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REGIÓN V ALTOS TSOTSIL TSELTAL, MEXICO – Touching leaves of his coffee plants with his dark hands, Marcelino Santis explains that a rust fungus has spread through his crop with unusual strength.
“Now the plague is stronger, tougher; it won’t give in,” says Santis, 60, who farms a plantation in the southern Mexican state of Chiapas. “And, it is infecting other coffee seedlings little by little.”
On the recommendation of his neighbors, Santis has increased the dosage of agrochemicals he applies to his coffee plants to avoid losing a great part of his crop, which he will harvest between November and February 2016.
The chemicals are hurting his health.
“I put a handkerchief on my face, on my nose,” Santis says. “It’s that (the agrochemical) is very strong. Sometimes one feels dizzy, or wants to throw up.”
Santis is one of many indigenous coffee growers in the area putting their health at risk in an all-out battle to save their crops.
The intensity of the 2015 rust plague has spurred many organic coffee growers in the region to adopt conventional agricultural techniques. Those who were already using agrochemicals are increasing the dosage. All are desperate to save their harvests – their primary or sole source of income.
Their health suffers because they are applying these massive doses without the necessary equipment and training.
Sixty-eight percent of the more than 600,000 inhabitants of Región V Altos Tsotsil Tseltal, popularly known as Los Altos, is indigenous, and 88 percent of the region’s population is poor, defined as having per capita income below 1,677 pesos ($109) a month, according to the Regional Development Program 2013-2018 report.
Thousands of indigenous farmers grow coffee here. The crop is raised on more than 20,000 hectares (49,421 acres) of Los Altos, according to 2013 data from the Ministry of Agriculture, Livestock, Rural Development, Fisheries and Food.
The area produces more than 55,500 tons of coffee per year.
The coffee rust plaguing these plantations is caused by the Hemileia vastatrix fungus. Considered the most devastating coffee fungus, it weakens the plant, causes premature leaf fall and can be lethal, according to the ministry.
The fungus has afflicted coffee plants in the region since 1981, but it became especially strong this year, says Leopoldo Gómez, head of the Directorate of Productive Projects of the Chiapas Ministry for the Sustainable Development of Indigenous Peoples.
Unusually high rainfall in recent years created humid conditions that enabled the fungus to flourish, Gómez says. In 2013 and 2014, Chiapas had rainfall totals of 2,278 milliliters (89 inches) and 2,056 (80 inches), respectively. The 2012 rainfall total was 1,885 milliliters (74 inches).
Santis fears coffee rust will cut his yield in half. If that happens, he doesn’t know how he will support his family.
Santis, who farms 4.5 hectares (11 acres), ordinarily produces an average of 3 tons of coffee per hectare per year. Last year he made 85,000 pesos ($5,500) from the sale of his harvest.
Santis also grows corn, and he says his corn harvest will help him cover his family’s food costs. But without an average coffee harvest, he doesn’t know how he will meet his family’s other expenses, such as medicine and clothing.
Indigenous farmer Armando López, 25, says coffee rust has infected more than 60 percent of his coffee plants this year.
“The fungus has always affected our coffee plantations, but it was only one or two plants per year,” he says. “Coffee rust is beating us.”
Most coffee growers in the region fight the fungus with copper oxychloride-based agrochemicals, Gómez, Santis and López say.
Farmers do have a natural alternative: They can battle the fungus by applying mineral broths – mixtures of water with calcium hydroxide – to their plants. But most growers prefer faster-acting copper-based agrochemicals, Gómez says.
López says he began using agrochemicals because the organic methods he used to practice – including pruning, taking care of the soil and severing the root – were no longer sufficient to preserve plants.
“We cannot keep losing our coffee plantations,” he says.
The careless application of megadoses of agrochemicals is harming farmers’ health, says Ramón Mariaca, researcher at the College of the Southern Border, a publicly funded scientific research center that supports sustainable development.
“We have discovered that when a product stops having an effect, people double the dosage,” he says. “Or, they mix products that are oftentimes the same but of different brands.”
Applying more than the recommended dose is actually counterproductive, Mariaca says. At high doses, the chemicals themselves can kill coffee plants.
Furthermore, he says, farmers breathe in the chemicals and absorb them through their skin when they fail to take proper precautions, such as wearing masks and gloves.
Santis and López say they do not wear gloves or masks when applying agrochemicals because they believe they are not necessary. They simply cover their eyes and hands with handkerchiefs.
Misused agrochemicals cause nausea, vomiting, skin irritation, respiratory irritation, headaches and general discomfort, says Dr. Valery Cruz, who runs a rural health clinic in the municipality of Larráinzar, where Santis and López live.
Between April and March, Cruz treated 15 men for severe headaches and dizziness after they had applied agrochemicals. Farmers did not report such symptoms before March of this year, she says.
Santis says he goes to see a doctor whenever he has a serious medical problem, but he does not think the discomfort he now feels warrants medical care.
López believes he has to give his body time to adapt to the chemicals.
“The body will get used to it,” he says. “I only feel more tired than before every time I use these chemicals.”
The application of agrochemicals does not affect the health of coffee consumers, Mariaca says.
These fungicides are applied to coffee leaves before the plants fruit, between July and September. The fruit, which contains the beans that are roasted and ground, is not exposed to fungicide, he says.
To protect growers’ health, the government should provide training in the use of agrochemicals and distribute masks, gloves and protective clothing, Mariaca says. Currently it does neither.
The Directorate of Productive Projects of the Ministry for the Sustainable Development of Indigenous Peoples does present talks on organic methods of fighting coffee rust, Gómez says.
Organic farming, including soil management with compost and vermicompost, produces hardier, more disease-resistant plants, making it a better long-term solution to the rust outbreak, Gómez says.
Mariaca advises farmers battling coffee rust with agrochemicals to carefully follow the dosing instructions on the packaging and to wear waterproof coverings.
López, however, follows the advice of fellow farmers, fumigating during the relative cool of dawn and setting aside a pair of pants and long-sleeved shirt to wear when applying agrochemicals.
López does not allow his wife and four children to come in contact with the liquids he uses.
Santis does not want his family around when he fumigates either. He does not allow his youngest, a 12-year-old son, to accompany him when he applies the fungicide. Like his neighbor López, he sprays in the morning and trusts that he’ll be all right as long as he can save his crop.
Fernanda Font, GPJ, translated this article from Spanish.
HAJAN, INDIAN-ADMINISTERED KASHMIR – Ghulam Nabi Darzi carefully flips through his worn-out diary and, finding a page on which he noted the qualities of an eligible young man, he passes the diary to a young woman seated before him at his home office in Hajan, a city in Bandipora district in Indian-administered Kashmir.
Darzi, 48, is a matchmaker: He provides details of potential brides and grooms to families and brokers marriage agreements.
In Kashmir, most marriages are, in some sense, arranged, though brides and grooms have much more say in the matter than in past generations. Even when partners essentially choose each other, parents will often engage a matchmaker to negotiate a dowry and formalize the arrangement.
Rafia Jan, 25, and her mother, Zarina Begum, have come to consult Darzi about a prospective groom for Jan.
Jan, her gaze lowered shyly, her voice just above a whisper, reads Darzi’s notes about the prospective groom – age, education, career.
Darzi takes the diary back and, occasionally glancing at his notes, tells Jan and Begum about the man, including his income, his mother’s temperament and the size of his family.
At the end of his monologue, Darzi glances at Jan. She shakes her head. The man is eight years older, and she does not agree to the proposed marriage.
Begum confidently asks Darzi to suggest other prospective grooms.
“Tell me what type of a boy you want – handsome or prudent?” Darzi asks Jan in a joking manner.
Unamused, Jan flashes her dark eyes at Darzi as she angrily responds, “Both!”
Darzi reopens his diary and suggests a few names and addresses of prospective grooms. He asks Begum to verify their details through her network of neighbors and relatives. He advises Jan to take her time in evaluating the men.
Begum tries to pay him for his services, but Darzi refuses. Ever since the floods first hit Kashmir in September 2014, causing widespread economic hardship, Darzi has provided his services free of charge.
“You do not need to worry for money,” he tells Begum. “You select any groom from the suggested list of addresses. It is my job to properly verify your selection.”
As the mother and daughter leave his office, Darzi encourages Jan to be hopeful; he tells her he will find her a prince.
Darzi, who arranges marriages in the Bandipora district of Indian-administered Kashmir, encourages an austere approach to weddings.
Because the floods in September 2014 and March 2015 destroyed many livelihoods, upsetting family budgets, Darzi urges families not to request or offer dowries or put on extravagant celebrations.
Last September, floodwaters killed more than 280 people in the Indian-administered area of Kashmir and damaged nearly 660,000 homes and buildings, forcing 226,000 people to evacuate, according to the state’s Revenue Department records. March flooding killed 44 people, damaged nearly 12,600 structures and displaced 2,900 families.
Responding to the pervasive loss of livelihood in the region, the Indian government has promised 50 billion rupees ($785 million) in aid to affected families, according to the Revenue Department. By October 2014, the central government had released 26 billion rupees ($405 million) to the state government for post-flood relief work and financial assistance to affected people.
Many young Kashmiris are delaying marriage for lack of funds, says sociologist Bashir Ahmad Dabla, a professor at the University of Kashmir.
The average age at which Kashmiri men marry rose from 24 in 1989 to 32 in 2009, according to Dabla’s 2009 study “Emergence of Late Marriages in Kashmir.” Over the same period, the average age at which Kashmiri women marry rose from 21 to 28.
Dabla found that the rising cost of marriage is the primary reason for delayed marriages.
First, the bride’s family traditionally must come up with a suitable dowry. Dowry sizes vary with income level; a middle-class family might spend 500,000 to 1 million rupees (roughly $8,000 to $16,000) on gold jewelry, furniture, kitchen accessories and clothing for the groom and his family.
In addition, the groom must secure a regular income sufficient to support a wife and family, and both families shoulder the cost of an expensive wedding celebration.
Darzi, following in his father’s footsteps, has worked as a matchmaker since 1996. Like his father, Darzi earns a modest income – which he felt uncomfortable disclosing – embroidering pherans, a traditional loose unisex gown and a popular bridal gift.
Working across Bandipora and other areas of the Kashmir Valley, Darzi has arranged about 315 marriages to date.
“I am doing matchmaking as a social service,” Darzi says.
He seeks blessings from his client families, and that makes him happy, he says.
In the aftermath of the September floods, Darzi heard people say that extravagant weddings set an impossibly high standard, prompting families that could not afford lavish events to delay their plans.
September, a time of moderate weather when far-off relatives return to the valley on holiday, is traditionally the peak wedding season in Kashmir, Darzi says.
But during the 2014 wedding season, many poor families in Bandipora, Srinagar and Baramulla districts suffered under the heavy burden of large dowries and extravagant weddings.
Darzi pledged to do what he could to ease their burden.
He spoke with families, encouraging them to forego dowries and to host simple marriage ceremonies, he says. Many vowed to make their weddings affordable and modest.
But Darzi went a step further, providing his services free of charge. Ordinarily, a matchmaker is paid primarily by the families of brides.
Dabla calls the offer extraordinary.
“Matchmakers who arrange simple marriages or offer free-of-cost matrimonial services are rare,” he says.
Darzi had 15 confirmed marriages arranged before the September floods hit. Eight families canceled their weddings amid the disaster, but seven marriages were solemnized in an austere manner.
Naila Rasool, 32, entered a marriage arranged by Darzi in October 2014.
Her groom did not request a dowry, and the wedding was a simple affair for about 50 close relatives and friends, Rasool says.
She dressed simply on her wedding day. She didn’t decorate the house. No caterers scurried about setting tables or serving a variety of dishes. No professional musicians performed. The guests enjoyed tea and simple refreshments.
The floods were hard on Rasool’s family. Her father’s handicraft shop in Srinagar was submerged for weeks, destroying his stock and forcing him to close shop.
The modest celebration cost her family only 50,000 rupees ($800), Rasool says. Usually, a wedding costs around 500,000 rupees ($8,000).
Rasool’s family chose not to offer a dowry. Matchmakers the family had consulted previously all insisted that the family offer a dowry; their recommendations included cash, gold jewelry and a car.
“My family didn’t end up in any debt or come under any pressure,” Rasool says. “The marriage happened simply, and everyone enjoyed it.”
With the money it saved, Darzi’s family began renovating her father’s shop in April. He hopes to reopen the shop by the end of July.
Darzi is inspiring other matchmakers to advocate simple weddings.
Abdul Majid Dar, 40, of Sadunara A village, 8 kilometers (5 miles) from Hajan, has been a matchmaker for three years.
Matchmakers in Kashmir usually take in fees and gifts from the bride’s family, Dar says.
“The uniqueness of Darzi’s work is that he simplifies marriages,” Dar says. “I have not ever seen or heard of anyone like him who offers free services.”
On average, Dar earns 10,000 rupees ($150) to 100,000 rupees ($1,600) from the families of the bride and groom.
“I wish to become like him and earn respect, instead of making a mere business out of marrying off people,” Dar says.
Darzi says he did not expect to earn the respect of his community but now cherishes it.
“Becoming a matchmaker is the best thing that has ever happened to me,” Darzi says. “Everyone respects me. It is overwhelming.”
Darzi’s wife, Poosha Bano, 40, is proud of her husband’s work and the high regard people have for him.
“It is not only because of free services,” Bano says. “But with sincerity he finds the match without hiding any details or telling a lie to tie a knot.”
Darzi and Bano have four sons and two daughters. Bano hopes that at least one son will follow in the footsteps of his father and grandfather.
In Indian-administered Kashmir, most formal matchmakers are men. Matchmaking is essentially a negotiation between families; in this patriarchal culture, families are customarily headed by men – and they usually prefer doing business with other men.
Female matchmakers informally mediate marriages and are not usually compensated.
Not everyone in Bandipora district believes weddings must be simple.
“Why should one not celebrate the weddings with lavishness?” yells Abdul Rashid Dar, a local wedding contractor who provides catering, tents, furniture and decorations.
Abdul Rashid Dar believes that if people are willing to spend money on clothes, travel, food and assets, they should not hesitate to spend freely on weddings as well.
But Darzi is convinced of the need for austere weddings. He plans to offer his services free for the duration of 2015. That will give families time to recover from their economic losses, he says.
So far this year, he has arranged 15 modest wedding ceremonies, Darzi says.
“I will continue to inspire people and instill a change through austere weddings,” he says.
Abdul Majid Dar and Abdul Rashid Dar are not related.
Aliya Bashir, GPJ, translated interviews from Urdu and Kashmiri.
BUENOS AIRES, ARGENTINA – While responding to an emergency medical call in a Buenos Aires slum one night last summer, Dr. Paula Fernández capitulated to the demands of street thugs in order to save her life.
The ambulance she was riding could not reach two people with gunshot wounds because the streets of Villa Zavaleta, a slum on the city’s south side, are narrow.
“We got off the ambulance with the driver and walked two blocks down a corridor,” Fernández recalls. “It rained and rained. The place was crowded with people and police. At the end of the corridor, there was a dying patient, with a gunshot wound to his face, and next to him, another one, with a firearm wound to the abdomen.”
Gazing as if watching that moment in July 2014 unfold anew, Fernández says she immediately tended to the person with the abdomen wound, but allies of the person with the face wound ordered her to stop.
“No, not that one!” she recalls people yelling. “You bitch, help this one!”
Before she could even react to their demands, they carried the person with the face wound to the ambulance.
“I saw they were coming to look for me,” she says. “They wanted to carry me too. So I went fast to the ambulance and we took the victim with us. I thought, ‘I do what they say, because if not, they will kill me.’ I felt scared! Very scared!”
Straightening her white coat, Fernández says she never understood why she had to tend to one victim over the other.
The drug trade has so sharply increased violence in the slums of Buenos Aires that doctors and ambulance personnel refuse to enter some areas without police backup. As a result, tens of thousands of people are not guaranteed access to emergency health services. Doctors and ambulance personnel train to de-escalate tense situations and manage their risks, but they add that there’s no substitute for public respect.
The Emergency Medical Care System of Buenos Aires, known by its Spanish acronym, SAME, is run by the city government’s Ministry of Health. It aims to cover the population’s emergency medical needs.
SAME stations its 130 emergency vehicles at 34 public hospitals and other strategic locations. An emergency communications center dispatches the nearest ambulance to each of the roughly 2,400 medical emergencies called in each day.
Buenos Aires, a city of 200 square kilometers (124 square miles), is home to 2.9 million inhabitants. The city is surrounded by a metropolitan area known as Greater Buenos Aires, home to more than 15 million people, according to the 2010 National Census.
More than 5 percent of the population – about 163,000 people – lives in slums, according to the census.
Argentines apply the term slum (villa miseria in Spanish) to neighborhoods with dirt roads and precarious housing on publicly owned land.
Almost 20 percent of the city’s population, lacking any form of medical insurance, depends solely on public health care, according to the census.
So far, no doctor or paramedic personnel has been killed servicing the city’s slums, says Dr. Jorge Gilardi, president of the Municipal Doctors Association, the trade union that represents public hospital doctors in the capital.
Still, his colleagues fear for their safety, he says.
“There is fear! There is fear!” he says. “We will keep going, but we won’t commit suicide.”
The increase in violence became noticeable about five years ago, Gilardi says, but it is constantly increasing despite the presence of the police, the Naval Prefecture and the National Gendarmerie, which provides border security, in the slums.
“The assaults were growing in quantity and intensity,” he says. “They became more serious, going from a push, to a blow, to a threat with a firearm.”
At some hospitals, a police unit accompanies each ambulance dispatched to a slum. In other cases, police guards are assigned at the request of ambulance crews.
The situation has been getting worse, says Dr. Alberto Crescenti, general director of SAME. These days, ambulance teams do not know what they will find when they respond to an emergency call.
“This is a profession of risk,” he says. “We know when we are going, but we don’t know if we will return.”
Ambulance drivers also voice fear.
In the year he has driven for SAME, Juan Carlos Murillo has been insulted several times, and his ambulance has been stoned.
“Sometimes we cannot even enter, because even police tell you, ‘We cannot give you a guarantee,’” he says. “The police themselves tell you the thing is intense, and we cannot go in.”
Juan Godoy, 32, a resident of slum 21-24, also on the city’s south side, says he throws stones at ambulances whenever he sees them in his neighborhood because he believes emergency crews discriminate against people of the slums.
“They’re a bunch of cats,” he says, using a local term for people who consider themselves superior. “You call them and they don’t come. They leave you for last.”
Gilardi denies that health care staff discriminates against slum inhabitants.
“We never discriminate,” he says.
Out of institutional principle, SAME responds to every emergency call, Crescenti says. But ambulance personnel are expected to take all necessary precautions, including not entering a situation they deem dangerous, to protect themselves.
“No one is a superhero,” he says. “We are all human, and we must recognize that sometimes we feel afraid. One feels afraid of losing their life, and it is not a minor thing.”
Murillo says he disregards about 20 percent of emergency calls out of fear for his safety.
While letting ambulance teams decide whether to enter a slum may protect them from harm, the practice deprives slum dwellers of a full right to health care, says Maximiliano Marín, a sociologist who specializes in homeless populations.
Sonia López, 37, a resident of slum 21-24, says she has twice been denied emergency care for her children.
In April 2014, her 5-year-old son ran a high fever and had seizures.
“The ambulance never arrived, and my son was about to die, because his face was getting all black,” she says. “I took a taxi right from there and we went to the hospital.”
And in February 2015, her 9-year-old daughter suffered a shock when she touched a bare power cable. Again, she says, no ambulance came, and she took her daughter to a hospital via taxi. Her daughter needed five days in intensive care.
López says her neighbors assume no ambulance will come, so they try to get to the hospital by other means.
Slum violence is worst in areas controlled by drug traffickers, Marín says.
Drug traffickers take over the territory in which they operate, he says. Their control of their area makes it difficult for social workers, doctors and government organizations to carry out their missions.
In high-crime slums, Marín says, doctors no longer expect to be treated with respect for their intentions and wellbeing.
“This has to do with who runs the slum and how he or she does it,” he says. “The state has no control there.”
Organized, large-scale drug trafficking has risen over the past five years, Marín says.
GPJ contacted the Ministry of Security on four occasions to confirm this information and ask about the law enforcement strategies implemented in slums. Elizabeth Bak of the agency’s Communication Department says she is “not authorized” to disclose that information.
The Metropolitan Police force has been carrying out operations aimed at eradicating drug trafficking in the south of the city for more than nine months, according to the agency’s website.
The inhabitants of slums and precarious settlements confirm the rise in drug trafficking in their neighborhoods. They perceived it as rising 50 to 60 percent from 2010 to 2014, according to “Increased Drug-trafficking in Slums, Severe Addiction Problems in Families and Populations at Risk,” a report published by the Argentine Pontifical Catholic University in May 2015.
Leoncia Laino, who has lived in the Villa Zavaleta slum for 42 years, says she has witnessed drug dealers growing in number and gaining more power in the neighborhood over the past year – despite the presence of law enforcement agencies.
“There are the gendarmes, and it’s as if there was nobody,” says Laino, 46.
Marcelo Munilla Lacasa, the prosecutor for the district that includes the Villa Zavaleta and 21-24 slums, also says drug trafficking has grown stronger and more violent.
The drug trade causes collateral damage, putting emergency personnel at risk and keeping innocent slum residents from getting the emergency care they need, he says.
The ideal solution would be to eradicate slums and drug trafficking, Marín says.
“But they are things that are too ambitious,” he says.
To empower its employees, SAME two years ago began requiring training in responding to high-risk situations.
Instructors, including a psychologist specializing in violence, train emergency responders to de-escalate violent situations, Murillo says.
Gilardi urges slum inhabitants to respect and protect the medical personnel who strive to serve them.
“If we as a society take care of the health team, the health team will take care of us,” he says. “We want to use a white coat and not a bulletproof vest.”
Fernanda Font translated this article from Spanish.
KAMPALA, UGANDA – Justine Nantume lounges on a flowery woolen carpet in the break room at NBS Television, a station where she presents a program on marital issues.
Her legs are stretched before her, the left crossed neatly over the right. She holds a piece of white paper folded at both ends to represent female genitalia.
“Do you know how many holes exist in a woman’s private parts?” she quizzes this reporter.
“They are four,” Nantume says, pointing to the folded paper.
“They all bring in air,” says Nantume, explaining why she advises women to stretch their labia minora. “That is why pulling closes in and keeps the vagina warm.”
Nantume, 43, is a traditional sex education therapist – in the Luganda language, a ssenga.
As a child in Masaka, a district in Uganda’s Central region, Nantume watched her mother, a traditional birth attendant, prepare teenage girls for marriage.
When she grew up and moved to the capital, Kampala, Nantume realized that most women were getting married without the traditional preparation, which includes sex education, advice on relating to one’s husband and in-laws, and instruction in cooking and cleanliness; in some communities, ssengas teach their students how to stretch their labia minora, a traditional practice that many people here believe enhances sexual pleasure.
Nantume started offering these lessons at a fee to married women and girls preparing to marry. Fourteen years after she began her practice, her services have become so popular that she has her own show on NBS Television.
Herself unmarried, Nantume offers lessons on sex, partnership and homemaking.
One aspect of her work has come under legal scrutiny.
Nantume was arrested last December under the nation’s infamous new Anti-Pornography Act, which prohibits sexually explicit photos and videos.
In Uganda, paternal aunts – known as ssengas – traditionally prepare their nieces for marriage, teaching them about everything from housework to sex. But thanks to urbanization and modernization, many blood-related ssengas today are either too busy in the working world or live too far from their nieces to provide such instruction.
A new profession, the commercial ssenga, has emerged to fill this gap. About 40 registered ssengas offer their services in Kampala.
But the work of professional ssengas has come into conflict with Uganda’s controversial Anti-Pornography Act of 2014, which prohibits sexually provocative images and behavior, such as wearing revealing clothing.
Nantume is one of two Kampala ssengas arrested in the past six months on suspicion of producing and distributing pornographic materials. The defendants say the materials in question provide basic sex education.
The traditional ssenga system ensured that girls had sufficient knowledge of sex and relationships before getting married, says Florence Muhanguzi, a gender specialist and lecturer at Makerere University.
Ssengas took their nieces through this process before they turned 16. Traditionally, ssengas also were responsible for ensuring that their nieces remained chaste until marriage, Muhanguzi says. Among the Baganda people of the Central region, a ssenga would collect bed sheets after the wedding night to check for blood stains – evidence the bride had gone to bed a virgin.
In some tribes in western Uganda, such as the Bafumbira and Banyarwanda, ssengas have long taught their nieces to elongate their labia in preparation for marriage.
The traditional ssenga system has waned in Uganda, especially in urban areas.
“I can’t tell when these cultures started dying out, but they are no more,” Muhanguzi says.
Professional ssengas, or sex education therapists, have emerged in Kampala and other Ugandan cities, offering traditional ssenga instruction for a fee. Ssengas give sex talks at bridal showers, in their own homes, at women’s workshops and on TV.
About 40 professional ssengas are registered at a Kampala cultural center, Nantume says. Their clients include married women and single adult women as well as teenage girls.
Nantume sees anywhere from 15 to 100 clients a week at her home. When she holds group sessions, that number can go as high as a thousand. A session takes half a day.
Most of her clients want to learn how to elongate the labia minora, a practice that Nantume and her peers claim keeps the vagina warm, making sex more pleasurable.
“They like that most,” she says. “Their husbands bring them here for me to teach them.”
She gives clients a powder made from a local herb, mperewe, to apply when stretching the labia.
But Dr. Elizabeth Sunya, a gynecologist at Nkozi Hospital in Mpigi, a district neighboring Kampala, says elongating the labia has no known medical benefits. (The practice also has no known negative effects, Sunya adds.)
Nantume offers postpartum mothers another local herb, kagyampuni, to tighten their vaginas.
Joyce Kawuku, another professional ssenga in Kampala, entered the field to fill a need. The operator of a beauty clinic, Kawuku started offering marital preparation lessons and sex lessons after many of her clients inquired about such services.
In her marital preparation lessons, she teaches young women how to relate to their husbands and in-laws. In sex therapy sessions, she teaches them how to have sex, the roles women play during sex, and how to make sex pleasurable. Kawuku, who offers both half-day and full-day sessions, instructs about 50 women a week.
Kawuku also gives sex talks at four to six bridal showers a month. During the holiday months of April, August and December, she attends up to 12 showers. She charges 150,000 shillings ($50) a session.
Virginity is still cherished in Uganda, but it is less common for women to be virgins when they marry, Kawuku says.
To help, she sells women soaps that she claims will tighten their vaginas, giving the illusion of restored virginity, and provide other benefits, such as enhancing their sexual urges. She makes the soaps with natural ingredients such as eggs and pawpaw leaves. The soaps, which she sells for 5,000 shillings ($1.60) to 8,000 shillings ($2.50) apiece, are popular with unmarried girls, she says.
While their work is sought after, professional ssengas are running afoul of the strict anti-pornography regulations Uganda enacted in February 2014.
The law forbids the production, publication or broadcast of pornographic content. Violators can be fined up to 10 million shillings ($3,000) and imprisoned up to 10 years. The law – last year dubbed Uganda’s miniskirt ban – even forbids sexually suggestive attire and public conduct.
Nantume and another ssenga, Mariam Ndibasa, were arrested for allegedly producing and distributing pornographic materials.
Nantume was arrested in December 2014 while conducting a training in her home, she says. She was in police custody for one night.
Police said videos sold at a local market led them to Nantume. The videos allegedly feature her voice and provide a phone number for her.
Nantume denies producing the videos. She does produce audiotapes with sex lessons, but someone must have added visual sexual content to some of the tapes, she says.
She says she was producing the audiotapes long before the anti-pornography law was enacted.
“I did not know it was a crime to teach couples how to better their marriages and sex lives,” she says.
Ndibasa was arrested a few weeks later, on Jan. 8, and spent two days in jail. She too is accused of producing videos with sexual content.
Fred Enanga, press officer for the Uganda Police Force, says the Nantume and Ndibasa investigations are ongoing. Once police obtain enough evidence, both will be charged with producing and distributing pornographic materials, he says.
Teaching women about sex using images of any kind does run counter to the law, Kampala attorney Peruth Nshemereirwe says, stressing the broad reach of the law.
Recording artists have been arrested for producing music videos containing nudity or clothing deemed risqué. Even private individuals whose nude photos were leaked online have been arrested, she says.
Calling porn and immodesty inducements to commit sex crimes, members of Parliament say they crafted the law to protect women and children, according to the Parliament website.
Many women, however, support the work of ssengas, saying it makes them better wives.
Jalia, a Kampala mother of two who requested partial anonymity to avoid stigma, says her marriage would not have lasted had she not visited a ssenga.
“My friend, these ssengas are helpful. I would not be having any marriage if it was not for ssenga Nantume. Hmmmmm,” she sighs, adding emphasis. “I got married when I did not know anything. My father has no sisters, and my mother did not talk to me about these things.”
Before she received instruction, Jalia found sex painful. She often experienced bruising. She began to resent sex. Three months into her marriage, Jalia’s husband asked her to seek the services of a commercial ssenga.
Nantume gave her sex lessons and some herbs to use in elongating her labia minora. Jalia says sex became more pleasurable for both her and her husband, who have now been married for four years.
Juma Ssentongo, a butcher who works in Luzira, a Kampala suburb, says his wife became better in all of her wifely duties after a ssenga gave her some lessons.
Women trained in marriage manage homes better, Ssentongo says.
“Ever since my wife was trained by a ssenga, she is more neat and organized and can handle the kitchen and bedroom better,” he says, smiling.
Some women, however, do not see the necessity of ssengas.
“If children are not taught how to suckle, then why should adults be taught about sex?” says Linda Nabwete, a mother in the Kampala suburb of Gayaza.
Ssengas who train women to elongate their labia seem to be challenging God, Nabwete says.
“I think God who created us the way we are was not wrong,” she says. “If he knew we needed extra parts, he would have created them.”
Margaret Ntakirwa, a 35-year-old business woman in Bwaise, a Kampala slum, abhors the culture of elongating labia. Ssengas assume that every woman will get married to a man who likes elongated labia, she says.
“Suppose one marries a man who hates them, do they have to go for surgery to remove those extra things that have no biological name?” Ntakirwa shouts. “If one happens to marry a man who likes elongated labia, he should pull them himself.”
She says ssengas are more interested in making money than promoting morals and good marriages.
But Nantume defends her profession, saying not all ssengas are interested in money. Some are dedicated to tackling marital issues, she says.
Muhanguzi, the gender specialist and lecturer, says commercial ssengas could play a vital role in family planning and disease prevention. It’s unfortunate they spend their time teaching outdated customs, she says.
Nantume disagrees. She says family planning and disease prevention are better left to medical practitioners. Ssengas are not trained to offer such services, she says.
It remains to be seen if the anti-pornography law will hamper sex education in other settings.
Muhanguzi says sex lessons should be given to both young men and young women as they prepare to get married. But most Ugandan cultures teach women to please men sexually rather than teaching men and women to pleasure each other, she says.
“Gender and sexuality within marriage has a male perspective,” she says. “They want a woman to impress the man, but they don’t think the man should please the woman. In any relationship, both parties have to take charge. They all should be prepared.”
Nantume advises couples not to struggle in marriage when counselors like her are available.
“Those who have marital challenges should seek help because it is available through ssengas,” she says.
Apophia Agiresaasi, GPJ, translated some Interviews from Luganda.
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