Global Health and Happiness: Thoughts and Questions from Afar

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by Sara Veltkamp

I recently had the privilege of being in the field with the Ethiopian team of our client Dignity Period and photographer Joni Kabana. We visited rural schools in the Tigray and Afar regions in north and northeastern Ethiopia. Our goal was to get photos of and stories about the girls, boys, and teachers Dignity Period supports with menstrual hygiene education and sanitary products.


There is no shortage of barriers that affect the education and lives of women and girls in these regions; among them is the lack of access to education about menstruation and the supplies to manage periods. This is doubly true in Afar, the region of the country that borders Eritrea and Djibouti.


The landscape in Afar is mountainous and arid. People are traditionally nomadic as they move with the rains to provide for their livestock. This way of life is hard on women. While men work to sustain their families through difficult and often itinerant labor, women are responsible for keeping the home life going. This means that they construct traditional houses by hand, gathering wood for months and then building with the help of other women in their villages, binding the sticks together with handmade twine and mudding the walls one handful at a time. Every day they prepare meals, gather firewood, care for their children, and fetch water – tasks that can take many hours if not the entire day.

A woman and young girl carry large bundles of firewood on their backs.
A woman and young girl carry large bundles of firewood on their backs. Photo by Joni Kabana

Along with rigorous daily chores, Afar women face social challenges that I cannot imagine. Early marriage – while illegal in Ethiopia – is still practiced within this traditional culture and many women in the more remote locations are married as soon as they first begin to menstruate.


Yet in the face of this pervasive adversity, women were surprisingly happy. When I asked Luliasin, the wife of an Afar clan leader, if she was content, she replied, “if we are healthy, we are happy.” My gut reaction was that if Luliasin understood the choices we have as Americans, she would feel oppressed. Yet experience has led me to question my ability to make these kinds of judgments. Luliasin and I carry completely different filters in terms of values and reference points from which we judge happiness.  


Who am I to say who can or cannot be happy?

Luliasin, the clan leader's wife - photo by Joni Kabana
Luliasin, the clan leader’s wife – photo by Joni Kabana

Cultural and moral relativism are tricky topics, especially when we venture into issues like early marriage which the majority of people – myself included – recognize as unjust and detrimental. On the one hand, I have a hard time imagining a world in which we allow practices like this to continue, even if women and girls willingly engage in them. On the other, I am endlessly frustrated with cultural superiority. I am angered when I overhear Americans complaining that “nothing works in Africa” and that people from these regions are inefficient, corrupt, and poorly managed.


That level of blanket criticism is arrogance disguised as advice and can be summarized as follows: It’s not the way we do it, so it’s not the best way.


Does that mean that I believe people in Afar are better off without support for women’s health? Of course not. As Luliasin notes, health is key to happiness. What needs to change is the deeply entrenched American/Western-centric attitude that says we know what’s best for the world – because it’s clear we don’t, not even close. We need to partner with people in places like Afar and find out what support would be helpful, not tell them how to address the problems they understand more thoroughly than we ever could.

Generations of Afar women - Photo by Joni Kabana - Photo by Joni Kabana
Luliasin’s daughter and mother-in-law – Photo by Joni Kabana

Dignity Period is a great example of an organization that is counteracting this outdated attitude toward global health and development. Their menstrual hygiene work is led and implemented by people who live and work alongside those they are supporting.


Fatuma, one of Dignity Period’s program managers in Afar, was once a student at a school we visited on this trip. She understands what it’s like to miss school during her period and the shame and fear that girls often feel. This deep knowledge and connection mean that she is best-positioned to serve the women and girls in her own community in delivering education and menstrual hygiene products.

DP Afar Coordinator Fatuma (right) with her mother in their village - Photo by Joni Kabana
DP Afar Coordinator Fatuma (right) with her mother in their village – Photo by Joni Kabana

Fortunately, many global health and development organizations are beginning to recognize this need to change mindsets. More and more organizations are moving their headquarters to the countries in which that work is being done, and narratives are shifting from an emphasis on “lifting people from poverty” to an emphasis on collaboration, mutual learning, and partnership with those that can enact change within their own communities, countries, and continents. This is a change in the right direction.


There may be no shortage of barriers to women’s health and education in the Afar region, but there’s also no shortage of women – and men as allies – who can address them.

About The Author

Sara Veltkamp

Sara Veltkamp

Vice President

Sara lives in Chicago, Illinois and is Minerva's vice president. She takes a lead role in all aspects of Minerva Strategies’ smart communication strategies and implementation. She loves a challenge and is obsessed with learning new things, from how to use new platforms and tools for storytelling to languages like Amharic, French, or Farsi to mastering a difficult yoga pose. She applies this energy and curiosity to all clients’ communication challenges. Learn more about Sara.