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Number 187 - November 2018
On 1 November, All Saints’ Day, we pause to celebrate those who have responded to God’s call to holiness, whatever their path in life. We especially remember those we have known who have inspired us to be better people. ‘Each saint is a mission, planned by the Father to reflect and embody, at a specific moment in history, a certain aspect of the Gospel’(Pope Francis, Rejoice and Be Glad).
On 2 November, All Souls’ Day, we remember all those who have died, especially those dear to us. Let us also keep in mind those who have died in various disasters in our time, due in part at least to human activity, and as a result of conflict and violence.
Several other days this month remind us of significant issues affecting our world today.
World Diabetes Day occurs on 14 November and was initiated by the International Diabetes Federation (IDF) and the World Health Organisation (WHO). According to the IDF website, the theme for 2018 and 2019 is ‘The Family and Diabetes’. The campaign aims to raise awareness of the impact that diabetes has on the family and on the support network of those affected. It promotes the role of the family in the management, care, prevention and education concerning diabetes.
WHO points out that Type 2 diabetes comprises the majority of people with the condition around the world. This type results from the body’s ineffective use of insulin and is largely the result of excess body weight and physical inactivity. Until recently, it was seen only in adults but it is now occurring with increasing frequency in children. It is largely preventable through regular physical activity, a healthy and balanced diet, and a healthy living environment. Families have a key role to play in addressing the modifiable risk factors.
Symptoms for Type 2 diabetes may be similar to those of Type 1 (excessive urination, thirst, constant hunger, weight loss, vision changes, and fatigue) but are often less marked. As a result, the disease may only be diagnosed several years after onset, once complications have already arisen.
It is estimated that diabetes is undiagnosed in half of those who have the condition. Early detection and treatment are essential to prevent complications and achieve healthy outcomes.
International Day for Tolerance occurs on 16 November. The UNESCO 1995 Declaration of Principles on Tolerance states: ‘Tolerance is respect, acceptance and appreciation of the rich diversity of our world's cultures, our forms of expression and ways of being human.’
The UNESCO Director-General's message for 2017 pointed out that ‘many societies are undergoing deep transformation, just as globalisation is accelerating.’ While this provides many opportunities for dialogue and exchange, it raises new challenges, increased by inequality and poverty, enduring conflicts and movements of people.
The message suggested that ‘tolerance must be seen as an act of liberation, whereby the differences of others are accepted as the same as our own.... This means standing up to all forms of racism, hatred and discrimination, because discrimination against one is discrimination against all. We are members of the same family, all different, all equally seeking respect for rights and dignity.’
Universal Children's Day, celebrated on 20 November, aims to promote international togetherness and awareness among children, and to improve children's welfare. On this date in 1959, the UN General Assembly adopted the Declaration of the Rights of the Child. It is also the date in 1989 when the General Assembly adopted the Convention on the Rights of the Child, the most widely ratified international human rights treaty.
Unfortunately, the rights of children today are unashamedly ignored in conflict zones. UNICEF USA says that nearly 250 million children live in areas affected by prolonged, violent conflict. Its website states that in less than a year, the conflict in South Sudan has displaced 490,000 children. More than 10,000 children have lost their lives in the Syrian conflict.
UNICEF Executive Director Henrietta Fore said, ‘From the Central African Republic to South Sudan, and from Syria to Afghanistan, attacks on children in conflict have continued unabated during the first four months of 2018.’ Her shocking statement continued: 'With little remorse and even less accountability, parties to conflict continue to blatantly disregard one of the most basic rules in war: the protection of children. No method of warfare has been off-limits, no matter how deadly for children: Indiscriminate attacks on schools, hospitals and other civilian infrastructure, abductions, child recruitment, besiegement, abuse in detention and denial of humanitarian assistance were all too commonplace.’
Who is responsible for fueling these conflicts? It is time to say, ‘Enough!’
On 25 November, we mark International Day for the Elimination of Violence against Women. Of great significance this year was the awarding of the 2018 Nobel Peace Prize to Dr. Denis Mukwege, from the Democratic Republic of the Congo (DRC), and Nadia Murad, a Yazidi woman from northern Iraq. They received the prize for their work to highlight and eliminate the use of sexual violence as a weapon of war and armed conflict.
Emily Sulivan, in an article on the NPR website on 5 October 2018, said that Dr. Mukwege, a gynaecologist, has treated victims of sexual violence in the DRC for most of his adult life. In 1999, he founded the Panzi Hospital in the eastern Congo, called the ‘rape capital of the world’ by UN officials. It supports survivors of sexual assault and has treated tens of thousands of women for rape.
In a 2016 speech, Dr. Mukwege said that while the hospital's original mission was to curb maternal mortality rates, ‘our first patient did not come to deliver a baby. She had been raped with extreme violence.’
Ms. Sulivan said that Dr. Mukwege developed a model of treatment that emphasizes both physical care and justice. It allows survivors to heal from physical, emotional and spiritual trauma. Dr. Mukwege has received multiple threats for carrying out his work.
‘His basic principle is that justice is everyone's business,’ the Nobel committee said.
Ms. Sulivan pointed out that Nadia Murad herself is a victim of sexual war crimes. Taken captive by ISIS members who attacked her village, she was held as a sex slave for three months before escaping. In 2016, she was named the UN's first Goodwill Ambassador for the Dignity of Survivors of Human Trafficking.
Ms. Murad has spoken extensively about her experience, despite the great shame her culture associates with rape. The Nobel committee said, ’She refused to accept the social codes that require women to remain silent and ashamed of the abuses to which they have been subjected.’
According to Berit Reiss-Andersen, chair of the Norwegian Nobel Committee, this year the committee wanted to send ‘a message of awareness that women who constitute half the population in most communities actually are used as a weapon of war.’
In this newsletter you can read about the life of one of our Sisters who recently celebrated fifty years of commitment in MMM. Also this year, a community in Tanzania obtained access to clean water, relieving a great burden for women and children. In Nigeria, using a holistic approach to healing, women affected by obstetric fistula have been given new life.
Thank you for working with us to make all this possible. We remember you daily in our prayers. Please pray for us as well.
‘If you have come to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together’ (Lilla Watson, Australian aboriginal elder, educator, and activist).
Expressing our creative fidelity
‘Now, I hope you will all grow in understanding of different peoples – this is essential for an International Congregation which ours is’ (Mother Mary Martin, letter 1954).
In July 2018, Sister Agnes Hinder celebrated fifty years as a Medical Missionary of Mary. Our only member from Switzerland, she had wide training and experience before joining.
Born in the canton of St. Gallen, Switzerland in 1927, Agnes trained and worked in domestic science for five years before qualifying as a children’s nurse. She worked as a private children’s nurse for four years and then completed studies in general nursing and anaesthetics.
In 1962, at the invitation of Bishop Jobidon in Malawi, Agnes and another woman, Maria Raber, prepared to go to the Diocese of Mzuzu, under the auspices of a Swiss lay missionary group. Beforehand both women were sent to Drogheda, Ireland, to learn English and to study the ethos of MMM. They lived with a local family, working in the International Missionary Training Hospital (now Our Lady of Lourdes Hospital) in the morning and learning English in the afternoon.
When the two women arrived in Mzuzu, the Swiss group had built a house for them – always referred to as ‘the Swiss house’. Agnes was well qualified for the development of Saint John's Hospital, the first MMM foundation in Malawi. She spent four years there as a lay missionary and then decided to join MMM. She completed her postulancy in Malawi in 1966 before proceeding to Drogheda for her novitiate training.
After first profession Agnes qualified as a midwife and was assigned back to Mzuzu. She served there for four more years, doing general and paediatric nursing as well as anaesthetics. At that time the demands continued to grow in providing extended health services from Saint John’s Hospital.
Ready for new ventures In 1974, she was assigned to a new rural mission in the diocese, in Nkhata Bay. There she developed a mother and child welfare clinic and an outreach programme.
In 1976 Sister Agnes returned to Switzerland for a refresher course in anaesthetics, after which she was back in Mzuzu. For the next twenty-three years she was involved in general and children’s nursing. She also worked in the nutrition unit and in anaesthetics in the operating theatre.
Agnes was a competent, experienced and compassionate nurse who also became a mentor for the many lay volunteers who spent time in Saint John’s.
MMM later handed over Saint John’s Hospital and moved out of Mzuzu Diocese. In 2001, after a sabbatical, Agnes was assigned to Chipini, a new mission in the south of the country. Here she encountered a different people with their own language and traditions. For six more years she cared for the children she loved.
At the age of seventy-nine Agnes returned to Drogheda. There she served in the infirmary and clinic in the Motherhouse. She has accompanied many of the Sisters who were her friends in Malawi on their journey home to God. Willing to assist in any place she was needed, she also helped in the stamp department.
Agnes is now in our nursing facility, Áras Mhuire, receiving the care she needs. May she be richly rewarded for her own care and dedication.
How can this happen?
According to a World Health Organization (WHO) report in January 2018, 'each year, between 50,000 to 100,000 women worldwide are affected by obstetric fistula’, an abnormal opening between the birth canal and the urinary tract (VVF) and/or the rectum (RVF). The injury is directly linked to a major cause of maternal morbidity and mortality: obstructed labour, which accounts for up to 6% of all maternal deaths.
The report continued: 'It is estimated that more than 2 million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa.’ Women who experience this preventable condition cannot control their urine, or with an RVF, their bowel contents. This may lead to skin infections, kidney disorders, nerve damage, and even death.
The baby, often the mother's first, is unlikely to survive.
Rejected by society, these women suffer profoundly from their loss of status and dignity. Left with no means of support they must often resort to begging or sex work to survive.
Obstetric fistula has been largely eliminated in the developed world with improved maternal care. It can also be prevented by delaying the age of first pregnancy and stopping harmful cultural practices. Because many health care systems still fail to provide accessible, quality antenatal care and basic obstetric services the wider issue of women’s and girls’ rights in society must be addressed. Preventing and managing obstetric fistula are part of Sustainable Development Goal 3 for improving maternal health.
We can do better A UNICEF report in June 2018 stated that 86 per cent of pregnant women worldwide access antenatal care with skilled health personnel at least once (UNICEF website). Nevertheless, in sub-Saharan Africa and South Asia, among the regions with the highest maternal mortality rates, only 52 per cent and 46 per cent of women respectively receive at least the recommended four antenatal visits.
Regular contact with a doctor, nurse or midwife during pregnancy allows women to receive services vital to their health and that of their future children. Women prepare for delivery and learn about warning signs during pregnancy and childbirth. Nutrition supplementation is possible, as is immunization against tetanus, treatment of hypertension to prevent eclampsia, and HIV testing. Medications can be started to prevent mother-to-child transmission of HIV. In malaria-endemic areas, pregnant women can be given medications and insecticide-treated mosquito nets to help prevent this debilitating and sometimes deadly disease. Women with risk factors for delivery, especially for first pregnancies, can plan to deliver in health facilities. They can come for early admission, if necessary.
Prevention is better for everyone. Women with uncomplicated fistulae can have a simple repair operation. According to the WHO, approximately 80-95% of vaginal fistulae can be closed surgically. Nevertheless, most occur among women living in poverty and many affected women are still left with chronic ill health as the result of their injuries and neglect. Many cannot afford the cost of transport to fistula repair units and surgery. Often treatment is needed for pre-existing conditions before an operation.
There are numerous challenges associated with providing fistula repair services in developing countries. There is a scarcity of available and motivated surgeons with specialized skills. Training is critical and health professionals must be continuously trained in prevention and management. Funding is needed to support both surgery and post-operative care. Called to bring healing Medical Missionaries of Mary have long been involved in the prevention of obstetric fistula by providing access to quality antenatal, obstetric and child care. MMMs in Itam, Nigeria also provide fistula repair services with the help of committed visiting surgeons several times a year. Three camps have already been held in 2018.
A holistic approach is needed. Because risk factors for developing a fistula include lack of education and skills to earn a livelihood, affected women who come to Itam are taught income-generating activities. Among these are training in sewing and hair dressing, when the women are in better health and their wounds are well healed. Donations from various individuals and groups, local and overseas, have made it possible to buy the equipment for the skills training and to set up the women in business.
Making a lasting difference Sister Sylvia Ndubuaku is matron at our hospital at the Family Life Centre in Mbririt, Itam. She told us about the lives that were changed as a result of the support of Gay and Keith Talbot in the UK. They have donated funds for a number of VVF/RVF surgery camps. In addition, they were pleased to allocate funding for ten women who had repair operations to set up in business in sewing and hair dressing. Sylvia reported on the send-off ceremony that was held for the women in September.
‘We are very grateful to Gay and Keith Talbot for their generosity, which made the empowerment ceremony possible. The event for our ten rehabilitated women was very colourful. It seemed the whole environment celebrated. Present were the Honourable Commissioner for Women’s Affairs and Social Welfare, a representative of the United Nations Population Fund (UNFPA), and Sister Celine Anikwem, MMM West Africa Area Leader.
‘Five women received training in sewing. Each was given a sewing machine, a cutting table, an iron, a wall mirror and other equipment, as well as twenty thousand naira (about fifty Euro). Five women were trained in hair dressing. Each received a hair dryer, a wash basin, a roller stand, a mirror and other equipment, and twenty thousand naira.
‘The twenty thousand naira was given towards renting a shop to start up in business. The women’s families were also encouraged to contribute towards the rent to involve them in the women’s reintegration. We are taking the women home to assess their environment and will do further follow up.
‘The women were very happy. During their welcome song they showed some of their products, demonstrating the changes in their lives. They shared their life testimonies and how the Family Life Centre has helped them. They changed “from being nobody, rejected and abandoned, to being somebody” - able to make handwork for making a livelihood today. It was very touching. Their drama was also very instructive about the prevention and causes of vesico-vaginal and recto-vaginal fistulae. May the good Lord continue to bless them and keep them strong and healthy always.’
Water for life
Sister Sekunda Kimario is based in Nangwa, Tanzania. She told us how the people of nearby Matangarimo village have been part of changing their own lives for the better with the support of committed partners.
‘MMMs have been working in Nangwa since 1985. Our main focus is on the health of mother and child and the poor and needy, especially those living on the margins of life. We run a dispensary and mobile clinics for six villages. One of these villages is Matangarimo, which always had a big problem in accessing sufficient water. Water is needed for cooking, drinking, hygiene, watering livestock, and other domestic purposes. The area is very dry and people had to walk more than ten kilometers to find water, especially in the dry season. This situation affected the ability of most people to carry out their daily activities. For instance, children who attended school had to get up as early as 3:00 a.m. to search for water before leaving for classes. Some arrived late; others did not go at all.
‘It was the same for mothers who brought their children to the clinic or who needed to attend antenatal services.
'When we asked them, “Why are you late?” or “Why didn’t you come for your appointment?” it was very distressing to hear them say, “We went to look for water.” Children often had to be left at home and they spent these hours without food. Sometimes women went to look for water at night, with risks of attack by hyenas and snakes. They could be threatened by young men taking alcohol and other drugs. Village development was affected. Women said it was not possible to build permanent houses. They spent so much time collecting water that they couldn’t join village committees or have enough time for farming. When the rains came they felt it was heaven on earth.
‘It usually rains from March to May and during this time, life changes. The area becomes green; people plant crops; they get water from the river. But this lasts for a very short time. Various solutions for the dry season, such as dams and boreholes, had been tried without success.
‘The situation was a great concern for us working nearby in Nangwa. During the 2013 visit of our Congregational Leader, Sister Siobhan Corkery, and her councilor, Sister Radegunda Shayo, we raised the issue and arranged a visit to Matangarimo. When the villagers saw the Sisters, they were filled with hope.’ A sustainable solution Dr. Eamonn Brehony, an MMM Associate based in Tanzania, was involved in the work that was subsequently done to provide dependable water sources for the Matangarimo sub-villages. He explained that rainwater harvesting is one of the simplest and oldest methods of self-supply of water for households and communities, with the collection and storage of rainwater in natural reservoirs or tanks. Rainwater is also substantially free of salts – a common problem in these dry areas. Water can be collected from roofs, through sand dams, and by catching water runoff from big rocks (rock catchment).
In our 2014 MMM Yearbook, Eamonn described how a number of partners worked together to provide a resolution to the chronic problem. First, a needs assessment was done. The villagers themselves asked to learn about harvesting rainwater, especially using sand dams, which they felt were much more appropriate and cheaper to set up and run than pumping schemes. The water engineer also found a large rock with potential for rainwater harvesting in the sub-village of Uyumo.
Also, with support from the Irish Embassy in Dar es Salaam, a team including the District Water Engineer and two members of staff from Mbulu Diocesan Water Department visited rainwater harvesting systems in Kenya. A programme was then drawn up to support each of five Matangarimo sub-villages to have a harvesting project - four for sand dams and one for a rock catchment system.
The MMMs at Nangwa Health Centre then implemented the Water Harvesting Programme at Matangarimo, along with the Mbulu Diocesan Water Department and the Hanang District Council Water Department. The villagers were involved from the outset Part one: Building sand dams A sand dam is a wall built across a seasonal sand river with a solid rock foundation. When it rains the dam captures soil-laden water behind it. The sand sinks to the bottom and silt remains suspended in the water. Some rainwater is retained behind the dam and the remainder continues its natural flow towards the sea. Eventually the dam fills with sand, with water stored between the sand particles. As more water is stored, it seeps out of the sand. Then a hand-dug well is built so people can access the water. With the enthusiastic cooperation of the villagers, sand dams in four sub-villages were completed by 2016, with funding by MMM and Misean Cara.
Part two: Rock catchment With this technique, flat rocks are cemented around the edge of a large rock with a slope, and rainwater is directed into a catchment tank. Up to 300,000 litres per year can be harvested.
In November 2017, work began on a rock catchment project in the fifth sub-village, Kwa Chere, near Nangwa. It was completed in July 2018.
Dr. Brehony wrote: ‘MMM, with support from a group in Kostal Factory in Abbeyfeale, Ireland; another in Nenagh; and Misean Cara, helped this community of about 500 people to initiate the project. By God’s providence the village is endowed with some very large rocks. We showed the villagers how to clean a suitable one. They then built a rim of stone, a holding wall, around the end of the rock to direct the rainwater via a large pipe into a tank, which can hold 125,000 litres. The tank is lower than the rock, so the water comes into the tank by gravity. The wall had to be very large and well reinforced because water can come with great force.
‘The rock and tank are about a fifteen-minute walk up a steep hill from the village, so to make the water more accessible the people decided to run a one-inch pipe to a small tank in the village itself. They decided to charge the equivalent of €0.20 for each twenty litres of water they collect. MMM also gave the villagers a challenge. If the villagers build a second tank of 125,000 litres then MMM will help them to build a third tank. In this way they should be able to collect enough water for the needs of all the villages for the whole year, especially in the dry season.
Looking to the future ‘The Tanzanian Government has shown interest in this project because it is a new idea. The local Member of Parliament is also a member of the Parliament Agriculture, Livestock and Water Committee. She hopes to persuade some committee members to come to see the rainwater harvesting so Parliament will encourage other villages to do the same.’
Sister Sekunda said that the sand dams and rock catchment have changed the lives of the Matangarimo people: • Students are now punctual at school. • Women are able to attend antenatal and child welfare clinics regularly. They don’t have to wake up early in the morning and walk many kilometers to fetch water. • People can plant vegetables, increasing the amount of food for the people. • They can build houses using water to make bricks. • Water is available for household chores. • Personal hygiene has improved.
Sekunda told us about one woman who had been so frustrated by the lack of water that she wanted to run away. ‘Now that there is water’, the woman said, ‘I will build my house here’.
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