When Dr Uwemedimo Uko Esiet took up his calling as a doctor in public health, he probably did not know exactly what he would come across in his day-to-day work.
Many things were a shocker. He saw a doomed continent and realised that he had to find a way of working with others to save it.
My background in public health medicine made me realise that we must find out why Africa continues to bear the greatest brunt of diseases and sexual health issues such as Aids, unsafe abortion, maternal mortality and Sexually Transmitted Diseases, he says.
In his search for the root cause of why Africa is afflicted by many diseases, he found out that Africa is a continent where sex and sexuality i ssues are absent from public discourse.
There is, therefore, an urgent need for us to challenge this notion and work with kindred organisations and persons to break the invisible barrier of silence, Esiet advises.
This can only be done if each and everyone has a role to play in protecting future generations.
But how do you protect future generations?
By working with the young people, says Esiet, who has specialised training in family planning for doctors and nurses, sexuality education, adolescent counselling, strategic planning and gender/policy.
Young people are the entry point to working with the youth in adolescent health sexuality, says the man who has worked in various capacities in Nigerias medical institutions.
Esiet, who is popularly known as Uwem, says there is a lot of misconception over the term sexuality.
People tend to equate sexuality with sexual intercourse. Sexuality is about the totality of who we are as male and female and about our interaction in being male and female, he e! xplains.
The World Health Organisation gives the working definition of sexuality as that which is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction.
Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships.
Not all these dimensions of sexuality are always experienced or expressed.
Innovative and participatory projects
Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical and religious and spiritual factors.
On realising that Africa was a very diseased continent and that there was urgent need to put youth on the agenda, Esiet, together with others, established Action Health Incorporated (AHI) an organisation that promotes youth health and development. The organisation tar gets youth as a starting point to tackling sexuality issues.
Established more than 15 years ago, AHI has worked with community and opinion leaders, policy makers, parents, local and government officials and youth to design and implement innovative and participatory projects in education, service provision and advocacy, providing models that have been adopted and expanded by government and other civil society organisations.
Adolescence is a period of transition from childhood to adulthood. As Nigerias more than 26 million adolescents prepare to enter adulthood, they face enormous challenges in an environment of rapid urbanisation and social change, says AHI of its obligations as documented in the Internet.
Caught between traditional culture and rapid urbanisation
The organisation says the transitions typical of adolescence are magnified for Nigerian youth who are caught between the markedly different cultures of traditional communities and changes brough t about by rapid urbanisation, globalisation and a media-sat! urated e nvironment.
Emerging data on adolescent sexual and reproductive behaviour indicate that the age of sexual initiation is reducing and now ranges from 1216 years. They also show that much of these encounters are unprotected, such that the outcomes include unwanted pregnancy, unsafe induced abortions and sexually transmitted infections, including HIV/Aids, states the site.
AHI has partnered with the Lagos State Ministry of Education to implement the National Family Life and HIV Education curriculum in more than 300 public junior secondary schools in the state.
It has trained more than 1,000 subject teachers and contributed to the monitoring and evaluation activities.
Initiative to tackle sexuality at a global level
But will working with Nigerian youth save the continent from dying?
No. Esiet and his colleagues realised that to achieve their goals they had to go beyond Nigeria.
With a group of like-minded professionals and support from Ford Foundat ion, they joined hands to form an initiative to tackle sexuality at a global level.
The Global Dialogue on Sexual Health and Well-being Initiative established sexuality resource centres in Latin America, Africa, Asia and North America, to work on sexuality research and advocacy aimed at strengthening national and regional efforts. It seeks to promote and legitimise sexual health as a discipline.
The initiative emerged out of the need to promote an informed public dialogue on human sexuality and to contribute to positive changes in relevant policies and programmes, by creating mechanisms for learning and advocacy at local, regional and global levels.
The initiative is a multi-faceted, five-year (2002-2007) grant-making effort of The Ford Foundation that aims to give greater visibility, depth and legitimacy to the field of sexuality.
Promoting public education, capacity building and networking
It was developed to respond to the challenges and opportunities that exist for building upon practical approaches that f! oster he althy sexuality and to bridge the presently wide gulf between research, interventions, and policymaking.
For the continent, the Africa Regional Sexuality Resource Centre (ARSRC) hosted by AHI in Lagos, Nigeria was established in 2003. It covers Kenya, Nigeria, Egypt and South Africa.
It aims at promoting public education, capacity building and networking.
The goal of the ARSRC is to promote more informed and affirming public dialogue on human sexuality and to contribute to positive changes in the emerging field of sexuality in Africa, by creating mechanisms for learning at the regional level.
In public health the resource centre works with partner institutions such as the Al Azhar Universitys International Islamic Centre for Population Studies and Research in Cairo, Egypt, explains Esiet.
In South Africa, its partnering with the Health Systems Trust while in Kenya it used to work with the Kenya Association of Professional Counsellors but it is now in the process of getting a new partner.
Centre trains a minimum of 32 Africans annually
In Nigeria ARSRC collaborates with the department of Community Health at the College of Medicine, University of Lagos.
The centre undertakes public education in each of these countries, says Esiet who is also trained in public health at postgraduate level.
The resource centre annually trains a minimum of 32 Africans from the four countries.
Trainees upgrade their knowledge and skills around sexuality through various methods through the Annual Sexuality Leadership Development Institute, which is a three-week course for selected Africans who are fully sponsored.
Individual countries also organise annual sexuality institutes on specific themes.
This is a one-week course for senior professionals chosen from the academia, media, civil society and government institutions, says Esiet.
This years Sexuality Institute on the theme Sexual and Reproductive Health and Right Within Marriage was held last month in ! Cairo, E gypt. Next years institute will be held in Nairobi.
Networking and information sharing
The organisation also carries out networking and information sharing. It produces a quarterly publication on sexuality.
It mainly focuses on issues surrounding sexuality and receives articles from Africa and beyond, says Esiet.
The resource centre has an interactive website where people can check for information from a database.
The place is open to African professionals and interns are greatly encouraged to use it.
The resource centre has a special library with more than 2,000 publications on sexuality and sexuality issues and a website in three languages English, French and Arabic. Although the ARSRC operates only in four countries, opportunity to learn is not restricted to them.
Esiet was a technical consultant for the WHO/AFRO Consultation on Adolescent and Youth Friendly Health Services in 2000, and the WHO Geneva Consultation on Adolescent and Yout h Friendly Health Services in 2001.
Currently he is the secretary for Africa in the World Association for Sexual Health, previously known as the World Association for Sexology. He is also the convener/accounting officer for the African Federation for Sexual Health and Rights.
I have been able to participate in several global conferences on sexual health and I too carry out several consultations on the same, he says.
Typical African with a public education
Esiet, who is married with two children, believes he is as a typical African with a public education. He was born in a family of nine siblings. His father was a policeman while his mother was a housewife.
From the age of six, he lived away from home and interacted with different people from different backgrounds which gave him various experiences like any other growing child.
Esiet went to primary school in Ibadan Nigeria. His secondary schooling was in Ibadan and Osogbo while he did his A le vel at a polytechnic in Ibadan.
He did his undergraduat! e at the University of Nigeria. His postgraduate training in public health, law and diplomacy was at Nsukka University in Lagos.
In June this year, he was at the forefront when the Second African Conference on Sexual Health and Right under the banner: Sexuality, Economics and Development was held in Nairobi. More than 400 delegates attended the conference from 25 African countries.
The participation of Kenyas Vice-President Mr Moody Awori raised the profile of the conference, Esiet says.
Promoting issues of sexual health and rights
The first Africa Conference, whose theme was Sexual Health and Rights, was held in Johannesburg in 2004. The next one will be held in Nigeria in 2008.
The two conferences were organised under the auspices of the Africa Federation for Sexual Health and Rights, the regional arm of the World Association for Sexual Health.
The main objective of the conferences was to bring together African professionals to discuss sexuality issues in Africa and suggest solutions as well as build capacity of those dealing with these issues, explains Esiet.
The World Health Organisation defines sexual health as a state of physical, emotional, mental, and social well being related to sexuality and not merely the absence of disease, dysfunction or infirmity.
Good sexual health makes it possible to have a safe and enjoyable sexual life. It is premised on a positive and respectful approach to sexuality and sexual relationships, free of coercion, discrimination and violence.
Between the two conferences Nairobi and Johannesburg there was a delegation to the African Union in late 2004 that sought to explore how issues of sexual health and rights can be concretely promoted in the continent, he says.
Need for comprehensive sexuality education
The Africa Federation for Sexual Health and Rights uses the public health paradigm and development paradigm to discuss these issues, Esiet says. He add s: You cannot discuss sexuality without referring to development.
There has to be access to sexual health and this can only be done by breaking the silence, Esiet advises. This can be done by advocating for access to age appropriate gender sensitive, factual sexuality education across life spans.
He says it has to start with the school systems where the education system needs to approve, facilitate and implement comprehensive sexuality education. Others, like religious and traditional institutions, can also implement sexuality education programmes.
He says there should be constructive engagement with religious and other institutions to remove suspicion and built trust in order to enhance collaboration.
Speaking in Cairo during the Sexuality Institute 2006, Esiet said he would like to see more informed African professionals shaping policy.
They should be able to build skills and capacities of the African in the promotion of sexual well being, says Esiet. Its only then that well have an Africa where sexuality discourse will no longer be a taboo and we will be able to resolve challenges and prevent future catastrophes.
(Source: Jane Godia, East African Standard (Kenya) - 10 December, 2006)