Mark Maina works for The Fred Hollows Foundation in Africa. His role gives him a first-hand view of the blindness gender disparity in Kenya. As a father of a young girl, he's particularly in tune to the issues that he sees women in Kenya facing across the board. Here, he shares with us his thoughts about gender, health, and education.
In Kenya, gender is a prickly issue. Traditional gender roles abound, although in recent times it's been heartening to see great strides made towards increasing women's participation in the corporate, social, economic, political and health sectors.
Women here have better prospects than in the past, and the 2016 African Human Development Index ranked Kenya 18th for advancing gender equality. However, there's still a way to go globally, with the country being ranked a low 145th.
As a father of a young girl, I'd love to see a more level playing field for girls and women. But because Kenyan culture typically favours men, it's taking time to create this environment.
Nowhere is this inequality between the sexes seen more than in health treatment and outcomes.
Working for The Foundation means I visit different areas of regional Kenya regularly, and it's easy to see that women are at a higher risk than men of acquiring eye infections and diseases. Recently, the Fred Hollows team documented the story of Nabiritha – a case which illustrated some of the challenges and injustices that a blind girl faces in Kenya.
Girls in Kenya already suffer many injustices because of their gender: child marriage, denial of education, and gender based violence . If a disability like blindness is added to the mix, a girl – and her family - can be trapped in a cycle of despair and poverty that’s unlikely to end.
It does hurt me to see a bright young girls like Nabiritha suffer as a result of avoidable blindness. I'm so glad we were able to help her in the end, but the story isn’t the same for many others.
From what I can see, addressing health issues is a key factor in changing the broader landscape for women and girls in Kenya. But several things must be understood if development programs and government intervention are to have any success.
Attitudes that limit us
It's frustrating, but even when services are available, accessible, and affordable, many women don't use them. In many families, the health of women is simply not prioritised - particularly if it's a condition that’s not life threatening.
Another factor is cost. Like many patriarchal cultures, women here do not control the family finances or resources. In Kenya, a woman invests 90 per cent of her income in her family while men invest only 30-40 per cent.
Additionally, many women in Kenya still have to seek support and/or permission from men in order to get services like cataract surgery due to regressive gender roles. The problem is that cataracts need to be treated quickly, otherwise they keep developing and can render the person completely blind.
Fear of the unknown
Many women have a fear of health workers involved in eye care. They stay away because of they don't understand exactly what these people can do for them. There's also the fear of travelling to unfamiliar cities where services are located. That unfamiliarity can seem even worse because of the lack of convenient and disability-friendly transportation from rural to urban centers.
Interestingly, women who suffer avoidable blindness will often seek treatment from alternative sources that are close to their homes. 'Eye care' shops and traditional medicine providers are used and if these methods don’t work, fatalism prevails: it's God's will. Sadly, sometimes the traditional medicine makes the condition worse.
Knowledge is key
In my opinion, to address these challenges around women’s eye health (and health in general), the key is education. Bit by bit, we're getting there. Kenya has definitely improved and education is now being viewed as a basic right for all children.
Today, more girls are completing the full education cycle and progressing beyond secondary education to tertiary study and doctorate levels. The obvious drivers seem to be government interventions such as Free Primary Education and Free Secondary Education that were introduced in 2003 and 2008 respectively.
Something to aspire to
When I think about my own daughter or girls like Nabiritha and what they could achieve if they were given all the same opportunities as men, I look no further than Jane Ohuma, who is the Country Manager at The Fred Hollows Foundation Kenya. For me, she's a shining example of women who have strived to break down barriers. I think about the way she's advocating for those who need help the most and this seems to be the way to a better world.
As my daughter grows, I truly hope that the gender disparity lessens and lessens: in education, in work, and most definitely in eye health outcomes.
I, for one, remain hopeful.