NGOs and Sex Ed in Bosnia
By Jennifer Gersten
Instead of delving into schoolwork, the small group of eighth graders at QSI International School of Sarajevo is going to spend a few minutes with a reporter talking about sex. At first, they look delighted.
Save the students’ giggling, however, the room remains silent. No one speaks up, at least not while the teacher, who is trying to make herself inconspicuous by standing against the back wall, is in the room. Two students finally reveal that they have dated, but not seriously. A mischievous-looking boy points at a girl and accuses her of dating an upperclassman; flushing, she denies it. A third of the classroom says they have watched porn or received advice about sex online. All of them agree that they are shy to approach adults with their questions about sex. They sound, in short, like typical eighth graders.
With relief, the students resume their computer projects. The moment is only a preview of class sessions to come. Before graduation, all students at QSI (Quality Schools International), a private pre-K-12 school in Sarajevo, must pass a required health education class with a unit on sexual health.
In Bosnia’s public schools, however, sex education is largely absent from the curriculum. Across the country, the quality and content of public school sex education differs dramatically along deep-seated political and ethnic lines. The result has been a countrywide lack of awareness, particularly among adolescents, about safe sexual practices.
In late December 2014, Bosnia’s lack of sex education made minor headlines in a story from Belgrade-based news site Inserbia.info. Seven girls aged 13 through 15 had reportedly dropped out of school with startling news: on a five-day class sightseeing trip to Sarajevo, the girls, aged 13 through 15, had all become pregnant. In the article, Sarajevo-based gynecologist Senad Mehmedbasic, director of the Mehmadbasic Gynecology, Perinatology, and Infertility Institute in Sarajevo, said that the incident speaks less to adolescent recklessness than to widespread ignorance about sexual health.
Dubious though the story may be — it reached the Daily Mail, the New York Post, and Cosmopolitan UK, with facts inconsistent across publications — Mehmadbasic’s observation holds water. While most public school biology classes in Bosnia will spend a few days on the anatomy of reproductive organs and hygiene, explains Dayana Cvjetkovic, a representative at the Bosnian youth sex ed advocacy NGO Association XY, many teachers will not discuss human sexuality or safe sex, including contraception, in the classroom. In some schools, the focus of sex education is not on humans at all, but rather plant and animal anatomy. “For family planning, [teachers] will even talk about the bees and flowers,” she says. Many teachers avoid the subject, says Haris Karabegovic, director of the Sarajevo-based NGO Partnerships in Health (PIH), because they feel they are insufficiently trained, or are too uncomfortable, to discuss the subject.
Sex is a taboo subject in many Bosnian families, particularly those who are deeply religious. QSI’s guidance counselor Sladjana Hvelja says that she lets students know that she and their teachers are available for any sex-related questions. But she says students are shy and reluctant to bring their curiosities to the classroom, let alone to voice them at home.
Now NGOs promoting public health are emerging to bridge the knowledge gap. In Bosnia, PIH and Association XY are among the NGOs spearheading in-class workshops in public schools and sexual health advocacy, calling for safe spaces for sex talk in their offices and beyond. In all forms of instruction, organization members teach comprehensive sex education, which teaches abstinence, types of contraception, and communication skills, as well as emphasizing rights in relationships and responsible decision-making.
During school workshops sponsored by Foundation CURE, a feminist and gender rights organization, CURE representative Marija Vuletic makes women say “vagina” in an attempt to make them more comfortable with hearing the word. At first, she says, they are ashamed. “It’s a dirty word, in our shaming culture,” she says. Then they make their own vaginas out of art supplies.
Many NGOs have found success connecting youth to volunteer peers of the same age. This mode of peer-to-peer teaching, Karabegovic says, helps correct the inaccuracies most students hear about sex from their friends, or online, as is increasingly common.
“I feel pretty well informed about [sexual health]” said Hasan Dapo, a sophomore at International University of Sarajevo. But the amount she and her peers understand about sexual health feels “dependent on how much you can find out on your own,” she says, as her and many of her peers’ public school curricula did not address the subject.
Karabegovic and Association XY representative Cvjetkovic say that contraception is cheap and available in developed areas. But while students are familiar with condoms, Cvjetkovic says, many girls she has worked with in rural areas had never heard of the pill, or had heard horror stories about the pill’s potential side effects. Some girls are reluctant to take condoms from XY representatives, afraid of being thought immoral. In rural areas or regions where religion is more dominant, PIH has also met with difficulty: for two years, Karabegovic says, Mostar’s Catholic church prohibited the organization from presenting a sex education seminar in Mostar’s public schools.
Regarding STIs in particular, Cvjetkovic says, there is a startling, country-wide ignorance, even in an urban area like Sarajevo. “The reaction is laughter, at first,” she says. “They say, ‘[Sexually-transmitted illnesses] can’t be possible in our country. That was during the war, not now.’” Between Bosnian parents and children exists a generational gulf of experience exacerbated by the war. For older family members, Cvjetkovic explains, STIs seem a remnant of a fraught past they are eager to leave behind.
Cvjetkovic tells participants in her workshops how to contact Association XY-affiliated psychologists if they have questions, and where to find public services in nearby cities, including at Association XY, which has an in-house gynecologist who serves patients free of charge. In some cases, she works individually with students. PIH and XY provide free condoms from their offices and during workshops and street actions — visibility campaigns on the streets of Sarajevo and other cities where passersby can ask questions of organization representatives.
Cvjetkovic also does part of her job in rural villages, where XY representatives occasionally travel to hold workshops. The typical visit lasts three days or more, enough for her and her staff to get their bearings and establish some rapport with the community.
At the beginning, Cvjetkovic takes it slow. “We must be careful because of the parents, who can forbid us to come again,” she says. The curriculum starts with basic information about relationships, followed by confidence in relationships. Then she asks harder questions: the age when students first had sex, or what opinions students tend to have of a girl who has sex versus a boy. On the fifth day of a six-day training for peer educators, she says participants finally feel comfortable enough to speak with her one-on-one.
Karabegovic says the anecdotal response to PIH’s efforts has been generally positive from both school administration and participants. He is now in his tenth year with the organization, which he joined as a volunteer while in high school. Yet he takes a bleak view of PIH’s potential to create sweeping change. He cites his country’s convoluted political infrastructure: Bosnia has 14 different ministries of education: one at the state level, two at the entity level, 10 at the cantonal level, and one in the Brcko District. Despite the existence of a central state ministry, regional interests and politics hold sway over subordinate ministries, complicating efforts to pass legislation or work across political divisions.
While hurdles expanding and standardizing the sex education curriculum exist on the government level, Karabegovic and Cvjetkovic say their organizations are in high repute on the ground. Public schools often invite Association XY to present in public schools, Cvjetkovic says. Recently, Association XY became the first NGO in the Balkans to be asked to join the International Planned Parenthood Foundation, which provides access to sexual and reproductive health education and resources in 170 countries. She believes Association XY has the potential to grow and expand — slowly, but surely. In 2012, Association XY, in collaboration with health and education ministries in Republika Srpska and the Federation of Bosnia and Herzegovina, agreed to form a group to start work on a “Healthy Lifestyles” curriculum that might spread beyond the pilot city of Sarajevo if successful.
Karabegovic and Cvjetkovic say they find it especially encouraging that most parents are on board with their aims. “[They] are happy someone else is talking about [sex],” Karabegovic says. “It is clear that we’re not saying what they should or should not do, but what they should do just in case.”
Yet Elma Karman, a stay-at-home mother, insists she will not shy from discussing sexual health with her child when the time comes. “I wish it could be a subject,” she said. With a hand on her stroller and a fond glance at its tiny occupant, she said, “I will tell my child everything.”
Jennifer Gersten is a senior English major in Saybrook College. Contact her at jennifer.gersten@yale.edu.