This World Sexual Health Day 2023, we talk to one of our close collaborators on sexual health education in Mali, Niger, and Burkina Faso, Lalla Fatouma Traore, about this year’s theme – consent.

Lalla has worked with KIT on numerous projects. She taught most of the content related to sexual and reproductive health and rights (SRHR) for the FORCE project and was the lead researcher on abortion for the FIGO project in Mali, to name a few. Lalla is a teacher-researcher for the Department of Education and Research at the Faculty of Medicine and Dentistry (University of Technics and Technologies of Bamako) in Mali, where she teaches master’s students and future doctors about SRHR.

Lalla’s first foray into SRHR education began in high school in Mali, long before she started working. “Two events in my life made me aware of how difficult it was to access reliable information on issues related to sexuality for adolescents,” says Lalla. 

“The first was when I got my period. I had no idea what it was. The second was the reluctance of the sex education teacher or ‘domestic education’, as it was called then, to answer any questions related to sexual intercourse.” Since the answers were not forthcoming, Lalla and her classmates took matters into their own hands. “We set up a book of questions and answers on sexuality and circulated it. Fellow students, both boys and girls, made a note of their questions and those who had the answers responded. That was the start of a life-long commitment to SRHR,” she reminisces.

“While I was frustrated at the time, over the years, I realised my teacher was weighed down by social norms, as were my parents who hadn’t talked to me about menstruation.” These norms dictate what is suitable to talk about and express. They also largely inform the meaning of consent. 

Consent doesn’t just start and stop with sexual relations

According to Lalla, consent is one of the cornerstones of SRHR. It doesn’t just start and stop with sexual relations; it is also important in the delivery of sexual health care and services. Consent is proof of good communication and mutual respect, and it upholds the dignity of the individual within a family and in a romantic relationship.

That said, the expression of consent changes with context and culture. In some contexts, the explicit expression of consent for example a yes or a no is taken as such. “But, in Mali, if girls say ‘no’ to sex it is interpreted as ‘yes’ because boys have been taught that girls don’t really want to say no. Generally, girls of all ethnic groups in Mali are taught to make themselves desirable. Which, in Mali means even if they like or desire someone, they should not express it for fear of being labelled an easy or poorly educated,” explains Lalla.

Given how important consent is not just in a relationship, and how ambiguous it can seem at times in Mali, how can it be unravelled?

“In my courses, I put forward two conditions to unravel and simplify the concept of consent. First is validity: consent is only valid when it is given freely without a hint of moral blackmail. For example, many girls agree to get married for fear of repudiation of their mother. The second is integrity: the decision only has integrity if the person knowingly engages once they have all the information including the advantages and disadvantages. For instance, 76 percent of excisions (cutting/Female Genital Mutilation or FGM), were performed before the child turned five. In these cases, the decision is made by others and clearly lacks integrity.”

Education is the key

However, for these values to be embedded in their thinking, families, communities, and governments need to acknowledge the autonomy of the individual and respect their decisions. When asked if the answer would be to make consent a constitutional right in Mali (it is not now), Lalla replies that, while that should of course be the case, it would only be truly effective if a critical mass of individuals in each community in Mali understands and internalises behaviour that respects the dignity and autonomy of each person without exception. Not simply so they are well-perceived by the international community.

For this, the institutionalisation of comprehensive sexuality education is absolutely vital. “In my training workshops, I’ve witnessed a change in attitudes first-hand towards FGM and child marriage. Many parents understand that fighting against harmful social practices such as these can save their daughters’ lives if it’s not too late,” says Lalla. “We must respect human lives and education is the key.”

Before we let her get back to her classes, we ask Lalla if commemorative days like this help with raising awareness of SRHR issues.

“I think they do. At the same time, its effects are limited because the people who organise, participate, and engage in these days are already sensitive to SRHR issues. To reach people who would otherwise not be reached it is necessary to make judicious choices of dissemination channels, while considering their socio-demographic profile” 

With her focus on education and establishing channels to access information, in many ways, Lalla is still in that classroom which stoked her outrage and sparked her interest in SRHR education all those years ago.

Only now, she’s the one at the front of class, and today her struggle is to find ways to openly share the information that she so keenly wanted to access and has finally managed to gather.