Medical Complications of Female Genital Mutilation
by David Epstein, Patricia Graham, Mary Rimsza
SOURCE: Journal of American College Health 49 no6 275-80 Mar 2003
ABSTRACT
More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation "surgery."
THE CASE
A 23-year-old Somalian woman whose chief complaint was lower abdominal pain was seen in a student health clinic. She also had a 3-year history of severe dysmenorrhea and heavy bleeding with her menses, which were regular and lasted about 4 to 5 days. Other symptoms included dysuria and prolonged micturation (about 15 minutes). She had no other medical problems, and her past medical history was significant for including genital mutilation when she was 5 years old.
On physical examination, she had mild lower abdominal tenderness, but no masses were palpable, and the medical examiner physician found no guarding or rebound. Inspection of her external genitalia revealed a midline fusion of the labia minora that completely obscured visualization of the vagina (Figure 1). Superiorly, a 5-mm tissue swelling was noted and identified as the clitoral bulb. The patient's urethral meatus was not visible. Two small openings were noted in the midline, and a 2-mm opening was identified below the clitoral bulb. Inferiorly, a 5-mm opening was identified at the forchette. Because of the labial fusion, a speculum and bimanual exam could not be done.
The rest of her physical exam was unremarkable. Laboratory evaluation revealed a microcytic, hypochromic anemia consistent with iron deficiency and normal urinalysis. An ultrasound examination demonstrated prevoid bladder enlargement (10 cm 5.2 cm 12 cm) and bilateral hydronephrosis (Figures 2 and 3).
We discussed the results of the ultrasonography with the patient and recommended reconstruction of her perineal anatomy. After discussing the matter with her fianc she declined to have the surgery. In her country, she explained, it is customary for the husband to "break" the scar during intercourse. Two weeks later, she married.
After several unsuccessful attempts at intercourse, she returned to the clinic and said that she and her husband had been unable to have intercourse because of her severe pain. Again, she was advised that it would be best to have the scar removed under general anesthesia. We discussed the situation with both the patient and her husband, scheduled surgery, and performed a perineoplasty without complications. The fused labia minora were separated and her external genitalia reconstructed (Figure 4). There was some residual shortening of the labia minora and the remaining structures appeared normal. We noted that she had an intact clitoris, which accounted for the 5-mm superiorly placed tissue swelling the physician identified on initial exam. Her original perineal anatomy was defined as type I female genital mutilation.
The patient's follow-up examination revealed well-healed, reconstructed perineal anatomy, and the follow-up ultrasound of the kidneys and bladder 5 months after the surgery showed resolution of the calicectasis in both kidneys (Figure 5 and 6). The patient was quite pleased with the results of the corrective procedure. Her micturation time was greatly reduced and she experienced no dysuria or dyspareunia.
COMMENT
An estimated 130 million women worldwide are subjected to female genital mutilation or "circumcision," with an additional 2 million new cases each year.(FN1) Most American physicians rarely encounter genital mutilation because most circumcised women live in Africa, the Middle East, and Southeast Asia.(FN2) However, because of the increased immigration that has occurred over the last 20 years, American physicians can expect to be exposed to this procedure with increasing frequency, and we need to be aware of it the associated complications.
Genital mutilation is classified into various subtypes (Figure 7).(FN3) Type I or sunna ("tradition" in Arabic), is the least extreme form of this procedure and consists of a subtotal clitoridectomy of varying degrees. It involves excision of the skin surrounding the clitoris with or without excision of part of or the entire clitoris.
Type II, referred to as excision, consists of clitoridectomy and, sometimes, removal of all or parts of the labia minora. Type III, the most extreme form, is referred to as infibulation or pharaonic circumcision and consists of the removal of the entire clitoris and some or all of the labia minora. Incisions are made in the labia majora to create raw surfaces that are then stitched together to cover the urethra and vaginal introitus, leaving only a small posterior opening for urinary and menstrual flow. In Type III genital mutilation, the patient will have a firm band of tissue replacing the labia and obliteration of the urethra and vaginal openings. Medical complications are most commonly seen in women who have had infibulation.
Type IV genital mutilation includes different practices of variable severity, including pricking, piercing, or incision of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization of the clitoris; and scraping or introduction of corrosive substances into the vagina.(FN3-5)
Genital mutilation typically occurs when the female child is around the age of 7 years, but may be done at any time between infancy and puberty. For the family, the young girl's infibulation ceremony is considered a time for celebration. A midwife, village woman, or gypsy often performs the procedure for a fee. Anesthesia is rarely provided and the instruments that are used to perform the procedure may include razor blades, kitchen knives, scissors, broken glass, a burning piece of wood or coal, or other crude tools.
Once the procedure is completed, the raw edges of the vulva may be pasted together with gum arabic, sugar, or egg. Sometimes the vulvar edges are pinned together with long acacia thorns, but surgical materials such as silk or catgut sutures are rarely used. In type III genital mutilation, the small opening is kept patent by inserting a small piece of wood or matchstick to allow the passage of urine and menstrual blood. In this most severe form, the young girl is often bound from her hip to her ankle for up to 40 days so that scar tissue will form.(FN4,6) This ordeal was graphically described by Waris Dirie, who is now a model living in the United States. Dirie was born in Somalia and was approximately 7 years old when a "gypsy woman" or killer woman, as she is referred to in the author's description, performed the infibulation. The following is an excerpt from her book, Desert Flower: The Extraordinary Journey of a Desert Nomad:
"The next thing I felt was my flesh... being cut away. I heard the sound of the dull blade sawing back and forth through my skin. When I think back, I honestly can't believe that this happened to me. I just sat there as if I were made of stone, telling myself the more I moved around, the longer the torture would take. Unfortunately, my legs began to quiver of their own accord, and shake uncontrollably, and I prayed, Please, God, let it be over quickly. Soon it was, because I passed out.
When I woke up, I thought we were finished, but now the worst of it had just begun. My blindfold was off and I saw the Killer Woman had piled next to her a stack of thorns from an acacia tree. She used these to puncture holes in my skin, then poked a strong white thread through the holes to sew me up. My legs were completely numb, but the pain between them was so intense that I wished I would die.
My memory ends at that instant, until I opened my eyes and the woman was gone. My legs had been tied together with strips of cloth binding me from my ankles to my hips so I couldn't move. I turned my head toward the rock; it was drenched with blood as if an animal had been slaughtered there. Pieces of my meat... lay on top, drying undisturbed in the sun."(FN7(pp 42-43)*)
Although some upper-class families may have the opportunity to have the procedure performed in a hospital with sophisticated medical equipment, the vast majority of women are subject to primitive tools and nonsterile technique. Religious and cultural factors seem to propagate the tradition of female genital mutilation, despite the suffering and risks associated with the procedure.
Many religious and cultural issues foster female genital mutilation. Although some proponents of the practice claim that it is required by Islam, there is no specific support for this claim in the Koran.(FN1) From a cultural perspective, women look at the operation as something they do "for" their daughters instead of "to" them, as a means of securing their economic and social future through marriage.(FN4) The genital scar provides proof for the prospective husband that a woman has been trained in moral and practical responsibilities and has maintained her virginity.(FN6)
Uncircumcised women are stigmatized and considered unsuitable for marriage.(FN1) Therefore, parents are willing to incur great expense for the procedure to ensure their daughters' desirability as a marriage partner. Parents are often unaware of the potential medical risks, physiologic consequences, and psychological effects of the procedure.(FN3)
The psychological consequences are varied and not well understood. Many of the adverse emotional effects relate to the woman's traumatic memories of the procedure, especially during intercourse.(FN8) Women often experience painful menses and micturation; fear of the first intercourse is common among infibulated women. Dyspareunia may occur from difficult penetration, scarring, and mental trauma. Anxiety and phobic behavior may occur as some women psychologically experience the pain and trauma of the procedure and its complications over again and again during intercourse.(FN8)
In Waris Dirie's book, she relays the uncomfortable experiences of prolonged urination and excruciating menses that would incapacitate her for 7 to 10 days each month. She also shares the feeling of freedom that she experienced after she was surgically deinfibulated.(FN6)
Although many suffer the severe psychological consequences of the experience, some women say that experiencing the procedure is a source of pride and belonging. Thus, the victims of the practice are sometimes its strongest proponents.(FN2) It is difficult to make generalizations concerning the psychological impact of the procedure.
Whether or not adverse psychological consequences are evident, the medical risks and consequences cannot be ignored. The medical complications can be categorized into acute, intermediate, and chronic levels. Approximately 30% of the women with type II or III genital mutilation suffer from some form of intermediate or chronic complication, and approximately 15% of those with type I genital mutilation experience recurrent urinary tract infections and pelvic inflammatory disease.(FN5) Immediately after the procedure, the young girl is at risk for infection, hemorrhagic shock, septicemia, tetanus, gangrene, or death. Later complications include delayed wound healing, anemia, malnutrition, necrotizing fasciitis, pelvic inflammatory disease, dysmenorrhea, vulvar cysts and abscesses, keloid formation, neuromas, adhesions, dermoid cysts, and a number of other sequelae.(FN3-6,8)
The chronic complications include slow urinary stream, dribbling, incontinence, and urinary calculi. When a blind pouch is created around the urethra and vagina by infibulation or another subtype that involves labial fusion, frequent vaginal and urinary tract infections may occur. In addition, a narrow introitus may obstruct passage of menstrual blood and result in dysmenorrhea and hematocolpos. Rectovaginal fistulas, dyspareunia, and vaginismus also occur. For the victims, the risk of infertility is increased, in part as a result of chronic pelvic infections and obstruction to intercourse.
Furthermore, a number of accounts of reduced sensitivity as a result of the destruction of the vulvar nerve endings have been reported. This seems to reduce the female libido and ability to achieve orgasm. When the woman does become pregnant, obstetrical complications are common and morbidity and mortality are increased for both the mother and child during childbirth.(FN3-6,8)
Transmission of the human immunodeficiency virus (HIV) during female genital mutilation is another serious concern. The use of nonsterile and, possibly, shared instruments for the procedure is a definite possibility, given the circumstances under which the procedure is carried out. The connection between transmission of HIV and female genital mutilation has never been documented, yet the risk exists in a region such as sub-Saharan Africa, where the prevalence of HIV in the population is 20% in some areas. In 1998, 1.8 million people died from HIV infection in this region, a number that is almost double the number of deaths from malaria and eight times the deaths from tuberculosis.(FN9) Because of the high prevalence of HIV in adults and, subsequently, congenital or acquired infection during childhood, the risk and concern for transmission of HIV is real.
Our patient, with type I genital mutilation that included labial fusion, experienced a number of the complications often associated with infibulation, including dysmenorrhea, dysuria, prolonged micturation, and dyspareunia. In addition to these symptoms, our patient had radiologic evidence of urinary outflow obstruction (hydronephrosis). Although hydronephrosis occurs frequently in children as a consequence of vesicoureteroreflux or posterior uretheral valves, it is uncommon in adolescents and young adults.
In a review of the literature, we found observations of urinary retention and outflow obstruction in women with genital mutilation, but no reports of hydronephrosis resulting from infibulation. After relief of the obstruction, our patient's hydronephrosis resolved without any apparent permanent sequelae. However, the problem may be more common than we recognize, and the long-term complications of hydronephrosis resulting from genital mutilation are yet to be determined.
Although education, public awareness, and legal action have begun to reduce the number of women subjected to genital mutilation, the prevalence is still high and many girls continue to suffer the consequences of such "surgery."(FN10,11) Eradicating a practice that is based on cultural and traditional patterns that have existed for more than 2,000 years is a complex and delicate process.(FN2) Until young girls are no longer subjected to this procedure, all physicians must be informed about the various types of genital mutilation so that they can manage the psychologic and physiologic consequences of the procedure, including hydronephrosis.
David Epstein is a pediatric resident and Patricia Graham is a member of the Obstetrics/Gynecology Department at Maricopa Medical Center in Phoenix, Arizona. She is also a clinical assistant professor affiliated with the University of Arizona College of Medicine in Tucson. Mary Rimsza is director of student health services at Arizona State University in Tempe. In addition, she is a professor of pediatrics affiliated with the Mayo Graduate School of Medicine in Rochester, Minnesota, and Scottsdale, Arizona.
FOOTNOTES
* 1998 by Waris Dirie. Reprinted by permission of HarperCollins Publishers, Inc. William Morrow.
1. Douglas JH, Female circumcision: Persistence amid conflict. Health Care for Women International. 1998; 19:477-479.
2. World Health Organization, International Federation of Gynecology and Obstetrics. Female circumcision: Female genital mutilation. International Journal of Gynaecology & Obstetrics. 1992;37:149.
3. American Academy of Pediatrics: Committee on Bioethics. Female genital mutilation. Pediatrics. 1998;102(1):153-156.
4. Council on Scientific Affairs, American Medical Association. Female genital mutilation. JAMA. 1995;274:1714-1716.
5. Walker LR, Morgan MC. Female circumcision: A report of four adolescents. J Adolesc Health. 1995;17:128-132.
6. Elchalal U, Ben-Ami B, Brzezinski A. Female circumcision: The peril remains. BJU International. 1999;83 (suppl 1):103-108.
7. Dirie W, Miller C. Desert Flower: The Extraordinary Journey of a Desert Nomad. New York: William Morrow; 1998.
8. Horowitz CR, Jackson JC. Female "circumcision": African women confront American medicine. J Gen Intern Med. 1997; 12:491-499.
9. Watts C, Kumaranayake L. Thinking big: Scaling-up HIV-1 interventions in sub-Saharan Africa [Commentary]. Lancet. 1999;354:1492.
10. Research Action and Information Network for Bodily Integrity of Women (RAINB[Graphic Character Omitted]) at www.rainbo.org (includes access to a "Quick Reference Chart" on female genital mutilation, in addition to other references concerning the procedure). Accessed Feb 2001.
11. American College of Obsteticians and Gynecologists (ACOG) and the Society of Obstetricians and Gynaecologists of Canada (SOGC). Female Circumcision/Female Genital Mutilation: Clinical Management of Circumcised Women (Slide Lecture Kit). For further information, contact ACOG at (800) 673-8444 or www.acog.org.
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Issue 1 | January 2003
SciDev.Net Africa Newsletter
Science communication for sustainable development A workshop on science communication for sustainable development was organised by
SciDev.Net in Entebbe, Uganda from 29 September to 3 October 2002.
A consensus statement issued at the end of the meeting reached the following conclusions about the problems and opportunities currently facing science
communication in the region: Obstacles to overcome
Low awareness by scientists of the importance of communicating their research to the public;
Low interest of media editors and other 'gatekeepers' in science-related stories, leading to poor demand for science stories by such individuals;
Inadequate infrastructure and basic working tools (for example, Internet connectivity) for science communicators;
Insufficient resources committed to science communication;
Lack of suitable professional training and personal development opportunities for science communicators; and
Poor remuneration for science journalists.
Institutional responsibilities
We urge governments to introduce comprehensive policies and strategies on science communication into their national planning and resource allocation, and to
strengthen such policies and strategies where these already exist;
We urge all scientific bodies, including research institutions and scientific academies, actively to support science communication, and to enhance the communication of
their research to the public;
We encourage science communicators to develop their professional skills and capacities;
Participants at the Entebbe workshop
We urge international aid agencies to consider introducing support for activities in this field, and increasing such support where it already exists;
We encourage the creation of national and regional networks to promote science communication, and the crossfertilisation of ideas and experience between members
of such networks, for example through the use of SciDev.Net and its regional arm, SciDev.Net Africa;
We encourage institutions of higher education in Africa, in particular schools of mass communication where these exist, to introduce courses on science communication;
We urge media editors and other 'gatekeepers' to raise the priority given to sciencerelated stories in their coverage; and
We urge the New Economic Partnership for Africa's Development (NEPAD) to include support for science communication in its programmes.
Tasks for communicators
Organise professional science communication associations (for example, associations of science writers or information officers) on a national basis;
Compile a regional database of science communicators;
Compile a short introductory booklet for those who want to be science communicators;
Develop ways to recognise and reward best practice in science communication, for example through annual science-writing or sciencecommunication prizes;
Investigate ways to reduce the cost of access to electronic information about science;
Explore ways to develop and support internships and other practical ways of building bridges between scientists and science communicators.
A full report on the workshop, which was supported by IDRC, the British Council, the African Technology Policy Studies (ATPS) network, and UNESCO, is available at
(
http://www.scidev.net/entebbe/report.pdf.
This is the first newsletter of the African Science and Development Network (SciDev.Net Africa) and is an outcome of a workshop on Science Communication for Sustainable Development held in Entebbe in October 2002 (see below). Some 50 participants, mostly from East Africa, decided that a regular newsletter keeping each other informed of science communication activities in the region could help to maintain momentum after the workshop. We look forward to hearing your reactions, and welcome proposals for the next newsletter, to be published in May 2003 (see page 4 for details on how to submit articles or other material).
Network launched in West and Central Africa SciDev.Net's Entebbe workshop in October 2002 was the catalyst for the establishment of the West and Central African Science Communication Network, WCA-SCNet. The coincidence of the announcement of the sequencing of the malaria genome with the workshop provided an immediate
demonstration of the role, public perception, future prospects and challenges of science communication in Africa. Very few news outlets reported on the event*, and
as yet the breakthrough has had little impact on policy. The inadequacy of the media coverage of this event goes to the heart of one of the objectives of WCA-SCNet: to
identify good science, get it into the policy decision- making process and raise the profile of science discourse among policy makers. So far, the body has members from
Ghana, Cameroon, Senegal and Nigeria, with the Fantsuam Foundation hosting the secretariat. We are all aware that membership must be representative of civil society
in the sub-region in order to generate a critical mass that can initiate, promote and sustain public awareness of relevant scientific issues, and ensure that these are used to
inform policy decisions. It may sound like a long shot, but we believe that we have taken the first steps.
Malaria and the media: advocating health policy and practice in East Africa
Every 30 seconds a child dies of malaria. In the poorest 20 per cent of the world's population malaria takes many more lives than HIV/AIDS. Why then do we hardly notice
malaria stories and programmes in the media This situation is now being addressed by a new network of print and broadcast journalists in East Africa committed to improving the quantity and quality of reporting and programming around malaria. The initiative - funded by the Gates Malaria Partnership (GMP) and the Commonwealth Media Development Fund - was kick-started by a five-day workshop in Tanga, Tanzania in late October 2002.
The course focused on developing innovative and strategic ways to inform and educate the public about malaria. This included advocacy and entertainment strategies, as well as programming options. A number of key experts, researchers and policy advisers from Tanzania were on hand to provide accurate and relevant malaria information.
The workshop was attended by 40 journalists from the public and private sectors of the print and electronic media in Tanzania, Malawi, Kenya and Uganda. GMP also provided grants to assist three participants to attend the 3rd Multilateral Initiative on Malaria Pan-African Conference held in Tanzania in November 2002.
A number of other initiatives have since been set in motion. An award for excellence in health reporting is being established in collaboration with the Commonwealth Broadcasting Association and the Commonwealth Print Union, with the first two years focusing on malaria journalism. Discussions have also been held with the Tanzanian School of Journalism (now part of the University of Dar es Salaam) to develop a Diploma in health communication. This is part of a move towards the recognition of health journalism as a specialist field and the establishment of permanent health desks at media houses.
Future plans include science communication training for malaria scientists and researchers, as well as greater integration of mass media initiatives across all GMP programmes. Stronger partnerships and effective communication between scientists and the media are necessary if we are to gain any ground in the fight
against malaria. Angela Dawson | Liverpool School of Tropical Medicine, UK e-mail: adawson@liverpool.ac.uk
Workshop on use of ICTs in HIV/AIDS communication
More than 80 applications have been received for a training workshop that is being organised by SciDev.Net, in collaboration with UNESCO, on the use of information and communication technologies to improve reporting on the science of HIV/AIDS. The workshop is taking place at the University of Makerere in Kampala, Uganda, from 7 to 11 April 2003, and is aimed at women who are - or would like to be - directly or indirectly engaged in communicating HIV/AIDS information to the public through print, radio or electronic means. It will focus on how to identify, research and report on the latest scientific developments, and will provide practical tuition in both basic and advanced Internet skills - including searching for reliable information and resources, and networking with special interest groups - as well as basic journalism skills. The workshop will also involve discussions on the challenges of reporting about HIV/AIDS in Africa, and the role of African people in the research and development of new vaccines and drugs. Applications for the workshop have now closed. However, given the strong demand for participation in this event, plans are being discussed for repeating it at another location in sub-Saharan Africa. To be informed of future workshops, please contact: info@scidev.net
A developing-world view of science literacy
In December, a two-day workshop in Cape Town, South Africa, found that new definitions of science literacy are needed to ensure that public communication of science and technology addresses the real needs of people and societies in the developing world. The workshop "Achieving public understanding of research in developing countries" was part of the 7th conference of the International Network on Public Communication of Science and Technology. It brought together more than 50 individuals from 16 countries and six continents. Our discussions focused on whether our vision of what makes a good public understanding programme in developed countries
had any relevance in the developing world. While the developed world has the luxury of detached interest in reliable knowledge about the natural world, public understanding in the developing world must focus on knowledge upon which one can act immediately.
We concluded that research - including open and honest appraisal of the knowledge embodied by indigenous systems - offers tools of great value to the developing world, and that it is vital to convey the excitement of such research, especially to children. After all, recruiting the next generation of scientists is as critical, perhaps more critical, to the culture of the developing world than to the developed world.
A more detailed report is available at (
http://www.scidev.net/lewenstein)Bruce Lewenstein, e-mail: BVL1@cornell.edu
Environmental journalist training focuses on Lake Victoria
The most serious environmental challenges facing Lake Victoria and the Great Lakes region are changes in fishing patterns and eutrophication, with a decline in fish populations. The media can play a vital role in raising public awareness of these issues, and reversing environmental degradation. To this end, a regional training programme in environmental journalism and communication has been set up. The programme is hosted Lake Victoria, Uganda and coordinated by Makerere University's Department of Mass Communication. Other stakeholders include: School of Journalism at the University of Nairobi in Kenya; School of Journalism and Communication at the National University of Rwanda; St Augustine University in Tanzania; and the Press House in Burundi. The first intake of 20 students on the postgraduate diploma
in environmental journalism come from Kenya, Tanzania, Rwanda, Burundi and Uganda. One-week courses are also available. Contact: Goretti Nassanga |
nassanga@masscom.mak.ac.ug
A World Federation of Science Journalists was launched in November to help science writers from across the globe improve their professional skills, with a special focus on
the needs of young journalists. For further information contact V‚ronique Morin at upswing@ca.inter.net.
Who are we The Science and Development Network (SciDev.Net) is a free-access, Internet-based network devoted to reporting on and discussing those aspects of modern science and technology that are relevant to the social and economic needs of developing countries. SciDev.Net is based on the premise that those who stand to benefit most from modern science and technology are also those who have least access to information about it, leaving them illequipped to take part in discussions about issues that profoundly affect their lives. Our goal is to provide a focal point for both authoritative information and informed debate on relevant science and technology issues. By doing so, we seek to empower individuals and communities in developing countries, increasing their ability to ensure the effective contribution of science and technology to development. We have a core team in London, with advisers and freelance contributors located around the world. We are developing regional networks to help our work on the ground, and will be launching SciDev.Net Latin America in May. The networks will be key in organising events, such as the workshop on using ICTs to report on
HIV/AIDS in Uganda in April (see page 3). SciDev.Net Africa The African Science and Development Network (SciDev.Net Africa), the first regional network of SciDev.Net, was launched in October 2002 in Entebbe, Uganda. The network aims to enhance communication between the media, scientists, policy researchers and decision-makers - and to promote intra-continental dialogue - on science-related issues, to increase awareness of the contribution of science and technology to the region's development needs, and to raise the skills of science communicators in the area. The network will also help SciDev.Net to increase the regional content of its website, and to disseminate material locally through non-electronic means. The network's activities will be guided by an advisory panel, with members from a range of countries in the
region. Alex Tindimubona (right), executive director of NURRU, Uganda, will chair the panel.
Alex Tindimubona SciDev.Net Africa is initially being coordinated by Tom Hewitt who is based in Dar es Salaam, Tanzania. Please contact Tom if you would like further information (tom.hewitt@scidev.net). About SciDev.Net Free weekly e-mail alert We invite you to register with us so that:
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http://www.scidev.net, that includes `dossiers' of policy briefs, opinion articles and background
information on key science-related issues We build regional networks of individuals and institutions committed to improved science and technology communication
We organise workshops and other meetings aimed at capacity building in this field.
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'Roadmap' proposed for science in Africa
Tamar Kahn, Ben Ngubane
[JOHANNESBURG] Representatives from a group of major African countries have adopted what one participant described as a "roadmap" for the development of science and technology on the continent, as well as a strategy for pushing science and technology higher up the agenda of national governments.
In order to help achieve these goals, they have also agreed to set up a continent-wide `forum' on science and technology, to be made up of African science ministers and presidential science advisers.
The agreement on these initiatives came yesterday (19 February) at the end of a three-day workshop in Johannesburg on the role of science and technology in the New Economic Partnership for African Development (NEPAD).
The new science forum will be set up within NEPAD - which is expected to spearhead social and economic development across Africa - and will report to a secretariat being established at the Council of Scientific and Industrial Research in Pretoria, South Africa.
It will be advised by a panel of experts, including scientists, industrialists and policy makers, who will be given the task of developing a NEPAD science and technology "programmatic framework". This is expected to bear many similarities to the multi-year Framework programme, first launched in the early 1980s, which is used to fund research programmes through the European Commission in Brussels.
The Johannesburg workshop was hosted by the South African Department of Science and Technology, and attended by more than 80 science policy experts and government officials from countries across Africa. These included four of the five founding nations of NEPAD, namely South Africa, Nigeria, Algeria, Egypt. (A delegation from Senegal failed to show up.)
In an opening address, Ben Ngubane, South Africa's Minister of Arts, Culture, Science and Technology, said that the participants had a mission "to ensure that we leverage resources nationally, regionally and continentally . and to commit ourselves to [developing] a knowledge base for a more equitable, prosperous and sustainable Africa".
Ngubane said that Africa should take heed of the lessons learnt in Europe, where knowledge and innovation "underpinned by intergovernmental instruments" remain the key drivers of economic growth.
"The truth is that if we want to transcend the scourge of poverty and disease, the only viable modality open to Africa and the rest of the developing world is the creation of regional and sub-regional growth and development strategies, sustained by a new global partnership in science and technology."
There was a high level of agreement among the delegates on such sentiments as they discussed the role of science and technology in improving the lives of African people within the context of NEPAD, emphasising that science and technology were an essential element for development, rather than a reward for it.
"The most important thing about this meeting is that it gives us a roadmap with which to craft a wider African process around science and technology," said Adi Paterson, chief operating officer in the South African Department of Science and Technology.
Keen to draw up a broad declaration that would spell out areas of common concern while avoiding either internal or external tensions, the delegates shied away from controversial topics such as intellectual property rights.
Instead, the consensus document that they adopted highlights concerns that face the continent as a whole, such as the exodus of skilled scientists, poor quality science education, and the low level of investment in science and technology as a percentage of GDP.
Delegates resolved to conduct a review of Africa's policies and performance in science, mathematics and engineering education. They also plan to review the research taking place on the continent to see whether it meshes with NEPAD's priorities, and to ensure that science and technology are integrated into NEPAD's sectoral programmes on health, agriculture, education, environment, governance, infrastructure, security, investment and trade.
Finally the delegates agreed to strengthen scientific `centres of excellence' and regional research networks throughout Africa. The declaration does not detail specific priority areas, leaving this to national governments. But it does emphasise broad areas that could benefit from regional co-operation, including desertification, biotechnology, space science and information technology.
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A few nails and a yard of wire
Keith Warren, Universidade Eduardo Mondlane, Mozambique
Teaching science in a laboratory without a laboratory - one academic, a cameraman and a demonstrator with a few nails and a yard of wire show how in Mozambique
One of the most pleasant parts of our work is to go to a village where we are going to demonstrate science to children. We work very informally, usually where we are known at least to the children who sometimes turn up and talk to us, sitting on a log under a tree, ask us things and, as likely as not, give us more information than we give them.
We like to arrive with nothing in our hands because we go to demonstrate with local resources, and do not want to import any non-local things except ourselves. And if we come up against a block where we have to have something that absolutely does not exist in the village, it forces us to look for a substitute. That was how we discovered how to use old chicken netting,
Talking with the children we occasionally refer to 'your laboratory' or 'our laboratory', and when the children look puzzled and ask where it is or what we mean, we ask one of them to stand there and extend her arm, point a finger out horizontally and slowly turn around. "There it is," we say.
There is a general complaint in Southern Africa that we have no laboratories, no science apparatus and no chemicals. But our group's speciality is to show that this is the wrong way to look at it. People have become accustomed to see problems and complain, even despair. But there is an alternative - to find opportunities. The more you look, the more you find.
Magnets in the village
"Let's go and buy a battery," we say to the little group of children. They are keen to help because they know they are going to see something interesting. We wander with them to the market - two little stalls, one with vegetables and fruit, and the other with common things like soap, matches, batteries and so on, where we buy a common large-sized torch battery. This turns out to be our only investment for the day.
Then we bargain for a three-inch nail. The stall-holder wants to sell us a dozen but we settle for just two. "Go on, take them," he says, "We know you are professors from the university, helping to teach our children."
Well, they are one third right. I am the academic, Mateus is our cameraman and Alberto our demonstrator. We call ourselves the 'Spark Group'.
"Throw in three of those other little nails," we say, and he does.
On the way we back to our tree we pass a piece of rather rusty chicken netting. "Nationalise that," we say, and the children laugh and bring it.
Then comes the main part of our little drama. Two of the children undo some of the chicken netting to get a yard of wire - fiddly work but not difficult - and pull it back and forward to eliminate its wrinkles over an edge of the log we are sitting on. The wire is a bit rusty but that will make no difference to what we are going to do.
They wrap a bit of newspaper round the shank of the nail. That is the insulation. Then wind the wire over the paper, making sure adjacent turns do not touch. Then when the nail is full, another layer of paper and another winding of wire. Then a third layer of paper and wire until the yard of it runs out. Then some sewing thread wound over the end turns so they do not come undone.
Connect the ends of the wire to the battery and... we have an electromagnet that picks up the little nails.
Everybody has a go. "Magic!" they say, delighted.
"No," we say gravely. "Science. Technology."
The next day several children will have made electromagnets at home and some father will complain that his son has nationalised a battery from the family radio and run it down.
Permanent magnets and a magnetic compass
Sometimes common nails are semi-steel and once magnetised will hold a little magnetism. In this case the young experimenters see that one of the little nails stays attracted when the battery is disconnected and understand that the magnetic effect somehow stays in the electromagnet.
We ask the children to make another magnet but with the paper and wire not so tight, so that after magnetising the nail they can pull it out. So they do this and then of course they have a weak permanent magnet.
If the nails are not steel, we ask the children to try to get a piece of old bicycle spoke or an umbrella rib, and bend it backwards and forwards until they have broken a piece off. These are steel and the young people can usually find one or the other in the village. If all else fails, they get a handful of chicken netting and fold, hammer and twist it until they have a tight bundle. This retains magnetism well.
Now they can make a magnetic compass.
They get a thread of fine plastic hair from a girl's plaits, tie it round the middle of the nail, adjust it to hang horizontally, fix it with a bit of chewing gum, and hang it up.
"It will point North and South," we say. But of course it does nothing of the kind. As you can guess, it oscillates interminably and swings in the wind.
So we cut a clear plastic bottle to make a cup, half-fill it with water and hang the nail in the water from a pencil across the top. The water damps the movement of the nail and it comes to rest North-South. A real working compass.
The children of course know where the sun rises and sets so they know roughly where north is, and they take the nail out of the water, fix bits of paper marked 'N' and 'S', on it with chewing gum, re-balance it, and put it back.
More classic physics
Then they make another weak permanent magnet so that with this and the compass needle we can do the classic experiments of north attracting south, repelling another north, seeing if the effect will go through paper or a person's hand, and so on.
"Aha, yes!" they say - that exclamation every teacher likes because it is the arrival of insight - "We learnt about this in the book but we never understood it."
Well, now they will never forget it. In its small way it is dramatic, as all science lessons should be.
They try other things. Will the magnet attract a coin Yes, our Meticais are cupro-nickel. Of course the weak magnet is far from being able to pick one up but the children can detect the effect by seeing that the end of their compass needle attracts itself to the coin, held near outside the plastic. One of my brass Yale keys No. The cut-off top of a Coke tin No, it is aluminium. The sides of the can Yes, they are iron. And so on and so on. In the end, you can tell that some of the children feel themselves to be real little scientists.
In a primary school, a laboratory is no more needed to teach appropriate science than a language laboratory is needed in a home to teach a baby to talk.
How little we do: Notice that we visitors have done almost nothing physically in these demonstrations; the children have done it all. But we have transmitted some knowledge and confidence to a dozen of the younger generation through our encouragement. Encouragement makes children blossom.
A dozen is not many, but we have a potentially powerful technique to multiply the effect. Later Alberto, Mateus and I will come back with the video camera and the children will do the experiments again and explain in their own way as they do them. Such activities make rather marvellous films. We have our own video equipment and editing table, so the films are cheap to make, and we hope teacher training centres will use them.
With similar local resource methods, we can demonstrate a great deal of curriculum material from primary to second year university physics and technology, though at the higher levels we use materials available in towns, much of it from rubbish piles on the street corners. Mozambique is especially good on street garbage. We buy some stuff from street stalls and very occasionally from shops - for example certain tools for higher level work. But our main principle is that in general the things must be extremely accessible to lots of children and teachers.
Chicken netting is just one of our many examples. A better one would have been our solar cooking demonstrations. Villages do not need magnets but they do need solar cookers. However, we find that it does not matter where we start. Once young people find they can do practical, fascinating things, they will take an interest in almost anything. In fact we started these activities many years ago with music, but that is another story.
Kenyan women hit out at male hold on science
David Karanja
[NAIROBI (PANOS)] What are boys and girls made of According to the nursery rhyme, sticks and stones and puppy dog tails [boys]; sugar and spice and everything nice [girls].
And "nice" Kenyan girls don't study engineering. Like Peninah Wanjira, who finished among the top five students in her secondary school. She wanted to be an engineer, but her headmaster prevented her from specialising in science. Too difficult, he told her. Boys whom she consistently outperformed took her place.
"I will never forgive him. He killed my dream," Wanjira, a sociology graduate currently working as a clerk in Nairobi, says bitterly. "Look at what I do: signing and stapling forms all day."
Fortunately, Kiriri Women's University of Science and Technology (KWUST), which opened in September 2002, is challenging generations of gender stereotyping and an entrenched culture that favours males at all levels of education.
Offering degrees in computer science and mathematics, the Nairobi-based private university admits 90 students annually who must meet steep fees of US$1,220 per term. It emphasises practical skills and research and aims to bridge the gender gap in science and technology.
"We have opted for technological courses because they are the building blocks for development," explains KWUST vice chancellor, Professor Rosalind Mutua. The university hopes to add engineering and medicine to its curricula in the future.
A recent World Bank report, Constructing Knowledge Societies; New Challenges for Tertiary Education, warns that poor countries cannot boost economic growth, reduce poverty and build equitable societies without closing the educational divide - particularly at the university levels - between themselves and wealthier countries.
In Kenyan universities women make up little more than a fifth of the total student population - mostly clustered in liberal arts studies - reflecting a gender gap widened by dropouts through primary and secondary years. At Jomo Kenyatta College of Agriculture and Technology, the only university in Kenya specialising in scientific courses, women make up only 14% of students.
Government figures indicate that while 63% of girls of school-going age enrol every year, only a third complete primary school, compared to half of enrolled boys. Experts say the reality for girls is likely to be worse.
The Ministry of Education attributes the gender disparity in schools to early pregnancies - 45 per cent of teenage girls become mothers by the age of 19 - forced or early marriage, a heavier domestic workload for daughters, and son preference in some communities.
Sexism, whether conscious or not, also influences family decisions to keep girls out of school and produces a girl-unfriendly learning environment at home and in the wider community, according to Kenyan researchers Dr Wangoi Njau and Dr Sheila Wamahiu.
Many parents do support education for girls; but sexual violence by some male secondary students - and some teachers [demanding sex for grades] - against young women has also led to girls being withdrawn from school by parents fearing rape, unwanted pregnancy and HIV infection.
Sexism also plagues Kenya's institutions of higher learning. "Sexual harassment in universities became a big problem when the government introduced self-financing in the 1990s," acknowledges Mutua. Soaring tuition and boarding fees, coupled with decreases in scholarships and student loans, leave some female students, particularly from low income families, "vulnerable to abuse in their struggle for survival," she says.
Female university students have been forced to trade sexual favours for financial support from older men, from single, affluent male students and from lecturers.
Kenyatta University was the first institution to publicly acknowledge the problem in 1993, when it convened a committee to investigate complaints of sexual harassment. In 1998, after two students were raped, a second investigation resulted in the appointment of a female Deputy Director of Student Affairs. Female guards and halls' janitors were also hired.
There have been some victories. In 1999, a `sex for marks scandal' erupted at Egerton University after female students gave authorities names of lecturers who demanded sexual favours for passing grades. Six lecturers were suspended.
The government has welcomed the establishment of KWUST. "There is need to encourage more women to enrol in these disciplines to increase their employment opportunities and enhance their participation in the country's development," Minister for Science and Technology Gideon Ndambuki asserts.
But increasing female enrolment in tertiary education requires keeping girls in school in the lower grades. A recent parliamentary bill making primary education [grades 1-8] free and compulsory should help reverse the drop out rate among girls.
Kenya is not unique in wanting to get - and keep - women in the sciences. In Britain, according to a 2002 government report, there are 50,000 women science, engineering and technology graduates not working in their respective fields at any one time.
A subsequent report by Susan Greenfield, Oxford University professor of pharmacology and director of the Royal Institution, which specialises in scientific education, highlighted bullying, isolation, low research budgets, family unfriendly policies and lack of support for those returning from maternity leave as difficulties encountered by women choosing scientific careers.
Greenfield said that although women scientists have gone "beyond the bottom-pinching stage" they still face "institutionally sexist" attitudes.
In Kenya not everyone has signed up to the idea of a women-only university such as KWUST. Some male university students see it as a `feminist attempt' to shield women from fair academic competition, while others argue that gender seclusion is the wrong way to deal with sexual harassment.
"I agree there is sexual harassment in our universities. But I think attention should be focussed on stamping it out rather than creating special institutions for women," says Peter Mwenda, a second year student at Maseno University. "You don't solve a problem by running away from it."
Prospective students of the new university, however, are thrilled with the opportunity to pursue their specialised higher education.
Nancy Wanja, who plans to study computer science, says she had enrolled for a diploma at Kenya Polytechnic but pulled out to study at KWUST.
"Now I will be able to have a degree. After I acquire my B.Sc., I plan to go for a masters elsewhere and then become a university lecturer," Wanja says confidently.
Source: Panos
SciDev.Net is sponsored by Nature and Science in association with the Third World Academy of Sciences. It is published with the financial support of the UK Department for International Development, the Swedish International Development Cooperation Agency, and the International Development Research Centre in Ottawa, Canada.
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Hidden Links: Irrigation, Malaria, and Gender
Keane J. Shore
July 19, 2002
Photo Caption: Women transplanting rice in Cte d'Ivoire. (Photo courtesy of Renaud De Plaen)
In African countries, where the weather is extremely variable, irrigation is seen as one obvious way to increase agricultural production. But, irrigation affects more than the crops that grow in farmersfields. In fact, researchers around the world are finding that irrigation can also affect people health in sometimes unexpected ways. Malaria is a case in point.
By increasing wet areas, irrigation can increase breeding grounds for mosquitos the main vectors (or carriers) of malaria. This, in turn, increases the likelihood that people living nearby will contract the disease. Moreover, a recent study by Renaud De Plaen, a researcher with Canada International Development Research Centre (IDRC), suggests that the impact of irrigation on health extends even further. When farmers start irrigating their fields, a whole range of social and economic changes take place. These particularly affect women and can change the way they treat malaria cases in children.
Malaria is a debilitating disease that claims an estimated two million lives each year in Africa. Malaria hits children hardest: one in four childhood deaths on the continent is attributed to the disease.
An ecosystems approach to research
To uncover links between malaria and irrigation, De Plaen took an ecosystems approach to human health in his research. This approach is based on the understanding that there is a complex relationship between human health and the ecosystems in which people live.
"To understand the impact of irrigation on malaria," says De Plaen, " it is necessary to look at the ways irrigation changes environmental conditions and host-vector contact. But it is equally important to assess the impact of irrigation on farming systems as well as the social and cultural environment." According to De Plaen, these factors can influence how vulnerable farmers are to malaria. He adds that understanding these factors can help local communities better manage ecosystems to improve their health and the health of the ecosystem.
In 1997, De Plaen was involved in a health project undertaken by the West Africa Rice Development Association (WARDA) in Northern Ce dvoire, near Korhongo. IDRC provided support for part of WARDA research. De Plaen was the lead researcher and coordinator of the social science team. In addition, he designed his PhD research to complement the work of the project. In 2001, De Plaen joined IDRC as a program officer.
Irrigation and women income
De Plaen research focused on four villages in northern Ce dvoire that were a subset of WARDA larger research sample. In all four villages, farmers grew crops in both lowland and highland fields: rice was the staple crop. Two villages grew just one crop of rice in the lowlands during the rainy season. In the other two villages, where irrigation was available, farmers succeeded in growing two crops of rice.
In the villages with irrigation, food production increased. But De Plaen research revealed that this improvement was not a boon for women in the village. In fact, he says rather than increasing women income and food security, irrigation reduced both.
The role of women "personal fields"
Among Soufo people in the study area, men and women assume different roles and responsibilities within the household. Traditionally, men are responsible for ensuring the family has basics: food, clothing, shelter, schooling, and so on. Women, on the other hand, take care of children, cook the meals, and usually provide the first treatment in case of illness using traditional remedies.
In the villages without irrigation, most food comes from upland family fields. Men manage these fields, where the whole family grows rice, maize, sorghum, peanuts, and cotton. Crops harvested from the upland fields are stored in family granaries. Men manage these granaries and sell part of the harvest to raise money to buy clothing, pay for health expenses, maintain the house, acquire farm equipment, and so on. Most of the household food comes from the family granaries.
Lowland fields, on the other hand, are customarily considered to be women personal fields. Women grow rice during the rainy season, and vegetables during the dry season. They store their crops, which they use to make sauce and to provide food for special occasions, in their own separate granaries. It is only when the family granaries are empty that men ask women to contribute to the household food from their personal granaries.
Women also sell their surplus crops to earn extra income. Moreover, during the dry season, they undertake other money-making projects for example, they make and sell beer, charcoal, crafts, or a cooking spice known as sumbala.
New roles for men and women
In villages with irrigation, a shift in gender roles is taking place. Because rice production in the lowlands increased to two crops a year, men began devoting less time to growing food crops in the upland family fields. Food production for the family therefore moved from family fields to women personal fields. A larger proportion of the food that is consumed by the household now comes from women individual granaries rather than from family granaries. In fact, it is mainly when the women granaries are empty that men contribute from family granaries.
In addition, women spend more time tending the second crop of rice. As a result, they have less time to grow vegetables or to produce other goods for sale activities that are traditionally an important part of their earnings. "The increase in rice production," says De Plaen, "therefore results in reducing women net income."
A decline in food security
Surprisingly, De Plaen found that women from villages with two harvest of rice complained more often about not having enough food to feed their families. In part, this is because the second crop of rice is used to compensate for the smaller quantity of food now grown in the rain-fed uplands. In addition, women in two-crop villages have to sell a larger part of their agricultural production to raise emergency cash.
"Therefore," says De Plaen, "it appears that the intensification of rice production in Northern Ce dvoire, while considerably increasing women workload did not improve their economic status or the nutritional status of their children." However, De Plaen says these women value having greater control over managing their families food supplies. It allows them to feed their families without having to beg a moody husband to dole out staples from the family granary he controls. Most women see this as a net improvement of their status within the household.
Changes in "health-seeking" behaviour
Comparing villages with irrigation to those without, study teams also found differences in "health-seeking" behaviour and learned that these differences affected how quickly children are treated for malaria.
In all the villages, men are responsible for seeking health care for their family and for paying the bill. However, when symptoms of malaria first appear in children, women usually react by first administering indigenous treatments.
Differences between the one-crop and two-crop villages arise when the first set of treatments is ineffective.
An important customary rule is that the person who starts a treatment is responsible for paying all the related bills. In villages without irrigation, women have more income at their disposal. So, if the first treatment for malaria fails, these women usually quickly buy anti-malarial pills from the local market to start a second course of treatment. If malaria still persists, they then ask the head of the household to take the child to the health centre.
In villages with irrigation, women have less money at their disposal. So, if the first treatment fails, these women generally don buy anti-malaria pills. Instead, they ask their husband to take the child to a health centre. This means children are taken in charge by the head of the family sooner, and subsequently go to the health centre sooner. However, this referral takes place later than the second treatment option (anti-malarial pills) initiated by women in unirrigated villages. Early treatment for malaria is an important factor in reducing the severity of malaria episodes.
Drawing conclusions
De Plaen draws two main conclusions. One, very specific to northern Ce dvoire, is that the involvement of women in anti-malarial treatment is a key factor in the frequency and severity of malaria episodes.
The wider lesson is that traditional approaches to studying environmental changes and their effects on disease do not cover all the bases and that an ecosystems health approach is an important complement to classical epidemiology.
"This research, I believe, helps to show that the impact of agricultural techniques, such as irrigation, on the health of human populations cannot solely be apprehended through usual approaches," De Plaen says. Uncovering the problem many facets is, he adds, "much harder to assess, but I think it essential."
Keane J. Shore is an Ottawa-based writer and editor.
International Development Research Centre
http://www.scidev.net,
Poor nations must embrace knowledge economy
Ben Ngubane
"It is the knowledge and technological capacity to apply the inputs of labour, capital and resources that make modern economies work," South Africa's science minister, Ben Ngubane, recently told government officials preparing for the World Summit on Sustainable Development.
Despite this, Ngubane added that "somehow, we have failed to talk enough about the knowledge resources that can fundamentally change the future of the economies of the developing world."
Until comparatively recently, said the minister, science and technology have not been given a central role in the sustainable development debate. "Science and technology were often seen as a source of problems relating to environmental sustainability or, in some cases, also the solution to those same problems," he said.
Since then, however, it has become clear that there is a "crucial" relationship between science, knowledge and the availability of human capital to address the issues of sustainable development.
For example, recent work by the Economic and Social Council of the United Nations indicates that most practitioners and policy-makers have undergone a significant paradigm shift in recognising the critical role of technology - and knowledge more generally - in development.
"This is a very different approach from the traditional narrow thinking of development economics and practice over the past 30 years," Ngubane said.
It is now widely recognised, for example, that scientific and technical capacity have to be built up and maintained in countries that currently lack a minimum, critical mass of capacity in science and technology.
The minister said that the challenge to all policy-makers in the developing world was to recognise that untapped human potential represents an effective and sustainable path out of the dilemmas of under-development. "The only long-term strategy that can work is based on quality education to create human capital."
To help achieve this, South Africa is proposing a significant shift away from a narrow concept of technology transfer to a far broader idea of "technology and knowledge partnerships".
"Sustainable development will not be achieved unless there is a redirection of our efforts to develop the full potential of people through education: an education that must include mastery of modern technologies," Ngubane said.
He added that few, if any, future scenarios for Africa and other parts of the developing world talk about the contributions these nations will make in science and technology for sustainable development.
"This is surely not right," said the minister. "Perhaps we have convinced ourselves that developing countries cannot be players in the knowledge economy. I believe that this mindset needs to be broken and removed from our consciousness."
Science and technology are often seen by policy-makers as little more than instruments with a well-defined functionality, like a light switch or a key in a lock, acting as the hand-maidens of greater goals such as economic development or improving the quality of life, he said.
"This instrumentalist approach does great damage, because it does not recognise that the potential of people trained in science and technology is far greater than the primary scientific knowledge that they hold," Ngubane said.
"Science and technology is not a static category into which we plug machine-like robots that become instruments of production. Sustained effective science and technology investment is in fact a broad strategy to address the persistent challenge of under-development of our world."
One way of bringing about changes is through the transformation of education. For example, science, mathematics, computing and technology should be a requirement in the education curriculum in the developing world up to matriculation level.
Furthermore, the misunderstanding of the sciences by the general public "leads to serious underestimation of their usefulness in defining better solutions". Historically, scientifically literate communities have demonstrated the highest rates of economic development, the highest commitment to democratic values, and have created an enduring and sustainable quality of life in the communities they serve.
"I am not only talking of what is sometimes wrongly called Western or 'First World' science," said Ngubane. "South Africa, like many countries, recognises the unique potential of the knowledge resources of our people."
Indigenous knowledge systems, for example, hold great promise for eliminating the alienation many people feel from science and technology as it is traditionally taught. "Indigenous knowledge projects in South Africa have already shown a rich potential for better curriculum development, as well as new technological innovation."
At the same time, information and communication technologies could play a major role in making education more attractive and accessible to communities previously excluded from high-quality education in the sciences.
"This area is being actively explored in a number of bold experiments across the developing world - but we must be even bolder still," said the minister. "Experimentation is not enough for it does not reach a sufficient number of people."
Another requirement is excellence in science and technology in the research and educational institutions of the developing world, Ngubane said. "Societies that are not involved in the production of new knowledge and technologies are poorly equipped to make choices about the technologies they transfer and adopt from the developed world."
Carefully constructed programmes have to extend to strengthen institutions of higher learning. There are many great universities in the developing world, but knowledge generation in science and technology need to be strengthened considerably, while centres of excellence needed to be set up and sustained in key areas of technology.
"A science and technology based university and research infrastructure creates confidence in investors and leads to higher rates of new business start-ups within an economy," said Ngubane.
Governments need to invest more funds in research and development, and the private sector needs to have incentives to do the same. However, in the economic structure of many developing countries this process is made more difficult when large global corporations, which earn significant revenue from developing countries, fail to carry out research and development in those countries.
"There should be an obligation for proper R&D investment, tied in some meaningful way to the revenues earned by these companies, especially when the countries themselves are investing in R&D," Ngubane said.
(c) SciDev.Net 2002
by Richard Fuchs
"IN A BOOKLESS SOCIETY, WHY START WITH BOOKS "
The USAID officer, committed and caring fellow, said to me: "Richard, computers in schools Uganda is still a bookless society. They need books, not computers!" I had to think about this before replying: "In a bookless society, why start with books"-a digital variant of Wayne Gretsky's injunction to "skate to where the puck is gonna be!"
Uganda has come a long way. And this country made an indelible impression on my life.
In 1997, when I first visited Uganda, I went to see a memorial building in rural Nakaseke. 1,300 skulls stared at me. The people of Nakaseke, in Uganda's infamous Lowero Triangle, had been loyal to the current President, then known as General Museveni. He had led the liberation forces against the genocide of Idi Amin Dada and later Milton Obote (or Obote II, as Ugandans refer to it). Nakaseke residents had been butchered mercilessly for their loyalty in the 1980s. The survivors I met - their gait, the look on their faces, how they gazed down at the ground when walking - all bespoke the horrors they endured, horrors which remain unimaginable to me. Their trauma was palpable. I could see it everywhere I looked.
Nakaseke is the unlikely location of the first rural telecentre in Africa. Beginning in 1997, this small town, where the phone lines had been down for more than a decade, was selected by international development agencies to pilot this new approach to development assistance.
By the time I returned to Nakaseke in 1998, change was starting to happen. The telecentre building was being renovated and the computers were soon to arrive. Christopher Senono, a young man who had lost his seven brothers and sisters in the genocide, wanted to know how these computers could help his business. A digital camera, a portable colour printer - and the first "sign" was produced in Nakaseke. Christopher had put his lumber and concrete blocks on sale and used the proceeds to pay for the production of the poster.
Three years later, Nakaseke is a very different place than it was. There are now public telephones outside the telecentre. A private-sector cellular company has emerged in the country. The telecentre with eight work stations is filled almost every working hour. Nurses prepare patient records. Teachers design lesson plans. Students write papers. Businesspeople produce signs for their stores. And Christopher Senono no longer has to make the 16-km return trip down the narrow country road on his bicycle to make a phone call for his business.
Uganda and, increasingly, all of Africa are entering their very own "Information Revolution". More and more international development assistance is coming to understand that wealth, both the social and economic varieties, have something to do with information and communications. Information because it improves decision making. Communications because it accelerates decision making. Together they help to build networks that serve as channels of social and economic opportunity.
But questions remain to be answered. The industrial revolution all but bypassed Africa, just as it did many rural parts of North America. Will the Information Economy bypass the developing world, too Will they be locked out of the jobs, the incomes and the social benefits that the Information Economy has brought to so many of us Will their health, education and governance be enabled by the use of ICTs, as ours has been
The telecentre in rural Nakaseke has been put together by the local library committee, the schools, the district council and the regional hospital. Not the government. Not the private sector! But rather by what international development jargon refers to as the "civil society": organizations preoccupied with social wealth and social dividends. 'Turns out they're the digital innovators! 'Turns out, as well, that their innovation is building new business opportunities locally. It also encouraged the national government to create more reasonable, pro-poor and pro-rural telecoms policies.
In many developing countries, it is this sector of society that has the greatest access to the poor. That creates the greatest reach of social investment. That, in fact, innovates and creates eventual markets, and that builds the experience and skill base for entrepreneurs to be incubated.
Beginning in January 2002, the eyes of the world will be on Canada. Our Prime Minister, Jean Chr‚tien, will be the President of the G8 for 12 months. There's much more at stake here than what the demonstrators will do with the rural venue in K-country.
The G8 has received and adopted a report produced by the Digital Opportunities Task Force, also known as the DotForce. DotForce was created in July 2000 by the leaders of the G8 who wanted to focus considerable attention on the impact of information technologies and the growing risks of a global "digital divide".
This first DotForce report calls upon the G8 leaders to refashion and expand their notion of what "development" means to include digital capacity and information technology literacy. Incidentally, civil society organizations are members of the DotForce. They include members from the public, private and not-for-profit sectors and participants from developed and developing countries. Canada's International Development Research Centre (IDRC), where I now work, is a Canadian Co-Chair of the DotForce.
Canada's history in bringing digital and information literacy to bear on the challenges of economic development has been rather successful, maybe the most successful in the world. While all of our regions have had huge adjustment problems (including where I come from in Newfoundland), we have all, more or less, made the transition from a resource to a knowledge economy. A large country with a small dispersed population has to be good at this. We Canadians now are!
Richard Fuchs is currently Director of the Information and Communication Technologies for Development Program at IDRC and member of the Canadian Delegation to the DotForce. He served as the Executive Director, and later as a Commissioner, of the Newfoundland Economic Recovery Commission. He was also the founder and CEO of the Enterprise Network, a Crown Corporation and Canada's first rural online service. In 1996, he set up Futureworks, a firm specializing in the development of distance technology systems and services. It won the Newfoundland and Labrador EXPORT award in 2000.
(
http://www.scienceinafrica.co.za/
March 2003 Feature
Education, indigenous knowledge and globalisation
Gemma Burford, Lesikar Ole Ngila and Yunus Rafiki, Aang Serian Community College, Tanzania
The interface between indigenous knowledge and globalisation: rewriting education for African realities - developing a model for the systematic integration of indigenous knowledge into formal and semi-formal education.
As members of an organisation with the primary aim of promoting and preserving the traditional knowledge and cultures of Africa, we are concerned that the colonialist or early missionary mentality is still very much alive in societies that were once colonised. There is still a widely held view that anything associated with culture and hereditary values is pagan, and thus backward, as reflected by the vast number of urban Africans who feel embarrassed to associate themselves with their own cultural background. It is time for us to recognise this deeply rooted mentality as the product of a particular time and of specific policies in human history, and to acknowledge the limitations it imposes on our development, as well as its devastating effects on the natural environment.
The majority of African youth still subscribe to the "American dream", and on a smaller scale, to the "urban dream". The growing trend towards urbanisation is encouraging thousands to abandon their indigenous knowledge, in the belief that new knowledge and new opportunities are to be found in town. Yet the realities of mass unemployment, the high costs of urban life and of further education, and the growing pandemic of AIDS testify that this is not the case. Many end up homeless, jobless and penniless, with neither the traditional skills that sustained their ancestors nor the specialised and expensive skills required for employment in a modern town. The inevitable result is poverty.
The enormity of the threat posed by the break-up of indigenous communities has not yet been fully realised by many of those now in power, although it has always been obvious to community elders. Many mistakenly believe that the reason that rural African societies have not evolved in the same way as the "civilised" west is a lack of knowledge. In truth, it has been a matter of free choice to protect the natural environment and to maintain traditional lifestyles. The culture and traditions that form an integral part of indigenous knowledge provide codes of conduct addressing all aspects of the community - economic, social, environmental and psychological. When they are in place, they keep the society in its equilibrium.
It is widely assumed that poverty is an unavoidable consequence of climate change such as drought. For centuries, however, indigenous knowledge has provided Africa's tribal peoples with practical solutions to the problems of a fluctuating climate. As an example, the Maasai pastoralists of northern Tanzania and southern Kenya traditionally know where to find water, and green shrubs that can be fed to young calves, even during long periods of drought. Likewise, in Ethiopia, often regarded as inevitably dependent on Western aid, the threat of famine can be overcome by local expertise, as Worede (in Seabrook 1993:31) explains:
"There is a wild plant that grows on the Somali border, under the driest conditions, less than 200 mm of rain a year. There are other crops, things people have known where to find in distress times. They go to the mountains and pick them and survive somehow. But if you destroy the natural environment of such plants, you lose these resources, and your monocultures won't save you."
In our opinion, the greatest threat to the economic stability of the African continent is not its changing climate. Rather, it is the gradual erosion of indigenous knowledge and the accompanying destruction of natural wealth - plants, animals, insects, soils, clean air and water - and human cultural wealth, such as songs, proverbs, folklore and social co-operation. This robs people of their ability to respond to social and environmental change, both by removing the resource base, and by attacking the foundations of human identity.
There are many fashionable phrases currently popular with international agencies - sustainable development, conflict resolution, good governance, poverty alleviation, environmental stewardship - which could all be translated as "fostering a sense of peace with ourselves and our cultural identity". It is never easy for the oppressed to become anything other than oppressors, but we believe that it can be achieved through rebuilding the sense of self-esteem and confidence that colonialism and the global market have sought to eliminate. This does not mean a return to the destructive tribalism, grounded in insecurity and fear, which has haunted so many countries in Africa. Rather, in order to live on good terms with the neighbours - local and international, human and non-human - with whom we share this planet, we must first rediscover an awareness of who we are. At the same time, we belong to a tribe, to a nation, and to the world.
The real meaning of education: 'bringing up and drawing out'
The English word 'education' is often taken to refer to the formal systems of schooling originally introduced to Africa by colonial administrators, and further developed by post-independence governments. An examination of its original meaning, however, reveals something quite different. Senge (1990) highlights the fact that education is derived from two Latin words: educare, 'to rear or foster', and educere, 'to draw out or develop'. Education thus incorporates all the processes of raising up young people to adulthood, and drawing out or developing their potential to contribute to society, that are traditionally found in rural communities. Learning to hunt wild game or herd livestock, prepare food or weave cloth, search for wild honey or distinguish medicinal plants from poisonous ones, is arguably closer to the true meaning of 'education' than learning to make and interpret marks on paper.
This should not be interpreted as meaning that literacy, numeracy and the acquisition of new languages are unnecessary. No society can exist in isolation: people have always sought ways to communicate with one another and to trade in goods and services, and this has never been more important than it is today. In an increasingly interdependent world, it is as essential for us to be fluent in the languages of international economics and politics - in order to defend our rights and demand development on our own terms - as in the languages of animal tracks, bird calls and weather patterns.
What is currently missing, in most societies, is a system of teaching and learning that can combine the two. African children are either kept in their home environments, missing out on the 'modern' aspects of education, or (increasingly) forced into full-time formal schooling, missing out on the 'traditional'. The latter often furthers the neo-colonial mentality by building aspirations of urban life and encouraging young people to believe that they have no future in rural communities.
Case study: Aang Serian Community College, Tanzania
Aang Serian, meaning 'House of Peace' in the Arusha dialect of Maasai language, is an independent, non-profit cultural association founded by young Tanzanians and a recent Oxford graduate in 1999. The organisation, registered with the Tanzanian National Arts Council, aims to empower young people by helping them to explore their identity at the tribal, national and global levels (c.f. Rafiki, Knight & Power 2002). We do this mainly through our Community College, housed in a small rented office in Arusha town, which provides low cost post-primary education to some 40 young adults between the ages of 16 and 35. What makes the College unique is its search for an appropriate balance between `indigenous' and `Western' knowledge, skills and teaching methods. Conventional classes such as English, Kiswahili, computer studies and basic literacy are combined with an innovative seminar course on Indigenous Knowledge (IK) and Globalisation.
Aang Serian leaders developed the concept of the IK and Globalisation course after a meeting at the United Nations headquarters in New York in August 2001, to commemorate the International Day for the World's Indigenous Peoples. During this meeting, indigenous leaders from around the world emphasised integrated education as an effective way of slowing the destruction of indigenous knowledge. Our course, still very much a 'work in progress', is based on the following principles:
1. Active Participation
During seminars, students share their personal experiences and views relating to the themes of the course - History, Culture, Environment and Health. A trained local facilitator encourages every student to make a contribution, thus helping to build self-esteem and to ensure that new information is placed in a familiar context: everyone may be an 'expert' (c.f. Sterling 2001: 38) Ideas are exchanged in an environment of open-mindedness and willingness to listen, with an emphasis on what the different ethnic, religious and national groups can learn from one another.
2. Critical Thinking
We believe that sustainability depends on challenging received ideas about the meaning of `progress', in particular the identification of 'development' with Western-style industrialisation. Thus, many of our seminar questions demand critical thinking about social change, and the evaluation of both positive and negative aspects of modernisation processes. This includes consideration of the role of international institutions such as the United Nations, World Bank, International Monetary Fund and World Trade Organisation.
3. Learning from Elders
Each student is given an individual workbook of questions relating to the four themes mentioned above, and required to fill in answers by interviewing parents, grandparents or other community elders. A week of study leave after every three weeks of classroom-based work facilitates this enquiry. For those students who are unable to return to their home villages for reasons of distance or cost, we attempt to help them to identify elders of their ethnic group living in Arusha town. Wherever possible, however, the focus is on learning within the home environment. This helps to close the 'generation gaps' that so often result from formal education: rather than despising older relatives for their illiteracy, our students are expected to recognise them as holders of valuable knowledge, and to acknowledge their contributions at the back of the completed workbook.
In addition to their role in teaching, community elders are also included in the assessment process. Before students can be awarded a certificate, they must be interviewed by at least one elder of their ethnic group, who must be satisfied with their knowledge and understanding.
4. Integrating Theory and Practice
The current requirements of the course are for each student to complete at least three out of five selected practical tasks - medicinal plant identification, construction of a material object relevant to his/her ethnic group, performance of a traditional song, performance of a dance and/or drum routine, and preparation of a local dish - and to explain their cultural significance. These tasks must be carried out to the satisfaction of both an Aang Serian faculty member and a community elder. This helps to raise awareness of the importance of praxis-based learning, while conserving some of those elements of culture that cannot be readily captured in written documents.
Vision for the future
The course is in the process of accreditation by senior academics at the University of East London, UK, as a University Certificate that qualifies the holder for entry to its undergraduate course in anthropology (given an adequate standard of spoken and written English according to international examinations). It is hoped that, in time, many African universities will also accept the IK and Globalisation Certificate as an entry qualification for appropriate degree courses.
We are also in the process of developing a rural branch of the Community College in Monduli District, north-west of Arusha, Tanzania. In addition to the existing language and literacy courses, and the IK and Globalisation course, we plan to develop an integrated approach to organic agriculture, livestock management, ethnobotany and health care. Over the next four years, we also hope to include subjects such as human rights, international environmental law, comparative cultural studies and research methodology. The buildings will be constructed from natural, locally available raw materials as far as possible, and will use solar and satellite facilities for information and communication technologies.
While initial capital has been provided largely by individuals and institutions in industrialised countries, the Monduli College is expected to become self-sustaining by providing courses for international students, whose fees will help to subsidise tuition costs for the local participants. The latter are also expected to contribute according to their means: if unable to pay in cash, they may provide handicraft goods for sale in the Aang Serian fair trade shop in Arusha, or food resources such as livestock and agricultural produce that can help to sustain the college's economy.
Conclusions
The goal of 'sustainable development' in Africa calls for a re-acknowledgement of the power and contemporary relevance of indigenous knowledge, and its systematic integration into formal and semi-formal education. We have presented a model developed through collaboration between young and old, and between rural Africa and the industrialised world, which might serve as a catalyst for other grassroots organisations to develop educational strategies appropriate to their own circumstances.
We are particularly keen to hear from individuals and organisations already active in educational reform and curriculum development, and are launching an International Network on Sustainable Education via the Internet during 2003. The network will serve as a forum for further exchange of ideas and experience, avoiding the duplication of efforts, and helping to create new curricula and reading materials. If you would like to be added to the mailing list, please contact Matthew Kinsley, Network Co-ordinator, on mck@imsa.edu.
Further information on Aang Serian can be obtained from the website, (
http://www.aangserian.org.uk, or via aang_serian@hotmail.com.
More information
Rafiki, Y., Knight, C., Power, C. (2002) 'An Arusha declaration for 2002'. Anthropology Today, August 2002.
Seabrook, J. (1993) Pioneers of Change: Experiments in Creating a Humane Society. Philadelphia: New Society Publishers & London: Zed Books
Senge, P. (1990) The Fifth Discipline, New York: Doubleday Currency.
Sterling, S. (2001) Sustainable Education: Re-visioning Learning and Change. Totnes, Devon, UK: Green Books/The Schumacher Society.