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Metta: SRH Project for Rohingya Youth

Empowering Young Rohingya Refugees in Bangladesh by educating them on Sexual and Reproductive Health

Photo of Krishti Aung Leona
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What specific problem(s) are you trying to address?

The Rohingya community suffers from high birth rates and high maternal mortality rates. The Rohingya refugees currently in Bangladesh are all illiterate and hence they have no knowledge on SRHR. Child marriages are a common phenomenon of the Rohingyas. Young girls are married off without any prior knowledge on SRH. There are hundreds of teen mothers and pregnant teens who are at risk due to the recent crisis. Also, both married and unmarried teen girls and women are at risk as they have no place to sun-dry their period cloth. This unhygienic menstrual routine is leading to vaginal infections. The current humanitarian crisis has led to higher unplanned pregnancies and girls are dealing these unplanned pregnancies by fatal unsafe abortions.

What are some of your unanswered questions about the problem(s) you are working to address?

There is a census ongoing to document the exact number of Rohingyas who have entered Bangladesh through the Myanmar-Bangladesh border. We know that there are 400,000 Rohingyas who are currently in Bangladesh and of them 67 per cent are women and girls. Among them 13 percent are pregnant. Although the numbers are increasing everyday. We are still trying to know the exact number of young people aged 14-19 in the Rohingya Refugee camp in Cox's Bazaar in Bangladesh.

Explain Your Idea

The name of our project is “Metta”. The word “Metta’’ is of Pali and Sanskrit origin meaning loving-kindness and good-will for others. 400,000 Rohingya Refugees have recently surged to Bangladesh from the Rakhine State of Myanmar. The refugee families have settled in Cox's Bazar in temporary camps. The UNFPA has reported that so far an estimated 67 per cent of the arrivals are women and young girls. Among them, 13 per cent are pregnant or breastfeeding. And these numbers are increasing every day. The entire community is illiterate and have zero knowledge on Sexual Health. Therefore, suffers from high maternal mortality rates, high rates of child-marriages, unplanned pregnancies and vaginal infections. In such a vulnerable situation an unplanned pregnancy can be a severe and devastating problem for a young girl. Girls are at the highest risk for sexual violence during such humanitarian emergencies, as populations are displaced and protection systems are disrupted. Also, lack of spaces for sun-drying cloths used for menstruation is leading to vaginal infections and will lead to uterus cancer among these girls soon. We will organize 6 workshops in total for 300 Rohingya girls. The workshop will cover issues on: 1. Contraceptive choices 2. Menstrual Regulation (MR) 3. Menstrual Hygiene Management 4. Maternal Health and Post-Partum care After the training, the Rohingya girls who has participated in our workshop will become peer-educators in their community.

Name the three most important ways that your idea will address your identified problem(s).

Session on Contraception: By educating girls on Contraception it will lead to lower unplanned pregnancies among Rohingya girls through educating them and creating their access to contraceptive choices. 2. Session on Menstrual Regulation: A significant decrease in maternal mortality rates due to unsafe abortion by educating Rohingya girls on MR Services and how to access them. We will discuss with them the different methods of safe abortion (MR). 3. Session on Menstrual Hygiene: We will educate them on the proper usage and disposal of sanitary napkins. 4. Session on Maternal Health: Lower rates of maternal mortality and lower child-deaths. We will educate them about how they can take care of their health during and after their pregnancy

How is your idea unique?

Our comparative advantage for working with the Rohingyas is that we can fluently communicate in Rakhine language. This will make them comfortable in sharing their problems with us. Therefore we can further tailor our project to address their SRH needs. Currently there are a few organizations addressing humanitarian needs of the Rohingyas in Bangladesh. Mostly relief agencies and other non-profits are working towards food and shelter. However, the issues of SRH such as unplanned pregnancies, sexual violence, lack of contraception, zero access to MR services have been under-looked. We believe it is important to seriously address SRH issues in a humanitarian crisis although SRH issues are often left behind during such crisis.

Who are your end users?

Our project "Metta" aims to empower the Rohingya refugee girls by educating them on SRH. Our target group is 14-19 year old Rohingya girls. The Rohingya community is one of the most deprived and vulnerable community in South Asia. The have been socially and economically deprived since 1972. Many Rohingya girls have faced sexual violence over the years. They have been denied family planning services and hence tend to have unwanted pregnancies, unsafe abortions and finally bigger families. We want to educate young Rohingya women so that they have the power to take decisions about their bodies, families and life.

Where will your idea be implemented?

  • Bangladesh

What is the primary type of emergency setting where your innovation would operate?

  • Armed conflict
  • Prolonged displacement

Tell us more about the emergency setting that you intend to implement in

Since August 25, 2017 Rohingya refugees have fled to Bangladesh through borders to escape the alleged ethnic -cleansing in Myanmar's Rakhine State. The community has settled in Cox's Bazaar in Bangladesh. Till now more than 400,000 Rohingyas have settled in temporary camps here in Cox's Bazaar. Of them, 67 per cent are women. 13 percent of these women (mostly teen girls) are pregnant. They do not have any idea where from where to access contraceptives, family planning services.

What is your organization's name?

Aung Health and Education Development Foundation (AHEDF)

Tell us more about you.

The project will be implemented jointly by Aung Health and Education Development Foundation and Bangladesh's Assembly of Youth Advocates (BAYA).

Organizational Characteristics

  • Women-led organization
  • Indigenous-led organization
  • Youth-led organization

What is the current scale of your proposed innovation?

  • Still in planning phase and does not exist yet

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

Bangladesh

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Early Stage Innovation: exploring my innovation, refining, researching, and gathering inspiration.

Website

www.facebook.com/ahedf.org www.facebook.com/bayaofficial

How has your idea changed based on feedback?

During the feedback Phase we visited our project area - Kutupalong Refugee Camp. Our target group (beneficiaries) shared with us their poignant stories of survival and struggle in their native language. Our beneficiaries could fully express themselves without any lingual or cultural barrier. We spoke about and shared our workshop's idea and with Young girls, new mothers and also young men and young fathers. There is a dire need for Contraceptive Education among all of them. We have come to the conclusion that until and unless we include young men and young fathers in our family planning edu programs our goals remain obscure. Therefore to provide comprehensive SRH services to women in the disaster stricken area, we must involve men in the Contraceptive workshop (separately, not in the same group in women trainees), without that the stigma around Contraception will not lessen. All the Rohingya families are highly patriarchal. To empower women and girls, we must include men.

Who will implement this idea?

Our team will implement this idea. I am an SRH Trainer and Advocate myself from the past 4.5 years. We will include a mid-wife to discuss on MR procedures and we will also translate the words of the mid-wife in the language of the Rohingyas. Our core team will consist of 7 full-time staff. To make the Rohingya Refugees culturally comfortable our team will constantly speak to them in their native language. Also our team will comprise part-time staff as well as volunteers.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

Our organization is led by indigenous women and young indigenous persons. We generally take big decisions with our Chairperson, Executive Director and Project Coordinator for the particular project. Our organization is dedicated to work on SRH and hence we believe our team will face no obstacles in working together to achieve our common goal.

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

Our end users face plenty of challenges in the Refugee Camp. What we came across is a dire need of Family Planning Services. As women do not stop giving birth during a disaster, we must make sure that women do not face unwanted pregnancies further. They do not have any contraception available. Even if some orgs. are providing, the women and young mothers do not know which one to avail or which is best suited for them. Also there is lack of sanitation facilities, they Rohingya Refugees live in small cramped and dilapidated spaces. Rohingyas are constantly threatened by the outbreak of diseases. Also more and more people (mostly women) with HIV are being discovered. I have attached a picture with one of our end-user. She has just given birth to her 11th child. She lives in the Camp.

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

IMPACT: By 2022, we aim to build an empowered network of Young Rohingya men and women who are educated on SRH and know how to take better decisions free from stigma and myths for themselves and their families. QUESTION: How can we keep our network active and organize regular meet-ups with our end-users and bigger Rohingya community even after the end of our project period?

What is it that most attracted you to Amplify instead of a more traditional funding model?

We could build and tailor our project idea accordingly to the needs of our end-users. The several phases of the challenge helped us research more on our project idea and ponder and meditate over them to bring out the best solutions for our end-users. Also, working in a highly restricted area meant plenty of ambiguities, challenges and obscurities. We learnt to accept our ambiguities and foster our project in a better way.

Do you intend to implement your Amplify idea in refugee camps / temporary settlements?

  • We aim to implement our Amplify idea in a refugee camp / temporary settlement.

How long have you and your colleagues been working on this idea together?

  • Less than 6 months

How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • Under 5 paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are registered in all countries where we plan to implement.

My organization's operational budget for 2016 was:

  • We didn't have an operating budget

What do you need the most support with for your innovation?

  • Other Technical Expertise

9 comments

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Photo of OpenIDEO
Team

Hi Krishti Aung Leona and Team,

We’re excited to share feedback and questions with you from a set of experts that are supporting this Challenge.

We encourage you to think about this feedback as you continue to improve your idea, whether that’s refining it or adding more context. You are welcome to respond in the comments section and/or to incorporate feedback into the text of your idea. Your idea and all associated comments will all be reviewed during the final review process, but all critical information should be in the body of your contribution somewhere.

- You clearly capture the needs of your intended user group and identify a market gap. Great job! One of our experts writes, "Targeting young Rohingya women who are refugees in Bangladesh is an excellent idea, especially if you can communicate in the same language."
- We're curious to know more about how you will help support your users retain the information/training you are providing. Peer education can be an effective model for information sharing, and we want to know if you have prototyped with one topic (for example: menstrual hygiene) and gather feedback from your users to then expand to additional topics.
- A provoking question to ask yourself: will several training workshops covering a broad range of SRH issues be too much new information for the girls & women to absorb? A helpful exercise may be to start slow and small with one topic area, gather feedback from your users, and consult with girls + women about what topics THEY want to learn about.

Here is a resource you may find useful in the development of your idea:
- https://www.rescue.org/resource/menstrual-hygiene-management-mhm-emergencies-toolkit

In case you missed it, check out this Storytelling Toolkit (ideo.to/OZznV4) for inspiration on crafting strong and compelling stories as well as the recorded Office Hour (ideo.to/Gf1Cs6). Storytelling is an incredibly useful tool to articulate an idea and make it come to life for those reading it. Don’t forget - the last day to make changes to your contribution on the OpenIDEO platform is October 26 at 11:30PM PST.

Have questions? Email us at amplify@ideo.org

We look forward to reading more, and thank you for the important work that you are doing!

Photo of Krishti Aung Leona
Team

Thank you very much! It feels great to be so closer to our Project Implementation Phase!

After visiting the Kutupalong Refugee Camp we have realized that we must also include Young Men and Young Fathers in our program. The Rohingya Men in the Refugee camps need to be educated on SRH as well. They need to support the the female members of their family to receive Family Planning Services. As Rohingya families are all governed by men, therefore to provide Comprehensive SRH services for women and young girls we must eradicate the Stigma around Contraception choices from men, and must as well educate men on Menstrual Hygiene to remove the myths so that they become supportive towards the girls and women in their families.

Also, we have come to realize that to include a wide range of SRH topics, we must make sure that our groups of trainees are very small and intimate. So that they can better share their needs with us comfortably in their language and cultural context.

Photo of OpenIDEO
Team

Hi Krishti Aung Leona and team!

An important reminder, Refinement Phase closes this Thursday, October 26 at 11:30pm PST.

We can only consider complete submissions, so please make sure that you have reviewed the Feedback and Refinement Phase Checklists and answered all of the questions on the platform. Note that we added one more multiple choice question to the end of the form.

If you're having trouble figuring out how to edit your idea, please refer to this guidance: https://docs.google.com/document/u/1/d/e/2PACX-1vQUuV2N-wO8Oy8MysMAza3CbKUA1ZcMenollZjPh4FA0fGgIDcVXwWtEe6CLh36_Wik5AypEHixreFH/pub

Best of luck!

Photo of Mashaka
Team

I congratulate you for this good idea. I have learned that you are targeting the young girls in this regard, but I think you should also include (to some extent) influential people, parent and guardians as well.

Otherwise I wish you and others (with selected ideas) a `good journey' to serve our communities. We are all brothers and sisters, regardless of our boundaries. Remain blessed.

Photo of Krishti Aung Leona
Team

Indeed we are!
I have always worked on SRH for the marginalized groups. I believe SRH should be accessible at all socioeconomic spheres. I will certainly try and involve the community seniors in our project. Surely this will spread more positivity.
Thanks a lot.
Love from Bangladesh!

Photo of ACISDA AFAR
Team

Hi Krishti, you have a very nice idea. women and girls during conflict and drought situation the gender based violet ion is going to increase. Therefore, to protect girls in Rohingya Refugee camp in Cox's Bazaar in Bangladesh. In addition, as for the current real situation of the Rohingya people your idea is valuable and outstanding issues. 'I have added you as a team member' Thank you!

Photo of Krishti Aung Leona
Team

That really means a lot! Thank you very much! Hope I can work for the Rohingyas and other minority groups on a larger scale soon!

Photo of Ashley Tillman
Team

Hi Krishti Aung Leona , great to have you in the Challenge! If your proposed project goes well, would love to learn what you would consider a success within your work and what your longer terms goals might be for this work?

Photo of Krishti Aung Leona
Team

So glad to hear from you! Thank you very much for your response.
Problem: Young girls from marginalized groups such as the ‘Rohingya Refugees’ in Bangladesh have to bear the burden of a large number of children with little or no resources at all. The newborn children and infants often die due to poor nutrition and lack of adequate food and shelter. Young mothers find it very difficult to find income opportunities as they need to take care of children.
Goal 1: To educate 300 young Rohingya girls on contraceptive choices
Outcome/Indicator:
1. Prevention of unwanted pregnancies among young Rohingya Refugee girls
2. Lower child mortality rates
3. Better family planning information and increased access and increased use of family planning tools among young Rohingya girls.
4. Lower fertility rates among refugee girls will increase their income opportunities for themselves and their families.

Problem: Women do not stop getting pregnant in case of an armed conflict or prolonged displacement but there are higher chances of unwanted pregnancies during such crises. According to the UNFPA, most Rohingya girls in the refugee camps in Cox’s Bazar have been sexually abused and many young girls are suffering from unwanted pregnancy. They are seeking unsafe ways to terminate their pregnancy. The young rape victims are the most vulnerable in the Refugee camp in Cox’s Bazaar.
Goal 2: To educate 300 young Rohingya girls on Menstrual Regulation (MR) and the consequences of unsafe abortion.
Outcome/Indicator: Abortion is illegal in Bangladesh. But, like in other South Asian countries, MR is legal and widely available. It is possible for women in Bangladesh to terminate an unwanted pregnancy through an MR.
1. Rohingya Refugee girls will choose the safest and legal way to terminate their unwanted pregnancies.
2. The rate of maternal mortality will decrease.
3. Rohingya women will no longer fall in trap of unsafe abortion providers.
4. Discussing MR with a large group of women will help break the stigma and taboo around MR.
5. Women who earlier had no choice but to keep an unwanted pregnancy will be able to seek an MR Service and economically benefit their families.

Problem: The scrap of cloths which Rohingya women use during their menstruation cannot to sun-dried due to lack of shelter. Hence, these cloths catch mite leaving young girls with vaginal infections and uterus cancer in the long run.
Goal 3: To discuss about Menstrual Hygiene Management with 300 Rohingya Refugee girls
Outcome/Indicator: There are free sanitary napkins distributed among Rohingya girls, but they do not know how to use or dispose them properly.
1. After our workshop Rohingya girls will be able to properly use and dispose sanitary napkins.
2. Rohingya girls will not use cloths which have been sun-dried properly.
3. They will be prevented from vaginal infections.
4. They will also be prevented from uterus cancer.

Problem: More than 60,000 women are currently pregnant in the Rohingya Refugee camp in Bangladesh. The number is increasing every day. Among them 13 percent are mothers to newborns and breastfeeding. Many of those who are pregnant are teenage girls
Goal 4: Educate 300 Young Rohingya girls on Maternal Health
Outcome/Indicator:
1. Lesser maternal morbidity and visible decrease in maternal mortality within the refugee camp
2. Significant decrease in the ratio of child morbidity
3. Bond among pregnant women and young girls therefore they can rely on each other for help in cases of emergency
4. Higher number of young mothers educated on SRH

Sustainability and long term goal: Build a strong network of young Rohingya girls who are aware of their sexual health and reproductive rights. They will become peer-educators in their community and act as SRH advocates within their community. While our 300 young girls will continue to share their SRH knowledge with their fellow community members, the number of young girls and women using family planning tools will increase within the community. As a result they will no longer have to deal with unplanned pregnancies, unsafe abortions, and will not suffer from the ill consequences of not knowing where to receive family planning consultation. Rohingya women will soon be able to take proper decisions about their bodies and their lives. Our training will give them the power to break free from their shackles of poor knowledge on Sexual and Reproductive Health. We will constantly monitor and evaluate our project impacts throughout the year 2018 – 2019. At the end of one year, our team will publish a Report on the overall impact of our proposed workshops.