Young people's reproductive health is essential to the future of the country, as young people aged between 10 and 29 years old make up about 40 per cent of Egypt's population, totalling around 34 million people. Reproductive health can have an impact on overall health as it affects education, work and political and social participation. Investing in young people's health and particularly reproductive health is a huge investment in the health of the coming generations. But despite its importance, Egyptian traditions sometimes make it embarrassing to talk about reproductive health, which is why there are few programmes dedicated to it in the country. According to Amr Hassan, a gynecologist and founder of the “Enty Aham” (You are more important) initiative, poor reproductive health among young people may be as a result of female genital mutilation, sexual harassment, lack of knowledge, or inaccurate information gathered from untrustworthy sources. “A parent's refusal to talk about sexual issues is a result of wrong inherited customs, and this means that many young couples do not perform pre-marriage medical tests,” Hassan said. Female genital mutilation still exists in Egypt, especially in rural areas, because of the false belief that it will protect a girl's honour, despite all the awareness-raising campaigns that have been organised by the Ministry of Health. “It is a form of psychological and physical violence towards girls, and it can lead to health problems like inflammation and urinary retention. In some cases it may even cause death,” Hassan said. Early marriage can also threaten reproductive health. It can mean early pregnancy, giving birth multiple times, and high exposure to sexually transmitted diseases, especially if the husband is older than his wife and has a lot of previous experience. “Not using birth control weakens reproductive health,” Hassan said, adding that some young people were also not as aware as they should be of the dangers of unprotected sex. “HIV is the cruelest negative consequence of unprotected sex, but there are also others, including various kinds of sexually transmitted disease,” he said. Men who have sex with men are at particular risk of contracting HIV, Hassan said, as are intravenous drug users. “Studies have shown that one-fifth of men who have sex with men are drug users, and this means that if they expose themselves to the risk of contracting HIV they are also endangering their wives and children if their wives are pregnant,” Hassan said. Over the past decade, more than 30 youth-friendly clinics have been set up in most governorates, with the support of international organisations, to provide services and information to young people on reproductive health in a way that protects their privacy. “These clinics also provide young people with information related to sexual health, birth control, healthy nutrition, how to deal with puberty problems, pregnancy and various services and advice. They can also provide treatment for sexually transmitted diseases,” Hassan said. He stressed the importance of education about reproductive health for both men and women, and he said that this should start at an early age. “I know that this information is included in the science programme at the preparatory stage, but most teachers don't explain it precisely or pass over it quickly because they feel it is embarrassing to discuss in class,” he said. Today, the Ministry of Health and civil society associations provide confidential advice to young people on telephone hot lines, and qualified doctors and experts are available to give young people the information they need in a safe and confidential manner. A platform that provides information on reproductive health is the “Love Matters” website, the Arabic version of which “is especially dedicated to young people, providing a safe place to find reliable information on sexual and reproductive health and to engage in discussion on topics related to health and relationships,” explained Abeer Sarras, the site coordinator. “We give young people vital information to enable them to make the best choices in their lives. We address reproductive and sexual health issues in an inclusive, open and culturally sensitive manner,” she added. “We have physicians and experts to give reliable answers to all the questions that young people might want to ask, and we do it in a way that does not cause embarrassment.” Sarras believes that the main problem is not embarrassment, but the lack of reliable sources of information. “If Egyptian or Arab young people are going to English-language websites for information, it is because the Arabic sites do not provide it,” she said. Too often, schools teach reproductive health from the biological point of view, which is not enough for anyone, let alone young people. Instead, Sarras says that schools should develop communication skills with the opposite sex, discuss relations between men and women, and raise the question of appropriate boundaries. “Each sex should know about the other, because barriers are the core of many problems that we are experiencing today, among them sexual harassment,” she said. The writer is a freelance journalist.
