21-year-old Betty Namanya was born in the Rubirizi District in Western Uganda. She grew up with no electricity or running water and used to walk to a nearby lake to gather water for daily use. Betty’s father had multiple wives and she grew up with 18 siblings. Her father and stepmothers struggled to afford school and food for Betty and her siblings. “They tried so much, but we were so many,” she said.
Betty faced a number of challenges growing up. When she was three, Betty’s mother left her to be raised by her stepmothers who did not treat her well. “They mistreated me so much,” she said. She struggled to find enough food to eat and money for school, saying, “I had to drop out of school because I didn’t have much food to eat while at school. When my friends were [eating] food, I didn’t have water. If I asked my father for money for books we would quarrel so much, and then when I asked my step-mother for food she would tell me it’s for her children. So I would be so hungry and my father was also quarreling because of books, so I decided to drop out.” Betty dropped out of school in Primary 7, or 7th grade, adding “I wanted to be a doctor or a nurse.”
After dropping out of school, at age 15 Betty took a job at a local bar to support herself. It was at this bar she first learned about contraception. Because the bar paid so little, Betty explained that her friends encouraged her to have sex with men to earn a sufficient income. “When I got that job my friends told me, ‘you can’t work here if you don’t have family planning, because definitely you will get men here, you will sleep with them.’ …. The bar they pay you very little money, you have to have a side income by getting men,” she explained.
Eventually Betty got an opportunity to leave her small town and move to the capital, Kampala, when her older half-sister secured her a job as a house keeper. On her own, Betty took the seven-hour bus ride from her town to Kampala. Betty took the job, but quit after a short time because she was mistreated by the woman whose house she was cleaning.
Today Betty lives in Kampala with her boyfriend of three years, who she refers to as her husband. “I’m not married, I’m cohabitating, but it’s a marriage …. I really love him,” she said. Her boyfriend sells fruits, tomatoes, onions, or whatever is in season, and makes a small income to support Betty and their new baby Jonathan. “He gets enough money to take care of us, me and the baby and our family, to rent a house. He also has no family, his mother died and never showed him his father and his family, so I’m like his mother; we’re his family,” Betty said. Still, Betty added she wishes she had finished school so she could get a job and earn an income too. “I wish I had gone to school, because I believe if I had gone to school, maybe learned English, I would be able to get a job, maybe, which would give me some money, some income,” she added.
The day the Universal Access Project met Betty, she had come to the Naguru Teenage Information and Health Clinic seeking a seven-year contraceptive implant. Betty had not planned to have a baby, although she added that she is very happy with Jonathan. She was using Depo Provera, the three-month contraceptive injection, and accidentally became pregnant after she wasn’t able to afford a shot and missed her injection. She wanted a long-term contraceptive because she wanted to focus on taking care of Jonathan before having another child. “We want first to see if we can be able to care of Johnathan, take him to school .… then we shall have another child,” Betty explained.
For Betty, access to a long-term contraceptive will enable her to plan her family, build a better life, and perhaps even go back to school. “I would love to go back to school, but I don’t have money. After my primary exams, when my results came, I requested from my father money to go to school. He said ‘I don’t have money to waste’ …. I still have hope that one day maybe I will go for adult education and at least learn English,” she said.
She also wants her life to be different from her mother’s, and sees family planning as one of the keys to achieving that dream. “My mother gave birth to too many children from other men … they did not go to school …. So I really want my children, when they grow up, to [go] all the way to university.”
When asked what she would tell other girls and women in Uganda about family planning, Betty said, “Family planning is important because these days, it’s not easy to take care of children. For example, if I didn’t know about family planning I would be now having so many children. This year I give birth, next year, like that. And I wouldn’t be able to take care of all these children.”
Betty concluded with a message to U.S. policymakers, saying, “I would tell a Senator, I would tell him that you know we can’t avoid family planning …. In the government facilities the lines are very long, the health workers are poorly motivated. You wait in the lines the whole day, and you’re tired, you may even go without the service. If you say you want to go to a private clinic, you may buy drugs that are expired …. So, I request the US government to give more funding. Supply us with drugs, motivate the health workers, so that they can give us these services.”
Betty left the Naguru Center without receiving the contraceptive implant she wanted. The clinic staff who offers contraceptive services had already left for the day by the time she arrived. The clinic staff took Betty’s information and said they would call her with a time when she could come back for the implant. The Naguru Center, which focuses on providing sexual and reproductive health services for young people in Kampala, is funded by the Ugandan Government and the Swedish Government, but they continue to be underfunded and understaffed, according to a nurse on duty. In Uganda, 1 in 3 women have an unmet need for family planning, three-quarters of the population is under 30, and nearly a quarter of girls aged 15 to 19 have had a baby or are pregnant.
“We want first to see if we can be able to care of Johnathan, take him to school .… then we shall have another child.”