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Telling the Story:
Three Faces of Reality

Here are three illustrations of the Facts of Life as real people have experienced them.

Grace Delano literally wrote the book on reproductive health for Nigeria. She is a nurse-midwife who heads reproductive health programs in Africa's most populous country. She can attest to the effectiveness of spending on reproductive health and contraceptive services. She can also document the tragedies that occur when funds are curtailed. She wrote the manual on reproductive health in four languages. In a few short years, she saw the prevalence rate for contraception rise from 10 percent to 20 percent of the population. But the advent of AIDS in her country, as well as political instability, led to a cutback of funding for reproductive health care-and the contraceptive prevalence rate dropped to 12 percent.

"The saddest thing is that we have rightfully created a demand for family planning by the poorest of the poor. Now they cannot get what they know is so important for the well-being of their families," she said. The rate of infant and maternal mortality is on the rise once again, and unsafe abortions threaten the lives of thousands. Yet Grace Delano remains optimistic. The network she helped create has changed the lives of millions of Nigerians, especially Nigerian women. They helped register over a million women for the recent elections, and they negotiated an agreement with the government to ensure that up to 30 percent of non-elected office holders on the municipal level will be women.

Roksana Kahondokar is a lawyer in Bangladesh. In 1974, the prevalence rate for contraception was 3 percent there. Today, 60 percent of the population uses contraception. Over the last 25 years, information has been passed from woman to woman, household to household. Lives are being changed. A country is being changed. As head of the Khan Foundation organization, she says, "Family planning leads to economy planning leads to nation planning. And central to it all is the changing role of women. After all, a country cannot develop with the participation of only half its citizens."

Tomás Jimenez Araya is head of the UNFPA office in Managua, Nicaragua. Half the population of Nicaragua is unemployed, and 70 percent of the people live on less than a dollar a day. The country is growing at a rate of 2.85 percent per year, one of the highest rates in Latin America. Yet Jimenez Araya will tell you there has been great progress: in the last several years, family size has fallen by a third, and life expectancy has risen from 55 to 68 years. And infant mortality has been halved since 1970.

Jimenez Araya has been described as "a master of the art of the possible," a major force for change. With a staff of just 11, including only five professionals, he helped link the Adolescent Center for Reproductive Health at the Bertha Calderón Hospital in Managua to 1,500 such centers nationwide. Through this outreach, 2,200 secondary school teachers have received training in sex education and reproductive health issues. The number of unsafe abortions and maternal deaths among adolescents has begun to drop, and Jimenez Araya is confident that conditions nationwide are bound to improve.

September 1999