Dushishoze….say that 3 times fast! Meaning “Think about it” in Kinyarwandan, Dushishoze comprises 4 youth centres nationwide where kids may access free medically accurate reproductive health information, services and products such as voluntary HIV/Aids testing (with rapid results) and counseling (and appropriate referrals if they are +…I saw a positive test while I was there) and birth control, as well as activities that improve them socially and economically, with an emphasis on employability. The centers are full service, and I believe this holistic, integrated model is the best and most cost effective way to reach vulnerable youth for total poverty reduction; it is the way forward.

Looking at the old fashioned ledger in which kids who come to the centre sign in, many cited “games” as their reason for coming, but just as many came for counseling, and HIV tests, and for skills learning sessions. The 4 centers countrywide have tested no fewer than 25,000 Rwandals, a huge number in a country with the social disruption it has experienced.

Used to be, aunties and uncles where the folks in a family who educated young people about their sexuality. The complete collapse of family systems, however, in 1994 has left an entire generation, going into a second, in complete ignorance about their bodies. The average Rwandais woman has 6.3 babies, and they start young. No one has any sex ed at all. It’s absolutely tragic. The centres have replaced traditional cultural practices that were wiped out.

The activities are so cool. There is a weekly call in radio show called “Abajene,” a rally cry for youth, which is hosted by a young idol we have empowered with medically accurate information. For kids without electricity and phones (so many!) our Cinemobile does tours to rural parts of the country gussied up with an audio/visual kit in order to attract kids, give them “info-tainment,” and let them use the provided cell phone to call in their teen age dilemmas and inquiries. On site, there is dance, singing, games, recreational pursuits, a football pitch, and job skill training. Within these “services” kids learn everything from personal hygiene, prevention and treatment seeking behaviors (how/when/why to go to a medical clinic), and let us not forget, they have a chance to simply be kids, to play, to run, to forget, for a few precious moments, all their burdens and cares, the back breaking chores that await them at home, and how they will probably be going to bed hungry. Again.

I love this approach, not just because it is holistic, but because it embodies the ideal of collaboration with other grassroots organizations.

The local Episcopal church is a great friend of ours in this area, and that represents a breakthrough PSI pioneered in Rwanda. After intensive negotiations, all 5 religious entities in Rwanda signed a “non aggression” pact, declaring they would not oppose sex education and pregnancy prevention for youth, and that they would support proven HIV prevention methods. The signees were the Catholic, Episcopalian, Protestant, 7th Day Adventists, and Muslim superiors and is thought to be unprecedented world wide. Hearing about how intense the dialogue was, and how it almost fell apart many times, it fantastic to know PSI persevered and was able to help religious leaders grasp that they must not be obstacles to and contradict the use of family planning.

Children ran about joyfully and my aching arms were at last filled with small ones to tote about with me, to shift from hip to hip, to load on my lap. In the way of the poor, they could crowd on my lap, up to 5 at a time, and never complain; they are used to being crammed into tight spaces and they each seemed to grateful for touch and nurturing. Maybe it was all the open windows and the mountain setting, but the children didn’t even smell so bad, except for that one fart!!!

“Baby” was a real favorite of mine. Chubby cheeked and wearing a dirty sea foam green polyester dress, she would stare ambiguously then reward me with an incandescent smile. She was wearing my necklace, which was a flower, and my sunglasses, upside down. I had to pee at one point and reckoned she probably needed to go, too, and she loved letting the sink water run over her little hands. She washed and washed, and I thought, Dushishoze in action!

Her mother is a sex worker who has been reached by Dushishoze. She and her peers have been educated as to their incredibly high risk for HIV, STI’s, and unintended pregnancy, and how such pregnancies perpetuate the poverty and poor health trap. They have been given income generating training to ease them out of sex work; as yet, though, they each need the money from one paid sex act a day to eek out a living. Baby had a pile of brothers and sisters…regulating fertility is an alarmingly urgent public health need in Rwanda. I can’t say it enough.

As always, our time was too short and there was the uncomfortable emotional twist upon leaving in not having been able to sit with and honor each person’s story, from orphan to counselor to sex worker to teen ager who is head of household.

Talking about programs like this is always tricky. They do remarkable things….the weekly call in show, nationwide, the 25k kids who’ve been tested, the one-on-one time that is holding the space a beloved auntie should be filling….but there is always in these desperately poor countries so much more, more, more that our programs can and should be doing. It all comes down to money. Rwanda’s government is literally doing everything it can, swimming as fast as it possibly can. Rich governments like ours, foundations, the private sector, wealthy individuals, we need to be doing more.
Day one — arrival
Day two — genocide memorial
Day three — the countryside
Day three — the PSI.org offices
Day three — malaria nets
Day four — you go, global girl
Day four — water purification
Day five — world malaria day
Day six — Women for Women International
Day six — Democratic Republic of Congo
Day six — heal Africa
Day seven — Sonrise
Day seven — Dushishoze
Day seven — reflections