edo Women's Conference and I thank the First Lady of the Edo State for her kind invitation. The title of the conference, Women - the Strength of the Nation, shows that Nigerian women maintain the spirit and confidence of all the Nigerian girls and women I have known at school and College and in international organisations, and I salute you for your commitment to your role in the development of Nigeria.
My contribution today, Women - Your Health is Your Strength, will, I hope, encourage you and other women here to remember that you must care for yourselves and other women first in order to be in a position to care for the nation.
The position of the girl child in many societies has over the years been considered of less importance than that of the male child. Indeed, the female child's battles start nowadays in some countries before she is born. In India the girl child is considered a burden rather than a blessing in some families. A pre-natal diagnosis of the sex of the child can be made now by ultra sound scan. It is sad that such a useful modern medical instrument is being used to select girls for abortion. We already are aware that such practices in China in pursuit of their one child policy has resulted in there being many millions of young men in China now who cannot find brides. This has resulted in the stealing of girls in some areas and the trafficking of women. The social consequences of such practices are frequently not considered and all of us on the international stage must promote the value of the girl child.
It is important to remember that most health issues are as important and the same for women as for men. Once the child is born the child, no matter what sex, needs the same care and nourishment. Nigeria is fortunate in having a very high rate of breast- feeding amongst its mothers. In Ireland, the overall rate of breast-feeding at discharge from maternity hospitals, where most women give birth, is only 40%, an improvement from 30% 10 years ago but still low. It is noteworthy that the breast-feeding rate amongst professional women and those with third level education is over 65%, but in women from disadvantaged areas it is 20%. These are some of the worst breast-feeding rates in Europe and we know that breast-feeding children for up to two years is recommended by the World Health Organisation. Not only is it nutritionally better for the child, but also the child is less likely to become obese and develop Type II diabetes, sometimes as early as the age of ten years. The association between Type II diabetes and obesity is well recognised and a world wide epidemic is developing, so be warned. Malnutrition due to lack of calories is a frequent problem in parts of Africa but an abundant supply of food of the wrong type, such as those which are high in refined sugars, salt and fats, can do very serious damage to the child's health, too.
While I am not an expert in HIV or AIDs I believe that even in women who are HIV positive it is considered better for women to breast-feed, despite the fact that some of the virus is transmitted in the breast milk. This is because of the difficulties in ensuring water to make up babies' formula is always bacteria free. Not everyone has access to clean water. The death rate amongst small children from water borne diarrhoeal infection is a dreadful problem in many countries and children who are breast-fed are less likely to get infected.
As well as malnutrition and diarrhoeal infections girls are as much at risk as boys of the many infectious diseases which affect children. Vaccination is available for conditions such as measles, tuberculosis, meningicoccal infections, tetanus, diphtheria and so on and it is most important that all children receive these vaccinations.
All children, too, are affected by another of the great killers of small children in Africa, and that is Malaria. The Global initiative on HIV/AIDs, Malaria and Tuberculosis has meant that there is a far greater supply of bed nets in those parts of the world where the mosquito which spreads Malaria lives. The girl child must be under the net as well as the boy.
My concern about the promotion of the child's health is great as you can see, because the child is the parent of the adult. The education of the girl child is vital, too, if she is to be the adult that this country needs. She needs to know how to care for herself before she can contribute to the welfare of others. The infant mortality rate of the children of girls with primary education is much less than those without education, and secondary education improves the situation even more.
An issue which does affect girls and women exclusively is the fact that pregnancy to date, and childbirth, can only be undertaken by women. The maternal mortality rates in many countries in Africa are still very, very high, in some about 200 women per 100,000 live births die. About half a million women die each year world wide in association with childbirth or pregnancy, about one quarter of these involve abortion which is almost always illegal. 99% of cases of maternal mortality occur in the developing world.
Teenagers are twice as likely to die as adult women. Despite the fact that most countries have a legal age for marriage in the mid to late teens it is frequently not enforced for cultural reasons. This is unfortunate and women should make every effort possible to ensure girls do not embark on a first pregnancy until they are safely able to give birth. It is easy to understand, however, how poorer parents may see early marriage as one less child to feed but the dangers for the girl are considerable. Female genital mutilation is a cultural practice in some parts of Africa which I will mention only in saying that some people do not associate this practice with the health problems which can arise for the women in later life, for example, repeated urinary tract infections and difficulties at childbirth. Female genital mutilation is not practiced in a large part of the world and this is often not realised either.
Young girls who have difficulties giving birth have a high risk of developing fistula. The baby is frequently stuck in the pelvis for so long that it dies, the floor of the girl's pelvis is destroyed and in bad cases she becomes incontinent of urine and faeces as well. This is a dreadful thing to happen to any girl, you will have seen more cases than me, and repair, if it is available, is difficult. She can become rejected by her family and society. It is impossible to have maternity hospitals with facilities for delivery by Caesarean Section at every cross roads but it would be good if all women and girls had access to a healthcare worker who can pick out those pregnant girls who are most likely to run into trouble. For example, UNFPA have trained traditional birth attendants in some countries to recognise that girls below 5ft. in height - they are given a stick to measure the girl - are more likely to run into trouble. And they are given a watch and taught that any woman in labour for more than 8 hours on her first delivery should be got to more expert help if at all possible. The birthing kits supplied by UNFPA, which cost only 25 cents, contain a clean blade to cut the umbilical cord and clean string to tie it. Such simple measures have greatly decreased the incidence of neonatal tetanus. Promoting such small initiatives can greatly help the health of rural women in particular. Trying to assess their health during pregnancy is very important. For example, are they anaemic, is it due to parasitic infestation or to lack of iron, both easily and cheaply dealt with? An anaemic woman dies far more rapidly from haemorrhage than one with a good haemoglobin level.
Family planning services which will allow a couple space and limit their families are naturally vital for the health of women. In rural areas methods which require less frequent access to family clinics may be more popular, for example, injectibles such as Depot Provera, but where possible women should have a choice. It is important to remember that, apart from abstinence, condoms are the only method which, if properly used, will help curtail the spread of sexually transmitted diseases including HIV infections.
Violence against women is an international problem. The violence can be domestic or due to wars or uprisings, civil disorder and refugee problems. Domestic violence usually involves a man who is a close relation beating up or psychologically traumatising a woman. Occasionally there is gender reversal. Another form is abuse of the elderly. This can occur because a carer is totally unsupported either by their family, the community or the state. People are slow to complain about such abuse because they are afraid or feel humiliated and even if they do complain to the police may withdraw the complaints before the case comes to court. We are all slow to interfere in family disputes but death or serious injury can be the end result of non-interference. In Ireland we found that alerting women health workers to the possibility that a woman's injuries could have been the result of a beating was helpful. The very least it did was give the woman the comfort of knowing someone cared abut her. If the abusive situation is very serious and the woman will not complain, the health authorities are now able to step in with limited success. Alcohol is not the cause of such abuse but it is frequently a contributory factor.
Women who are displaced within, or from without, their own country are very vulnerable to abuse, including rape. Refugees are frequently women, children and older men and when family units are broken up the restraints that society exercises are lost. Special attention needs to be given to women in such situations.
The World Health Organisation repeatedly reports on the burden of mental illness on the person and on society. All of us have a one in four chance of developing mental illness at some stage in our lives, in the case of women depression being one of the most important. The needs of these women are frequently overlooked. Women with depression in the Edo State need and are as entitled to mental health care as much as women in Dublin and I do hope this will become a priority.
Finally, it is of great importance to encourage women to train for work in the health services. When I studied medicine 40 years ago 8 out of our class of 56 were women. Nowadays in Ireland women are admitted to medical school on academic ability. It is very competitive and about 70% of those who gain admission are women. This increase in the number of women doctors qualifying has gradually occurred over the last 20 years and women are now becoming a force at consultant and professional level. This, we all hope, will promote women's health issues. Nurses, who are mainly women, have a greater status, too, than they had in the past, their qualification now being at degree level.
It is important also to have women serving on hospital boards, local health boards and going forward at local, state and country level for election to councils and parliaments. It is only by displaying their talents that women's value can be recognised and that they can advance issues which are of importance to themselves and the nation. I feel quite sure that the Edo women are well able for such a challenge.
