15 August 2023

Written and photographed by Gaia Squarci, this essay originally appeared in Marie Claire Italia

I’ve just returned from a journey proposed by a pair of friends: a long road trip from Milan, Italy, to Dakar, Senegal, to report on women’s sexual and reproductive health and rights and the work that UNFPA does to improve them. My friends Dario de Lisi and Simone de Eguileor took the wheel, and I joined them to meet women and girls along the road.

I think of the women I met and the weight that a female body always bears. A body constantly charged with meaning and symbolism, in radically different ways that are determined by the place where a woman happens to be born.

Here, the women and girls I met along the way.

Al Wava Centre, Mauritania

At a classroom on the outskirts of the city of Nouakchott, adolescent girls sit at their desks, learning to read and write in Arabic. They’re in a two-year program, receiving education and legal aid at a facility supported by UNFPA, after reporting cases of gender-based violence to the police. For most of them, it comes down to rape.

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Adolescent survivors of gender-based violence learn to read and write in Arabic at Al Wava. Those who are mothers can bring their children to class. © UNFPA/Gaia Squarci

During a break from class, I talk with two teenagers, Mariam and Hawa, whose names have been changed for privacy and safety. The two have been sitting close to each other, holding hands and whispering, while also trying to keep a grip on their babies. They tell us how they got here.

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Hawa, whose name has been changed for privacy and safety, was raped by someone in a position of power. © UNFPA/Gaia Squarci
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Mariam holds her baby. © UNFPA/Gaia Squarci

Wrapped in a white veil, or melhfa, with gold stripes, 17-year-old Mariam has big, intense eyes. An orphan, she and her siblings live with an aunt. One day a little more than a year ago, she tells me, a neighbor blocked her way as she was bringing food to her brother at work. Holding a knife, the man said, “If you shout, I’ll kill you.” She realized that even if she did call for help, no one would hear, as she was in a deserted zone amid construction sites. The man raped her, then said, “If you tell anyone about this, I will come and stab you. If you don’t believe me, ask my sister. I stabbed her too.” It was true, she says. Everyone in the neighborhood had heard about it.

Mariam pauses and takes Hawa’s hand. The girls exchange a few words, then Mariam begins breastfeeding her daughter, before returning to her story. It was not until the second time the neighbor raped her, a few months later, that she found the courage to press charges. A woman had found her roaming the streets in a confused state after the assault. At first, police officers did not believe her. When Mariam went to the hospital, she turned out to be five months pregnant.

Hawa, 16, wearing a shade of yellow reminiscent of the desert, sits by Mariam’s side. She tells me how she was raped by a friend of her father – a doctor who used his position to convince her that no one would believe her if she told. But she did tell her mother, who thankfully believed her. Hawa became pregnant as a result of the rape, and the doctor admitted his crime and proposed marrying her – an option her father would have welcomed in a country where his daughter’s future was now compromised. She refused.

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Young mothers Hawa and Mariam have become good friends. © UNFPA/Gaia Squarci

“The centre has become a refuge where I found new sisters”

- Hawa

Hawa, having endured unspeakable trauma, is now raising her baby, while her father no longer speaks to her. “The centre has become a refuge where I found new sisters and I forget all the problems I have at home, especially with my father,” she says. “The social workers help in the maintenance of my baby, especially buying diapers, sometimes milk, and clothes. My ambition is to get married, help my family and receive forgiveness from my father.”

Both perpetrators, despite the formal complaints, walk free. While Mauritania has made some progress on women’s rights, the country’s traditions remain deeply rooted in discriminatory social norms.

I talk with Aichetou Mbarek, a midwife and director of the Al Wava facility, about the girls who arrive at the centre. “I’d say most of them are around the age of 12 when they come. I check if there’s been rape, an attempt of rape, blows, wounds,” she says. “After the visit, I give them a certificate that helps them in their legal claim.” 

Mrs. Mbarek offers the emergency-contraception pill when she can, but the girls, traumatized, under threat, and aware that rape can result in rejection from their own families, rarely report the crime during the 72-hour window for the pill to be effective. Mauritania authorizes abortion only if the pregnancy endangers the life of the mother, so many rape survivors end up giving birth, with no other choices available to them.

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Aichetou Mbarek greets adolescent survivors of gender-based violence when they arrive at the centre, which is supported by UNFPA. © UNFPA/Gaia Squarci

The biggest results at the facility, according to the staff, include helping girls avoid full rejection by their families and ensuring that no newborns are abandoned in the streets, with documents provided for all. Social workers also try to prepare the girls for jobs to help them carve out a future. The girls are from underserved areas, and few have had the chance to go to school; now they’re learning Arabic and mathematics.

I ask Mariam and Hawa what they would ideally hope to do for work. Both say they would love to learn French, which is widely spoken here, in addition to Arabic. Mariam would like to do computer work – computer courses have recently started here, with support from UNFPA. Hawa says matter-of-factly, “I’d do any job that comes my way, I know I have no choice.”

As I watch the girls and their friends holding their babies, I wonder about the relationship between mother and child. It’s the hardest, most painful question, and I decide not to ask. I tell myself it is for them, but it is for me as well. It would be too hard to look into their eyes as they answer.

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Seventeen-year-old Yahdiha, right, with a friend at Chami after her first gynecological visit. © UNFPA/Gaia Squarci
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Along the road in Mauritania. © UNFPA/Gaia Squarci
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Yahdiha heard about the health centre through UNFPA and local partners. © UNFPA/Gaia Squarci
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A patient receives care at the centre. © UNFPA/Gaia Squarci
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Midwife Maimouna Niang (left) and nurse Rougui Dia and her daughter, Zahra, sit in the gynecological room at Chami. © UNFPA/Gaia Squarci

Chami Health Centre, Mauritania

In the city of Chami, we meet Yahdiha, a teenage girl who is feeling relieved after going to her first gynecological checkup. “It went well. I was scared at first. I thought that some electric machine could hurt me during the visit,” she says with a laugh. Then she gets more serious, explaining that “anything that revolves around sexuality is taboo in school,” so she didn’t get much information growing up. Sexuality and sexual reproduction aren’t openly discussed in this country.

Yahdiha heard about the Chami Health Centre, the only facility offering gynecological services in the city, through a WhatsApp group – one of the channels that UNFPA and local partners use to inform people about services. Gold-mining activities in Chami have attracted male workers from other parts of Mauritania and surrounding countries, creating a fertile ground for women’s sexual exploitation. The health centre is crucial.

“Anything that revolves around sexuality is taboo in school”

- Yahdiha

As I take a break in the sun-drenched courtyard of the facility, a man approaches. He thinks I’m a doctor and opens his mouth to show me some missing teeth. I point him inside. The facility serves mostly women, but men can get help as well.

A few minutes later, I talk with Marieme Vachet, a visiting gynecologist contracted by UNFPA. “There’s no gynecologist stationed here, so we’re working on increasing my visits to a weekly basis,” she says. She has taken a break from a busy schedule to talk with me about her work. By the end of the day, she will have seen 68 patients, mostly pregnant women.

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Dr. Vachet performs an ultrasound. © UNFPA/Gaia Squarci

“Sexual desire is still taboo for women here, so they open up with me about their concerns more easily than with a man,” Dr. Vachet tells me. 

Women and girls face many hurdles in Mauritania. Here, the rate of child marriage is high, with 37 per cent of girls married off by age 18. The harmful practice of female genital mutilation – which involves altering or injuring the female genitalia for non-medical reasons – persists. The practice “causes pain during sex, infections and complexities during childbirth,” Dr. Vachet says. “All women with FGM are sent to Nouakchott. We can’t take risks here.”

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A camel caravan crosses the Mauritanian desert. © UNFPA/Gaia Squarci
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A UNFPA driver on the road in Mauritania. © UNFPA/Gaia Squarci

As we cross vast stretches of land, we see occasional camel caravans and fishermen’s huts, while a fine dust is suspended in the air. A desert fog dims the sun, turning colors to pastel. I think about the freedom of road trips – our ability to decide our pace and itinerary, when to stop, who to talk to. Most of all, the ability to leave. Most of the women we’ve met don’t share this freedom.

Richard Toll Hospital, Senegal

We head south, crossing from Mauritania into Senegal, and the sand turns reddish, while colors get brighter, losing their pale hues. 

We stop at the Richard Toll Hospital, where a doctor in the pediatric ward rushes from a room holding a four-year-old child who looks lifeless. We push ourselves against the wall to let them pass. I hope the child might just be unconscious, but the desperate look on his mother’s face as she runs after the doctor speaks for itself. Dr. Suleymane Ba, who stands next to me, puts a hand on my shoulder in silence when he sees the dread on my face. 

“He died on the way to the hospital,” Dr. Ba tells me later. “Our ambulances are for transportation, but they’re not yet equipped for reanimation.” I ask him if the child died in an accident. “No, he had respiratory distress when he was at home, and from what I understood, there was a delay in looking for help. Sometimes here it’s cultural – mothers usually wait for the father to be at home to make important decisions about their children, hoping the situation gets better in the meantime. Sometimes, when they do, it’s too late.”

Dr. Ba is the director of the gynecology department. The maternity ward in the hospital became operational with the support of UNFPA, and the hospital continues to benefit from UNFPA support including medical equipment, training of health care providers and other key services.

As Dr. Ba leads us around the rooms full of women who are either waiting to give birth or have just done so, my friend Simone observes, “There’s not a single father around.”

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A gynecologist performs an ultrasound at the Richard Toll Hospital, which is supported by UNFPA. © UNFPA/Gaia Squarci
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Bane Diablo, a 20-year-old patient who gave birth the day before, speaks on the phone with her husband at Richard Toll. © UNFPA/Gaia Squarci

Bane Diablo speaks on the phone with her husband. She is 20 years old and gave birth yesterday to her first child. Her husband is a breeder in Ronkh, about an hour away from the hospital. “No, he hasn’t seen the child yet. He’s at work,” she says. The newborn is under observation because he started vomiting earlier in the day. I ask her if she uses contraceptives for family planning. At first she has trouble understanding the question, then she laughs. “It’s God’s decision,” she says.

In a bed nearby, Aminata Diop, who is 39, lost her baby in the third month of pregnancy. She has three children but this was her fifth pregnancy, because her first child was born dead. The look on her face is sad, tired, but calm.

UNFPA works in Senegal to support family planning services, helping to educate women, girls and midwives, as well as men and boys, and to make contraceptives accessible. Deeply rooted traditions here hamper the use of sexual and reproductive health and family planning services and the elimination of female genital mutilation, child marriage and other harmful practices.

FASS Adolescent and Youth Advisory Center, Senegal

In the city of Dakar, girls sit together in a room, watching a video that warns them against the dangers of child marriage. 

Here at the FASS Center, young people receive guidance and support for their reproductive health and rights. The facility, which UNFPA helps support, also helps fight against harmful practices including child marriage, teenage pregnancy, female genital mutilation and sexually transmitted infections. It is managed and run by young leaders from local girls’ clubs, as well as peer educators and neighborhood godmothers, among others.

I meet Adja, a tall, slender, young woman of 27. Shy at first, she soon opens up, telling me how she loves to write and that she used to attend a good school. When her father, the main breadwinner of the family, died, she couldn’t continue her studies, and her life started going downhill, as her uncle began trying to push her and her mother out of the house.

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Getting support at the FASS Center. © UNFPA/Gaia Squarci

Adja tells me she used to play on a basketball team, but she had to stop because of mounting panic attacks. She became isolated and believed she was possessed by evil spirits. “You know, we have spirits here in Senegal,” she says. “I went to see a marabout, asking him to free me from them, but he wanted too much money. I didn’t have it.”

She shares a poem she wrote on her phone, about a turtle who dreams with her eyes open, hiding her pain. “The turtle is me,” she says quietly.

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Coumba, 32, is a social worker at the FASS Center. © UNFPA/Gaia Squarci
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Adja, 27, who receives support at the FASS Center, sits in front of a poster that says “Don’t touch my sister.” © UNFPA/Gaia Squarci

The richness of Adja’s interior world is clear from the look in her eyes, and despite her shyness, she is willing to share it. We talk about writing more poems, about picking up a basketball again.

As she and I walk around the centre, she says hello to a social worker named Coumba, 32. I’m immediately struck by Coumba’s confidence. I soon learn that she earned it the hard way. When she was young, her parents ran out of the means to support her, and they sent her to live with an aunt in Kolda. Her uncle started forcing her to wake up at 5 a.m. to sell cold water in the streets before going to school in the morning. “If you don’t sell, you don’t eat,” he would tell her.

“Sometimes he would wake me up at 3 or 4 a.m., throwing frozen water in my face and beating me up,” she says. “I refused to keep selling under those conditions.” To punish her, he made her sleep in a hallway.

When a street vendor offered Coumba a place to sleep, she soon fell pregnant with him. I ask what her feelings were towards him. “I don’t know if I was in love. I was 15, and he helped me,” she says. “We married so I could have the baby, and he pushed me to keep studying. My main goal has always been to come back to Dakar, where I’m from, and I made it. I got my high school diploma.”

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A baobab – a revered tree in Senegal – is lit by streetlights in Dakar. © UNFPA/Gaia Squarci

As our road trip draws to a close, I think about how there hasn’t been much space to talk about love during this trip. Coumba was the first to mention it.

Considering the difficult situations we encountered, it might sound naive to talk about love. But looking at it from a different angle, services that support sexual and reproductive rights and health for women and girls help build the foundation for emotional, intellectual and economic independence, giving women the possibility to understand what love means for them, what they want from it, and from themselves.

Gaia Squarci is a photographer and videographer who divides her time between Milan and New York, where she teaches digital storytelling at the International Center of Photography.

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