Eradicate Female Genital Mutilation(FGM)

I am Mahnaz M. Harrison, founding President & CEO of Last Mile4D, a Fulbright Scholarship awardee, and a graduate of Johns Hopkins School of Advanced International Studies. I drafted a Comprehensive Cancer Control Policy in the country of Georgia, which led to the establishment of LM4D.

Having grown up in Iran, I am committed to eradicating Female Genital Mutilation (FGM), through innovative solutions to this and other health related women’s issues in the world's remotest areas. Through collaboration with local, regional, and international stakeholders, I have successfully moved projects from the pilot phase to implementation. My innovation is Voice Power Pack (VPack), which has enabled me to bring my passion for women's and girls' health rights to fruition in Kenya. VPack is used to collect real time data on FGM in Kenya. While the technology is critical, my expertise is designing protocols and curricula that develop field traction.

We are committed to eradicating FGM a problem that afflicts 3 million girls a year - one every 10 seconds - and is the leading cause of school dropout for girls, often dooming them to a life of poverty and submission to abusive men.  We propose using VPack an integrated technology that provides real-time data of girls at risk, allowing in-time interventions through field staff and law enforcement authorities. We also provide teaching and training about the pernicious health and economic effects of FGM, creating awareness of what has become a silent crime. Eradicating FGM, which according to WHO has impacted 200 million girls and women globally, elevates half of humanity out of pain, suffering, the child marriage syndrome and a future of perpetual emotional, economic and political depravation.  

The World Health Organization (WHO) defines FGM as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs, with no known health benefits.” FGM causes significant health risks including infections, bleeding, injury to adjacent organs, birth complications & even death.  Kenya’s national prevalence of FGM is 27%, and WHO considers FGM a global problem that affects 3 million girls a year (200 million in total). It is the leading cause of school dropout for girls, perpetuating a cycle of poverty and submission to oftentimes abusive men for girls at the base of the economic pyramid. FGM is illegal in most countries, including Kenya, yet it is a crime that goes undocumented, and therefore is committed in silence. It is stigmatized, meaning girls are dissuaded from speaking of it. Thus, it rarely makes its way into the public space, where law enforcement could be effective. The silence and the lack of evidence of this crime has perpetuated the widespread but ancient practice of FGM. This is relevant to our project, which is aimed at ending the silence, prompting societal and law enforcement intervention.

Our project is to eradicate FGM by using VPack with our field partners. VPack is, an integrated system that combines 1) innovative teaching methodologies to create awareness, 2) a password protected online Channel to collect real-time data, producing evidence-based reports for in-time intervention to stop at- risk girls from being cut 3) informs law-enforcement to protect them and enforce the law. VPack is solar powered so it can reach the remote areas of Kenya, which lack dependable sources of energy. In conjunction with our local field partners, the Channel is used for peer-to-peer dissemination of gender sensitive educational material, communication and documentation and generates data analytics to allow interventions in-time to rescue girls from FGM. Use of VPack with field trainings 1) Significantly reduces incidence of FGM, taking burden off of the health system, 2) Creates awareness among parents, girls, societal influencers of harmful effects of FGM, including its illegality. 3) Uncut girls stay in school longer, providing opportunities to break out of the cycle of poverty 4) Informs policymakers in local and national governments to direct resources towards enforcement of FGM laws. 

We are working with girls ages 5-15 at risk of forcibly undergoing FGM, who live in the impoverished communities of Western Kenya with highest prevalence of FGM. I have personally witnessed the downcast gaze of girls who have been cut. On the girls’ behalf, we work closely with partners, who are familiar with the community. We don’t come in imposing solutions. We work with our partners so that our methods consider cultural sensitivities. With them we use our community centric approach that engages boys, parents, religious and opinion leaders, tribal chiefs, and legal authorities. This centers on three key pillars of Awareness, Cultural Adaptation and Enforcement (ACE) embedded in our innovation VPack. By integrating innovative teaching methodologies and online access to information and programming we work with the communities so that they have a stake in eradicating FGM. The project uses education and information dissemination methods to spread awareness about the harmful effects of FGM on girls and communities.  It appeals to the good-faith reasoning of parents and community influencers while connecting with local authorities to enforce the law. Framing FGM as public health and economic issues helps create traction in solving this age-old scourge.

As a health administrator, fortified by my Fulbright work in Georgia, I came to believe freedom from gender-based violence (GBV) is a fundamental human right. But the reality is impoverished girls don’t have access to information about their rights. Last Mile4D (LM4D) was born to bring awareness on this issue. We discovered that FGM is the most egregious act of GBV against girls and is happening despite being illegal. We believed we could use the community centricity methods that had worked with other GBV problems to FGM. What we found was that FGM is seldom documented, making it a silent crime. We developed a strategy for creating societal pressure by making the crime silent no longer. With local partners, we applied to Grand Challenges Canada to pilot eradicating FGM using our system to create real-time intervention for 1,000 uncut girls. The system’s design is LM4D’s brainchild. Kenyan partners are the implementers and LM4D has constant oversight. We have brought massive awareness to the problem of FGM and produced astonishing analytical data that has broken the silence on FGM, forcing the community to face reality for the first time. We have rescued 36 girls and ensured the safety of all 1,000.

Having worked with women and girls on behalf of their rights to health, safety and freedom from gender-based violence (GBV) for over twenty years, I have been haunted by the horrors I have witnessed of GBV generally and FGM more specifically.  Hollowed eyes and gaunt faces reveal the hidden wounds invisible to the eyes but inflicted on the soul of a GBV victim. You can set a broken bone, but repairing a broken soul is more tenuous. Since there aren’t enough jails for perpetrators and enough shelters to house victims, I am committed to overcoming the societal barriers that perpetuate practices and traditions that condone and enable such behaviors. Having come from Iran, I have observed first-hand the horrific effects of GBV in the Middle East, which I now see in Africa. I was exposed to girls from traditional families who underwent FGM, and girls that were killed (honor killing) because they were raped. These experiences have had profound effects on my thinking and have shaped my commitment to design solutions that impact women’s lives by positioning practices, such as FGM, as a public health threat to girls and their communities.

My cultural background, education (Johns Hopkins SAIS and Fulbright), and work experience in international public policy and health management, which has focused on the “how to’s” of having a lasting effect on the lives of women and girls afflicted by GBV, has uniquely positioned me to deliver this project. Through my firm LM4D I have trained social workers, lawyers, nurses, journalists, leaders of civil society organizations (CSO) and community activists from the Middle East, Central Asia, the Caucasus and East Africa on prevention, protection, and prosecution of GBV.  I developed programs that not only train women on the theoretical knowledge of GBV, but also on how to leverage the knowledge gained in seminars to affect real change. Curtailing FGM requires working, not only with girls and their families, but also with the communities that are part of the problem, but also potentially part of the solution. I have already done that on behalf of FGM in Kenya and in Georgia and Iran on other forms of GBV. In Kenya, after our community stakeholders meeting, individuals, tribal chiefs, government officials, religious leaders and activists signed a declaration that they will speak up against FGM and will stop it from happening in their community. That commitment has enabled us to keep the girls safe in that community.  I am a passionate communicator that connects to people at all levels and I bring all stakeholders to the space so they own the action and will live up to it.

In Kenya, the school holiday from Mid-November to early January is the cutting “season” during which girls can be forced to undergo FGM. I made sure we had all the girls accounted for and informed about what to do if they feared that they will be cut. Prior, we made sure their parents had undergone our educational modules. Despite all of our efforts, I learned in early December that 36 parents of our girls were set to cut their daughters. Our local partners were ready to throw up their hands, while I couldn’t! I personally reached out to the County’s Police Commissioner, reminding him about his declaration and sought his help. I worked tirelessly with field coordinators and government officials including the police to rescue 36 girls. Our local partners, with the help of the authorities and our emergency fundraising efforts, rescued 36 girls and brought them to safety in one of the boarding schools that was emptied for the remainder of the school holiday. In the safety of the safe house they learned more about how to advocate against FGM and keep themselves safe. Parents were re-educated about harms of FGM.  I persevered and prevailed!

I arrived in the U.S. from Iran as a student and because of the1979 Iranian Revolution, I became a political asylee. Even with a master’s degree I worked for minimum wage of $3.50/hr. in order to support my young child, continue my university education and make a living in the U.S. During these forty years, I have reinvented myself a couple of times. I rose to the top of the ranks in my capacity as a health administrator and served in different capacities in our state committees to advance the well being of the elderly. I served as President, Chair and Director of community, national and international non-profit organizations and raised significant money for these various charitable organizations, while also serving on their boards. I have trained hundreds of women and girls about their rights to health and safety, most of whom reference me as their role model and mentor. My mid-career change, going to Johns Hopkins School of Advanced International Studies/SAIS, receiving a Fulbright scholarship to Georgia and founding LM4D to be able to put all my energy in eradicating GBV and FGM, are testaments to my leadership and tenacity.

Our organization is virtual, our computers are our offices and we have a multi-country team that works on various projects, when we secure funding for the project. We are extremely efficient and deliver quality work. We work with local partners, who are registered and have a clean record, therefore, we do not have to have an overhead in different countries, making development funds go further in the low-income countries.

Our innovation; VPack, ties FGM interventions at the bottom of the pyramid with unconventional technology. VPack is, an integrated technology that combines 1) innovative teaching methodologies to create awareness, 2) a secure and password protected online platform, Channel, to collect real-time data, which produces evidence-based reports for in-time intervention to stop at- risk girls from undergoing FGM, and 3) informs law-enforcements to protect the girls and enforce the law. VPack is solar-powered so it can reach the remote areas of Kenya, where they lack dependable source of energy. The Channel is used for peer-to-peer dissemination of educational material, communication and documentation and generates real-time data analytics to inform programmatic solutions in time to reach and rescue girls from the scourge of FGM. VPack enables field officers to collect data at the point of contact (POC) and create a greater impact on in-time intervention of girls in Western Kenya. The field officers use VPack to access gender sensitive education materials to spread awareness about the harmful effects of FGM and conduct trainings among school age girls and boys of 5-15 and Stakeholders. This appeals to the good-faith reason of parents and community cultural influencers but failing this it works with local authorities to enforce the law against FGM.

Our theory of change is that field officers (FOs) trained in use of VPack, data collection and training about FGM will effectively collect evidence, bring awareness to and advocate against FGM among parents, communities’ tribal and religious leaders, influencers and local government authorities (Stakeholder) and get their buy-ins, ending FGM in line with domestic and international laws.

Use of VPack by the trained FOs in 10 schools, targeting 1,000 uncut girls ages of 9-15, their male classmates and the Stakeholders has enabled us to communicate, document, and capture real-time data at the Point of Contact (POC), which aided the identification of 874 girls, out of 1,000, at risk of undergoing FGM in the cutting season (November 2019- December 2019). Constant monitoring of the school progress of the 1,000 girls and curtailing their undergoing FGM led to the successful rescue of 36 girls in the FGM season. In addition, we have used VPack to sensitize 4,000 Stakeholders in the target community. Our ability to use real-time evidential data generated by VPack along with massive campaign against FGM has enabled good attendance at educational meetings and workshops. Informed Stakeholders have become advocates and spoke persons against FGM and 94% of parents signed up to volunteer to speak out against FGM and its harms.

During this past year of FGM eradication project activities in Western Kenya, we have recorded real-time data on the Channel, which demonstrated that the evidence generated by the VPack innovation has had enormous impact on the understanding and behavior change of the Stakeholders i.e., signed declaration that they will not cut their daughters and will act collectively to eradicate FGM. Use of evidence-based reports in our campaign to eradicate FGM shows a reduction in the number of girls undergoing FGM among schoolgirls aged 9-15 years from 79% to 45%. In addition, the innovation increased the knowledge in the community about the dangers of FGM and empowered the law enforcement personnel with real-time data to act in time and enforce the law.

The current number of people we are currently serving through our work:5,000+
The number we will be serving in one year with Elevate Prize 40,000+

The number we will be serving in five years with funds 2.2 million

Our ability to reach ties in with the financial support that we need to scale the project and cover the whole country and beyond.

We have broken the silence on the evidence of FGM in Kuria, Kenya. Our goal for this year with the help of Elevate Prize is to eradicate FGM in Western Kenya. We think financial and other support from Solve will give us visibility to be recognized by the international organizations such as the UN and provide them the much needed evidence. Our goals for the next five years would be to scale up further and cover east Africa and beyond. We know there is a lack of data and evidence on FGM. The UN agencies, the World Health Organization and others constantly have said that there is not enough data available on FGM.  We can generate this data, we need the resources to engage FGM practicing communities, everywhere to use VPack and eradicate FGM. We have the potential and capacity to scale as fast as we have the demand and the resources to pay for the local teams to engage communities and expand our system’s capacity.  The scaling of our work will truly elevate half of the humanity, women and the next generation of girls from ever knowing or fearing FGM.

We believe that the financial and cultural barriers are the biggest obstacles to our work and success.  We need financial support to scale our innovation to the countries that have high prevalence of FGM. Without the financial support to engage every FGM practicing country and work with the stakeholders to draft a plan and roll out the implementation will not be possible. To overcome the cultural barriers, we need to engage local partners for understanding the cultural nuances and adapt our approach to the cultural needs of these communities.  Technically and programmatically these are not difficult issues for Last Mile4D to address and advance the VPack operational ability, once financial support is secured.

For the financial barriers we hope to receive the Elevate Prize and continue our work with Grand Challenges Canada to further scale the project to eradicate FGM. We are already a member of GlobalGiving crowdfunding platform and have raised funds through them.  We also have a very active board that helps with fundraising.  Our goal is to reach the Bill and Melinda Gates Foundation to achieve a global reach to eradicate FGM.  UN agencies are all interested in data about FGM and have resources that could help us overcome this barrier. 
Cultural barriers require community centric approach and engagement for each country. This is one of our strengths, to recruit a large cadre of stakeholders that can creates the right community synergy to advocate against FGM and get the buy in of the rest of the communities. We can do this, once we have secure resources that can pay to facilitate these stakeholders’ engagements.  

We currently work with few local organizations in Kenya and Uganda.  In Kenya, there is ChildsLife International and GOCESO Women Network. We have partnered with them to use VPack innovation to eradicate FGM in Kuria, Kenya. They implement the field work. In Uganda we work with SEEP orphanage to elevate the girls level of education and safety.

We are member of large US and International GBV Coalitions.   

We do not have debts.  We have applied for grants with our local partners in Kenya.  Two grants for innovation from Grand Challenges Canada, to our local partner ChildsLife International.  It is the policy of Grand Challenges Canada to only award organizations in LMIC.  The grants were awarded because of our innovation and its scalability. Each grant was a few dollars under $100,000 Canadian. 

We have received other grants from various funders to provide capacity building for the women activists in the Middle-East.  A full disclosure will be provided, once we are a candidate to receive the Elevate Prize.  

Full report will be provided once we are selected as a candidate for the Elevate Prize.

Full report will be provided once we are selected as a candidate for the Elevate Prize.

We are applying for Elevate Prize, because we believe it will help us position ourselves to scale both through providing us the funds and the additional support from the team to build our scalability.  We are a small, but very effective organization and this prize and the holistic support will help us to get to our goals and overcome our barriers. 

We have an idea about the funding and revenue model, but we certainly can use additional informative support. 

We are able to do great deal of monitoring and evaluation ourselves, however we think receiving external M&E helps us build more credibility and validates our data collection processes.

We have great needs for media and exposure.  We have developed crisp and attractive marketing materials, but getting exposure and visibility is very important.  

We just published in the prestigious Council of Foreign Relation an article about FGM, which was Co-authored by Mahnaz M. Harrison, CEO of Last Mie4D and Ambassador Mark P. Lagon. Here is the link:https://www.thinkglobalhealth....

We would like to partner with the UNICEF, UN Women, and other UN agencies working on SDGs, the World Health Organization (WHO), the Melinda and Bill Gates Foundation (MBGF) and the national governments that have pledged to eradicate FGM.

We will provide the tool and training for the local communities to eradicate FGM, using VPack and the current channels/field providers of the UN agencies and the WHO.  

Our work aligns with the mission of MBGF and we will seek grants from them to scale eradication of FGM to meet the SDG 5.3 by and before 2030.