Spotlight: Hewan Areaya and the Menstrual Health Movement

Issue: Street Children

On a cold morning in Addis Ababa, I met Tsegaye. She was among a dozen or so children who had gathered, in a government school, to receive the breakfast offered by UNICEF and answer my questions about their experiences living on the streets of Ethiopia's capital.

An incredibly slim young woman, she was almost 16 but had the demeanor of someone much older. She spoke very low with her legs crossed, her skirt brushing the ground, and her back hunched over as if she was reading something on her lap. Through my translator, she told me that she slept in the walkway leading to the entry of the church grounds last night, but she was not sure where she'd sleep tonight. Her home was in Oromia, the largest region in Ethiopia, with a population of 37 million. She said she was working in Addis Ababa to send money back to her parents. She livened a bit as she continued: “I am the oldest of seven and it is important that I contribute to their care.” I asked how she makes money. She shut down. “Do you beg?” “Yes,” she says. “Do you sell things?” “Sometimes.” “Do you work for someone?” She loudly and proudly answered, “No!”

As the child protection officer in the UNICEF country office, I developed an ambitious work plan that cut across the various sectors to address issues that affected the most marginalized children and women in the country. As the timeless border struggle between Ethiopia and Eritrea escalated into a full‐fledged war, I committed to working with the peacekeeping troops deployed by the Secretariat with headquarters based in Asmara to provide human rights training on the protection of civilian populations. I was also tasked with training police, judges, and correctional staff on the human rights of women and children in the country's legal system. And, finally, I worked with the regional office's child labor program to provide and advocate for services to children working on the streets of Addis Ababa.

The idea to focus on street children had come from my Ethiopian colleague and boss Desta. Within the UN system, it is rare to have staff members from the local country supervise international officers. I considered myself lucky to have a senior Ethiopian woman run the office of child protection, as well as an amazing Ethiopian staff working with and for me. Desta previously founded civil society organizations that provide direct services to feed children, find them homes, ensure their schools are adequate; the list goes on.

So she was naturally the first person I consulted when, as part of the regional child labor project, I was tasked with finding children who were subjected to work conditions that violated standards set by the International Labour Organization, Convention on the Rights of the Child (CRC), and other international treaties. She said she was most concerned about the well‐being of the children and teens increasingly coming from their villages to beg on the streets of Addis. Where were they sleeping? They were often arrested for stealing food, thrown into jail with the general adult population with no concern that, as children, they needed special treatment.

I ran this by the regional lead on child labor. Can we do what Desta is asking? The ILO didn't classify street children as laborers. But we both wondered why not? We went to the streets for a first round of interviews of the children to document their circumstances. We found that, like Tsegaye, close to 80% were sent to Addis with the blessings of their parents to “make money” to help support the household, though I'm sure the parents were not aware of the difficult circumstances their young teens experienced.¹

Roughly 20–25% of children working on the streets were girls like Tsegaye. There were rumors of prostitution among working children, but it was hard to confirm. In our interview, Tsegaye was not keen on answering any questions on the subject. At the end of the conversation, as I did with all the children, I offered her services. I let her know there were shelters where she could stay, go to school, and receive funds to go back to her parents. As a part of UNICEF's program, we also offered her a stipend to take back to her village. Her eyes brightened as she accepted.

I didn't expect to meet Tsegaye again. But a few months later, Desta reported that she'd seen her while out feeding the hungry. Tsegaye had been repatriated to her village, but on her arrival, her mother remarked that she looked like she was pregnant, and due to the shame she feared would come to her family, she'd returned to Addis. Stunned by this news, I was reminded that we should be including health care services, especially sexual and reproductive health care, into the program. In hindsight, it seems insane that I was more concerned about offering housing, education, and psychosocial support to these children than health care. After all, if they were not physically well, how could they take advantage of the other services?

I found Tsegaye at a small church shelter, asleep, with eyes swollen from crying. The attendant said she was not eating, which wasn't healthy for a girl in her circumstances. Before thinking, I asked if she could come home with me. She spoke no English and my Amharic ended with greetings, but as she settled into a warm bed in my house, she accepted a warm plate of injera and wot. The next day, we went to an obstetrician, who inquired about the father of the child, which elicited no response. We later learned that the father is most likely the “kind” man who periodically offered her a warm room in which to sleep, food to eat, money, all in return for allowing him liberties with her body, an arrangement she did not see as prostitution. There were a couple more such opportunities with older men but none of them as frequent. There were also other times when she was attacked and raped by peers.

Desta suggested that Tsegaye should be tested for HIV, as she was seeing an upswing in cases among the street children. When Tsegaye returned from the doctor with the results, I saw in her eyes that it was not good news. With her permission, I spoke to the doctor, who said he had explained to her that while she was HIV positive, it was still possible for her to have a healthy baby. But somehow, Tsegaye heard something very different. The next morning, she left without my knowledge. After two days of being worried sick, Desta reported that Tsegaye was at a convent outside the city where she was undergoing a fasting protocol that many believed cured HIV. I later found out that she and her baby died after 12 days without food.

I wonder, to this day, if things would have been different if Tsegaye had received comprehensive sexual and reproductive health care that included the options to choose adoption or an abortion. This was five years before the Ethiopian laws were expanded from allowing abortion only in the case of saving the mother's life to permitting the procedure in the case of rape, incest, or fetal impairment. Adoption, although common and still legal at that time for foreigners, was still seen as a service for those orphaned, not a plan for an able‐bodied young mother. Both adoption and abortion was seen through a highly religious and cultural lens, making it less likely for young women in Tsegaye's circumstances to consider such options.

From Desta, I learned how important it is to include those most affected in the decisions we make about programs aimed toward them. Although Desta, an Ethiopian herself, was intimately involved in the design of the work and I benefited greatly from her insights, there was no participation from the youth working and living on the streets themselves. We interviewed them, but we didn't include them when determining what kinds of services and support to offer them. They were treated only as recipients. After the time I spent with Tsegaye, I came to realize that she and many others like her would have made excellent movement creators. Desta knew this.

Desta is an everyday feminist.

Local Knowledge Produces Local Impact

The fourth major lesson that listening to and observing everyday feminists in action across the globe for more than three decades taught me is the closer, the better.

In developing a program for a particular community, it is vitally important to have input from those who are most affected by the problem the program seeks to address and who will be directly affected by it. That may seem obvious, but too often, in my career, I've seen this lesson ignored.

I, too, have been guilty of it. I'd built an amazing strategy from the headquarters of power and, once I had a very pretty document, send it to the community for review. Often, there was a nice budget attached to the plan as well. The community, understanding that the resources were contingent on signing off on a plan that was not their own, would usually acquiesce and accept both the plan and the resources. Usually these resources would be tied to a contract or grant to a large company or NGO that would implement the plan and provide some small portion of the budget to “help” the community meet the project's objectives and collect the data for metrics also set out in the plan. The plan, the objectives, the metrics—none of it may have been what the community would have come up with themselves.

This approach is like fitting a square peg in a round hole.

Children Living and Working on the Streets

There is perhaps no issue I've seen more affected by this dynamic than homelessness—or, in the case of my time in Addis Ababa, the particular plight of children living and working on the streets.

The phenomenon of street children like Tsegaye is a complex social emergency that affects cities all over the globe. Though it is difficult to quantify the exact number of children living on the streets, UNICEF estimates a population of nearly 120–150 million children between 6 and 24 years of age.² According to a report commissioned by the United Nations Human Rights Council, there are numerous factors that contribute to the problem³—from drug use, migration, and social displacement in more wealthy nations to extreme poverty, an unregulated process of urbanization, and mass exodus due to famine, war, and drought in developing countries.

In 1983, the Inter‐NGO program on street children and youth defined it as any girl or boy who has not reached adulthood, for whom the street (in the widest sense of the word, including unoccupied dwellings, wasteland, etc.) has become his or her habitual abode and/or source of livelihood, and who is inadequately protected, directed, and supervised by responsible adults.⁴ Although the definition of what constitutes an inter‐NGO program has been determined by the UN, in Addis Ababa the term has a great deal of stigma associated with it. These children are often viewed by mainstream society as a threat and a source of criminal behavior.

After many years working on interventions for these children at community, national, regional, and international levels, I believe that the programs that worked best were those in which the children were known by those building the solution. I don't mean that the parents had to be known to the organization—though that was helpful—but those working on the issue at least had to know the children's language, their neighborhood or community, and they certainly had to have a clear understanding of their culture beyond the socioeconomic circumstances that had led them to the streets. In designing the programs, those closest to the children were best equipped to determine what they needed and what success for them and their extended families looked like.

Even in Addis Ababa, there was not a one‐size‐fits‐all approach for the children working on the streets. These nuances were clear to Desta, but much of what was delivered was dictated by the regional UN office. And metrics to report and determine success were also provided by those far removed from the problem.

Whose Evidence Counts?

Thankfully, it is increasingly recognized that developing programs without the input of the communities affected is not only patronizing but ineffective. In decolonizing aid and philanthropy, it is becoming best practice instead to subscribe to and support strategies that come from the community and are already proven to work.

I am pleased to hear national and multinational corporations direct their strategies toward so‐called place‐based solutions. This approach targets economic, social, and governance efforts at the specific circumstances of a place and engages the community and a broad range of local organizations from different sectors as active participants in their development and implementation. Development circles' recent use of the term localization is also encouraging. This is also an attempt to shift toward more holistic and long‐term approaches to aid delivery, with an increased focus on the root causes of conflict and inequality.⁵

Although there is still a lot to be sorted out, especially in the humanitarian sector, we seem to be moving in the right direction. However, the monitoring and evaluation frameworks of multilaterals and some bilateral governments still frequently ask local partners to meet metrics they did not create and speak to an agenda of which they are not involved in creating. For example, say there is an everyday feminist providing services to street children. As a condition of a grant, she may be required to show that she helps a certain number of children. That she counts all of the points of entry for service provided and, in some cases, writes their name, age, address, and so forth on a report for the donor. I have even seen requirements that the children's parents themselves sign a form accepting that their street children receive services.

Such demands are vestiges of a very colonial approach and should be considered as such. They are unrealistic, unfair, and impede the work of the everyday feminist—who is, by the way, busy reaching these children, with or without our support. Impact indicators and metrics for reports to donors must reflect the local circumstances if they are to create transformative social impact. The evidence sought and characterized in theory in the halls of Oxford or McKinsey are great suggestions. They cannot, however, reflect the reality of metrics of success set by everyday feminists in practice.