Daughters of the Diaspora Daughters of the Diaspora Daughters of the Diaspora, Inc. is a non-profit organization that teaches self-esteem and reproductive health to adolescent young women throughout the African Diaspora. The program partners with students at local universities who tailor the Daughters of the Diaspora (DoD) curriculum for their culture and locale in order to teach adolescent girls how to make great decisions regarding their life and reproductive health. Our design is centered on creating sustainable solutions for African women all around the world. DoD will educate and empower young women to make appropriate decisions concerning their reproductive health. About the Founders. Picture Picture Joy A. Cooper, MD MSc is a Philadelphia native and an Obstetrics & Gynecology resident at the Hospital of the University of Pennsylvania. She earned her MD from Howard University, completed a Master's in Sexually Transmitted Infections & HIV at University College of London/London School of Hygiene & Tropical Medicine and earned a A.B. in African and African-American Studies at Harvard College. When she is not on call catching babies or traveling the globe, she is fulfilling her mission to teach young women about sexual health and self-esteem through Daughters of the Diaspora, Inc. Nenna N. Nwazota, MD was born to Nigerian parents in Chicago, IL and currently resides in New York. She attended Harvard College and received a A.B. in Psychology, then went on to complete her medical degree at Baylor College of Medicine where she also completed her Anesthesiology residency. She remains interested in healthcare and serving underserved communities both domestically and abroad. She is a board-certified anesthesiologist working in Westchester County Hospital and has a special interest in obstetric anesthesia and pain management. When she's not working, Nenna can be found spending time with her growing family or indulging her passion for travel. Women throughout the African Diaspora have higher prevalences of sexually transmitted diseases like HIV and Chlamydia. They also have higher rates of pregnancy complications including: preeclampsia, ectopic pregnancy and maternal death. To combat this quandary, our theory is for young women to be educated about their bodies and sex before they have developed poor habits concerning their sexual and reproductive health. Our organization seeks to prevent these poor outcomes that beset black women no matter if they live in an underdeveloped country or the developed world. Millenium Development Goals. In 2002, the United Nations created the Millennium Development Goals (MDG) to create objectives to impact the growth of the developing world. Three of the eight goals are directly involved with the mission of Daughters of the Diaspora: #3 - Promote Gender Equality and Empower Women #5 - Improve Maternal Health #6 - Combat HIV/AIDS Below are facts from the UN that explain why these issues are important: Gender gaps in access to education have narrowed, but disparities remain high in university-level education and in some developing regions. In sub-Saharan Africa, a woman’s maternal mortality risk is 1 in 30, compared to 1 in 5,600 in developed regions. HIV remains the leading cause of death among reproductive-age women worldwide. (Part of reducing maternal mortality is reducing the large percentage of unwanted pregnancies through reproductive education and contraception) The World Health Organization has already done an analysis of data to support the notion that achieving MDG #3 is the conduit to achieving MDG #5.1 This document offers specific solutions to solving both goals collectively like increasing the health literacy of women, increasing gender equality within relationships and encouraging women to actively participate in their own health management. These are all modalities that Daughters of the Diaspora teaches through the curriculum. In Africa... The Human Immunodeficiency Virus (HIV) The face of HIV pandemic is a female one. Biologically, women are more likely to contract the virus. Of all the women around the world living with HIV, 76% of those women reside in Africa. 2 Roughly 60% of Africans living with HIV are women and girls.3 In Sub-Saharan Africa, young women ages 15-24 make up 72% of all young people living with HIV.2 Furthermore, research has shown that countries with a high HIV-prevalence among young women also have high teen pregnancy rates.4 These statistics paint a clear image of how the demographic that Daughters of the Diaspora targets represent those who are most vulnerable to HIV and really shape and carry the epidemic. Now that AIDS has been a reality for 30 years and has become one of the largest problems that faces the continent of Africa, only second to poverty the focus on HIV in Africa has to focus on the generation that can change the epidemic, young women. The interventions that Daughters of the Diaspora offers hope to not only protect girls and young women from the lesser known maladies like preeclampsia and chlamydia but also tackle the chief among all maladies in Africa—HIV. Adolescent Fertility & Maternal Mortality The adolescent fertility rate in Sub-Saharan Africa is 108 per 1,000 women aged 15-19.5 This coupled with a 500 per 100,000 live births maternal mortality ratio demonstrate the risk that both pregnancy and unintended pregnancies pose for young women. 5 Cervical Cancer Over 85% of the global burden of cervical cancer occurs in the developing world. In Sub-Saharan Africa, cervical cancer is the most common female cancer.6 Roughly 90% of the women in Sub-Saharan Africa have never had a pelvic exam.6 In the Caribbean... The Human Immunodeficiency Virus (HIV) The Caribbean is the second-most HIV-affected region in the world. The prevalence of HIV ranges from 1.4% to 3.1% among the different islands, with the Bahamas having the highest prevalence. Young women also make up a large portion of the epidemic in the Caribbean, as they are twice as likely to be infected with HIV than their male counterparts.7 Adolescent Fertility & Maternal Mortality The adolescent fertility rate in the Caribbean is 65 per 1,000 women aged 15-19.5 A look at the maternal mortality rate of 210 per 100,000 live births reveals the stark difference of the Caribbean from the rest of the neighboring Latin American countries with a maternal mortality rate that is nearly three times greater.5 Cervical Cancer With an incidence rate of 20.9 per 100,000 women, the Caribbean seems to fair better than Sub-Saharan Africa but still have not caught the wave of reduction seen in the developed world due to the Pap smear.8 The mortality rate of cervical cancer is 9.4 per 100,000 women.8 In the United States of America... Despite living in one the most developed nations in the world, African-American women still have health statistics that segregate them from the rest of the country. The Human Immunodeficiency Virus (HIV) In 2009, African-American women had the highest incidence rate among American women (39.7 per 100,000), a new infection rate that is 15 times the rate of white women.10 Approximately 85% of these women acquire HIV through heterosexual sex.9 The CDC sites the major reasons that young people (ages 13-29) acquire HIV is because of early sexual initiation, unprotected sex and older sex partners10, which is why Daughters of the Diaspora hopes to target adolescents and give them the tools and confidence to negotiate delaying sex, condom use if they are active and making good decisions about their partner choice. Adolescent Fertility & Maternal Mortality The overall adolescent fertility rate for the United States is 33 per 1,000 women aged 15-19 and overall maternal mortality rate is 21 per 100,000 live births.5 In the United States, most data on race uses the teen birth rate, which is 34.2 per 1,000 women. For black teens, the rate is 51.5 per 1,000 women.11 The maternal mortality rate for African-American women is 28.4 per 100,000 women, which is 2.7 times that of white women in the United States.12 This rate is also more than three times the rate of Hispanic women.12 Clearly, disparities exist in the realm of teenage pregnancy and pregnancy outcomes among African-American women. Cervical Cancer The issue of Cervical Cancer in the United States is mostly an issue of health disparities. Though African-American women get screened for cervical cancer at rates similar to their Caucasian counterparts, follow-up on positive results is lacking. One study found that only 44% of African-American women followed-up with the appropriate procedure and this demographic had the lowest follow-up rate.13 The goal in screening is to catch a precancerous lesion before it progresses to actual cancer. African-American women have twice the mortality rate of white women and the poorest 5-year survival of cervical cancer out of other races. Race Cervical Cancer 5- Year Survival Rate Whites 71% Hispanics 68% African-Americans 56% 14Adapted from data in The disparity of cervical cancer in diverse populations. Gynecologic Oncology. 2008. 109(S22-S30). References 1.WHO. Women’s Empowerment and Gender Equality: Essential Goals for Saving Women’s Lives. 2008. UNAIDS, 2010. Report on the Global AIDS Epidemic, pg 76. UNAIDS. 2011. AIDS at 30 Report: Nations at the Crossroad, pg 80. UNICEF, UNAIDS, UNESCO, UNFPA, ILO, WHO, and World Bank. Opportunity in crisis: Preventing HIV from early adolescence to young adulthood. World DataBank. http://databank.worldbank.org/Data/Home.aspx US State Department. Pink Ribbon Red Ribbon Overview. http://www.state.gov/r/pa/prs/ps/2011/09/172244.htm 2011. UNAIDS (2011, November) 'World AIDS Day Report 2011 IARC. GLOBOCAN. 2008. Prejean J, Song R, Hernandez A, Ziebell
R, Green T, et al. (2011) Estimated HIV Incidence in the United States, 2006-2009. PLoS ONE 6(8): e17502. doi:10.1371/journal. pone.0017502 CDC. HIV among Youth. 2011. NVSS. Births: Final Data for 2010. Child Health USA. Maternal Mortality. 2011. CDC and prevention: National Breast and Cervical Cancer Early Detection Program. 2007 The disparity of cervical cancer in diverse populations. Gynecologic Oncology. 2008. 109(S22-S30).