War Against Women Rages on as Kenyan women forcibly sterilised for having HIV

 

A few weeks ago, I published here a debate on weather contraceptives for Africa was a misplaced priority. While some sceptical persons like myself were of the opinion that Africa needed more education rather than pills, there were some who thought we were denying women their rights. Looking at this disturbing story by Maeve McClenaghan, I could not help but wonder.

Women deserve the right to Choose

Is there really a war against Africa’s future going on under the guise of protecting women?

If women can be sterilised without their knowledge, even when they are not at risk of having many kids, does that not account to the worst violations of their rights?

With NGOs like the US-based  Project Prevention  paying women living with HIV to have intrauterine birth control devices implanted, who is to say that the whole rhetoric about birth control in Africa is not clearly another silent war against the continent?

I am sure by the time you finish reading this story, you will ask many more questions – so happy reading!!!

They say “NO TO FORCED STERILISATION”

When she went to hospital to give birth Amani had a lot on her mind. Not only are maternal mortality rates in Kenya worryingly high but during an ante-natal check-up Amani had been told that she was HIV positive. The expectant mother was reassured that delivering the baby by caesarean section was the safest way to avoid transmission of the virus to her child. So as she was wheeled in to the operating theatre she could be forgiven for thinking she was in safe hands. But her trust was misplaced. During the procedure, and without her knowledge or authorisation, Amani was sterilised.

She only ever found out what had happened by chance. ‘I discovered that tubal ligation had been done when I took my baby to the clinic after delivery,’ Amani said. ‘The nurse requested me to allow her to examine my wound, and in the process a colleague passed by and asked how the tubal ligation scar was healing. I did not know about it and only thought they had cut me because I was having a baby.’

Amani’s is not an isolated case. A new report by NGO African Gender and Media Initiative details 40 case studies of Kenyan women who have undergone forced or coerced sterilisation because they were HIV positive.

‘I thought they had cut me because I was having a baby’
Amani

The report makes shocking reading, some women find their husbands signing the medical papers, allowing doctors to perform the irreversible procedure to tie their fallopian tubes. Others unwittingly sign documents thrust in front of them during the chaos of labour, only to later discover what they had signed up to.

Several of the women interviewed reported being mistreated by the health care workers trained to support them. Nekeska gave birth in 2008 at Kakamega General Hospital. There she faced a barrage of abuse. According to Nekeska the doctor told her ‘It is an offence for women who are HIV positive to have children’ and said she was told she could only have the baby she was due to deliver if she agreed to be sterilized. Nekeska put up a fight and refused to sign the consent papers, but was sterilised anyway.

Many of the women coerced or forced into sterilisation report finding themselves ostracized, cast out from their martial homes with the double burden of infertility and their HIV status. Amani’s husband died of Aids in 2004 leaving her and her daughter. ‘In the last few years I have had three suitors but I had to stop the relationships because if I get married to them, then I will be abandoned when they discover I cannot have children’, she said.

According to the 2007 Kenya AIDS Indicator Survey nearly one out of every ten pregnant women in Kenya is infected with HIV. Children less than 15 years of age account for 16 percent of all HIV infections; most of these infections were acquired through mother-to-child transmission. However, the chances of HIV transmission from mother to baby can be virtually eliminated through use of anti-retroviral drugs during pregnancy and labour, and by delivering the baby via Caesarian section.

NGO involvement
The report follows a Kenyan television news report in January which claimed that a US-based organisation Project Prevention was paying women living with HIV to have intrauterine birth control devices implanted. The Kenyan government reacted angrily to the news with the minister for medical services, Peter Anyang’ Nyong’o, announcing ‘It is important to stress that even HIV-positive women have the right to have children if and when they desire. HIV doesn’t take that right away, not at all.’

However it is both local health care workers and international NGOs that are implicated in this new report. Provision from Medicin Sans Frontier and Marie Stopes is mentioned in some of the women’s testimony.

Betty discovered she was HIV positive in 1993. She had just given birth to her fourth baby when community health workers visited her home and she claims she was then asked to accompany them to meet Marie Stopes doctors. Hoping she might receive financial assistance from the NGO she went along to the mobile clinic. Betty reports that there she was given forms to sign but she says ‘No one told me what I was signing for. I thought it was part of the registration.’ She was then operated on. After the procedure she was told community health workers had earmarked her as someone who should be sterilised because she was HIV positive and had no husband or income.

Marie Stopes responded to the report stating that ‘The process described by Betty is absolutely contrary to Marie Stopes International’s values, policy and practice on informed consent. We take any non-compliance on this issue extremely seriously.’ The NGO goes on to state that some of the case studies highlight that the sexual health body can ‘work with organisations who refer clients to Marie Stopes Kenya to strengthen their policies and practices around informed consent, and this is something we will seek to do immediately.’

A growing trend?
This is not the first time the issue of forced sterilisation has made the news. In June The Lancet reported on a government led sterilisation drive is Uzbekistan designed to control population growth. According to the report doctors received monthly sterilisation quotas and admited to tricking or pressuring women into the decision, or performing the operation without their consent, during caesarian sections.

The Uzbeki government firmly denied the reports.

 

Contraceptives for Africa – A Misplaced Priority?

English: Logo of the Bill & Melinda Gates Foun...
Bill & Melinda Gates Foundation. Source: 2007 Annual Report (Photo credit: Wikipedia)

The past week has been a stormy one for me on an intellectually stimulating Facebook Group Perception. The most challenging discussion has been the issue of 2Billion Dollars worth of Contraceptives that is being sent to Africa by the Gates Foundation and the UK government over the period of 8 years.

WORLD CONTRACEPTIVE USE

Despite being a Catholic (who should according to her religion denounce any form of modern contraceptive), Melinda Gates argues that this is going to be a milestone in curbing the rate of women dying in the continent due to child birth. While it can be argued that statistics support her, given that a study of 172 countries published in the medical journal The Lancet says that although bleeding, infections and other problems are the leading causes of mothers dying during pregnancy and childbirth in developing countries, “family planning is the primary intervention to prevent maternal mortality.”

The Lancet study further argues that family planning is already responsible for the prevention of a record 270,000 maternal deaths annually. These statistics are further given credence by the prime ministers of Rwanda and Ethiopia who state that more than 40 million women in sub-Saharan Africa would like to stop or postpone childbearing but have no means to do so.

Unfortunately, contrary to the research stats and the views of the Rwandan and Ethiopian PMs, opinions in African seem to be divided about the seemingly wonderful project.

Before I make any analyis on the situation, it will be good to look at some of the reactions posted by Nono Nkele on Perception.

***************** CAMEROON: *************

This is a misplaced priority. The world’s poor do not need this. What they need is basic necessities like potable water, electricity, decent and accessible healthcare, quality good roads, quality education for their children and accountable governments who do not steal their tax and national resources but they use them to enhance their quality of life. These monies will just end up subsidizing the pharmaceutical industry in Europe and America.

GOD SAYS GO AND MULTPLY WHY ECONOMISE? I thick it those with empty wallats who are advocating for contraceptives.

******************* GHANA: ******************

If abortion means killing, then the use of contraceptive like condom is kidnapping since the semen is trapped

I do support family planning. But it has not received much attention because of the misconceptions about its practice. It’s sort of looked at as something that will cause more harm than good in the end and so people are not patronising it at all. It is only found among the elites and the slightly educated folks around. I pray it will get the needed attention to help save our women and our mothers.

I think the issue is not about one supports family planning or not. Let us be fair to ourselves and stop this craze for wholesome acceptability of everything from this white people. How do you expect Bill and Melinda Gate Foundation to give you their millions of dollars for free when their own citizens are living in constant fear of joblessness and poverty? There cannot be any free meal and I don’t believe all of them. Until Africans are consulted in some of these things (not the elite) this effort will be in vain. It is not real!

I think is good and would help mothers and teenagers in Ghana

***************** UGANDA: ******************

Our president together with the first lady are doing much to see that people get to know as well as putting it in use, with those deep in villages coz many shun away after hearing it’s disadvantages but most of them are trying to use it. I think it’s ok to be brought and used in Africa coz the growth of our population is failing to be managed and think that it’s the best way to control all it’s disadvantages.

Some new drugs have been manufactured so lab rats are getting readied for tests

The hardest and most worrying state of it is that when financial or medical support lands in the hands of the corrupt officials in government. The poor will only hear about it but not giving them freely or cheaply

Africa is a third world nations with many diseases of no proper treatment, therefore we can produce many children as well so that disease will kill the rest while other remain

********************** KENYA: *****************

No! God is planning for us.

After getting educated most of us don’t understand ‘intercontinental politics’, VERY UNFORTUNATE. As a Registered Nurse I will not buy that idea contrary to my profession. Every child must be born and in turn must multiply is my greatest believe. What is the essence of believing in God and at the same time you want your own way of procreation. Yes I agree that too many births have its own challenges but what do you understand by ‘NATURAL FMLY PLANING’?. Why don’t they talk of ‘health services, proper sanitations, improved lifestyle’? I believe they are up to something, two billion dollars for free? NO DAY. I was raised too disagree with manmade family planning but strongly believe in NATURAL

Family planning is not yet welcome in my country. People are still ignorant about the benefits of it. Especially those in the rural areas are against it as they view it negatively. There is also major cultural and religious aspects to the whole issue of family planning. The priority is creating awareness on the need for family planning especially to the poor and vulnerable in rural areas as well as the urban poor who often have large families that they cannot cater for adequately

FAMILY PLANNING, exclusive breastfeeding and polygamy. These are the solution not Millions of dollars.

********************* NIGERIA: ****************

If there is only one country that supports birth control, that country should be Nigeria. Looking at the level of inequalities in allocation of resources and high level of illiteracy, particularly in the northern parts, the birth control policy could have been a good option of ameliorating our plights. But, because of religion sentiment and extremism, some unpatriotic Nigerians are seriously kicking against it.

The crucial question we must answer is Why do third world countries have a higher population growth than the developed countries? Britain did not talk of birth control until she put two things in place; free education and socialised medicine. What is family planning to a young girl or boy in a remote village whose stock in trade is to eke out a living by hawking in the street. Children are social safety nets and security to an average family in Africa. I am skeptical of developed countries’ patronising do-gooders. Money ploughed into these laudable projects may not filter to those who really need it. My take is (i) provide free and compulsory education accessible to all (ii) free medical services to the poor, children, and elderly (medi-aid, medi-care) (iii) use the media to inform the people of government programs.

Over population is one of developing countries greatest challenged.

Advocating birth control without explaining the benefit is a failure in itself never rely on Nigerian Government to pick your map and locate these rural communities if you wish to attain any meaningful impact

As it is in Nigeria now you don’t need to be told before you go for family planning because the standard of living over here is unfavourable to polygamous families

********************* MALAWI: ***************

Ha ha ha why do they have so much attention on Africa, why don’t they Use that Money in providing good housing and sanitation services in the areas they deem over populated. They should try China, it is exporting to many people to Africa. Or that Money should be used for sound and transparent economic reforms that can be favorable for all Africans, that is if they do that in True faith. Instead of contraceptives they should be aiming at building better hospitals, health centres and provide midwifery training in rural areas, buy ambulances and introduce other convenient services that would reduce maternal deaths. Africa is not only found in the Cities and Town Centres. Africa is in my village, where people do not have proper health services, Proper water ETC. I couldn’t agree more with this view notwithstanding I am for promoting contraception in Africa

I am sure that One’s mind is a Contraceptive on its own, it just needs to be well equipped, You tell people about contraceptive in my village they will laugh at you. Some of us are able to understand the goodness of contraceptives because we have learnt to equip our minds with knowledge, good and health life. We do not need contraceptives, we need services that can transform and change people’s mindsets. Otherwise transformation as an objective won’t arrive home…..otherwise, Africans are really African in their African Environment.

Contraception is anti-God. I support family planning but doubt if it is getting the attention it deserves

It’s not you who takes care of life but God alone. You have to read Mt 6:24-34(This is why I tell you not to be worried about the food & drink you need in order to stay alive,or about clothes for your body…..)

******************** ZAMBIA: ******************

Use of condoms, child spacing, pill and many others.

I live in rural Zambia and I work in a hospital and work mostly with pregnant mothers. My observations is that most women in rural areas don’t understand how some contraceptives work, and some can’t access the family planning drugs because they have to walk very long distances to the clinic/hospital. With proper education and easy access..It can work effectively.

Developing countries such as zambia were most of its population survives on less than a dollar per day and looking at the income per house hold family planning is inevitable. I support family planning because that’s the only way we can slow down the fast growing population in Zambia and Africa at large.

******************* SIERRA LEONE: *************

I support it and I hope the Catholic Church will get out of the way and stop misinforming people about its use

In my country where I live, Sierra Leone do accept and take family planning, contraception seriously, youth both male and female counterpart do prevent themselves from unwanted pregnancy except for teenagers who may not aware of it.

************** SOUTH SUDAN: ******************

Our population in our sub region is fine we don’t need family planning but we need basic needs like health, support agriculture ,roads, regional market, education etc.

Yes if it is true, then my country South Sudan should be served the first because it is one of the poorest Countries on the planet due to it being the youngest nation with the majority of the population under 25yrs.

It will really help my people in South Sudan, because we are still using traditional midwifes & our ladies are always victim.

**************** SOUTH AFRICA ***************

To the benevolent Foundation, thanks. But no, thanks. We are aware of the agenda of depopulation being pushed in the name of economy and helping us to better manage our families. It does not end with contraceptives but also with experimental vaccines that do not work against disease but against fertility. Investigative journalists worth their salt should look into that. It does not go down well with some of us that your work is done only in our lands. Lands with the potential to produce lots of food given all this manpower. Instead of supporting farming, people are concentrating on altering ovaries… Serio

******************* RWANDA******************

Family planning is needed because the number of people does not match with our resources,

*********CENTRAL AFRICA REPULBLIC: *********

We don’t need family planning. Stop all thing not contraception because it’s against the religion we’re Christians and we love God the meaning of contraception I read is not all for our society we must fight against deseases and family planning.

*************** SWAZILAND: ***************

I thought using condoms was the best and,not pills, injections and every thing

I suggest the Brits should start at home. Which will curb on the spiral of young single mums, or their draining resource on excess child care support. Cameron recently purported for a 3 child benefit policy- I think if they are really serious on budget cut. Then this package load of conceptive pill will work wonders in the UK than developing countries. After all Developing countries need to increase their economic market to align with the long time growth procrastination … While the Uk and the west need to shrink their market as it is over stretched. SO PILLS WILL MAKE A BETTER PLACE IN THE WEST THAN DEVELOPING COUNTRIES… Simply tosh

Oral Contraceptive Pill

After going through these comments and engaging in a heated debate with some critical minds across the globe, I was beginning to wonder if the problem was because I already was sceptical about any form of aid that came to the continent in the form of finished goods that were simply handed out to the people. I was also wondering if the problem could be the knowledge I had about the failed development paradigms since the 1960s. However, I was vindicated when Jerome Ngoh  came powerfully arguing that:

I can’t remember who said it but I can remember what he said: “it’s easier to pretend to be rich than it is to pretend to be poor”. Most of the comments in these thread make me laugh. Poverty is a societal self-sustaining philosophy. Yes, it starts with a male-dominated economic system in developing country but what keeps it in place has little to do with men. societal norms recruit previously exploited women to espouse and perpetuate this doctrine. Dady Kboy, is right: To change the story we need to tackle it from the economic/ educational empowerment of women. That is the recipe the West used. I am puzzled they deemed the chemical solution more appropriate for the “backward” people of the planet. That we are buying into it is more troubling. I hate bringing personal anecdotes into a story. I grew up poor. I remember the first time I told my mum about contraception, my grandma, not my father scolded me for bringing it up. I have discovered something about effecting change: I give my sisters the beat education money can buy. After exposing them to what the world has to offer, they don’t need a Bill- Melinda Gates foundation to educate them on the benefits of contraceptives.

I could not agree more with the above reasoning given that contraception is not a way of life – IT IS A CHOICE! Many women will have to choose to accept it or not! The ability to make that choice comes from education and awareness of what they want in life.

Provide all the contraception in the world to illiterate women and girls without the right economic and political atmosphere and they will become simply baby-less zombies.

Provide education, create jobs and an enabling environment and women will not need the Gates Foundation to provide for them – they will go look for it themselves and pay for it.

Empower the young women of Africa to think and stop thinking for them. Since a majority of these women are definitely illiterate, Melinda and her team have done all the thinking and decided that these women need it.

Actions such as these are what rob women of the ability to make informed choices and not the other way round.

Another aspect is the fact that when the West was faced with a similar crisis Malthus came up powerfully with his theory of population. As for the Malthusian theory of population I am not going to go in to all the theoretical debates he had with Ricardo and Keynesian contributions which clearly showed the contrary. However, let me state two points that are relevant to our discussion:

First, Malthus’s pessimistic conclusions have not been borne out by the history of Western European countries. The gloomy forecast made by Malthus about the economic conditions of future generations of mankind has not been realized in the Western world. Population has failed to grow as rapidly as predicted by Malthus and production has increased tremendously because of the rapid advances in technology. As a result, living standards of the people have risen instead of falling as was predicted by Malthus.

Secondly, Malthusian theory of population is based upon the law of diminishing returns as applied to agriculture. It on the basis of this law that Malthus asserted that food production could not keep pace with population growth. By making rapid advances in technology and accumulating capital in larger quantity, advanced countries have been able to postpone the stage of diminishing returns. By making use of fertilizers, better seeds, tractors and other agricultural machinery, they have been able to increase their production greatly. In fact, in most of the advanced countries the rate of increase of food production has been much greater than the rate of population growth.

Which brings me back to my basic question – can contraception solve any real economic problems in Africa? If so how?

Can education solve the controversy of contraception? YES! HOW? By giving women the knowledge to make informed choices.

Therefore – what Africa needs is the ability to think and not one foundation thinking and drawing conclusions – ones which they never implemented in their own case. Contraceptives may be good for birth control but when it comes to Africa as it is – I am apt to conclude that spending 2 billion is a misplaced priority.

Great Speech By Michelle Obama in Soweto: Video and Words

The speech Michelle Obama delivered this morning at the Regina Mundi Church in Soweto, South Africa:

Thank you. Thank you so much. It is such a pleasure and an honor to be here with all of you today.

I want to start by thanking Graca Machel for that just gracious, kind introduction. It is overwhelming. And I want to thank her for her lifetime of service as a champion for women and children. And from the bottom of my heart, I want to thank you for all of the kindness and generosity that you have shown my family for our visit here. Thank you so much.

I am also honored to share the stage with another remarkable leader, Baleka Mbete. She has played a vital role in advancing equality and promoting development here in South Africa. Thank you to the both of you for joining us here for sharing this moment with all of us.

I also want to thank the Archbishop of Johannesburg for honoring us today with his presence.

And of course, I want to recognize our guests of honor –- these 76 extraordinary young women leaders from here in South Africa and across the continent. (Applause.)

These are young women transforming their communities and their countries, and let me tell you I am so impressed by all of them. I am so proud of everything they have achieved.

And finally, I want to thank the leaders and the congregation of Regina Mundi for hosting us in this sacred space today. It has been more than three decades, but those bullet holes in the ceiling, this broken altar still stand as vivid reminders of the history that unfolded here.

And you all know the story –- how 35 years ago this month, a group of students planned a peaceful protest to express their outrage over a new law requiring them to take courses in Afrikaans. Thousands of them took to the streets, intending to march to Orlando Stadium.

But when security forces opened fire, some fled here to this church. The police followed, first with tear gas, and then with bullets.

And while no one was killed within this sanctuary, hundreds lost their lives that day, including a boy named Hector Pieterson, who was just 12 years old, and Hastings Ndlovu, who was just 15.

Many of the students hadn’t even known about the protest when they arrived at school that morning. But they agreed to take part, knowing full well the dangers involved, because they were determined to get an education worthy of their potential.

And as the Archbishop noted, that June day wasn’t the first, or the last, time that this church stood in the crosscurrents of history. It was referred to as “the parliament of Soweto.” When the congregation sang their hymns, activists would make plans, singing the locations and times of secret meetings. Church services, and even funerals, often became anti-Apartheid rallies. And as President Mandela once put it, “Regina Mundi became a world-wide symbol of the determination of our people to free themselves.”

It is a story that has unfolded across this country and across this continent, and also in my country — the story of young people 20 years ago, 50 years ago, who marched until their feet were raw, who endured beatings and bullets and decades behind bars, who risked, and sacrificed, everything they had for the freedom they deserved.

And it is because of them that we are able to gather here today. It is because of them that so many of these young women leaders can now pursue their dreams. It is because of them that I stand before you as First Lady of the United States of America. That is the legacy of the independence generation, the freedom generation. And all of you -– the young people of this continent -– you are the heirs of that blood, sweat, sacrifice, and love.

So the question today is, what will you make of that inheritance? What legacy will you leave for your children and your grandchildren? What generation will you be?

Now, I could ask these questions of young people in any country, on any continent. But there is a reason why I wanted to come here to South Africa to speak with all of you.

As my husband has said, Africa is a fundamental part of our interconnected world. And when it comes to the defining challenges of our times –- creating jobs in our global economy, promoting democracy and development, confronting climate change, extremism, poverty and disease — for all this, the world is looking to Africa as a vital partner.

That is why my husband’s administration is not simply focused on extending a helping hand to Africa, but focusing on partnering with Africans who will shape their future by combating corruption, and building strong democratic institutions, by growing new crops, caring for the sick. And more than ever before, we will be looking to all of you, our young people, to lead the way.

And I’m not just saying that to make you all feel good. The fact is that in Africa, people under 25 make up 60 percent of the population. And here in South Africa, nearly two-thirds of citizens are under the age of 30. So over the next 20 years, the next 50 years, our future will be shaped by your leadership.

And I want to pause for a moment on that word -– leadership — because I know that so often, when we think about what that word means, what it means to be a leader, we think of presidents and prime ministers. We think of people who pass laws or command armies, run big businesses, people with fancy titles, big salaries.

And most young people don’t fit that image. And I know that often when you try to make your voices heard, sometimes people don’t always listen. I know there are those who discount your opinions, who tell you you’re not ready, who say that you should sit back and wait your turn.

But I am here today because when it comes to the challenges we face, we simply don’t have time to sit back and wait.

I’m here because I believe that each of you is ready, right here and right now, to start meeting these challenges.

And I am here because I know that true leadership -– leadership that lifts families, leadership that sustains communities and transforms nations –- that kind of leadership rarely starts in palaces or parliaments.

That kind of leadership is not limited only to those of a certain age or status. And that kind of leadership is not just about dramatic events that change the course of history in an instant.

Instead, true leadership often happens with the smallest acts, in the most unexpected places, by the most unlikely individuals.

I mean, think about what happened here in Soweto 35 years ago. Many of the students who led the uprising were younger than all of you. They carried signs made of cardboard boxes and canvass sacks. Yet together, they propelled this cause into the consciousness of the world. And we now celebrate National Youth Day and National Youth Month every year in their honor.

I mean, think about the giants of the struggle –- people like Albertina Sisulu, whose recent passing we all mourn. Orphaned as a teenager, she worked as a nurse to support her siblings. And when her husband, Walter Sisulu, became Secretary-General of the ANC, it was up to her to provide for their family. When he was imprisoned for 26 years, it was up to her to continue his work. And that she did. With a mother’s fierce love for this country, she threw herself into the struggle.

She led boycotts and sit-ins and marches, including the 1956 Women’s March, when thousands of women from across this country, converged on Pretoria to protest the pass laws. They were women of every color, many of them not much older than all of you. Some of them carried their babies on their backs. And for 30 minutes, they stood in complete silence, raising their voices only to sing freedom songs like Nkosi Sikelel iAfrica. Their motto was simple, but clear: “If you strike a woman, you strike a rock.” (Applause.)

Ma Sisulu, the students of Soweto, those women in Pretoria, they had little money, even less status, no fancy titles to speak of. But what they had was their vision for a free South Africa. What they had was an unshakeable belief that they were worthy of that freedom –- and they had the courage to act on that belief. Each of them chose to be a rock for justice. And with countless acts of daring and defiance, together, they transformed this nation.

Together they paved the way for free and fair elections, for a process of healing and reconciliation, and for the rise of South Africa as a political and economic leader on the world stage.

Now, I know that as your generation looks back on that struggle, and on the many liberation movements of the past century, you may think that all of the great moral struggles have already been won.

As you hear the stories of lions like Madiba and Sisulu and Luthuli, you may think that you can never measure up to such greatness.

But while today’s challenges might not always inspire the lofty rhetoric or the high drama of struggles past, the injustices at hand are no less glaring, the human suffering no less acute.

So make no mistake about it: There are still so many causes worth sacrificing for. There is still so much history yet to be made. You can be the generation that makes the discoveries and builds the industries that will transform our economies. You can be the generation that brings opportunity and prosperity to forgotten corners of the world and banishes hunger from this continent forever. You can be the generation that ends HIV/AIDS in our time — (applause) — the generation that fights not just the disease, but the stigma of the disease, the generation that teaches the world that HIV is fully preventable, and treatable, and should never be a source of shame. (Applause.)

You can be the generation that holds your leaders accountable for open, honest government at every level, government that stamps out corruption and protects the rights of every citizen to speak freely, to worship openly, to love whomever they choose.

You can be the generation to ensure that women are no longer second-class citizens, that girls take their rightful places in our schools. (Applause.)

You can be the generation that stands up and says that violence against women in any form, in any place — including the home –- especially the home –- that isn’t just a women’s rights violation. It’s a human rights violation. And it has no place in any society.

You see, that is the history that your generation can make.

Now, I have to be honest. Your efforts might not always draw the world’s attention, except for today. (Laughter.) You may not find yourself leading passionate protests that fill stadiums and shut down city streets. And the change you seek may come slowly, little by little, measured not by sweeping changes in the law, but by daily improvements in people’s lives.

But I can tell you from my own experience –- and from my husband’s experience -– that this work is no less meaningful, no less inspiring, and no less urgent than what you read about in the history books.

You see, it wasn’t that long ago that my husband and I were young, believe it or not just starting out our careers. After he graduated from university, Barack got a job as a community organizer in the struggling neighborhoods on the South Side of Chicago. A lot of people there were out of work and barely getting by. Children had few opportunities and little hope for their future. And trust me, no one thought that this skinny kid with the funny name could make much of a difference.

But Barack started talking to people. He urged them to start working on the change they wanted to see. Soon, slowly, folks started coming together to fight for job training programs and better schools and safer housing for their families.

Slowly, the neighborhoods started to turn around. Little by little, people started feeling hopeful again. And that made Barack feel hopeful.

And I had a similar experience in my own career. Like my husband, I came from a modest background. My parents saved and sacrificed everything they had so that I could get an education. And when I graduated, got a job at a big, fancy law firm — nice salary, big office. My friends were impressed. My family was proud. By all accounts, I was living the dream.

But I knew something was missing. I knew I didn’t want to be way up in some tall building all alone in an office writing memos. I wanted to be down on the ground working with kids, helping families put food on the table and a roof over their heads.

So I left that job for a new job training young people like yourselves for careers in public service. I was making a lot less money. My office wasn’t so nice. But every day, I got to watch those young people gain skills and build confidence. And then I saw them go on to mentor and inspire other young people. And that made me feel inspired. It still does.

See, my husband and I, we didn’t change any laws, we didn’t win any awards, get our pictures in the paper. But we were making a difference in people’s lives. We were part of something greater than ourselves. And we knew that in our own small way, we were helping to build a better world. And that is precisely what so many young people are doing every day across this continent.

These 76 young women are outstanding examples. Take Gqibelo Dandala from here in South Africa. She left a lucrative career in investment banking to found the Future of the African Daughter Project, an organization that lifts up young women in rural and township areas. Of her work, she says: “…we are building a legacy which will outlive and outgrow us…”

And then there’s Robyn Kriel. She’s a young reporter from Zimbabwe who has written about corruption and human rights abuses in her country. She was beaten by police; her home raided, her mother imprisoned. But she still hasn’t lost her passion for reporting, because, as she put it, the people of Zimbabwe “want their stories to be told.”

And then there’s Grace Nanyonga, who joins us today from Uganda. Hey, Grace! You go, girl. Orphaned at the age of 13, she started cooking and selling fish during her school vacations to support her six siblings. Determined to get an education, she founded her own company, and she made enough money to put herself through university. And she’s now started an organization that trains local women to work at her company so that they can support their own families. Of her achievements, she says, simply — these are her words — “I made it against all odds” and “I want to be an example for girls in my country and beyond.”

Now, Grace could have been content to make lots of money, and just provide for her own family. Gqibelo could have climbed the corporate ladder, and never looked back. Where is she? Please stand. Grace got to stand. (Laughter.) Come on, where is she? Is she out there? And no one would’ve blamed Robyn — where’s Robyn? No one would have blamed Robyn if after all she’d been through she decided to quit reporting and pursue an easier career. But these young women — and these are just examples of stories that go on and on — these young women could not be content with their own comfort and success when they knew that other people were struggling.

You see, that’s how people of conscience view the world. It’s the belief, as my husband often says, that if any child goes hungry, that matters to me, even if she’s not my child. If any family is devastated by disease, then I cannot be content with my own good health. If anyone is persecuted because of how they look, or what they believe, then that diminishes my freedom and threatens my rights as well.

And in the end, that sense of interconnectedness, that depth of compassion, that determination to act in the face of impossible odds, those are the qualities of mind and heart that I hope will define your generation.

I hope that all of you will reject the false comfort that others’ suffering is not your concern, or if you can’t solve all the world’s problems, then you shouldn’t even try.

Instead, as one of our great American presidents, Teddy Roosevelt, liked to say, I hope that you will commit yourselves to doing “what you can, with what you’ve got, where you are,” because in the end, that is what makes you a lion. Not fortune, not fame, not your pictures in history books, but the refusal to remain a bystander when others are suffering, and that commitment to serve however you can, where you are.

Now it will not be easy. You women know that already. You will have failures and setbacks and critics and plenty of moments of frustration and doubt. But if you ever start to lose heart, I brought you all here today because I want you to think of each other.

Think about Grace, supporting her family all by herself. And think about Robyn, who endured that beating so she could tell other people’s stories. Think about Ma Sisulu, raising her kids alone, surviving banishment, exile, and prison. When reflecting on her journey, Ma Sisulu once said, with her signature humility, she said, “All these years, I never had a comfortable life.”

So you may not always have a comfortable life. And you will not always be able to solve all the world’s problems all at once. But don’t ever underestimate the impact you can have, because history has shown us that courage can be contagious, and hope can take on a life of its own.

It’s what happens when folks start asking questions — a father asks, “Why should my son go to school, but not my daughter?” Or a mother asks, “Why should I pay a bribe to start a business to support my family?” Or a student stands up and declares, “Yes, I have HIV, and here’s how I’m treating it, and here’s how we can stop it from spreading.”

See, and then soon, they inspire others to start asking questions. They inspire others to start stepping forward.

And those are the “ripples of hope” that a young U.S. senator named Robert Kennedy spoke of when he came here to South Africa 45 years ago this month. In his words, he said, the “numberless diverse acts of courage and belief which can sweep down the mightiest walls of oppression and resistance.”

And that is how a church can become a parliament. That is how a hymn can be a call to action.

That is how a group of young people with nothing more than some handmade signs and a belief in their own God-given potential can galvanize a nation.

And that’s how young people around the world can inspire each other, and draw strength from each other.

I’m thinking today of the young activists who gathered at the American Library here in Soweto to read the speeches of Dr. Martin Luther King for their inspiration.

And I’m thinking of how Dr. King drew inspiration from Chief Luthuli and the young people here in South Africa.

And I’m thinking about how young South Africans singing the American civil rights anthem “We Shall Overcome” in the streets of Cape Town and Durban.

And I’m thinking of how Nkosi Sikelel iAfrica echoed through university campuses in the U.S., as students -– including my husband –- planned boycotts to support students here in South Africa.

And I’m thinking of this church and how those stained windows depicting the struggle were donated by the people of Poland, and how the peace pole in the park outside was donated by people from Japan, and how every week, visitors from every corner of the globe come here to bear witness and draw inspiration from your history.

And finally, I’m thinking of the history of my own country. I mean, America won its independence more than two centuries ago. It has been nearly 50 years since the victories of our own civil rights movement. Yet we still struggle every day to perfect our union and live up to our ideals. And every day, it is our young people who are leading the way. They are the ones enlisting in our military. They’re the ones teaching in struggling schools, volunteering countless hours in countless ways in communities.

And in this past presidential election, they were engaged in our democracy like never before. They studied the issues, followed the campaign, knocked on doors in the freezing snow and the blazing sun, urging people to vote. They waited in line for hours to cast their ballots.

And I have seen that same passion, that same determination to serve in young people I have met all across the world, from India to El Salvador, from Mexico to the United Kingdom to here in South Africa.

So today, I want you to know that as you work to lift up your families, your communities, your countries and your world, know that you are never alone. You are never alone.

As Bobby Kennedy said here in South Africa all those years ago: “…you are joined with fellow young people in every land, they struggling with their problems and you with yours, but all joined in a common purpose…determined to build a better future.”

And if anyone of you ever doubts that you can build that future, if anyone ever tells you that you shouldn’t or you can’t, then I want you to say with one voice –- the voice of a generation –- you tell them, “Yes, we can.” What do you say? Yes, we can. What do you say? Yes, we can!

Audience: Yes, we can!

Michelle Obama: What do you say?

Audience: Yes, we can!

Michelle Obama: Thank you all so much. God bless you.