DJIBOUTI'S NOMINATION FOR THE INTERNATIONAL WOMAN OF

UNCLAS SECTION 01 OF 02 DJIBOUTI 000841

SIPDIS

DEPT FOR G/IWI AND AF/EX

E.O. 12958: N/A
TAGS: KWMN PREL KPAO PHUM PINR DJ
SUBJECT: DJIBOUTI'S NOMINATION FOR THE INTERNATIONAL WOMAN OF
COURAGE AWARD

REF: STATE 99729


1. Embassy Djibouti nominates Ms. Zahra Moussa Bouh for the
International Woman of Courage (IWOC) Award. For nearly two
decades, Ms. Bouh has played an instrumental role and has been an
important leader in the promotion of women's health in Djibouti.
Since 1992, she has served as a midwife, nurse anesthesiologist, and
as supervisor of Djibouti's Balbala hospital.


2. As a midwife, nurse anesthesiologist, and supervisor of a
hospital located in one of the poorest areas of Djibouti, Ms. Bouh
is an unsung hero in the fight to reduce Djibouti's high infant and
maternal mortality rates. For almost two decades, she has tackled
the challenges posed by Djibouti's extreme urban poverty, large
nomadic-pastoralist population, and lack of basic healthcare
infrastructure. By providing personal medical counseling and
training to scores of women, Ms. Bouh has been at the vanguard of
helping Djiboutian women face and overcome complex cultural, social,
and health challenges.


3. For Djibouti's urban poor and nomadic pastoralists, home delivery
with the help of family members or an untrained midwife is the norm.
However, because of the extremely high incidence of female genital
mutilation (FGM) in Djibouti, complications and hemorrhaging during
childbirth are common. Over 90% of Djiboutian women have undergone
some form of FGM, and the most common practiced form in Djibouti is
infibulation, the most extreme type of FGM. Outside of Djibouti
City, healthcare infrastructure simply can not provide anything but
the most rudimentary interventions. Medication cannot be stored
properly, so even a relatively simple complication, such as an
infection, often condemns both the mother and infant to death. In
the event of a hemorrhage or crisis situation, there is little hope
of transporting the patient to urgent care facilities in time.


4. Chronic water sanitation issues and cultural practices lead to
further problems after childbirth. Extended breastfeeding is not a
common cultural practice in Djibouti, and women often mix milk
powder with unclean water, leading to infant diarrhea, malnutrition,
and death.


5. On the cultural front, Ms. Bouh targets local elders and
community leaders in this predominantly Muslim country to convince
pregnant women to come to the hospital for delivery. At the
hospital, she runs a comprehensive education program on the benefits
of breastfeeding and the dangers of unsanitary water and living
conditions. This includes programs aimed at new mothers to
demonstrate how good personal hygiene can help save the lives of
their infants.


6. Ms. Bouh has also been active in enhancing access to healthcare
for women with HIV. In an environment where HIV is heavily
stigmatized, she runs HIV education and social awareness and
outreach campaigns to convince HIV-positive women to come to the
hospital for treatment.


7. Structurally, Ms. Bouh has worked tirelessly with the Government
of Djibouti, the Ministry of Health, local community leaders,
elders, and social workers to change current practices. Ms. Bouh is
a member of a key committee that drafted and submitted a National
Disaster Management Plan. She has pushed the Ministry of Health to
issue payment waivers and make reduced-fee services available for
the indigent, providing services for free or at cost. In addition,
she has modernized the pharmacy management protocols at Balbala
Hospital to ensure that medicines are properly stored, cataloged,
and disposed of. This has had the added benefit of reducing waste
and corruption, and making medicines close to expiration (within
limits) available to women in need free of charge.


8. Ms. Bouh's activism is remarkable in many ways. While
steadfastly reaching out to improve the lives of individuals and
groups of her fellow country-women in a real and immediate way, she
has also made great efforts to push for the structural reforms that
will have an even wider and longer-lasting impact. Her work is both
tangible, and transformative. Leading by example and hard work, she
has made a crucial contribution to two of her country's most
difficult challenges: the basic health of its people--and the
empowerment of Djiboutian women who can act as a positive force for
development and social change.


9. Biographical information:

Name: Zahra Moussa Bouh
Date of Birth: 15/12/1972 - Dikhil
Martial Status: Married - 5 children
Tel: (253) 82-26-32

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PREVIOUS POSITIONS
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DJIBOUTI 00000841 002 OF 002



1993-99: Midwife
1999-2004: Nurse anesthesiologist
2004-06: General Supervisor, Intensive Care Unit, Peltier Hospital

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CURRENT POSITION:
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August 2006: Supervisor of Balbala Hospital and surrounding health
centers

Ms Zahra occupies several positions:
- Supervisor of Balbala hospital,
- Midwife two nights per week at Dar El Hanan Maternity Hospital
- Nurse anesthesiologist for caesarian surgeries

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EDUCATION & TRAINING
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1988-92: Midwife school, Djibouti
2000-02: Diploma of Nurse Anesthesiology, Dakar, Senegal
2002-2004: Diploma in hospital management
2007: Seminar on reducing child mortality, Rabat, Morocco
2008: Conference on disaster management, Egypt

WONG