DARESSALAAM, TANZANIA – For 32-year-old Lilian James, the biggest challenge of her job as an engineer is not the complex designs she prepares to replace the aging waste-water and sanitation system of Tanzania’s largest city, but rather the increasing sexism she experiences in the workplace.
Yet James – who works with Dar es Salaam Water and Sewerage Authority (DAWASA) as an environmental engineer specializing in wastewater – is seemingly unfazed by the chauvinism of her male counterparts.
“Some people look down upon me just because I am a woman. When it comes to expertise, they are usually surprised by my ability to solve complex engineering problems,” she says.
Perched on a swivel chair, her eyes glued to a laptop screen, James scrolls through multiple complex engineering graphics while briskly scribbling details on a piece of paper laid out on a table beside her.
She is one of the few women in the East African country to have ventured into the male-dominated engineering field. In Tanzania, very few women hold technical engineering positions like this – ostensibly, observers say, due to a lack of motivation and a common belief that engineering is a no-go area for women. “It’s a very challenging job, especially when you are the only woman working among men,” she says.
Addressing Waste-Water Health Issues
Dar es Salaam is one of Africa’s fastest-growing cities and the majority of people who migrate there end up living in squalid conditions. According to the World Bank, 70 percent of the city’s 4.4 million inhabitants live in informal dwellings prone to waste-water pollution and epidemic diseases.
In Dar es Salaam city center, the sewage networks are often wrecked by flooding during the rainy season. This forces stinking effluent up onto the streets and exposes city dwellers to pollutants, local residents say.
Lack of sanitation is one of the world’s leading development challenges. Globally, around two billion people lack access to appropriate sanitation, and around a billion have no toilet. While many city residents prefer flush toilets, the acute shortage of water in many areas makes this a distant dream.
Residents sometimes drain the sludge from their pit latrines into the Msimbazi River, contaminating both drinking and bathing water.
In the bustling Kigogo neighborhood, James dressed in a shiny orange high-visibility jacket and hard hat is supervising the construction of a new sewage system, local residents are constantly grappling with the wastewater that flows from toilets.
“We understand the problems that residents in this neighborhood go through. The installation of a new sewage system goes along with modernization of the area, which entails relocating some residents,” she says.
Changing the Narrative
James says she doesn’t always feel valued, especially by her male colleagues. “People admire looking at engineering work but don’t always appreciate the people behind that creativity,” she says.
But, she says, the engineering profession is a good fit for ambitious and visionary women who are committed to changing the world, making it more renewable and sustainable. At the moment, it is a role with few women takers in Tanzania, who view it as an “unfriendly” career choice.
However, a new breed of young female engineers are changing the male-dominated narrative in the profession thanks to a special capacity-building program supported by the Norwegian government. Under the women-only Structured Engineers Apprenticeship Programme, groups of female engineers in Tanzania are being empowered and equipped with transferable skills to fully master their chosen careers.
The initiative, which started in 2003, has already bolstered the number of female engineers in the field significantly. According to Benedict Mukama, the assistant registrar of Tanzania’s engineering registration board, the $2-million five-year initiative has helped consolidate the expertise of more than 291 female engineers.
“We aim to increase the number of women engineers and bridge the existing gender gap in the profession,” Mukama says.
Rubhera Mato, associate professor at Ardhi University’s School of Environmental Sciences and Technology in Dar es Salaam, says the university’s commitment to mentoring women in water engineering is vital. “Female students need to see their role models performing somewhere to see their path to growth,” he says. “Having women faculty serve as mentors is important to foster the next generation of women engineers.”
Angela Shayo, an electrical engineer working for TEMESA, a Tanzanian government agency, sums up the issue succinctly: “We have a serious problem in this country. Men always think they are on top of everything, even things they are not capable of doing.”
This article originally appeared on Women’s Advancement Deeply. You can find the original here.
Also, the 2015 Centers for Disease Control and Prevention’s biennial Youth Risk Behavior Survey reported that, compared to non-Hispanic white boys, black high-school age boys are more likely to have made serious suicide attempts that require medical attention.
Suicide has become a leading cause of death in the U.S. among all age groups, but particularly in youth and young adults. It is the second leading cause of death among 10- to 34-year-olds. Parents, teachers and professionals must be able to both talk about it and understand the risks for vulnerable children of any race. But those of us who work with black youth may also need to address some myths about suicide in the African American community.
For example, one such myth has its start almost three decades ago, Kevin Early and Ronald Akers’ interviews with African American pastors concluded that suicide is a “white thing” and that black people are accustomed to struggling through life challenges without succumbing to suicide. those authors concluded that black people see suicide as a “white thing” but it is a myth that black people do not die by suicide.
Based on anecdotal conversations that many others and I have heard in day-to-day conversations and that sometimes emerge in popular media, this opinion about suicide in the black community has shifted relatively little.
More importantly, black youth at risk may even be more difficult to identify than non-black youth. One study referred to college age racial/ethnic minority people, including African Americans, as “hidden ideators” who are less likely than other youth to disclose thoughts of suicide. Because suicide is occurring and at shockingly young ages, comprehensive efforts are needed to address this public health problem.
Studies suggest that stigma about mental illness and the feeling that one will be outcast further or ignored may keep black youth from sharing their thoughts. Also, public health and mental health experts may be unaware that suicide risk factors could show up differently depending on ethnic group.
Simply put, a one-size-fits-all approach does not work for identifying suicide risk. And little or no action has been taken to address the increasing crisis. As an African American psychologist, I find this frustrating when children’s lives are lost – lives that could be saved.
Unique needs in African American mental health
Most mental health services are not designed with cultural and social nuances in mind. My research team has found consistently that the challenges that black kids face in navigating dual cultural contexts may increase their risk of suicidal thoughts.
In research on adults, we found that black men and women who used more Eurocentric or individualist approaches that was more self-focused rather than managing stress via the belief in a Higher Power were more likely to consider suicide. This was not true for those who used more culturally meaningful, spiritual coping.
When there are cultural differences, therapists must be willing to “think outside of the box” to fully evaluate risk for suicide. As an example, the racism that black Americans encounter increases stress for many. Thus, their stressors and mental health issues will need different solutions and approaches than treatments that work for white people.
In another study published in Comprehensive Psychiatry, we observed different patterns of risk for black adults compared to white adults who were admitted for psychiatric care. We examined sleep-related problems, which are elevated among black Americans, and suicide because sleep issues are a serious but understudied risk factor for suicide crisis. It turns out that inadequate sleep can escalate an emotional crisis. Our research found that problems staying awake for activities such as driving or engaging in social activities, which reveal inadequate sleep, were associated with a four-fold greater risk for suicide crisis compared to non-suicide crisis in black adults who were admitted for psychiatric treatment.
Caring adults are a child’s first line of defense. If a child discloses that he is thinking about dying, it is important to ask him to share more about his ideas and if he knows he might die. If a child has a suicide plan, it is time to get professional help.
The Crisis Text Line at 741741 could be an option for teens who need help to cool down in a crisis.
When it comes to finding a mental health professional, parents need an expansive list of referral options, including university-affiliated mental health clinics that offer evidence-based services on a sliding scale and federally qualified health centers for the uninsured. Regardless of the setting, a well-trained therapist may be of a different race.
Parents and caregivers must be willing to sit, listen and try to fully understand what is most upsetting for a child who is experiencing a difficult situation and a lot of emotions.
For those who believe that the alarming statistics will eventually reverse course without any action, this may be true. In the meantime, saving one life is worth the effort.
Thoughts of suicide do not mean that a child or teen needs to be hospitalized. It means they are in emotional pain and want the pain to end. Adults can investigate the problem and remove it or help the child deal with it. Online resources such as Stopbullying.gov include interactive videos that are useful to parents, educators and youth. Suggesting to a child that she “get over it” is less than helpful. A child who is already in a vulnerable state cannot problem-solve without meaningful support from the caring adults in charge.
As a result King’s words and work are still relevant. I study the civil rights movement and the field of peace geographies. Peace geographies thinks about how different groups of people approach and work toward building the kind of peaceful society King worked to create. Americans faced similar crises related to the broader civil rights struggles in the 1960s.
So, what can the past tell us about healing the nation? Specifically, how can we address divisions along race, class and political lines?
Martin Luther King Jr.‘s understanding of the role of love in engaging individuals and communities in conflict is crucial today. For King, love was not sentimental. It demanded that individuals tell their oppressors what they were doing was wrong.
King spent his public career working toward ending segregation and fighting racial discrimination. For many people the pinnacle of this work occurred in Washington, D.C., when he delivered his famous “I Have a Dream” speech.
Less well-known and often ignored is his later work on behalf of poor people. In fact, when King was assassinated in Memphis he was in the midst of building toward a national march on Washington, D.C., that would have brought together tens of thousands of economically disenfranchised people to advocate for policies that would reduce poverty. This effort – known as the “Poor People’s Campaign” – aimed to dramatically shift national priorities to address the health and welfare of working people.
Scholars such as Derek Alderman, Paul Kingsbury and Owen Dwyer how King’s work can be applied in today’s context. They argue that calling attention to the civil rights movement, can “change the way students understand themselves in relation to the larger project of civil rights.” And in understanding the civil rights movement, students and the broader public can see its contemporary significance.
Idea of love
King focused on the role of love as key to building healthy communities and the ways in which love can and should be at the center of our social interactions.
King’s final book, “Where Do We Go From Here: Chaos or Community?” published in the year before his assassination, provides his most expansive vision of an inclusive, diverse and economically equitable U.S. nation. For King, love is a key part of creating communities that work for everyone and not just the few at the expense of the many.
Love was not a mushy or easily dismissed emotion, but was central to the kind of community he envisioned. King made distinctions between three forms of love which are key to the human experience: “eros,” “philia” and most importantly “agape.”
For King, eros is a form of love that is most closely associated with desire, while philia is often the love that is experienced between very good friends or family. These visions are different from agape.
Agape, which was at the center of the movement he was building, was the moral imperative to engage with one’s oppressor in a way that showed the oppressor the ways their actions dehumanize and detract from society. He said,
“In speaking of love we are not referring to some sentimental emotion. It would be nonsense to urge men to love their oppressors in an affectionate sense[…] When we speak of loving those who oppose us […] we speak of a love which is expressed in the Greek word Agape. Agape means nothing sentimental or basically affectionate; it means understanding, redeeming goodwill for all men, an overflowing love which seeks nothing in return.”
King further defined agape when he argued at the University of California at Berkeley that the concept of agape “stands at the center of the movement we are to carry on in the Southland.” It was a love that demanded that one stand up for oneself and tells those who oppress that what they were doing was wrong.
Why this matters now
In the face of violence directed at minority communities and of deepening political divisions in the country, King’s words and philosophy are perhaps more critical for us today than at any point in the recent past.
As King noted, all persons exist in an interrelated community and all are dependent on each other. By connecting love to community, King argued there were opportunities to build a more just and economically sustainable society which respected difference. As he said,
“Agape is a willingness to go to any length to restore community… Therefore if I respond to hate with a reciprocal hate I do nothing but intensify the cleavages of a broken community.”
King outlined a vision in which we are compelled to work toward making our communities inclusive. They reflect the broad values of equality and democracy. Through an engagement with one another as its foundation, agape provides opportunities to work toward common goals.
Building a community today
At a time when the nation feels so divided, there is a need to bring back King’s vision of agape-fueled community building and begin a difficult conversation about where we are as a nation and where we want to go. It would move us past simply seeing the other side as being wholly motivated by hate.
Engaging in a conversation through agape signals a willingness to restore broken communities and to approach differences with an open mind.
St. James Elementary School principal Felisa McDavid and her husband, Ray, were crushed when their son, Treylind, arrived stillborn.
Every year on her stillborn son’s birthday, Felisa McDavid blesses an unsuspecting mother and her newborn son with a gift bag full of baby items.
McDavid’s son, Treylind, was delivered on Sept. 26, 2001, in a hospital near Charleston, her hometown. McDavid and her husband, Ray, were crushed when he arrived stillborn.
“I had a couple of miscarriages before we conceived him,” says McDavid, now a Forestbrook resident. “Losing him left me very distraught, of course. And I was not able to conceive after that; I’ve not been able to have children.”
As she mourned the loss of her son, friends and family tiptoed around her wounded heart. She couldn’t bear to hear about other pregnancies or deliveries, attend baby showers or share in the joys of other mothers with newborns. She steeped in grief for years.
“It’s been quite a process to get to the point where I could even talk about it,” she says. “Even members of my family were reluctant to tell me about their pregnancies.”
The McDavids desperately wanted children after they married on June 20, 1998.
An educator with a love for youngsters, McDavid has worked with children for 28 years. She now serves as the principal at St. James Elementary School in Myrtle Beach.
After several miscarriages, the loss of Treylind following a full-term pregnancy left the couple bereaved and broken.
Felisa McDavid questioned how losing her son fit into God’s plan for her life. She asked God for direction on how to deal with the void and her feelings of hopelessness.
Although others in her situation might have chosen to adopt a child or give to charities, McDavid says she didn’t feel led in either of those directions.
Instead, she was pulled somewhere else – to the hospital where she’d lost her son.
“I wanted to know what I could do about this void,” she says. “I’m always trying to give back, and I’ve always loved children.
“God spoke to my heart. He wanted me to revisit the hospital where I’d lost my child. While I was there, I thought, ‘Wouldn’t it be nice to give something to one of these children?’”
As difficult as it was to walk into the nursery that first time since losing her son two years before, McDavid knew it was exactly where she needed to begin healing.
On the third anniversary of her son’s death, McDavid brought a gift bag to the hospital and gave it to a woman who had given birth the day before.
“We talked and I shared with her my experience,” McDavid says. “I had the gift in my hand. I asked her if she’d receive the gift. She said, ‘Yes, and thank you.’ I cried. She cried.”
A ministry was born.
The following year, McDavid, who moved to Horry County in 2003, reached out to the team at Tidelands Waccamaw Community Hospital to tell her story and explain her interest in continuing her work at the hospital.
“They just received me so well,” she says. “The nursing team made me feel good about what I was doing.”
Her visit in September 2019 marked the 14th year McDavid has stopped by Tidelands Waccamaw on the anniversary of her son’s stillbirth to deliver a gift bag filled with rattles, bibs, onesies, stuffed toys and other items.
Every bag also contains an inspirational message from McDavid about the loss of her son and how the gift bag is a way to honor his memory by blessing another child.
Susan Follrod, a charge nurse at Tidelands Waccamaw, works with McDavid and the hospital’s labor and delivery team to arrange the gift deliveries year after year. Follrod also knows McDavid in her role as principal at St. James Elementary, where Follrod’s children attend school.
“It demonstrates that tremendous good can come from tremendous loss.”
“I am amazed and humbled by Felisa and her faith, as well as the way she turned a tragedy into a blessing for others,” Follrod says. “It’s truly inspiring. I feel very fortunate knowing her, and how lucky the students, parents and staff of St. James Elementary are to have her as their principal.”
Shelly Laird, director of women and children’s services at Tidelands Health, says McDavid’s efforts speak to the resiliency of the human spirit and helps raise awareness about the tremendous impact of losing a child.
“I was touched to hear about it,” Laird says. “It demonstrates that tremendous good can come from tremendous loss.”
One mother’s loss is another mother’s blessing
For McDavid, the most rewarding part of her mission is the opportunity to meet the mother and infant who will receive her gift bag.
“There’s a connection I make to each child every year, and I pray for them on that day,” she says.
McDavid believes God allowed her loss so she could minister to others experiencing the pain she knows all too well. When a friend lost her child a few years ago, McDavid used her experience to offer comfort and support.
“I know the Lord does things for a reason,” she says. “I’ve gone through this process so I can help others. It truly makes me feel good that I can bless another mother.
“And actually, it blesses me more than I can ever bless them.”
Sitting in the afternoon heat on her mom’s porch in Athens, Georgia, Hardy recollected how a recent “crisis” derailed her normal morning routine.
“It was time for my daughter to get on the bus, and she’s too young to go on her own,” Hardy recalled. “I was in so much pain I couldn’t walk. So, she missed school that day.”
Sickle cell disease affects red blood cells, which travel throughout the body carrying oxygen to tissues. Healthy red blood cells are shaped like plump and flexible doughnuts, but in people with sickle cell disease, the red blood cells are deformed, forming C-shaped “sickles” that are rigid and sticky.
These sickle-shaped cells can cause blockages in the blood vessels, slowing or even stopping normal blood flow. An episode of blockage is known as a sickle cell “crisis” — tissues and organs can be damaged because of lack of oxygen, and the patient experiences severe spells of pain.
‘It’s Like Torture’
Hardy tries to manage these crises on her own. She’ll take a hot bath or apply heating pads to try to increase her blood flow. Hardy also has a variety of pain medications she can take at home.
When she has exhausted those options, she needs more medical help. Hardy would prefer to go to a specialized clinic for sickle cell patients, but the closest is almost two hours away, and she doesn’t have a car.
So, Hardy often goes to the emergency room at nearby St. Mary’s Hospital for relief. Until recently, the doctors there would give her injections of the opioid hydromorphone, which she says would stop her pain.
Then, some months ago, the emergency room changed its process: “Now they will actually put that shot in a bag which is full of fluids, so it’s like you’re getting small drips of pain medicine,” Hardy said. “It’s like torture.”
It’s the same for her brother, Rico, who also has sickle cell disease and has sought treatment at St. Mary’s. The diluted medicine doesn’t give the same pain relief as a direct injection, they say.
Striking A Balance
St. Mary’s staffers explain that they’re trying to strike a balance with their new treatment protocol between adequate pain treatment and the risk that opioid use can lead to drug dependence.
It’s a local change that reflects a national concern. The U.S. is in the midst of an addiction and overdose crisis, fueled by powerful opioids like hydromorphone. That crisis has made medical providers more aware of the risks of administering these drugs. More than 47,000 Americans died in 2017 from an overdose involving an opioid, according to the Centers for Disease Control and Prevention.
That has prompted some emergency room leaders to rethink how they administer opioid medications, including how they treat people, such as Hardy, who suffer from episodes of severe pain.
“We have given sickle cell patients a pass [with the notion that] they don’t get addicted — which is completely false,” said Dr. Troy Johnson, who works in the emergency room at St. Mary’s. “For us to not address that addiction is doing them a disservice.”
Johnson proposed the ER’s shift to intravenous “drip delivery” of opioids for chronic pain patients because of personal experience. His son has sickle cell disease, and Johnson said he has seen firsthand how people with the disease are exposed to opioids when very young.
“We start creating people with addiction problems at a very early age in sickle cell disease,” Johnson said.
He brought his concerns to the director of the ER, Dr. Lewis Earnest, and found support for the change. Hospital officials say they also consulted national guidelines for treating sickle cell crises.
“We’re trying to alleviate suffering, but we’re also trying not to create addiction, and so we’re trying to find that balance,” Earnest said. “Some times it’s harder than others.”
St. Mary’s says the new IV-drip protocol is for all patients who come to the emergency room frequently for pain, and most of their sickle cell patients are fine with the change.
Caught In The Crossfire
The national guidelines cited by St. Mary’s also say doctors should reassess patient pain frequently and adjust levels of opioids as needed “until pain is under control per patient report.”
Some people who work closely with sickle cell patients, upon hearing about the new approach to pain management at St. Mary’s, called it “unusual.”
It’s more common for ERs to give those patients direct “pushes” of pain medication via injection, she noted, not slower IV drips.
People with sickle cell disease aren’t fueling the opioid problem, Andemariam said. One study published in 2018 found that opioid use has remained stable among sickle cell patients over time, even as opioid use has risen in the U.S. generally.
“If anything, individuals with sickle cell disease in our country have really been caught in the crossfire when it comes to this opioid epidemic,” Andemariam said.
She suggested that ER doctors and nurses need more education on how to care for people with sickle cell, especially during the painful crisis episodes, which can lead to death.
A study of some 16,000 deaths from 1979 to 2005 related to sickle cell found that men in the group lived to be only 33, on average. Women didn’t fare much better, living to an average age of 37. The same study suggested that a lack of access to quality care is a factor in the short life spans of people with sickle cell disease.
Researchers who study sickle cell say the opioid epidemic has made it harder for patients with the condition to get the pain medication they need. The American College of Emergency Physicians is focusing on the problem, asking federal health officials to speak out about sickle cell pain and fund research on how to treat it without opioids.
“We in the physician community are looking for ways to make sure they get adequate pain relief,” said Dr. Jon Mark Hirshon, vice president of the group. “We recognize that the process is not perfect, but this is what we’re striving for — to make a difference.”
Considering A Move To Find Relief
In the meantime, India Hardy said she feels those imperfections in the process every time she suffers a pain crisis, and she’s not alone.
In addition to her brother, Hardy said she has another friend in Athens with sickle cell disease, and that friend has also reported difficulty in finding pain relief at the St. Mary’s emergency room.
“It’s just really frustrating, because you go to the hospital for help — expecting to get equal help, and you don’t,” Hardy said, her voice breaking. “They treat us like we’re not wanted there or that we’re holding their time up or taking up a bed that someone else could be using.”
Hardy filed a complaint with the hospital but said nothing has changed, at least not yet. She still gets pain medication through an IV drip when she goes to the St. Mary’s emergency room.
At this point, she’s considering leaving her relatives and friends behind in Athens to move closer to a sickle cell clinic. She hopes doctors there will do a better job of helping to control her pain.
Since 1986, the third Monday of January has been reserved to commemorate the birthday, life and legacy of one of the nation’s greatest leaders, Dr. Martin Luther King Jr.
Dr. King—a Baptist preacher, scholar, and arguably the greatest leader of the Civil Rights Movement, selflessly fought for the equal rights of not only African Americans but all people.
In a time when Jim Crow and legal segregation were the law of the land, Dr. King became the face of a movement that sought to dismantle the institution of racial injustice. He advocated for persons in poverty, spoke against the Vietnam war, and worked to ensure that all Americans had equal rights and protections under the law. Nearly 50 years after Dr. King’s assassination, his legacy lives on.
Although MLK Day is a national holiday, the ways in which people choose to celebrate—or not—are endless. Many schools and organizations across the nation will have the day off and/or host an MLK Day program, while others may participate in a community service project or attend city-wide marches and rallies.
Just Another Day Off?
As our nation continues to fight issues of social injustice and racial tension, many question whether or not the ideals memorialized on MLK Day—a day of peace and tolerance—hold true throughout the year.
“We need to understand as a country that what [Dr. King] fought for still needs to be fought for today,” says Thomas McElroy, a long-time musician from Seattle Washington. “The path towards a country united under the principals he laid down for all of us still needs to be worked on.”
So, the question becomes, does MLK Day hold any true meaning in present-day society? Or, has it been reduced to a day off from work and school?
According to Erin Jones, “We have turned the day into an opportunity to rehearse the ‘I Have a Dream’ speech.”
“I can honestly say that, personally, I have never celebrated the holiday and have taken it as a vacation day,” says Elisabeth Scott, a recent college graduate of Western Washington University. “It wasn’t until going to my current church, that I participated in an MLK service. Had I not sung [during service], I probably wouldn’t have attended.”
However, Sergeant First Class Derek White, a 16-year member of the armed forces still sees the value in MLK Day, and what it means to the future of our society.
“I think that MLK being observed most definitely holds weight for both older and the younger generations. One way to ensure that our past does not repeat itself is by honoring people like Dr. King and his legacy and what he fought for and stood for.”
The Importance of Generational Knowledge
As an educator, Erin Jones argues that celebrating MLK Day does not have the same significance for young people today.
“Students have no context to understand the gravity of what Dr. King and his peers accomplished,” the educator says. “That being said, I believe it is our responsibility to communicate the value of this holiday, which is why I agreed to speak at so many schools.”
As a professional mentor to students, Jessica Crenshaw believes in giving back to the community but admits that she does not celebrate Martin Luther King Jr Day—for many different reasons.
“I do not celebrate MLK day as a holiday because I feel the significance of the day has been diminished,” Jessica says. “I feel it has been cheapened down for a “get-off-of-work-free card.”
For Jessica, an authentic celebration of MLK Day should include not only service to the community, rallies, and celebration events, but should serve as a day to reflect and organize for long-term change.
“I feel as if people should really take time to reflect over what Dr. King was trying to accomplish, and actually sit down and have planning meetings to plan out actions to make sure that his dream gets fulfilled,” she says. “Concerts and protests are good, but if you don’t continue to do this work after January 20th then you’re not doing it for a real reason.”