The Story Ritual

The end of 2013 saw the launch of Flight Press, a new publisher of short fiction. Its first collection, Edgeways, collated the winning and shortlisted entries in the 2013 Spread the Word short story prize which I judged alongside Courttia Newland and Tania Hershman. The Edgeways anthology also featured a new short story by me, entitled The Comforting of Children, and this essay on the ritual of reading short fiction.

Everyone knows the story ritual. It begins with ‘Once upon a time’ and it ends, in childhood at least, with ‘And they all lived happily ever after.’

As we get older the stories become more complex, more shadowy and circumspect. Perhaps yearning for some comfort and familiarity we turn back to the fairytales, fables and adventure stories we knew from childhood, only to realise that even they contain striking ambiguities and subversions. Bluebeard: wife killer. The wolf in Little Red Riding Hood: murderer preying on the elderly, human eater, sartorial necrophiliac and cross-dresser, child groomer. The prince in Cinderella: foot fetishist. The prince in Rapunzel: hair fetishist. The prince in Sleeping Beauty: rapist. Snow White: female masochist who finds happiness as seven men’s domestic drudge.

Even these stories, with their generic, Disney-colonised contemporary names, arise from rituals of recounting adventures, creation myths and folklore which long predate written culture and are strongly echoed by countless narratives all over the world. They are full of death, betrayal, selfishness, desire, heroism, ambition, bloody-mindedness, defiance, friendship, sadness, enmity: the stuff of life. The stories embody near-universal hopes and fears, provide escape, give warning, reprove or reward certain desires. They reflect both the time of their telling (and retelling) and the universality of our own impulses.

The story ritual isn’t about whether the narrative is committed to paper or to the air and the ears. It’s not even about literature, as such. Journalists and news crews pursue emerging stories, fashion spreads in high-end magazines are referred to as stories, private investigators try to get to the bottom of a story and witnesses of crimes give their stories to the police. Con artists have their stories too, often very elaborate ones. Part of the ritual is that you follow a story, if it’s a good one, all the way to the end. The mark of a rich tale, whether it’s epigrammatic or epic, is that you want to know what happens next. And if that ending is weak, the reader feels not irritated but actually betrayed. We are galled and disappointed, as if we were set up in good faith and then sold a dud.

I’m always intrigued by nurseries and prep schools that have a soft-furnished, quiet, special story corner, as if stories deserve their own place as well as their own time in which to flourish. Similarly, the ritual of parents reading their kids to sleep, which always struck me as incredibly narcissistic on the part of the adults, is a memory apparently cherished by many. My own childhood story ritual was listening to a tape of The Snow Queen every night as I attempted to drift off. The sound of the queen flying up to the children’s attic window, tapping on the glass and keening their names in a ghostly voice is one of my most harrowing, vivid recollections. It was only fiction, but fictions provoke real reactions.

Later, I was given a wonderful hardback book of hundreds of stories, each exactly a page long. One was about a young woman with waist length blonde hair. She was so tired of being teased (or as we say these days, sexually harassed) about it that she tried to dye it black in the kitchen sink. It turned green and she was mocked even more badly when she went to school the next day. I never quite worked out the moral of the story. Either it was ‘just be yourself’ or ‘just be sexy’.

Readers have rituals: they read before bed or on a long afternoon, in the chair they always use, or on the commute to work. They do or don’t fold pages, break spines, underline things or read the last paragraph first. Writers also have rituals, some more OCD than others. I know some who kiss their copies of Pablo Neruda or George Eliot when beginning a new book, put a lucky charm on their desk or, getting to the trickier end of common behavioural disorders, make sure they’ve washed their hands three times before they touch the computer keys. Others go to their study with just the right cup of tea and just the right biscuit.

We are hoping that if we get the ritual right, it’ll repay us in words, in inspiration, in insight and good judgement. All of us are striving to write that one, perfect, satisfying thing. Every word has to count, every shift has to happen at the right moment. It goes deep yet seems light; it’s a structure of iron hung with silk. I once met a writer whose story had won a competition I co-judged. She hadn’t expected to win. ‘I just wrote it in a week,’ she said, exhilarated and disbelieving. I reeled back. It takes me months.

The story ritual is so powerful that we carry its psychological imprint with us for the rest of our lives, even to the point of naivety. We assume that our lives will have a coherent narrative balance, moral shape, emotional form. We go into our thirties and forties believing that things will always work out in the end, with a natural karmic equilibrium; that we will fall in love, perhaps even at first sight like so many fictional characters; that we deserve or are justified in pursuing adventure; that any event or act can be explained and therefore understood; that any pathology or feeling can somehow be decoded. We assume that this mysterious thing called karma will eventually repay the balance of evil and good. We believe that every story we live through must have an appropriate end, which we call ‘closure’, and that we can bring this about as though we are protagonists. It is from stories, nothing more, nothing less, that we believe that everything that has begun will be ended, and will end somehow fittingly. This does not happen often in reality, yet still we keep the faith.

I had to come to faith sooner or later. Underlying all world religions is an indissoluble trinity of faith, story and ritual. The great books of nearly all the world’s major religious belief systems are really just short story collections presented either as emblematic myths or as faithful accounts of true events. And all the rituals of the world’s religions are built on those stories, and everything we believe is built not on the evidence of our own eyes but on stories. Angels and other supernatural harbingers do not exist. The Garden of Eden did not exist. A man cannot walk on water. A god can’t have ten arms or four arms or a monkey’s head or an elephant’s head. The part-animal sentinels and judges of the Egyptian underworld do not exist. But it doesn’t matter. We read the stories, we heed them and we invest them with meaning, regardless of whether they are true or possible. We extrapolate their conclusions, build them into morals and use them to structure the laws, beliefs, values and customs of societies of billions of people. We use the stories to justify both our violence and our generosity, our exploitation and our humanity, our abusiveness and our self-sacrifice. We perform various rituals we invented, inspired by the stories, and have done so for thousands of years. That is the power of the story ritual: to underpin, explain and motivate human society for as long as we have existed.

Further reading:

• All Bone and Muscle, an essay on the art and craft of short fiction which I wrote for the University of Chichester’s short story module. 

Spread the Word about a gorgeous new anthology called Edgeways

Carol Ann Duffy and Warsan Shire
Photo (c) Spread the Word

I've worked with and admired the London based literary organisation Spread the Word for as long as I can remember. Spread the Word support the city's most exciting writing talent, seek out new voices, organise public panel discussions about topical issues in literature and publishing, launch writing competitions, support the development of new work and generally inspire creativity and energy in anyone who encounters them. This autumn, their great achievement was to bring to public notice one of the most thrilling, searing and original writers I've ever read - the poet Warsan Shire, who is the inaugural poet laureate for London. Read the BBC's coverage of her appointment here. As The Bookseller and The Evening Standard report, her appointment was announced by Poet Laureate Carol Ann Duffy. I believe that Shire, along with Malika Booker, are the two most exciting poets and riveting performers creating in the UK today.

Totally fab image of Malika Booker taken by Naomi Woddis for Femficatio.
Visit the source site by clicking here.

After many years of hosting panel discussions with critics and authors, mapping the changes in the industry and encouraging fresh work from hundreds of writers, both emerging and established, Spread the Word are stepping up and becoming publishers in their own right. Introducing.... Flight Press:

I love that inky, indelible looking black block-printed star and punky grassroots Soviet template font. Initially producing sleekly formatted e-books, Flight Press plans to create limited edition, lovely-to-have-and-hold publications like the gorgeous volumes made by Pereine Press and & Other Stories, who published the 2012 Booker-shortlisted breakaway hit, Swimming Home by Deborah Levy, which I discuss here in an essay entitled Even The Rich Suffer.

The debut release by Flight Press is an anthology called Edgeways. Initially an e-book, the anthology brings together the winning and shortlisted writers of the 2013 Spread the Word writing competition for short fiction, which I judged alongside the writers Courttia Newland and Tania Hershman. In judging fiction I am always reminded that talent is not scarce but common. It's waiting to be discovered and is richly deserving of a platform, publication, critical attention, readerly celebration and support from the wider industry.

Courttia Newland's fiction is passionate, topical, fierce; he writes with urgency, great observation and grit. Tania Hershman's short fiction combines cerebral intensity, bullseye imagery and technical precision. And I'm super company at lunch. The winning story in the competition was Living It Edgeways by Claire Sita Fisher. We loved it for its upfront, fresh, mobile voice and impeccable creation of character. The story's narrated by a young guy whose humour and streety restlessness hide perceptiveness and vulnerability. Fisher's story was cut through with witty observations about city life, street slang and the effects of one incident on an entire family.

Edgeways the anthology has been edited by Courttia Newland, who's written an introduction about the competition's shortlisted entries, explaining what we were looking for, where we agreed and where we politely diverged. Tania Hershman has also contributed a piece of her unutterably perfect short fiction. The competition entrants whose pieces made the shortlist are Claire Sita Fisher with her winning story, Nick Black, KJ Orr, Toby Litt, Deirdre Shanahan and Saradha Soobrayen.

I have contributed an essay called The Story Ritual, about the art and craft of the short story. I've also written a new story entitled The Comforting of Children. It's my first work of original fiction since Dust, in November 2011. The success of that story, which can be read here, reprinted by the University of Chichester, gave me the faith to write The Comforting of Children. I can't think of a better way to explore the craft of short fiction than by being a small part of  new anthologies whose originality make such a strong case for the power of literature and the excellence, diversity and prevalence of new voices.

Further reading:

• All Bone and Muscle: an essay on short fiction written for the University of Chichester short story syllabus. 

Edgeways is available now as an ebook, published by Flight Press and edited by Courttia Newland. 

The Cut: daughters, elders and local health workers speak out about female genital mutilation in Western Kenya

If you’re interested in the issue of female genital mutilation you might also want to read Cutting Us Down To Size: Working To End Female Genital Mutilation

An excellent film called The Cut by Beryl Magoko – not to be confused with the equally impressive recent British documentary The Cruel Cut – received its UK premiere at the 2013 London Feminist Film Festival and was awarded the Best Feature prize there a couple of weeks ago. Filmed in Uganda and Kenya, The Cut is a careful and intelligent documentary which enables diverse members of the featured small, rural communities where FGM is practised to speak about its meaning and history, while maintaining a clear but unpressing authorial sympathy towards the girls who undergo it. Despite comprising interviews and talking heads as well as some close documentary observation, ultimately the body language and silent reactions of the young women speak the loudest. The Cut has already won Best East African Film at the Kenya International Film Festival as well as many other plaudits.

The Cut establishes female genital mutilation as a social practice with a history so longstanding that even its apologists cannot explain it adequately. Both those who oppose and those who defend it mention the pressure girls are under to have it done.

Watching some of the older male apologists for FGM is a chilling experience. They display an odd, chippy defensiveness at being challenged and their comments are shot through with contempt for the (as they insinuate) wilfulness and irrational bloody-mindedness of women. One man says, “If a girl wants she will be circumcised. She runs away and goes for circumcision.” What we see in the film, instead, is the establishment of a haven for countless girls who have gone there to avoid being cut. Despite the existence of this refuge some parents, of both sexes, take the girls away against their will to be cut.

“They make a small mark on the knee,” says one man dismissively. I do not think he is lying outright, although he is speaking with heavy euphemism; I think he genuinely does not quite know exactly what is involved. As the film goes on to show, FGM is a female-perpetrated community act in the moment, although as a cultural practice it is endorsed by both sexes and it is ultimately approved, instigated and organised by men with social power. As one woman warns, “the sons of council elders inherit the right to organise circumcision.” Despite FGM being presented by detractors and apologists alike as something done to women by other women, often those women who are closest to them, its survival as a tradition can only be ended officially by council sons of council fathers, not mothers, wives or daughters.

Another man in the early minutes of the film insists,  “We don’t force them, nobody forces them.” But force is not always physical and momentary. Peer pressure, the weight of long tradition, the heat of expectation, the actions of the majority and the social cost of resisting the practice constitute different types force in themselves – forces which are sometimes harder to resist than the application of physical power. One adult woman explains how an uncircumcised girl will be ostracised and describes being shouted at, verbally abused, mistreated and cold-shouldered at her school, where 98% of the girls had been circumcised. The girls are caught between forces which are at once oppressive of their own instincts and free will and yet socially inclusive, communally approved, deemed to bring order and harmony to all. Another woman says carefully, “a good child has to obey the parents.” Her personal pain and regret are subsumed into a wider vision of what would please the people beyond herself.

One of the many subtle arguments The Cut makes is that female genital mutilation is related to poverty and education. One man says that when a girl has been cut “she can get married, give birth and handle a family,” even though it is obvious that the girls in the film are still virtually children. The under-education (in terms of both social values and academic status) of the parents creates a cycle in which the under-education, physical brutalisation, sexual and labour exploitation and social disempowerment of girls is perpetuated. The cutting of a girl is presented as a sign of her initiation into womanhood and therefore her readiness to marry and procreate. Anti-FGM speakers in the film rail against “illiterate parents” who do not see the value of education for a girl; they circumcise and marry off daughters who might have wanted to continue with their studies.  

However, The Cut also conveys how strong the anti-FGM movement is, with leadership coming from both sexes. Indeed the defensiveness and vehemence of the apologists, virtually all of whom are of an older generation, shows that the drive to end the practice is gaining ground. We see groups of very little girls chanting and holding up signs reading, “Don’t circumcise me! Don’t hurt me!” and “When you circumcise a girl, you destroy her life.” Male preachers urge, “Leave this outdated cultural practice.” Handsome men of marrying age have a pretty persuasive line that makes me smile: they say that FGM excises “the sweetest and most delightful part of a woman.” I always thought that my most delightful parts were my brain and my heart, but there you go. Another man says he doesn’t want to marry a woman who has undergone  FGM because “I want her to be sexually satisfied.” Another man tells a crowd, “You can tell the difference between [happy] wives who have not had it done, and [unhappy] wives who have.” 

The Cut is expertly structured, with a sense of foreboding that increases with every testimony. The women who have been cut, some of them looking barely ten years old, seem bashful, not angry, when expressing their pain and disgust.  “It was very painful. I will never forget,” says one, her eyes sliding as she remembers. Another represses a shudder as she describes the way she was mutilated: “They would use [the razor] to cut everything [around the genital area].”

The Cut’s masterstroke – to use exactly the wrong word – is the access Beryl Magoko has gained to the circumcision rituals themselves. These happen for both sexes. The boys are circumcised in one area and we see them surrounded by countless male friends, neighbours and relatives, whooping, hopping, singing and celebrating. Then we see them standing with their willies hanging out, all looking like skinny kids. Each one clenches his jaw and keeps his chin up, lips firm, eyeing the boys on either side, full of determination not to show any pain. Despite that, quite clearly, it hurts a hell of a lot. When the circumcision is done the boys look dazed and miserable, oblivious to the partying around them. They’re escorted back home by all their friends, bleary eyed and unsteady, silent, as though all they want to do is lie down in a darkened room.

The girls are in a different area. Just like the boys, they are surrounded by their same-sex relatives and supporters. The atmosphere is wonderful, full of celebration, connection and encouragement. I can well understand the sense of rejection and chagrin, even confusion and blame, that a community would feel and then bring vengefully to bear on a girl who refused to undergo FGM. And I could well understand the conflicted feelings of any girl who does not want to be cut yet who is naturally drawn – as anyone would be – to a celebratory event in which everyone participates and supports each other. This is not about girls being too weak to say no, but about the strength of a culture in persuading, muffling, denying or overriding that no. Additionally, The Cut makes it painfully clear that the girls who submit to FGM do not do so because they are passive but because they are innocent. The reality of what exactly will be done to them is concealed from them until it’s too late. 

At the FGM ceremony there is an atmosphere of frenzy, an undercurrent of brisk determination to see it through despite anyone's hesitation or aversion and a core of dark zeal, as at any rite where blood is to be shed. Amidst the celebrations of the brightly dressed older women around them – a celebration in whose rhythms and music I can’t help but hear the refrain cycle-of-abuse, cycle-of-abuse – the girls themselves are subdued. They become increasingly and instinctively nervous as they are jostled to stand in a line and then pushed down to sit on the ground, then lie back when their time comes. We see money changing hands as women buy pairs of surgical gloves from a vendor.

The innocence of the girls is such that one casually helps her mother get a fresh surgical blade out of its sterile packet. The girls are forced back and told to relax with their legs bent and naturally apart. Fear spreads from girl to girl to girl. The older women grow carping, bossy and a little physically rough, relishing their one moment of power. They bully the girls and egg each other on. One of them holds the razor and cuts a girl. It’s unwatchable.

Afterwards, there is silence. The girls look sick, queasy with pain. Their faces are rubbery with shock and, for some, tears pour thickly down their cheeks. Their eyes are dead. The girls are unable to sit up. They are clearly, obviously, visibly traumatised, in shock. A sizzle of glee passes through the older women who throng, dance, gather. They look triumphant, like bullies who’ve gained a point.

A health worker filmed in her clinic says, “after FGM you can have death from bleeding out. You can catch an infection. There can be a cross-infection.”

A male apologist insists, “girls don’t bleed and are not cut painfully.” His comment is not just motivated by an arrogant dismissal of female pain but - as echoed by many of the speakers - a suspicion of health workers. Multiple commentators hint that “the negative effects come from doctors” who they say are misleading people about the risks of FGM despite having to deal with the consequences when things go wrong. There is, overall, a resistance to the kind of change that the clinic symbolises: a national, standardised and networked healthcare system relying on medicalised, non-naturopathic treatments. Something very simple lies at the heart of all this: resistance to change and fear of the loss of defining and unifying rites. “It may end gradually. We can’t stop abruptly. We say it’s an initiation and we believe it’s good for us,” says one man. Another person repeats fervently, “It will not end” because “culture doesn’t end. Ever.”

The girls are escorted home. Their faces have been daubed in talcum powder to mark them as ‘initiated’. With colourful hats and parasols held over their heads they look like little ghost emperors. The pressure of the bodies around them and the willpower of the crowd seem to be the only things holding them up. The people are singing, dancing and jogging alongside the girls.

A still from The Cut by Beryl Magoko

It’s a terrible journey back. The girls pass in and out of consciousness, crying, staggering, fainting, sweating and collapsing, barely able to walk. Their eyeballs roll, their necks go floppy. Blood runs down their legs. They are shaken firmly, scolded and harangued. There is no tenderness whatsoever. Never before has it been so clear that FGM – the entire day, not just the moment of cutting – is not about celebrating the start of womanhood but about forcing female obedience, beginning a trauma which makes girls mentally vulnerable and therefore susceptible to further control and abuse, women bullying girls and the deliberate debilitation and weakening of strong, healthy female flesh. FGM is a socially sanctioned brutalisation process justified as a rite so ancient that nobody can remember its purpose, thereby leaving it usefully open to conventional patriarchal justifications.

A woman describes the “excruciating pain” of female genital mutilation.

Another woman says, “I regretted having gone there – but it was too late.” It was done.

We see the girls being taken home, glassy eyed. They are so traumatised physically and mentally that they’re unable to speak. They are encouraged to lie down. They can barely manoeuvre themselves. We see one mother trying to get her daughter to eat a biscuit. The daughter is unresponsive. She is too weak to chew.

In the aftermath there are countless physical problems, in addition to the mental trauma. It is difficult to urinate and it can take up to three weeks to walk properly. One woman says she “can’t even bathe alone. You need to be held.” Much older women describe how they “staggered” and “couldn’t sleep or walk for ten days with the pain.”

The wound must be left to heal in a certain way. If a girl sleeps with her legs closed the wound is forcibly re-opened.

“It’s so painful that I can’t even explain,” says a woman.

“It is like taking a hot nail and putting it on the wound,” says another woman.

A health worker explains the biologically necessity of the clitoris, which helps the vagina to stretch during childbirth. But FGM can remove the clitoris, leaving scar tissue: “Scar tissue doesn’t expand, which leads to tears, which obstruct labour. This leads to tears upwards and also down to the anus in childbirth. So a woman can develop a third degree tear – vagina to anus.” It’s not the word ‘tear’ that gets me about that quote, it’s the phrase ‘third degree’. Because I’m guessing there aren’t a whole load of degrees to get though and third is pretty much the worst. From this, a woman can develop a fistula, which means that she passes faeces through the vagina, the barrier separating the vagina and anus having been ripped. 

Another health worker adds, “I feel [FGM] should stop. It’s just humiliating. If they want to do it let them do it on adults who can sign their own consent form.” For the villagers shown in The Cut, the power to end FGM officially and decisively is in the hands of the new generation of men, the sons of the council elders.

A woman who underwent female genital mutilation says, “If I could stop it, it would have ended.”

Further reading:

·           An interview with Beryl Magoko about The Cut and the issue of female genital mutilation.

·           The official press pack for The Cut, giving full credits and further details of the film’s history and making, can be accessed here.

·           Read Beryl Magoko’s directors’ notes about the challenges she faced when filming.

·           Listen to award-winning reporter Juliet Spare’s feature on female genital mutilation for Voice of Russia

Bidisha is a 2013 Fellow of the International Reporting Project, covering global health and development.

Taking action on the global health worker crisis

A couple of weeks ago I covered the importance of a well-trained, well-paid and well-respected human resources system in providing free universal healthcare globally. I analysed the challenges of doing so and examined some of the factors which can enable or inhibit good practice. Since then I’ve become aware of a new drive, flagged up by Health Poverty Action, which highlights the UK’s responsibility when it comes to global human resources in the field of health. It emphasises a developmental imbalance - with serious consequences for developing countries - created by the Western exploitation of global health worker labour.

Health Poverty Action has identified more than fifty countries, mainly in Africa and South Asia, which suffer from a “critical shortage of health personnel” while simultaneously carrying “a large part of the global burden of disease.” At the same time the increased necessity of long term care for ageing populations in European countries is creating strong demand for health workers, fuelling the migration of health workers to Europe from developing countries in today’s heavily globalised labour market.

Image of health worker in clinic in Tsumkwe in Namibia (c) Health Poverty Action

Health Poverty Action has been calling for the UK to “compensate developing countries for its role in the global health worker crisis.” There is a cached copy of the call here; I'm not sure what has happened to the plan to get supporters to write to UK MPs. The charity points to the shortage of health workers in developing countries and the UK's strong record of employing health workers who are originally from developing countries and migrate to the UK to work. HPA is not challenging people’s entitlement to move for work, to earn, to study and to create better lives, but instead seek simply to raise awareness of the consequences of the health worker shortage in developing countries. The responsibility for this must be on world governments engaged in large scale health infrastructure and planning. The shortage of health workers in developing countries results not only in poorer treatment there but in a variety of deficits which weaken the entire health system in the long term, from the under-staffing and under-maintenance of hospitals, clinics and rural health stations to poorer quality and less up to date training and education, the under-provision of medical equipment, the reduced chance of future investment when a future workforce cannot be relied upon and much more.

The charity adds,

It is estimated that 1 billion people [virtually all in developing countries] will never see a health worker, putting them at risk of dying from easily preventable diseases, from childbirth and basic health conditions.

The report Aid in Reverse challenges the UK government to play a conscientious and responsible role in ending the global health worker crisis, which Health Poverty Action labels a developing world “brain drain.” They suggest that in the UK the Departments of Health and International Development could work together on two complementary issues: first, treating the roots of the UK’s own shortage of health workers through better planning, training and education; second, giving something back to the developing countries whose health infrastructures are being weakened through lack – with severe ramifications for those nations’ own long term development – while they contribute so much to developed nations’ healthcare systems.

The challenge to developed nations who use the labour of talented health workers from developing countries to ensure their own citizens’ wellbeing is part of a pan-European initiative aiming to create a sustainable global health workforce. One of the main directives of the project is the implementation of a World Health Organisation Global Code of Practice on the International Recruitment of Health Personnel. The project’s tagline runs,

‘Healthworkers for all and all for health workers.’

Bidisha is a Fellow of the 2013 International Reporting Project, covering global health and development.

Twice Upon A Time by film-maker Niam Itani: for the refugee children of Syria and Lebanon

Lebanese film-maker Niam Itani - read a wonderful interview with her here - is working on a new documentary project about Syrian and Lebanese children, called Twice Upon A Time, which, as she tells me, "seeks to raise hope amongst refugees and parents of today." Itani has started a campaign page to raise post production funds for Twice Upon A Time and produced a trailer introducing viewers to Khalil, the charismatic and bright boy at the heart of the film:

There are only five days of the fundraising campaign left, and nearly $20,000 still to be raised for this important, humane and uplifting film project.

Niam Itani was born and raised in Beirut and Ghazzeh in Lebanon. The Lebanese Civil War lasted 15 years, consuming 9 years of her childhood. "I witnessed several periods of unrest and violence in Lebanon throughout my childhood and adult life," she tells me. "I’ve had to abandon my city and home with my family several times due to these conflicts; the longest of which lasted five years in the Bekaa Valley - a rural area of Lebanon - in a village called Ghazzeh."

Twice Upon A Time is a film drawing together themes with both political and personal resonance, highlighting the universal impact of war on children and on entire communities. In the campaign briefing Niam Itani writes the following:

"In 1989, my parents left Beirut for a small village in the Bekaa Valley called Ghazzeh. I was eight years old.

"In 2012, Khalil's mother left Syria and took refuge at our house in Ghazzeh. Khalil was ten years old.

"This film tells the story of my friendship with Khalil, and our efforts to find hope and joy in the midst of madness and despair. It is also a personal reflection on childhood, nostalgia, home, belonging, memory and war."

Khalil & Niam assemble kites together, Spring 2013

"The Lebanese Civil War (1975-1990) left behind an estimated 120,000 fatalities. A study conducted in 1992 under the title 'Assessing War Trauma in Children: A Case Study of Lebanese Children' showed that 'on average a Lebanese child has experienced five to six different types of traumatic events during his or her lifetime; some events were experienced several times.' (Journal of Refugee Studies, 1992, Macksoud)

"Twenty-three years later, in what I'd like to think of as a civilized and sophisticated world that we live in, another armed conflict took the same trajectory as the Lebanese one, with more horrifying outcomes. By September 2013, less than three years after its beginning, the Syrian Crisis had left more than 120,000 fatalities and 2 million refugees. The numbers grow on a daily basis. [Read my own coverage of the Syrian humanitarian crisis here.]

"Seeing these two conflicts happen in such a short period of time in history and in two neighboring countries is heart wrenching for me. The most devastating part is that I am forced to watch more children grow in the same damaging conditions that my generation grew up with.

This is not another film about children who are orphaned, hungry or homeless seeking food and shelter during war. This is a film about children with caring and loving parents, coming from middle class families like most of us, but finding themselves in the cruellest human condition of all: war."

Khalil & his siblings pose for a photo before school, Spring 2013

"By telling this story, I hope to bring more understanding and awareness about this issue and to mobilize additional psychological and material support for children refugees around the globe.

"On July 31st, 2012, Khalil's family crossed the Syrian Border into Lebanon to flee the armed conflict in their country. My mother gave them refuge at our summer property in Ghazzeh, in the Lebanese countryside. That is where I met Khalil (12 years) who would later change the course of this project, and therefore, my life.

"But the journey of this film started much before the arrival of Khalil's family to Lebanon, and before the Syrian Crisis altogether.

"It began in 2010 as an attempt to fill memory blanks pertaining to my childhood during the civil war in Beirut. I was searching for "nice memories" during the period between 1980 and 1989, which seem to have vanished from my memory."

This photo of Niam was taken on May 4, 1984, one month before her sister 

Heba (mentioned in the video) passed away at the age of 9

"During our regular visits to Ghazzeh every weekend in 2012, I started to help my mother in providing food and shelter to refugee families. It didn't take long to notice that the plight of refugees in the village was too identical to our own strife in the exact same place, two decades earlier.

"Since Khalil's family technically lives with us, an unorthodox but very special friendship grew between me and him. My witnessing of his daily struggle in the beautiful locale of my childhood served as a wake up call for me. I felt that Khalil was re-living my past right in front of my eyes. And this time I could document it, not only for myself but for the whole world.

"Something was urging me to bring my camera and film the bond that was developing between me and Khalil. A bond built on sharing the war related traumas and many common personality traits. As in many other documentary projects, when I first started to film I didn't know what I was specifically after, but the pieces quickly started to fall in place."

 

Aya (3.5 years old) is a one of the Syrian refugees in Ghazzeh

All principal filming on Twice Upon a Time is now complete. To arrive at this point, Niam has used her own resources and those of her family, friends and friends of friends. The "urgency, intuitiveness and unfolding of the story on a day-to-day basis", she says, obliged her to focus on shooting the film rather than file applications for production support and/or waiting for financial backing from film funds or institutions (which is the classic route). The film team now need your support to raise a minimum of 35,000 USD for this project. These funds will cover part of the post production process and allow them to hire an editor, a sound designer and other artists and technicians to create a fine cut of the film. Once they have that fine cut, they can use it to apply for post production funds from regional and international film bodies.

Niam Itani has been campaigning and advocating for Twice Upon a Time, speaking on Al Jazeera about both her own history, Khalil's experiences and the project:

When I became aware of the project, via an introduction from film-maker Marian Evans, I had to find out more about this skilled and impassioned artist, who studied  for her BA in Communication Arts and a Masters Degree in Education from the Lebanese American University in Beirut, then pursued an MFA in Screenwriting from Hollins University in Virginia, USA. She made her first professional documentary in 2001 for a conference at university when she was an undergraduate. It was a short film entitled Ghareeb (Stranger). In 2005 Itani completed a second short documentary, Zakira Mubsira (A Foretold Memory). Between 2005 and 2010, she got the chance to expand her documentary skills while working at Al Jazeera Channel in Qatar as a Programs Producer. At Al Jazeera Itani worked as assistant producer on the critically acclaimed series Al Nakba and went on to make her first feature documentary, Rokam Al-Bared (Ruins of Al-Bared), a documentary about the destruction of a Palestinian refugee camp in North Lebanon. Her last short film, Super.Full. (2010), played at several film festivals including two Academy Award Qualifying festivals and the Venice Film Festival. Itani's feature narrative project entitled Shadow of a Man, is currently in pre-production and has been selected at multiple regional and international film venues. In January 2013 she co-founded placeless films, a film production company in Beirut, Lebanon. As part of placeless films, Itani also recently launched ScriptExperts, a specialised story & script service catering primarily to writers and filmmakers in the Middle East.

Niam Itani told me more about her intentions as the creator of Twice Upon A Time. Below are selected quotes from her exclusive, honest and powerful interview:

"The original idea was a personal documentary project, that I started to work on in 2010 – a journey to document my own memories as a child, some of which were very vivid and some missing. I was going to interview family members mainly and try to fill in the memory blanks. This idea took a major turn; however, when Syrian Refugees started coming into Lebanon in 2012. The uncanny similarity of circumstances forced me to shift my focus to the “story” unfolding right in front of me in the present. A present that will be embedded in the memories of this new generation of children refugees. Twice Upon a Time was born."

"[As explained above,] the film is the story of my friendship with Khalil, a Syrian boy who had to leave Syria with his family in 2012, and took refuge in Ghazzeh (the village where we took refuge in 1989) as well. On a second level, it is the story of Khalil’s family and their recent experience of refuge and the story of my family’s experience of refuge 23 years ago and how similar are the challenges that we used to go through as children. On a third level, this is a film about hope, memories, childhood, nostalgia, and the notion of home."

"The film seeks to bring many issues to the fore. Some of them are everyday issues of refugee life like finding shelter, food, health-care, schools and a good environment to live in whether on the level of infrastructure or on a social/interpersonal level, and potential work and education opportunities for family members. Important issues that I want the film to call attention to is the children mental and psychological health during refuge, protecting them from witnessing additional trauma, and encouraging them to have hope, to give them opportunities to play and to pursue their education and bring their dreams closer to reality. Another major issue is the lack of compassion for the incoming refugees among host societies – Lebanon in particular. We won’t be delivering any of these messages to our audience but want them to see for themselves."

"The sources of hope for the Syrian children today lie within us, those who were children during times marked by war, hatred and destruction; and yet we made it to become successful and active individuals in our society today. I’d like to think that I give hope to Khalil when he appreciates what I do today and realizes that I lived most of my childhood years in conditions similar to what he is living through now. Hope lies in sharing the lessons that we learned from our own war, and stressing the importance of education, understanding others and working towards a better future."

"The film is a very personal and intimate story. In the film, the main people who speak are Khalil (he talks to me), myself (through narration and through talking to him), his mother, and my mother. We are exploring ways of partnering with International NGOs to carry this message through a concerted campaign, to raise awareness among both host societies and refugees, particularly across Lebanon, Jordan, Turkey and Syria. While this is the grand plan, we need more players and commitment to make this happen. On a more granular level, my sincere hope is that this film will touch people, irrespective of where they are, by sharing the message of understanding and compassion on a more individual human level."

"Mahatma Gandhi once said, 'If we are to teach real peace in this world, and if we are to carry on a real war against war, we shall have to begin with the children.' I have witnessed war as a child. Once it marks you, it will be very difficult to erase that mark. So the best thing to do is to utilize that effect and make it a tool for peace, love and understanding."

"I would like for viewers to put themselves into the shoes of the refugees, even if it is only for one day or one hour, and take into account the life that they must’ve been forced to leave behind. Their arrival as refugees in a new town or a new country is marked mostly by more hardship and challenges at the very basic level. I want this film to break many stereotypes, to spur people in societies that have refugees to accept them as fellows in humanity, to smile at them – if not for anything else. Ideally, I want people to help refugees wherever they are, to encourage them and support them in any way possible. We were there yesterday, they are here today, nobody knows who it could be tomorrow."

"I would like to bring a future of stability and safety to the children of Lebanon and Syria. One where bombs and bullets are considered dangerous accidents, not everyday life happenings. I want them to have the luxury to play and study without being forced to grow up so fast and carry more responsibilities and burdens than they are forced to do now."

Niam Itani with Khalil

The fundraising campaign for Twice Upon a Time is here. There are just five days left. If you like what you've read here, please support this vital project, which speaks to all those across innumerable countries, generations and cultures who have suffered displacement, conflict, societal breakdown and the fallout of violence and find themselves having to forge new lives as strangers - often traumatised, often mistrusted - in new places. 

With gratitude to Niam Itani for granting me her time and wisdom. Quoted campaign text (c) Twice Upon A Time.  Bidisha is a 2013 International Reporting Project Fellow reporting on global health and development. 

Monday 25th November is International Day for the Elimination of Violence Against Women

Trigger warning. From Karen Ingala Smith and all text (c) her:

Monday 25th November it is the International Day for the Elimination of Violence Against Women. I’ll be highlighting the UK’s shocking record of women killed through male violence in 2013.

Starting at 6.00am, on the twitter account @countdeadwomen, I’ll be going through the UK’s diary of women killed by men. I’ll be starting with the 2nd January when Janelle Duncan Bailey was strangled by ex-boyfriend Jerome McDonald, moving on to 3rd January at 6.10, when Akua Agyuman died, two months after being stabbed in the chest and abdomen by her husband Minta Adiddo. Every 10 minutes, I’ll move through the year to commemorate all the women who I have found who were killed though men’s violence. So far I know of 112 women killed this year, so I’ll still be tweeting at midnight.

Thank you all for your support. We’ve reached 2,500 signatures now but I'm still the one doing the counting. As I've said all along, I'll keep doing it, until I'm convinced the government is doing enough!

Images of some of the women killed by male violence in the UK at a rate of 2 per week

The text on the campaign page lobbying the UK government to Stop Ignoring Dead Women [please click and sign in solidarity] reads as follows:

On New Year’s Day, 2012, 20-year-old Kirsty Treloar got a text from her boyfriend Myles Williams:

Okay wer all gud now and my new yrs ressy is that I aint going to hit u again and I won't hit u 4 this yr next yr the yr after that the next yr after that.

The next day he broke into her family’s home, stabbed her brother and sister as they tried to help, then he dragged Kirsty into the back of his mother's car and drove her away. She was found dead 2 miles away, dumped behind a wheelie bin. Kirsty had been stabbed 29 times.

Michael Atherton, 42, also sent a New Year text. Shortly before midnight, he sent a text to his partner, Susan McGoldrick, saying he was going out and would spend the night away because he didn’t like her sister Alison Turnbull, 44, with whom she was spending the evening. But Susan and Alison came home before he had left. Atherton, who held a gun licence despite a history of arrests for domestic violence dating back 10 years, shot Susan, Alison and Alison’s 24 year old daughter Tanya, before killing himself.

On New Year’s Day, Aaron Mann, 31 repeatedly hit Claire O’Connor, 38, with a blunt object before smothering her with a pillow. Her badly beaten body was found wrapped in her son’s sleeping bag and covered in a sheet in the boot of her car on January 2.

On 3rd of January John McGrory used a dog lead to strangle 39-year-old Marie McGrory. Garry Kane, 41, killed his 87-year-old grandmother Kathleen Milward, though 15 blunt force trauma injuries on her head and neck.

So, by the end of the third day of January 2012, seven women in the UK had been murdered by men, three were shot, one was strangled, one was stabbed, one was beaten then smothered and one was killed through fifteen blunt force trauma injuries. Perhaps because it was the beginning of the year, I just started counting, and once I’d started, I couldn’t stop. Since then, I’ve counted 199 women killed through suspected male violence. I urge you to read Karen Ingala Smith's site for more information.

At first I counted women killed through domestic violence. Then, on March 9th 2012, Ahmad Otak stabbed and killed Samantha Sykes, 18 and Kimberley Frank, 17. Otak wasn’t the boyfriend of either of them, but of Elisa Frank, Kimberley’s sister. After killing Kimberly and Samantha in from of Eliza, he abducted Eliza and drove to Dover in an attempt to escape to France. The murders of Samantha and Kimberley don’t fit the definition of domestic violence, but they’re absolutely about a man trying to exert power, control and coercion in his relationship. Their deaths made it clear to me that concentrating on what we see as domestic violence isn’t enough. It’s wider than that. The murders of Kimberley and Samantha by were no less about male violence against women that they would have been if he had been the boyfriend of one of them.

Then there’s Andrew Flood, a taxi-driver who strangled and robbed Margaret Biddolph, 78 and Annie Leyland, 88. When I learned he’d also robbed a third woman it was clear to me that there was a pattern to his actions. In fact, last year, five older women, aged between 75 and 88 were killed by much younger men, aged between 15 and 43 as they were robbed or mugged, including Irene Lawless, 68 who was raped, beaten and strangled by 26 year old Darren martin. The murders of Margaret, Annie andIrene were not any less about misogyny, than those of women killed by someone they were related to. So my list doesn’t just include women killed though domestic violence. We have to stop seeing the killings of women by men as isolated incidents. We have to put them together. We have to stop ignoring the connections and patterns.

The Home Office currently records and published data on homicide victims and the relationship of the victim to the principal suspect and sex of the victim. This does not do enough to tell us about fatal male violence against women:

1. It doesn’t tell us about the sex of the killer

2. It doesn’t connect the different forms of male violence against women

3. It dehumanises women.

The statistic ‘on average two women a week are killed through domestic violence in England and Wales’ is well known but we don't seem to feel horror in our response to this. The murders of some women barely cause a murmur; lots don’t make it into the national media. And so the connections, the horror, the patterns, the deaths continue in silence. Unnoticed. Ignored.

Ultimately, I want to see men stop killing women.

I have launched this campaign, Counting Dead Women because I want to see a fit-for-purpose record of fatal male violence against women. I want to see the connections between the different forms of fatal male violence against women. I want Domestic Homicide Review reports to be accessible from a single central source. I want to see a homicide review for every sexist murder. I want the government to fund an independently run Femicide Observatory , where relationships between victim and perpetrator and social, cultural and psychological issues are analysed. I want to believe that the government is doing everything it can to end male violence against women and girls. And I think the government should be recording and commemorating women killed through male violence – not me, a lone woman in a bedroom in east London

Let’s start counting dead women, not ignoring them. If you want us as a society, the press and the government to stop ignoring dead women, if you want us to find ways to stop women being killed, please join me, add your voice and sign this petition.

All text (c) Karen Ingala Smith

"Every woman has basic human rights" The Circles empowering women for health, development, education and freedom from violence

Earlier this year I chaired a panel with Joan Smith, Baroness Helena Kennedy and the novelist Kishwar Desai. We were discussing male sexual violence in India, following the worldwide protests about the rape, torture and murder of a young woman in Delhi. The event, at The Nehru Centre in London, was held to launch Desai's latest novel Sea of Innocence, which tackles the same issue and also provides shocking details of the Delhi case which hadn't previously been revealed in the media. In its ability to combine a strong heroine with a thrilling plot and urgent contemporary issues, Sea of Innocence follows on from Desai's previous novel The Origins of Love, which looked at the Indian international surrogacy trade.

The conversation during the Sea of Innocence launch event was wideranging. We looked at all aspects of global rape culture, which transcends colour, religion, class, language, country, culture and hemisphere: the blaming of victims, the excusal of perpetrators, the prejudice against survivors of sexual violence, the silencing and abusing of survivors who speak out, extreme and perverse leniency towards perpetrators even when they are convicted. Male sexual violence, which is endemic, reflects, partially creates and also reinforces women's inequality, disempowerment and subjugation. This disempowerment is obvious in every area: in the discrimination against us in the workplace; in the exploitation of our labour, which is unpaid, under-paid, under-valued and over-consumed; in the denial of our rights over our own bodies; in the casual and constant judging, slandering, undermining and defamation which constitutes the majority of all comments made to and about women; in the way we are represented in mainstream culture, images, advertising and the media as silent pieces of nice-looking meat, pathetic and useless idiots or bitter, petty, malicious schemers; and in the strong resistance against female education, landholding, powerful visibility, money-making, public involvement, mobility in public spaces (which is delimited by harassment and threat), enfranchisement, leadership, influence, direction and presence. Writing specifically on rape culture, structural misogyny and gender inequality in India, there is a brilliant analysis by Tehelka Media which I urge everyone to read.

As UNIFEM states, "One woman in three will be raped, beaten, coerced into sex or otherwise abused in her lifetime." Male violence against women is so common that it has been described by the World Health Organisation as being "of epidemic proportions." Read the major, multi-national WHO study into domestic violence and see why they identify it as "a major public health and human rights problem throughout the world."

After the Sea of Innocence panel discussion I was approached by an impressive woman, Santosh Bhanot, who told me that she was involved in a project called The Circle, in affiliation with Oxfam. The Circle aims to address some of the fundamental issues and abuses which keep women worldwide in a state of disempowerment and inhibit our equality and our access to justice, rights and autonomy. Another underlying goal is to lift women out of poverty through gender empowerment.

The issue of poverty, often spoken of in general terms, is starkly gendered. According to Oxfam,

Of the 1.3 billion people living in extreme poverty worldwide, more than two thirds are women and girls.

Women and girls are the most disadvantaged of the disadvantaged, the most abused of the abused and the most exploited of the exploited. This has not arisen by some kind of unfortunate, fated magic but directly through the actions of patriarchal systems and many individual but misogynistically and patriarchally like-minded perpetrators, users and exploiters. When we defy all silencing and stigma to speak about what we have undergone we suffer the further grotesque abuse of being blamed for men's abuse of us, told that we deserve it, told that we brought it on ourselves by our own behaviour or told that we are lying out of malice to hurt men. We are then punished further by being slandered, marginalised or ostracised.

As Everjoice Win from ActionAid International, South Africa, states in a report about how helping women and girls is the key to ending poverty,

We believe that women are vulnerable and more impoverished compared to men because they have been systematically made vulnerable by years of violence, patriarchal power and control, as well as decades of inequitable laws and policies deliberately designed to put them in this position.

The Circle was founded in 2008 by Annie Lennox with the aim of connecting high profile, culturally influential women of expertise in various areas. A network of Circles will raise consciousness and money (here's the catch: money for Oxfam) to spend on a range of grassroots projects tackling everything from poverty to education to maternal health. They will also work "to reduce all forms of violence towards women, by helping to change attitudes."

The idea is that the various Circles support specific projects of interest but are all part of the wider Circle ethos of women helping women to change the world for everyone. A group called The Lawyers' Circle supports women's legal rights in Africa; The Music Circle raises money to protect women in the Democratic Republic of Congo; The Oxford Circle is looking at improving health and education in Niger and hopes to engage Oxford University and local city businesses in supporting this aim.

So far, significant money has been raised for a broad range of change-making initiatives. In Zambia the Circle project, working with Oxfam, is helping community schools. These are volunteer-run initiatives which provide vital education for one million Zambian children. However, those involved require more training and resources; the Circle's work in this area benefits 18,000 students in 25 schools and strongly supports the education of girls.

In Pakistan the We Can project is a grassroots initiative aiming to reach 800,000 people in combating "endemic" male violence against women, advocating for it to be reported and investigated and for a social shift which recognises male violence against women as abuse rather than normalising it and blaming victims rather than perpetrators.

The Circle has been working on improving maternal healthcare in Ghana, where 75 women a week die due to complications in pregnancy and childbirth. The focus here is on the provision of free healthcare to reduce maternal mortality. This is an achievable goal: other, non-Oxfam projects worldwide have shown the marked success of dedicated maternal mortality, pre- and ante-natal and newborn health projects. Please see my reports on Sierra Leone and Burundi and India for more details.

Two women's co-ops in Liberia have been helped to provide women with tools and training and empower them to bargain for better terms in a country in which, says Oxfam, "80% of ...women are unemployed." One little note to make here to correct that subtle patriarchal diss: these women, I can bet you, are employed. They are totally employed, to the point of exhaustion. They are employed in the never-ending, repetitive, back-breaking, all-consuming drudge labour of looking after the children, serving the men, running a household, cooking, cleaning and everything else - and these are all separate jobs - and their work is used and taken and exploited for free. They are paid nothing for their 24-hours, 7-day-a-week employment and it is callous and disrespectful to say that these same women are "unemployed." It is more accurate to say that they are exploited in an unjust situation. Despite the work they do, they are economically dependent on men and marginalised by them from economic power, political status, public influence and social clout. This exploitation and depletion of energy, financial and legal marginalisation and political discrimination mean that it is difficult for women to fight together for equality, rights and freedom from violence.

The latest addition to the Circle network is The Asian Circle, which works alongside Oxfam in helping South Asian women. It was founded and is chaired by Santosh Bhanot, the woman I met at the Kishwar Desai event. The focus is wide: The Asian Circle will be pulling together high profile women to support projects in agriculture, education, disaster relief and management, poverty reduction and sustainable development.

The Asian Circle was launched at the Houses of Parliament on 7th November 2013 in an event chaired by BBC reporter Ayshea Buksh and featuring speeches by Southall Black Sisters activist and journalist Rahila Gupta (read some of her human rights focused pieces here) and Kishwar Desai.

Santosh Bhanot spoke at the launch of The Asian Circle:




This week she told me,

Our focus is to work towards change with the skills and talents of ...[the] women who are part of the Asian Circle, a group of passionate and highly influential women from all walks of life. I wanted to help women who have an unfair chance in life and I particularly have passion and energy to work with women in South Asia because of my roots [as a South Asian woman]. Every woman has basic human rights.

On my recent visit to India I saw the positive impact of programs by Oxfam working with vulnerable women. For instance, building support centres for women subject to domestic violence and providing mediation and legal support. More programs are needed, especially in the poorer states.

The first programme The Asian Circle is supporting is called "Promoting Violence Free Lives." According to the Indian National Family Health Survey Round III report of 2005-2006 and the Oxfam India 2010 Baseline Survey, the statistics are damning, as are the social values which have been revealed:

• 35% of women suffer sexual or non-sexual violence in India
• 72% of men believe male violence against women is justified
• 68% of women believe that husbands are justified in beating wives

Rahila Gupta welcomes the connection between the feminism, profile and zeal of The Asian Circle and the structural support Oxfam can provide:

This is the launch of a very important initiative. If my last 24 years with Southall Black Sisters has taught me anything, it is this: funding, funding, funding. The time that we would like to spend delivering frontline services is spent instead on raising funds without which we'd have no money to deliver anything. So it's great that the Asian Circle aims to help Violence Against Women projects in India escape that vicious cycle.

The Asian Circle is focusing on the poorest states with a multi-tiered, thorough strategy: to build support centres in police stations for women who have suffered gendered violence; to engage community elders, young men and boys through educational initiatives to change their attitudes and their behaviour; and to develop networks of women working at a state level to make sure that domestic violence laws are implemented rather than ignored.

Kishwar Desai told me,

As someone who has been trying to raise awareness about some very disturbing gender issues in India for a while now, I am sincerely grateful to see the formation of The Asian Circle. My personal hope? That they will be the catalyst, eventually, for providing an international platform for Asian women, perhaps leading to a women's liberation movement in Asia.

Bidisha is a 2013 International Reporting Project fellow, covering global health and development.  

Nutrition and maternal, newborn and child health: joining the dots and looking beyond the Millennium Development Goals

A news bulletin sent around earlier this year by Dr Carole Presern, Executive Director of The Partnership for Maternal, Newborn and Child Health, threw down the gauntlet for the world community. At the time of the G8 summit – which I covered here in relation to the Enough Food For Everyone IF… campaign – the PMNCH highlighted the importance of nutrition. Since then I have found the work and the general approach of the PMNCH to be invaluable in joining the dots between various global health and development issues now that world leaders and development workers are considering a framework for initiatives extending beyond 2015.

The result of this summer’s discussions and presentations was the signing, by numerous international players, of the Global Nutrition forGrowth Compact, with up to $4.15 billion committed on this initiative up to 2020. Those who contributed to this strong pledge for a reduction in under-nutrition included the Bill and Melinda Gates Foundation, World Vision and Save the Children.

As Dr Presern writes,

Leaders should be especially motivated to see pledges result in measurable action. Bringing commitments to invest in nutrition under the umbrella of the Every Woman Every Child movement led by UN Secretary-General Ban Ki-moon would provide a useful framework for tracking their progress. We look forward to supporting efforts in this direction.

All of these issues are already very high on the international agenda. At the 66^th meeting of the World Health Assembly in Geneva in May this year, global delegates passed a resolution to implement the recommendations of the United Nations Commission on Life-Saving Commodities for Women and Children and also discussed a first-ever action plan pertaining to newborn health to end preventable deaths, which will be realised at the 2014 World Health Assembly.

At the Nutrition for Growth event in June, Justine Greening MP from the Department for International Development spoke about the importance of nutrition as a major development issue. She also outlined the financial pledges made by the international community of leaders in politics, social enterprise and business. She added,

Under-nutrition is stopping children and countries from reaching their full potential, accounting for the loss of billions of dollars in productivity. A strong and healthy workforce is vital if a country’s economy is to prosper. This means business and science taking a lead in fighting for good nutrition because we understand that better nutrition is the smart way to tackle extreme poverty, child mortality and economic underachievement.

What has to happen next is an integration of understanding between the issues – and, I would argue, an analysis of how gender inequality and sexist social values underpin many of the disadvantages, risks and problems covered.

The PMNCH’s own research provides a nuanced analysis of the relationship between nutrition, sustainable development and women’s and children’s health. Their findings were developed for the Open Working Group of the UN General Assembly in preparation for the formation of post-2015 development plans. They make a strong case for the importance of investment in nutrition for women and children as a major factor in ensuring sustainable development and its four pillars of economic development, environmental sustainability, social inclusion and peace and security; these criteria having been delineated by the UN System Taskforce on Sustainable Development.

This is about more than being hungry or not getting the right vitamins or minerals. Malnutrition and under-nutrition, rooted in long term poverty, inequality and disadvantage, have wideranging and interconnected health, social and economic consequences which do not affect just individuals but entire families, communities and generations. Their finding – spelled out in greater detail here, with references to specific studies – demonstrate myriad risks of malnutrition.

The report states,

Malnutrition contributes to disease and early deaths, especially for women and children. Malnourished women have lower birth weight babies resulting in children born into unhealthy, poorer families… and a lifetime of nutrition-related morbidity and mortality, which affects a woman’s own health and productivity and that of her offspring.

What is particularly interesting about the report is that it doesn’t just chronicle a problem, it also points to the benefits of action, stating that improved nutrition and greater health result in higher productivity. The findings are that women who are healthy, fed and working participate in the economy from a stronger position, both saving and investing. Healthy, well-nourished children have better mental development and learning skills and are more likely to stay in education and therefore to have a greater chance of earning more. The report points out that those who did not receive adequate nutrition in utero and in their earliest years “has been associated with reduced labor supply” and consequently lower adult incomes and therefore lower productivity at a mass level, across countries, where under-nutrition is widespread.

Whether or not you agree with this approach – that we should nourish human beings because they’ll then nourish capitalism more heartily instead of lying there like non labour producing duds - rather than seeing this as a human rights issue – it’s an interesting insight into the dramatic difference something as basic as nutrition can make.

There is also the cost of treating malnutrition:

• In some  low-income countries, the direct costs of iron deficiency (disease and death) are as high as 0.57% of  GDP, while indirect costs (related to physical and cognitive losses) can reach 4% of GDP.8

As a final thing to think about, the PMNCH also considers the risks and consequences to the health and the economy of too much food (and of the wrong time), not just too little food. In environments where the issue is not lack of food but over-consumption of food which is not nutritional and involves many risky factors (processed and refined food, food containing many additives and few nutrients, food high in salt, sugar and trans fats) there is an ever-rising figure, currently up to 8% of healthcare spending, associated with obesity. In China, right now, the cost of dealing with obesity is actually more than the economic costs associated with under-nutrition.

Related articles:

• The power of simplicity: reducing maternal mortality in Sierra Leone and Burundi
• Help the mother, help the child, secure the future: maternal and child health in India
• World hunger: time is running out

 Bidisha is a 2013 International Reporting Project Fellow reporting on global health and development.