Traffic and Sex on the Road to School
April 17, 2015
Anyone who has visited Dar es Salaam surely remembers the traffic. Stories abound of unreasonably long delays – 45 minutes to make a left turn, a four-hour line to get on the ferry, a drive that takes 20 minutes one day can take two hours on the next. There are obvious economic implications to the impressive traffic jams, but less apparent is the impact on sexual violence and teenage pregnancy.
I recently traveled to Tanzania as part of a CSIS delegation looking at the U.S.-Tanzania relationship around maternal health and child survival. Our first afternoon, we took a city tour with a guide whose encyclopedic knowledge of Tanzania set the stage for the conversations and site visits we would have throughout the week. He told us how Dar’s public transportation system - unreliable and often inaccessible to kids, who pay a reduced fare - frequently leaves schoolchildren with either hours-long commutes in each direction or trapped in the city without a viable way home. For girls, the latter poses a particular threat, exposing them to sexual exploitation and violence since getting home may mean exchanging sex for a ride or being harassed, assaulted, or raped along the way.
The proposed connection between traffic and sexual violence was unexpected, but upon further thought seemed obvious. Coercive sex is ubiquitous throughout the world and any structure that leaves women and girls at a power disadvantage inevitably leads to abuse. And the data seem to back this up: a 2011 report on Violence Against Children in Tanzania, which was coordinated by the Tanzanian government in partnership with UNICEF and CDC, found that almost 30 percent of girls aged 13-24 experienced sexual violence before turning 18. Of those who reported experiencing sexual violence, 23 percent reported at least one incident traveling to or from school, making the journey to and from school one of the top three locations for sexual violence. A 2009 report by AED (since acquired by FHI360) that looked specifically at the link between transportation to school and gender-based violence in Dar found that 35 percent of girls surveyed had accepted a means of transport to school that was not the public bus system, including rides from relatives, neighbors, strangers, and truck drivers (it is worth noting that 66 percent of those surveyed reported mistreatment by the bus driver, including sexual harassment and assault, on the public transportation system itself).
But this particular example also strikes at the complexity of implementing health and development programs that will truly make a meaningful difference. The lack of adequate roads and safe transport has long been acknowledged as a missing piece in maternal care, especially in rural areas where pregnant women often cannot access health facilities. But when we design interventions aimed at reducing maternal mortality, we don't necessarily include investments in the infrastructure that can help women and girls avoid coercive sex and unwanted pregnancies in the first place (pregnant adolescents face a higher risk of death than older pregnant women). When we applaud policies that mandate school attendance, we don't always also insist that structures are in place to ensure safe passage to and from school.
The solutions to this problem aren't easy, but at the very least include providing these girls with access to reproductive health information and services so they can prevent unwanted pregnancies and sexually transmitted infections, including HIV. The latest Tanzania Demographic and Health Survey found that only 34.5 percent of sexually active unmarried women ages 15-19 use some form of modern contraceptive method, and the country’s overall contraceptive prevalence rate is even lower. Almost 30 percent of women have their first child before age 18 (and 56 percent before age 20), and the inverse relationship between early motherhood and school attendance is well documented. In the quest to empower the young girl who is simply trying to earn an education, ensuring that she can access appropriate health services is an important step in the right direction.
But health services can only eliminate some of the many consequences of situations like this, and strategies to address sexual violence are necessary to end the other mental and physical impacts of coercion and abuse (it is worth noting that the Violence Against Children report found that over 13 percent of boys also reported experiencing sexual violence before age 18, with 15 percent reporting at least one incident on the way to school. While boys obviously cannot get pregnant, the benefits of finding ways to provide safe passage to and from school are not limited to girls). This will require reaching beyond the health sector and developing and implementing the multisectoral approaches that have been particularly challenging for donors as well as partner countries. The recent announcement by the World Bank of a $300 million loan to improve Dar’s roads and infrastructure is an opportunity to do just that - if the Tanzanian government and its partners at the Bank ensure that the needs of school children are considered and addressed by the project.
At the end of the day, the traffic-sex connection is an important reminder of the need to remain focused on the people who health programs are trying to reach, and to design initiatives that effectively mitigate the challenges they face on a daily basis – as well as the need for infrastructure and broader development programs to adequately address health and safety priorities. It is also reminder to consider the specific needs of women and girls and to acknowledge the different challenges they may face. If not, the educational aspirations of girls in Tanzania and elsewhere may continue to be derailed by the perils of just getting to school.