Fostering Social Entrepreneurship in Rwanda

This post also appears on the Spark blog. It serves as a profile of one of Spark’s most recent grantees, an organization I happily support, The Komera Project.

It’s not every day that you get to see the foundations of graduate school flourish into a burgeoning non-profit organization halfway across the globe. So, when one of my close friends from graduate school told me in 2008 that she was starting an organization in Rwanda where she had been living, I was of course eager to support her. And the more I learned about Rwanda and the work her organization was undertaking, I became invested in seeing its success grow.

Named The Komera Project (in Rwanda the word “Komera” means “be strong, have courage”), Margaret Butler developed the idea to start the group over the course of her many runs through the Rwandan countryside. She noticed that sometimes girls from the local villages would jump in and join her on these runs until she realized that her behavior wasn’t going to be considered socially acceptable. Combined with the fact that Margaret was seeing first hand how most girls did not make it to secondary school, she decided to host a girls-only ‘fun run’ one day to promote the education and rights of these girls. As they started off, supporters shouted “Komera!” to the girls, and the group was born.

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Working with the local government, schools, and some on the ground staff from Partners in Health based in Rwanda, Margaret steered the first of Komera’s 10 girls onto their fully funded secondary education path. Komera has since grown to over 60 scholars, and has expanded their reach beyond just funding the girls’ schooling. They now also provide mentorship, a leadership program, and now a social entrepreneurship program.

Some context and understanding of Rwanda is essential to underscore how significant this is. Only 17% of girls in Rwanda go to upper secondary school (high school). 87% of the country lives in rural areas. All Komera scholars are from these rural areas and live on about $1 a day from families working as subsistence farmers or tin miners – so these girls would be farming, mining, and/or working in their households if not in school. Komera focuses on supporting the girls in grades 10-12, since the majority of girls begin dropping from school in grade 10. Komera never takes on a scholar unless they have the cash to fully fund them for those three years – this cost is $500 a year for tuition, uniforms, boarding, all school supplies, and personal supplies like hygiene products.

By 2010, the focus at the Komera Project had shifted from primarily scholarship to figuring out how to keep the girls in school and create a real Komera community, and that’s when the themes of mentorship and leadership came into play.

The transition into boarding at school can be really difficult for the girls, especially since they are spread between 13 different schools. In Rwanda, once you have the funds to pay, the local government decides what school you will go to, so while Komera would prefer all the girls to be in the same 4-5 schools, that isn’t possible. However, they are all in the same district (there are 30 districts in the country total).

To help combat some of the difficulties around these transitions, Komera provides school-based volunteer mentors for all the girls – female staff or teachers who meet one-on-one with the scholars every week. They actually use curriculum to cover topics like health education, financial literacy, what their rights are as women in Rwanda, to any personal concerns they may be having. The girls also meet with the Komera social worker (one of only two paid Komera staff members!) regularly when she visits each school throughout the year. Their next goal is to launch a university mentoring program, and they have started to do some outreach to universities in Kigali (the Rwandan capital) to see if there is interest among Rwandan university women to mentor these girls.

Leadership is another key component of the Komera Project. The Komera scholars attend Leadership Empowerment camp during their month-long summer break, where they take part in the now-annual Girls Fun Run and participate in workshops focused on topics like English-speaking skills, how to use computers, and sex education. These have been essential for the girls, because these month-long breaks can be vulnerable times for the girls who go back home. Most stay with extended family, get pulled back into working with the family and can potentially be convinced that they need to leave school – especially true for the nearly 20% of girls who come from families who don’t fully support their education efforts.

In regards to the new Social Entrepreneurship Program that Spark is helping to support, most recently the idea of sustainability has come up – how does Spark keep the momentum of being a Komera Scholar going once the girls graduate from secondary school? This was particularly pressing since 15 girls will be graduating in 2013.

The girls had been requesting a social entrepreneurship type training for some time – wanting to learn the skills necessary to starting and maintaining a business, a non-profit or grassroots venture. When asked about social entrepreneurship training, all the girls said that they had never even considered how they might be able to give back to their community or considered themselves leaders, and they were really excited about the idea of learning how to create something to benefit and incorporate their community.

The winter break, in November-December hasn’t been able to be filled by Komera because they haven’t been able to fund camps both in May-June when they have the leadership and empowerment camps as well as during the winter months. Finding funding for this new social entrepreneurship training became essential, as well as a way to get a tested and evaluated curriculum in their hands.

A local Rwandan group, Global Grassroots, has been offering entrepreneurship, business training, and skills-based workshops for women in Rwanda since immediately after the genocide – and they’ve been doing so pretty successfully. They have agreed to modify their program for a weeklong intensive program for teen girls, as well as moderate the weekly follow-ups. This will be called the “Girls Academy for Global Conscious Change.”

The girls will work in groups of ten, separated by interests – they’ll select a topic they want to focus on, like health, education, water, and they will learn how to craft a mission statement, develop a program goal and implementation plan, and how to write and follow a budget. They will be given small grants of $50, which will be managed by the social worker and through each phase can retrieve part of the money for supplies, then implementation or advertising. The goal is to have them create these mini-organizations and incubate them throughout the school year, with the hope of maintaining it beyond that year, turning it into a profitable business, and growing it beyond their immediate school community.

When I heard that this was their well thought out plan, I thought Spark would be the perfect place for Komera to seek funding help to cover the costs of the girls supplies, food, transportation, and personal supplies throughout the training. The perfect way to blend two of the organizations that are most dear to me.

The Komera Project embodies the exact kind of values and practices that Spark looks for in grantees, and I look forward to what these budding entrepreneurs are up to in just a few years.

Check out their Facebook and Twitter pages, and visit their site to learn more about Komera and meet some of their scholars.

American Graduate, American Dropout

I don’t know how many of you educators were able to catch parts of PBS’ ‘American Graduate‘ series this year. It’s a great series that’s focused on the major issues of (mostly public) education in America, including urban versus rural education struggles, mentoring and counseling, adolescent health issues like substance use and sexual activity, ensuring that we’re serving the needs of immigrant students, social and economic class issues and how they impact opportunity and subsequently achievement (measured most commonly as high school graduation) and what’s behind some of the alarming and rising rates of dropping out across the country.

The latter three issues were behind a documentary that I was featured in and that aired in September. It was pioneered by a group of teen filmmakers at an organization based in Brooklyn called Reel Works, a group with a great mission that I encourage you to check out. If you want more background on the piece, check out the PBS brief before the video, which also includes a great interview with some of the teen filmmakers. Hope you find it interesting!

Is Media Use Slowing Kids Down Intellectually?

A couple interesting studies recently came out that I thought were clearly linked with implications for the development of our younger generations. I recently wrote a post for The 2×2 Project that discusses the impact of media use on the mental health of teens, so I thought this was fairly pertinent.

The first study showed how much the U.S. economy loses to social media use every year. Take a guess at what that amount is.

10 billion bucks? Nope.

100 billion? Not even close.

500 billion? Still no.

According to Mashable’s summary via LearnStuff, social media costs the U.S. economy $650 billion. Check out the infographic they put together:

I’m someone who is generally really torn about social media. I have a blog and am active on Twitter, though along with my Facebook profile I use these all primarily for semi-professional purposes. ‘Semi’ in the sense that they aren’t part of my job, but I use them to promote interesting finds or essays related to my field of public health; I’ve found the sites to be remarkably helpful in communicating important points and connecting with wider audiences compared to different – usually more traditional – media channels. I use social media heavily to promote work being done in my fellowship – my own and other fellows’ – and it unquestionably has helped us reach researchers and organizations it would have been otherwise very difficult to do.

That being said, I am also fairly hesitant about social media given that I don’t particularly like my personal life broadcast across channels, so I have to be pretty meticulous about what and how I use the mediums. I think it can be enormously helpful for children who have difficulty communicating and making connections; I also find that it can feel almost more isolating than no communication at all since it emphasizes and underscores that real interpersonal interaction isn’t exactly happening. So, I’m clearly torn.

The second study, by the great group Common Sense Media, addresses the concerns of teachers and educators that the various kinds and amount of time kids are using media at home is impacting the quality of their classroom work and engagement. 71% of teachers said that they think media use is hurting kids’ attention spans in school, 59% said that it’s impacting the students’ ability to communicate face to face, and 58% have said that the media use is impacting kids’ writing skills – and not in a good way.

Given that the LearnStuff infographic shows that 97% of college students are daily Facebook users, it seems that these symptoms have the potential to get worse at increasingly younger ages, and that by the time kids who grew up in this media-rich environment are in college…well, who knows. And 60% of people visit social media sites at work (something I found most interesting? that more people are on LinkedIn than Twitter), which are obviously impacting work in the sense that they are taking away from productivity or activities related to the job – unless the job is one that incorporates social media, as many jobs increasingly are. Not to be a doomsday reporter, but I do think the implications for these studies are very real.

Thoughts? Come chat on Twitter.

Social Media Continues to Make People Feel Bad About Themselves

A study out of the UK has found (as have others more than once), that use of social media sometimes doesn’t make you feel like…really socializing. Rather, it can make you feel anxious and depressed.

The study found that participants noted a drop in their own self-esteem after viewing the accomplishments of their Facebook friends. Combine this with the fact that 25% of them claimed to have had relationship issues due to online ‘confrontations’ (which could, of course, mean many things), that more than half were rendered uncomfortable when they couldn’t easily access their social media accounts, that other studies have claimed more socially aggressive (subtly termed ‘hateful’) folks use Facebook more often, that people often deliberately post bad pictures of their friends to make themselves look better and subsequently compare their weight, body size, and physical appearance to these friends, and that Facebook is cited in divorce proceedings as being problematic for couples, and you may be liable to think that this phenomenon offer little in the way of improving our lives.

A good thing to remember here, aside from the pretty remarkable things being done with social media in terms of education, research, medicine, and public health (this USC study is great news, and touches upon the influence of social networks in ways I’ve been exploring as it relates to substance use, sexual behavior, and disordered eating behaviors, and that other studies have shown the exact opposite in terms of emotional response, is that social media does allow users to tailor the perception and identity they project. Another recent study (I’ll try to find the URL for it!) showed, unsurprisingly, that what users often admire about their friends’ virtual lives is the positive sliver that their friends elect to promote about themselves.

Also encouragingly, those children and adolescents who will have known no life without social media, recently were surveyed about their use of technology and reported that they still preferred face-to-face communication. I put limits on myself in terms of use (though I’m sure to some of you it may not seem like it!) since I feel as though I miss a lot in terms of nuance when communication online, but it remains true that both my research and personal communication projects require a fairly consistent social media presence – I admit that I’m torn. As with most everything, balance is key, but how can we monitor our behavior in ways that allow us to strike that balance without teetering into territory that destroys our positive sense of self?

Thoughts? How about you ironically follow me on Twitter to discuss?

Social Media and Higher Education

Interesting infographic of the use of social media in higher education. Courtesy of the Online Universities and Columbia Teachers College EdLab:

I think this is interesting for a few reasons. What role does social media have in the administration of universities? How can they utilize social media to promote their in-house programs for students? What actually prompts students to follow higher education institutions on social media sites (aside from loyalty to their alma mater)?

How Images and Ads Impact Self-Image and Human Development

I got a lot of traffic and messages about a piece I wrote regarding Duke Nukem. People in the gaming community condemned it for its lack of originality, how it strayed from the original premise of apparently ostensibly mocking the ’80s action-hero genre, and how it overall disappointed those who are used to more complex and engaging videos. Some replies also included people needing to “get over it” when discussing images of coerced sexual activity or the game’s encouragement of merging violent and sexually explicit content together (I don’t post comments that are condescending or don’t encourage dialogue), something I found…disturbing. My initial argument, however, did not change – that is, that the imagery and the actions the gamer supposes in this video are tragically abusive and in fact detrimental to both men and women.

Many gamers also respond that they know when they are playing a game, and that their non-virtual socializing is not impacted by the game’s content. This, along with the recent news that the American Medical Association finally condemned the use of photoshopping in advertising campaigns and photo shoots, got me thinking about what repeated exposure to images and actions actually does to our brain and with who and what we identify.

A well-known study published in the Journal of Consumer Research found that repeated exposure to images and advertisements ultimately were processed in people the same way actual experiences were processed. That is, if you see or watch something enough times – in a video game, in a fashion magazine in which models are photoshopped to near obscurity, in a parent abusing your sibling – you begin to process it as though it was you yourself experiencing the act and identify with the “player” (model, game character) you are watching. You see enough pictures of a model like this:

Courtesy fashion-o-lic.com

And you begin to think you are supposed to align yourself with her, that this image is what is normal (the image on the right was criticized heavily in 2009 for being so drastically photoshopped). After so many exposures, you begin to mold yourself after her, to think that since this is how we project women for adoration in our culture, that you should begin appropriating yourself to match her image. Just like a gamer, after so many exposures, can begin to mold themselves after the image of the character they are impersonating in a game. And while they may not go out on a shooting spree, they are desensitized to the effects of that reality, just as they are desensitized to the effects of coerced sex in a game, which can lead to difficulty distinguishing that from a healthy sexual relationship.

As I have also discussed in previous posts, a foundational theory in behavioral science and education is the Social-Cognitive Theory, which has informed educators and psychologists for years in explaining that people learn by watching, and that even one observation of a behavior can influence perspective. It also importantly points out that while full on adoption of behaviors witnessed may not occur, the more we see, the more our attitudes and beliefs about them change. This can be good and bad. It can make us more accepting of others’ opinions and outlooks, and it can also desensitize and normalize the opinions and behaviors that are harmful.

We’re humans. We learn by watching, by then mimicking and imitating what we observe. It doesn’t happen all at once, which is why fashion moguls or game designers claim they have no real impact. Are girls entering periods of self-mandated starving as soon as they open this month’s Vogue? Are adolescent boys heading to the hills for a sawed off shotgun fight after the first round of Duke or stealing cars after playing the new Grand Theft Auto? No, of course not. But can it impact their sense of compassion, affect their interpersonal relationships? Can it make violence seem less threatening, less damaging, and less impacting than it is? Yes. Can that change the way people behave, from nuance to imitation? Sure. Even researchers who admit that it won’t necessarily turn children violent admit that’s likely true (and, interestingly, still disallow their children to play). Human development takes time – language acquisition, understanding of and the processing of visual messages, being able to comprehend meaning from a block of text – these are all cognitive functions that take years to develop and perfect, and their influence lies in the words and actions of children’s families, friends, teachers. Unfortunately, messages of gender have been largely commandeered by the media. And the repeated exposure, over years, to these specifics of models’ physical appearance has resulted in the erosion of self-confidence that many girls and women – and boys and men – experience as young children becoming adolescents. And the repeated exposure, over years, to the specifics of war, sexual violence, and the presentation of hyper-masculinity, can also result in the erosion of what kind of impact violence truly has, as they become desensitized, and what a healthy understanding of and relationship with the opposite sex is (as opposed to its portrayal in my Duke Nukem piece). As the study articulated, it’s about changing people over time, it’s about how perceptions and perspectives change when a new definition of the norm that is not contested or dissected – a Ralph Lauren model, a Duke Nukem – enters the picture. Women who suffer from eating disorders and body dysmorphia, while not blaming the fashion industry, have emphatically articulated that it certainly has had an impact as it normalized this destructive self-image and behavior.

I think it’s also relevant here to bring up the Supreme Court’s decision about a week ago to shoot down California’s attempt to ban the sale of violent video games to children. Timothy Egan, a Times columnist, had a great commentary on this, noting how ridiculous it seems for there to be a perpetual ban on nudity and sexually explicit images, but not on virtually dismembering a human or sexually assaulting a woman. It does seem…well, more than troubling, that a game in which a player can simulate murder and rape is protected by free speech but a bare breast is the height of vulgarity. (I found a great post from a female gamer about this kind of sexual violence in video games, and I agree with her assertion that sexual expression can in fact exist without it also involving violence and degradation.) I don’t think any of the representations of sexuality that I have seen in video games are appropriate for children because they overwhelmingly associate it with abuse and/or coercion (I’ve done a lot of viewing in the past couple days after my Duke Nukem post). To say that sexuality would have a more harmful impact than violence seems questionable, when representations of both are equally unhealthy.

It should also be said that I am far from someone who believes nudity and sexuality itself is vulgar. I celebrate and support healthy (and protected!) sexual expression in any way the individual consents and desires. I firmly believe that discussions of sex and sexuality should be brought up early on, so children can ask questions, be informed, protect themselves when they do engage in sex, and have an understanding of what a respectful, consensual sexual relationship is. I also believe that when these discussions in families don’t take place, and when sex is a taboo topic, that it is a disservice to these children, and that any confusion they have about sex or uncertainty about what a healthy sex life actually is will be magnified by the messages the media sends them.  I’m an advocate of early onset, comprehensive sexual health and reproductive health education. Sex shouldn’t be confusing, and it shouldn’t be stigmatized. Sexual violence, however, and a misappropriation of the presentation of sexual relationships that are abusive, coercive, and violent, should be condemned.

This is also why a diversity of exposures is important. It’s important to not be inundated with the same message over and over again. Advertisers know that repeated exposure is key to getting people to buy what they want to sell. If you see an image of a Coke bottle once, it won’t register with much impact. If you see it every time your favorite TV show breaks for commercial, when you’re leafing through the pages of a magazine, when you’re driving down a freeway and it’s up on a billboard, when you’re listening to the radio and it breaks for the Coke jingle – it adds up, as do afternoons in front of a game console, as do hours reading “women’s” magazines and fashion spreads, as do episodes of spousal or child abuse, (which we know increases the likelihood of the child being in an abusive relationship him/herself and hampers healthy development – the others are logical extensions, to a lesser degree). We have to have enough positive images, positive games, positive and healthy discourse about relationships to not just equal the stream of negative imagery and messaging, but to overtake it. Positive, healthy messages, not abusive, harmful, violent messages, have to be in the majority. The norm. It’s nice that the docs finally said so.

Abortion Isn’t That Simple, Mr. Douthat

Ross Douthat, one of the NY Times conservative columnists whose pieces I occasionally force myself to read, wrote an article yesterday about sex-selective abortion. In short, he claimed that the reason 160 million women were “missing” (that is, the reason they were so outnumbered in many countries like India and China, as well as other nations in the Balkans and Central Asia) was because they were “killed” via sex-selective abortion. In his words, the women weren’t “missing,” they were “dead.” (He also claims that the author of the book he cites, Mara Hvistendahl of the book “Unnatural Selection: Choosing Boys Over Girls, and the Consequences of a World Full of Men,” appropriates the issue to one of patriarchy, of greater social issues and inequities – which I agree with. He then says that “the sense of outrage that pervades her story seems to have been inspired by the missing girls themselves, not the consequences of their absence,” saying that she is more upset by the idea of abortion itself than she is about the issues surrounding abortion. Don’t you think that’s for her to decide? And doesn’t it seem she’s already decided what she thinks based on her book?)

Douthat, however, manages to contradict the crux of his argument near the start of his column.

He begins by saying “female empowerment often seems to have led to more sex selection, not less.” He then quotes Hvistendahl as saying “women use their increased autonomy to select for sons,” because male offspring bring higher social status. In countries like India, sex selection began in “the urban, well-educated stratum of society,” before spreading down the income ladder.

If this were the case – if in fact women had become truly empowered in their respective lands – culturally, politically, economically – then why would they be aborting based on the opposite – that men in their communities are still holding the cards? Are they imagining that men still hold positions of power and wealth in their countries, or are they living the ramifications of that painful reality everyday? Women do have some increased autonomy in many of these regions. But guess what? This autonomy has likely served to highlight the still very real inequities and disparities that exist in their communities, which contributes to the rates of sex-selective abortion. If women see which sex has the higher status, and one of the few autonomous decisions they can make is to choose the sex of their baby – they are likely going to choose the one with more status. This upsetting power dynamic shows just how far away true empowerment is for many of these women and their communities. If they felt their children would have the same opportunities if they were female than if they were male, the sex selection abortion Douthat decries would actually decrease. It is not the responsibility of the female fetus to ensure she is treated with the same respect and equality as the male fetus. Douthat seems to really care about female fetuses – but seems less interested in addressing the massive social, political, and economic issues that create so many difficulties for them once born. (His colleagues Paul Krugman and Nick Kristof seem to have handles on that. Too bad they were off yesterday.)

It seems that Douthat wants to push for the feelings of regret and remorse about abortion itself, separate from the issues surrounding it. Does sex-selection abortion sadden me? Yes. Does aborting a fetus that indicates it will have Down Syndrome sadden me? Yes. You know what else makes me sad? That a woman cannot afford a baby because she is single and has no familial or community support; because she has an abusive partner (homicide is the number one cause of death for pregnant women); because she has a low-wage hourly job that offers no maternity leave which could help her stay well while carrying the baby if needed; because she has no health insurance meaning she can’t access quality pre-natal care to make sure her baby would be healthy since we are systematically closing down those facilities that offer services for women who are uninsured (and also help provide birth control to prevent pregnancy!); because she has no way to pay for day care and she may have to quit her low-wage job to care for her baby; because she would then have no money for all the supplies, food, and developmental tools her baby would need to thrive which can lead to malnutrition, behavioral problems, child depression; because she could then become part of the 29.9% of families in poverty that are headed by single women, and her child could become part of the 35% of those in poverty who are under 18 years of age – the poverty rate for households headed by single women is significantly higher than the overall poverty rate.

We’ve cut child welfare services that aid women by the tens of millions in the past few years. Georgia alone cut over $10 million in Child Welfare Services. We’ve also cut subsidies that support adoption agencies – the organizations that help women find families that may be able to care for her baby were she to carry it to term – and who make sure these families are actually fit to do so! TANF (Temporary Assistance for Needy Families) provides women and families with aid so that children can be raised in their own homes or with relatives, instead of being placed in foster care and becoming wards of the state. How much have we cut from TANF? 17 of the poorest states, with some of the highest poverty rates in the nation, have already stopped receiving funds.

Birth control, one might say? Sure – birth control is expensive, so if she doesn’t have health insurance, she isn’t likely to be able to afford birth control (hey, Planned Parenthood can help with that, too! Seeing a pattern?) And if her partner refuses to wear a condom? If she is in an abusive relationship, if she fears leaving her partner, if she relies on her partner for added economic security – she’s much less likely to argue with him about the condom use. Or even feel that she has the agency to begin a negotiation discussion at all.

These facts make me sad. And all of these facts might lead a woman to decide she can’t have a baby. And many things not listed here may lead a woman to decide that she will not have a baby. And that she will have an abortion. Is it my decision? No. It’s not. It’s not yours or Ross Douthat’s, either. Again, Douthat represents the contingent of pro-lifers who want to make it seem like pro-choicers are cheering the performing of abortions right and left. What we are cheering is the right for women and respect of women to make their own decision based on their very specific personal circumstances. And given the fact that the medical establishment has not agreed with the pro-life camp in claiming that fetuses before a month into the third trimester can feel pain (reacting to stimuli does not equal pain, to reiterate, and pain without a cerebral cortex is seen by physicians as not possible), which has most recently become the pro-life camp’s wildly off-base rationale for preventing a woman’s right to choose, and given the fetus’ place of residence in the woman’s uterus as a part of her body, not as a human, these issues that Douthat sees as “sideline” are actually very much at the center of the argument. Bottom line – it’s the woman’s body. It’s the woman’s choice. She will be the one carrying it, she will be the one birthing it. No one else. So why should anyone else decide?

Additionally, it is not a crime for a woman to not want children. Since she is able to give birth, it is her decision as to when and how that will happen. Everything about her life and future will change once she has a baby. So she needs to be sure she is ready for that. How can one disagree with that? Douthat may not like it, but “the sense of outrage that pervades his story” (see what I did there? 😉 ) seems to me more rooted in his anger and frustration with his opinion not being considered by women in these decisions and not being able to control what a woman decides to do about what is going on in her body.

All of the things I listed – the job issues, the healthcare issues, the family and community issues, the issues that arise when a child doesn’t have access to food, clothing, and developmentally appropriate stimulation – are the causes. So why don’t we start figuring out how we can mitigate those facts and issues instead of attacking the effect – the abortion – which is a decision women come to after weighing all of those facts and issues just discussed. Douthat’s fear tactics of talking about female fetuses strewn across Indian hospitals is scary imagery. So is this:

Photo thanks to ehow.com

And this:

Photo via Captain Hope's Kids Blog

And this:

Photo property of streetkidnews.blogsome.com

Want less abortions? How about providing health insurance, that covers both birth control and pre-post natal care? How about equal pay for equal work, so women are more financially and economically secure, providing them with the resources to stay out of poverty and keep their children out of it, too? How about child care in work environments, helping women who cannot afford day care can stay in their jobs and remain a part of the economy? While we’re at it, how about great public schools and clean community centers, so women know their children are being intellectually fed and socially stimulated in safe environments that help keep them out of more dangerous and potentially life-threatening social circles? How about comprehensive sex education so men and women know how to protect themselves not only from pregnancies but from diseases that can endanger a fetus and create complications during birth and cause health issues for them and their children – creating more expense, particularly if one has no health insurance.

Let’s talk then. And how about you follow me on Twitter?