Posted on Jan 1, 2012

Adolescence is a difficult time for girls everywhere, but coming of age in a developing country carries even greater risk. Teenage girls living with HIV struggle to come to terms with their condition. As girls mature, they face contracting sexually transmitted infections such as HIV and human papillomavirus.


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Marie's Story: In Rwanda, a young woman gains access to an education

Pulane's Story (VIDEO): In Lesotho, a young girl receives treatment for multidrug-resistant tuberculosis



The Women and Girls Initiative Scholarship Program sends young women and girls back to school in rural Rwanda.


Some of the recipients of a new scholarship for adolescent girls in Rwanda.

By Grace K. Ryan, Department of Community Health and Social Development, Partners In Health/Inshuti Mu Buzima, Rwanda

The “New Life” club is starting to live up to its name, according to Marie*, an 18-year-old orphan from the Nyamirama sector of Eastern Rwanda. In January 2012, she and 40 other at-risk girls aged 12 to 19 started school for the first time in years, formally launching the Women and Girls Initiative Scholarship Program.

The Women and Girls Initiative was founded in 2009 by Didi Bertrand-Farmer, Director of Community Health and Social Development at Partners In Health’s Rwandan sister organization, Inshuti Mu Buzima (IMB). “The objective,” Ms. Bertrand-Farmer says, “is to produce girls who are independent, who have access to information so that they can make healthy decisions about their lives.”

With the help of local authorities, health center staff, and representatives from IMB, more than 120 out-of-school girls in Nyamirama sector were organized into six clubs, including “New Life.” These clubs meet weekly to discuss health and reproductive issues, offering peer-to-peer psychosocial support and a platform for health outreach programs organized through the health center.


"We want to eliminate barriers to education for these girls"

“But this is only the beginning,” says Ms. Bertrand-Farmer. “We want to eliminate barriers to education for these girls and ensure their economic independence.” IMB is currently seeking partnerships with local and international organizations experienced in vocational training, microfinance, and women’s cooperatives, in order to empower the girls economically. In the meantime, the clubs have identified 41 members who are ready to complete their education. These girls will receive school-fee support, uniforms, sanitary products, and other necessary materials to continue their schooling.

“Educating a girl is important,” explains Marie, “because a girl who can go to school can find work and money for her future. Otherwise she will look to a man to give her money.”

After a traffic accident killed both of her parents ten years ago, Marie was adopted by a single mother of seven, named Therèse. Now in her fifties and often in poor health, Therèse struggles to provide for her family as a farmer. Two years ago, she realized she could no longer afford her children’s school fees. Marie dropped out of secondary school and became pregnant not long after. 


Linking health, poverty, and education

The connection between health, poverty, and education are palpable in the stories of girls like Marie, who show not only remarkable resilience but also creativity in the face of adversity. Another 18-year-old scholarship beneficiary, Lucille, describes a special support system her club has developed. Each of the 20 members tries to bring 100 Rwandan Francs (about 17 US cents) to their meetings, to be pooled together and donated to a different girl each week. With the 2,000 francs ($3.30) collected, she can buy hygiene and sanitary products. “So we don’t rely on men,” Lucille explains.

PIH/IMB staff and partners from Nyamirama Health Center and local government, with scholarship recipients and their parents.

In the Rwandan health system, community health workers are responsible for pregnant women, infants, and children up to age five, but adolescents must rely on school programs for health education. Girls who cannot afford school fees are economically vulnerable and lost to the health system until they become pregnant—which is often all too soon. With limited access to the cash economy, girls struggling to make ends meet in rural communities may leverage their romantic relationships in order to survive. They may not fully understand the potential consequences—a teenage pregnancy or sexually transmitted infection—or how to protect themselves.

Girls in Nyamirama are particularly vulnerable. The sector was hard hit by Rwanda’s 1994 genocide, leaving a HIV infections and child-headed households in its wake. Of the girls who returned to school in January, 10 percent are orphans and 68 percent have only one living parent. Of the girls who do have two living parents, 33 percent have at least one parent who is incapacitated by illness or disability. Many of the girls themselves bear the scars of conflict, including Lucille, who was wounded in the leg as an infant during the genocide.

Marie said that she wouldn't have become pregnant even if she had been enrolled in school over the past two years, adding, “It’s time to change ideas.” She plans to take advantage of her education to pursue a career as a deputy in local government, so that she can help develop her sector, even as she helps herself, her baby daughter, and her adoptive family.

As Partners In Health Co-Founder Dr. Paul Farmer has written, “You will never break the cycle of poverty and disease without educating girls.” For the girls of the Nyamirama Women and Girls Initiative, scholarships are a humble first step.


*The names of the participants have been changed to protect their privacy.


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