17/11/2011 12:39 GMT | Updated 16/01/2012 05:12 GMT

Generation Y - Sick of Poverty and Bad Health

Booking your next holiday to Ethiopia? You're bound to receive countless offers to travel to the ethnically diverse south west of the country.

You're told that you will not only take in the beauty of the Rift Valley, but will meet one or several of this region's approximately 45 tribes, each with their own distinct languages, rich cultures and traditions.

Then come the travel industry's well-known disclaimers: Only in the extraordinary event that a local ceremony such as the bull-jumping or Evangadi dancing is coincidentally taking place during your travels will you be visiting a Hamer or Karo village to observe it.

Evangadi is a dancing event during which teenagers attempt to woo each other. This is an important part of the process of growing up where they are expected to gain sexual experience with as many others as possible. The higher the number of sexual encounters a girl has had before marriage, the more desirable a wife she will traditionally be considered.

When the zone of South Omo was only reachable via dirt roads and the ethnic groups living there interacted predominantly with each other, there were negative health effects from cultural practices.

But read a report about HIV/AIDS in this same region today and the facts will present themselves very differently.

Evangadi is no longer only performed during harvest time, but rather is organised for visiting tourists on multiple occasions across the year. It is not only in isolated incidences in which tourists have sex with these young people.

Add to this the number of workers that come with the new roads and you will quickly grasp the consequences of an increasing number of ceremonies involving unprotected sex for HIV-infection.

One big paradox in many of these cultures remains: You're more attractive for having had lots of sexual experience, but you're never to fall pregnant before marriage. The harmful practice of forced abortion by heavily massaging the abdomen affects approximately 25% of women in South Omo.

It is easy for us to judge these practices but they are as deeply engrained in people's cultures, as is the Friday night out on the binge or marrying the person you love in ours.

Improving people's health outcomes thus involves working with these cultures and supporting people to become agents for change from within.

Health Poverty Action does exactly that in 13 developing countries in Africa, Asia and Latin America where it supports the poorest and most marginalised communities in their struggle to achieve their right to health.

In South Omo, Ethiopia, the organisation has trained over a hundred health extension workers to facilitate community conversations on the different ways one can become infected with HIV, prevention and the benefits of voluntary testing, including early entry into a treatment regime.

Peer educators demonstrating condom use to their friends and neighbours is much more effective than a single visit from an outsider - after all they can credibly claim to be using condoms themselves as part of their culture.

Or look at Bai Dejene - one of 35 traditional healers trained by Health Poverty Action because they are such well-respected community members and are often the first port of call for those seeking health-related support.

The 45-year old says of his training: "After the training I started to boil the sharp materials that I use while providing the services. In addition I provide education on HIV issues and refer those who volunteer to testing services".

Among these semi-nomadic pastoralist communities over 60% of people are illiterate. Raising awareness about issues such as HIV and AIDS thus is an essential way of empowering them to make their own decisions and to demand the necessary health services from the authorities.

Health Poverty Action takes a similar approach in other marginalised parts of the world. In Nicaragua, for example, the organisation works with youth and adolescents to improve their access to sexual and reproductive rights.

Nicaragua has the second highest teenage pregnancy rate worldwide, and the communities in the North Atlantic Autonomous Region, where Health Poverty Action works, have the second highest fertility rate in the country. They occupy first place in the country's maternal and perinatal mortality rates.

The participation and empowerment of the communities and especially of their youth is considered one of the key factors in reducing the number of adolescent pregnancies by 5%.

Dayling del Socorro Torres Jarquin, for example, is a Municipal Youth Council member who also presents a youth radio programme which addresses health issues. She says "We are a new generation and we must bring about positive changes. I bet our community will not be the same in 20 years for our children". Her commitment encourages others and that is what Health Poverty Action works for.

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