Challenging a Culture of Silence: A Conversation with Dorothy Aken'Ova

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A linguist by training, Dorothy Aken'Ova has taught at university, been a drug enforcement officer, and worked for the Women's Organization of Nigeria for seven years. Not one to shy away from controversy, Dorothy formed the International Centre for Reproductive Health and Sexual Rights (INCRESE) in 2000 in Minna, Nigeria to confront local and national resistance to sexual and reproductive rights, and the lack of political will to address these issues. INCRESE advocates for the sexual health and rights of society's most disenfranchised groups, including youth, sexual minorities, survivors of sexual violence, commercial sex workers, and widowed women living with HIV/AIDS. Through education programs in its outreach center and advocacy throughout the community, INCRESE is promoting an understanding of sexual rights—and challenging the culture of silence around sexuality in a highly conservative environment.

In June 2006, Dorothy sat down with Beth Fredrick, IWHC's Executive Vice President, for a conversation about INCRESE's work.

Beth Fredrick, IWHC: When was INCRESE started and why did you think an organization working on sexual health and rights was needed in Nigeria?

Dorothy Aken'Ova: I founded INCRESE in the year 2000, inspired by the five-year review of implementation of the Programme of Action from the International Conference on Population and Development (ICPD), which took place in 1994 in Cairo. The process of appraisal both at the national level and the international level revealed huge gaps, especially in the area of sexual health and rights.

As discussion was taking place among feminist groups at the five-year review, we realized that the only way forward was to unpack the terms "reproductive and sexual health and rights" and have sexual health and rights addressed as core components on their own. Lumping together reproductive and sexual health and rights made implementation very tricky because people remained within comfort zones; thereby, a lot of issues having to do with sexual rights and sexual health were not adequately visible and were not adequately addressed in five years of implementation of the Programme of Action. Also, some groups were marginalized and not reached during these five years.

The way we thought we could move forward was to continue this discussion on the platform of emerging issues—even though these issues have always been there—and to create mechanisms that would facilitate dialogue on sexual health and rights and programming around sexual health and rights issues. INCRESE was born in that context to serve as a mechanism to facilitate and enhance this process.

BF:  What are some of the violations of sexual rights in Nigeria that play out and provide a context for the work of INCRESE?

DA: To start with, absent or insufficient information on sexuality is a fundamental infringement on the sexual rights of people, because one of the key provisions of sexual rights is to have accurate information on sexuality and to have adequate information about services that are available to address sexual health needs. In our context, there has not been proper machinery in place to ensure that people get this information. In other places, only selected information is given—in terms of what the norms are and the dominant moral values within the context—so a lot of issues get left out.

We like to talk, for instance, about the rights of young people to say 'no' to sex but nobody thinks about the rights of young people to say 'yes'. Or when they are sexually active, people deny it. There are diverse ways in which human beings express their sexuality and experience and express their gender identities, and these are also not adequately addressed. This results in infringement, or compromise, of the rights of individuals to bodily integrity and to personal dignity.

When it comes to female genital mutilation, sexual rights—which include a right to pleasure and also the right to protection from torture—are violated. Decisions to enter relationships—the individual right to make that decision whether to be in a relationship—with what partner to be in that relationship, and the right to set limits within that relationship are also compromised, especially among women and sexual minorities.

Other rights that are infringed upon, as far as sexual rights are concerned, play out in decisions whether to have children or not, to have an abortion or not. Divorce is also a very critical area, especially in our context, where there is frequent divorce and remarriage. Issues of sexuality are compromised. Sexual rights are compromised.

Through our work with women we have realized the right to sexual pleasure is not recognized, especially among women themselves. This plays out also in services that are available or not available. There is hardly a place where people can go to get information on issues of sexual dysfunction and sexual pleasure and get backup services to enhance pleasure in their lives.

BF:  Nigeria is an extraordinarily diverse and large country, and I imagine it would be much easier to do your work in some parts of the country than others. You decided to establish INCRESE in Minna, in a Sharia'h state—can you talk a little about what that means, and how that exacerbates some of the rights violations and health issues that you were just describing?

DA:  At the time that the formulation of INCRESE took place, there was also a lot of review taking place in Nigeria—population review like the health demographics survey. There was also an attempt to integrate the 1991 census and see what implications it had and would have, especially given the shift in the population paradigm from numbers to issues of poverty and health and rights. I took part in that exercise and discovered that the North of Nigeria was grossly underserved. If data or statistics from the Southwest or Southeast were put side by side with data from the North, generally speaking, it would appear that these were from two different countries. So there was clearly a need to extend services to the North. The need to have a feminist advocate activist northerner who would be based in the North was also there, because of issues of confidence and trust. I do come from this part of the country, and from the visibility studies that had been done it was evident that the people who could move the agenda within the North had to be northerners.

In particular, when the Sharia'h law was being debated—before the enactment of the full Sharia'h law like we have here today—I also took part in advocacy to see where women's voices were located in the process of interpreting and constructing the legal system. I was in Minna and I saw the yawning gaps that were there. Women were simply not part of the group that drew up the law and how it was going to be implemented. I thought that if INCRESE was located in Niger State then we would be able to facilitate some of the things to do with women's rights within the context of Sharia'h law, especially protecting them when their rights are being violated.

BF:  Can you tell us one story of how Sharia'h law has had an impact on a woman's life or on the issues that INCRESE addresses?

DA:  The case that jumps out is that of Fatima, who was sentenced to death by stoning by a Sharia'h court in Lambata for a sexual offense. She is a divorcee who left Kano to join her family in Lambata, and who had a relationship before the Sharia'h law was enacted. She became pregnant and had a child from that relationship. Her father reported the father of the baby to the court, and was seeking compensation on grounds that he had abandoned Fatima.

But politics and greed within the society translated the victim, Fatima, into the culprit. Her father asked the Court for 150,000 naira from the father of Fatima's child. The judgment was passed and the man was asked to pay a reduced fine of 15,000 naira. Since it did not favor the man, with whom Fatima had had a relationship, he took the case to the Grand Quhadi of Niger State. Scholars came together and deemed their extramarital sexual relationship an offense under Sharia'h law, and punishable by death by stoning. The judgment was reversed from a 15,000 naira fine to death by stoning for Fatima.

The level of ignorance is so glaring in this because the offense took place before the law was even in place. So there is no offense, so to speak. But because we do not have a clearly articulated procedure for implementing the Sharia'h legal system in the states, the process has not been exhaustively defined. She was sentenced but we are working in hopes that she will be acquitted and discharged in the end.

BF:  What role has INCRESE played in this case?

DA:  As soon as we heard we mobilized and got an NGO that had legal infrastructure in place and experience in defending these kinds of cases to come to her aid and provide her with a lawyer. We also provided support to her and the family—visiting, counseling—and we also made the case visible by going to the media and contacting the international community and sensitizing them also of the case. There was a similar case in Katsina that had drawn a lot of global attention and chances were that this one would have fallen off the table if we didn't place it squarely on the agenda, because people's minds were more on the case in Katsina State than in Niger State.

BF:  This kind of case touches on very personal and generally private issues, as does much of INCRESE's work. INCRESE does a lot more than just work on legal cases. You work across the board providing information to a number of different age groups and types of communities. How do you increase or expand the comfort zone in which these personal, private issues are discussed in such an environment?

DA:  We have developed tools that facilitate dialogue. We have developed models that stimulate conversation and we have trained staff to be able to facilitate those kinds of discussions by approaching it through various values clarification exercises that we have put together to enable people to learn. We also have ensured that the tools shock, because we think that shock therapy is necessary to wake people up so that they can begin to ask questions around these issues. We have also done advocacy and we've collaborated with the media a great deal in the process of shifting the horizon beyond what presently is to expand the scope of comfort around issues of sexual health and rights.

BF:  Now that you're six, almost seven years old as an organization, how do you feel INCRESE's approach has changed people's lives here in Niger State...in Nigeria, in the world?

DA:  When we began, we didn't have as many young people coming for the education sessions that we give as we do presently. I want to interpret that to mean that people have recognized that they need accurate information to navigate their sexuality safely and pleasurably, and come in for information. We have more cases of individual human rights abuses, the victims of which INCRESE has been supporting. Some of these cases we've taken to court and the kind of comments that we have received from these people are encouraging and show that we are affecting lives positively, especially women's and young people's lives. The fact that they are able to share our work with other people they find in difficulty and refer them to our organization confirms that we are doing the work and doing it well.

We have a community of sexual minorities who had for decades been in the closet and had formed social networks in some instances. What our presence in the Nigerian environment did—among other things I'm sure, but we definitely had a role—is to transform these social networks into political networks, like the bodily and sexual health rights policy network, where they are able to see the kinds of rights violations that are meted out to their communities and where they are able to mobilize and come together and have a voice. To have seen these groups move from social networks to change agents and advocates is also an indication of the kind of work that we are doing and how well we are doing it.

BF:  One thing that is very relevant to your work that can't be denied by anyone in Nigeria, by anyone in the world, is the spread of HIV/AIDS. How do you see the two as being connected—sexual rights and HIV/AIDS?

DA:  We, at least in this context, know that HIV transmission is facilitated in our region, and in Nigeria as well, by behavior—especially sexual behavior—and that falls clearly within the realm of sexual rights discourse and sexual rights issues. That creates a very fundamental link between the work that we do and HIV/AIDS prevention programming. We do believe that sexual pleasure is a critical component of sexual rights provisions and we believe that if sexual activities are not safe, then people's sexual rights are being compromised and that pleasure is remote. So in the work we do for pleasure we talk about issues of safety and safety has to do not only with protection from sexual violence, but also risk reduction and prevention strategies for transmission of HIV and other sexually transmitted infections.

BF:  When I was here in 1997, there was a high level of denial that HIV was going to be a problem. Nigeria seemed to be a tinderbox and set to have an epidemic like many other parts of Africa. In the ensuing decade, HIV has in fact come to Nigeria in a very powerful way. Can you share your thoughts on the evolution of HIV in Nigeria and how your government and the world community dealt with it here?

DA: There's been a lot of education, a lot of advocacy targeting policymakers, and I think what really got it into the realm it is today is the ability of the civil society organizations working around issues of HIV/AIDS to bring together people living with HIV and getting them to come out and share their experiences. That is how we got the breakthrough in the late 90s. Since then, we have acted together. The media was also targeted and their capacities were developed to see the issue in its right perspective and that has also helped. At that point, the government woke up to its responsibilities and developed a policy, owing to its responsibility at the international level in the international consensus documents. The civil society organizations that represented those spheres, for advocacy purposes, followed up at the international level. The National Action Committee on HIV/AIDS (NACA) was therefore born, like in many other countries in Africa, to take the lead in programming for HIV/AIDS issues in Nigeria. This structure runs from the federal level to the local government level nationwide, and provides an infrastructure for all activists to work in addressing HIV/AIDS within the country.

There were also efforts to bring in the private sector and this has worked out really fine. It's not to the degree we want but the fact that the private sector has bought into the process is also very encouraging. After the military regimes we finally saw a civilian government that was interested in allocating a reasonable amount of the budget—better than military regimes—to addressing issues of HIV/AIDS. These are the things that have created changes—more allocation of resources, more awareness, increased political will. They have all contributed to the shift from denial, especially by policymakers, and to action that we have now.

BF:  The world is waking up to the fact that women and girls are increasingly vulnerable and are becoming a larger part of new infections. How is NACA addressing women? I know you are part of a group of women leaders in Nigeria who are influencing their thinking on how to prevent new infections. Can you talk a little bit about that process, some of the implications for women and girls here and what you see as part of the solution?

DA:  The way programming was happening—and is still happening to a large extent—has been vertical funding and therefore vertical programming, vertical interventions. It hasn't been mainstreamed, to a large extent, with other issues of sexuality and other issues of reproductive health and rights. Of course, we are seeing the prevention of mother-to-child-transmission, which is a reproductive health kind of component. Otherwise, it's been vertical all through the funding, the design, the implementation, and the evaluation.

What we have observed also, with the dictate of the funding that is coming from the United States, is a tendency to pay more attention to treatment and providing antiretrovirals (ARVs). Even management of opportunistic infections has not gotten as much attention as the ARVs in recent times. The fact that the U.S. conditions—which emphasize an abstinence-only approach to prevention—are affecting programming in Nigeria has been a concern to feminist groups. This approach does not focus on primary prevention, which would reduce risk for women and girls whose low status makes them more vulnerable to HIV transmission.

So we came up with a group, the Gender, Human Rights and HIV/AIDS Initiative (GRI)*, that was committed, and is committed, in sitting together with the National Action Committee on HIV/AIDS in Nigeria to reformulate programming and intervention activities on HIV/AIDS through a shift in paradigm. We want HIV/AIDS interventions to be mainstreamed in the broader agenda of sexual health and rights and reproductive health and rights so that we do not have this vertical approach anymore. We're hoping this will make more visible the contexts that result in greater vulnerabilities among certain populations, and that is how we are envisaging addressing new infections among women and girls in Nigeria. We have had meetings with NACA in Nigeria and its chairperson and senior program persons to discuss with them this broader agenda, so that we are able to develop skills and capacities and change behavior, and ultimately have a full range of services available for women and girls. We have had some progress. It has not been as fast as we want. It has not been as profound as we wanted. But there is progress and I believe that the more we work at it the more we shall achieve.

*GRI members include Dorothy Aken'Ova, Mairo Bello, Ngozi Iwere, Bene Madunagu, and Grace Osakue.

BF:  You used the term primary prevention in talking about what was needed going forward, and I know primary prevention promotion is woven into all of INCRESE's work. Could you explain what some of the components of primary prevention are?

DA:  Primary prevention, for us, is, for one, providing comprehensive sexuality education to everyone so that they are able to make informed decisions on their sexuality. They are able to make choices that are right for them. For instance, an individual may decide that they are not going to engage in sexual activity. It doesn't stop at that. A lot of the times we make choices, but we don't have what it takes to implement these choices. And so the challenges around us would make us do things contrary to the choices we've made. So in that regard it is essential to build life competency skills, decision-making skills, negotiation skills, self-esteem, communication skills, pressure resistance skills, skills to identify sexual scenes. In other words, for individuals to be able to sustain the choice that they have made to say no, to abstain, which is a component that is usually missing in the promotion of abstinence-only as you have seen...just say no and zip up. It doesn't end there.

We also see primary prevention as making services available for those who choose to say 'yes, I wish to have sexual activity,' so that they have a full range of risk reduction devices. And these services must be accessible and affordable to people who need them. This includes male condoms, female condoms, and lubricants. We haven't given up on microbicides. We are hoping that work on microbicides will continue because I think that is a major way out, for women especially because of the inability to effectively negotiate sexual limits...especially within the context of marriage, where it is perceived in our setting that women must say yes to sex at all times to their male partners and in whatever way the male partners choose to have sex, protected or not protected.

We also see primary prevention within the larger context of human rights issues, because if people are educated on rights and there is infrastructure created to protect people's rights then they would be able to navigate safer sex in terms of reduction in violence against women, for instance. Because violence can predispose women to HIV transmission and we need to work also in that area if we are going to address primary prevention.

Poverty is also an area that we've been looking at when it comes to primary prevention, which is also looking at the bigger picture or context that makes people vulnerable to HIV transmission. We are looking at it beyond poverty at the household level. What is creating or perpetrating poverty at the household level is the bigger policies that take place at the World Trade Organization and all of the similar structures at the global level. We need to make interventions also targeting those places so that we can redefine what those policies are and we can put in the center of those policies the human face, the woman's face, the girl child's face, so that poverty at the community level can be reduced. This would make women and girls capable of better negotiation as far as navigating their sexuality is concerned, and they won't have to sell sex to get a meal, give sex to be housed, give sex to pass exams, and all the other contexts where sexual exchanges take place for basic necessities of life.

That is the context in which we see primary prevention.

BF:  You have a reputation as a brave dreamer in this field. What kind of world do you envision if we are actually able to embrace some of the things that INCRESE is promoting, if we are able to make some progress? I know that you certainly see that some progress has already been made, but what are some of your dreams for the future?

DA:  I dream of a future where inequalities are addressed at all levels and eliminated. I dream of a future where women and girls own their bodies. Where women and girls can have the last say on what is done with or to their bodies. I dream of a future where we are talking about sexual minorities not using the language of tolerance, but that of the right to be, to live, to experience, to express themselves as they are. I dream of a future where we don't have groups that are marginalized, that are abused, violated, molested because of their sexuality or gender identities and expressions. I dream of a future without poverty.