Woman's Hour - Post botulinum toxin experiences, Photographing all your objects, FGM

Episode Date: July 24, 2023

There has been a significant increase in the number of non-surgical aesthetic procedures over the past decade. And now the largest academic survey to date in the UK has just been published, relating the lived experience of over 500 people who have experienced an adverse event following administration of Botulinum Toxin. The study finds that a lack of awareness of reporting structures and the lack of regulation within the UK’s cosmetic injectables sector represents a significant public health challenge. Nuala is joined by the senior author of the study Ash Mosahebi, Professor of Plastic Surgery, and by Genee Schock who took part in the survey and runs a side effects support group for people impacted.How much time would it take to photograph every single item in your home? Photographer Barbara Iweins spent four years documenting the 12,795 objects she owns. Barbara wanted 'to see the representation – flat on the ground – of a mother and her children.' She joins Nuala.Victoire Ingabire Umuhoza is the leader of the opposition in Rwanda. She talks to Nuala about the challenges facing women and girls in Rwanda as well as the proposed UK-Rwanda asylum plan.Tributes are being paid to the former Labour MP Ann Clwyd, who has died at the age of 86. Not only Wales' longest-serving woman MP, Ann also became known as a passionate human rights campaigner, committing herself to many causes, including the banning of FGM - female genital mutilation - in the UK. In 2003 she introduced the Female Genital Mutilation Act, making it illegal to take a girl out of the UK to undergo FGM in another country. Nuala is joined by Hibo Wardere, anti-FGM activist and author of Cut.

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2. And of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, this is Nuala McGovern and you're listening to the Woman's Hour podcast. Hello and welcome to Woman's Hour. I hope you had a good weekend. We're going to take a closer look at botulinum toxin. We often call it by one brand name, Botox. And we're going to look in particular at the results of a survey completed by those who have suffered adverse effects following injections used for aesthetic purposes.

So that in a moment. Also today, Barbara Yvonne, she has documented all her possessions. Yes, all of them, totaling 12,795 objects. So we're going to talk about what she discovered about herself through the project. And she also talks about a desire to see the representation flat on the ground of a mother and her children. So my question to you today is, what object are you keeping that reminds you of your mother or of being a mother yourself. Maybe it's old, broken, maybe impractical, but nevertheless, you keep it. Why?

Well, to text the programme, that number is 84844 on social media. We're at BBC Women's Hour, or you can email us through our website. For WhatsApp messages and voice notes, that number is 03700 100 444. Also, we will speak about the former Labour MP, Anne Cluid, who died at the age of 86. Part of her legacy is making it a criminal offence for parents and others to take girls out of the UK to be subjected to female genital mutilation. So we will talk about the impact of that law.

And today we also have Iktuar Ngabire Umahosa, the Rwandan opposition leader. Women Deliver is one of the world's largest gatherings on gender equity. It is just closed in Kigali and many have been looking to Rwanda as a gender model for other states to follow. About 61% of its parliamentary seats are held by women. But does Ms. Ngabira Omohoza agree that it's a good country to be a woman? We'll talk about that

and also the UK immigration plan to send migrants to Rwanda. Does she consider it a safe country as required by immigration law? But let me begin with the significant increase, as we know, in the number of non-surgical aesthetic procedures over the past decade. The largest academic survey to date in the UK has just been published of the lived experience of over 500 people who've had an adverse event following the administration of botulinum toxin. The study finds a lack of awareness of how to report bad reactions to the procedure and that the lack of awareness of how to report bad reactions to the procedure and that the lack of regulation within the UK's cosmetic injectable sector

represents a significant public health challenge. And I call it botulinum toxin. You'll often hear the word Botox, but that is just one brand name for this injectable. I'm joined by the senior author of the University College London study. That is Ash Musahebi, professor of plastic surgery and also by Jenna Schock, who took part in the survey and runs a Facebook and Instagram

side effects support group for people that are impacted. Welcome to you both. Ash, let me begin with you. You looked at the cases of individuals who had suffered adverse outcomes from these injectables. Why did you decide to focus in on them? And welcome. Morning. Thank you for the invitation. Yes, I think we wanted to see this is a part of a wider study looking at injectable markets and the public impact of it. And one part of the study was looking at toxins, as you mentioned.

We wanted to see, really, following the Keogh report, which was over 10 years ago or 15 years ago, that the cosmetic market needs better regulation and patients need better safety net. And we wanted to see if anything has changed or what's going on with the injectable market. And we found that the things that you found, that in toxins, which was the first part of the study, people who have it, and if they have issues, they don't know really what to do with it, how to report it and where to go for help necessarily. And what sort of effects are we talking about here? Well, it's a wide range of effects, psychological as well as physical.

Psychological is the fact that they get a lot of depression, mood changes, and physical effect as well. And so there's a wide range of effects. Psychological effects are the longer lasting effect. And how do you understand that? How do you understand that being caused if that's what you're saying by these injectables well that's the next there's a whole range of stuff we are left to do left to do at the moment first study is just to see what is going on there what are the impacts what are the complications what are the issues and the next stage hopefully is look delve more into it and why is this being caused well you know i'd like to turn to jenna for a moment uh you took part in the survey you also run a facebook and instagram support group as i mentioned what has your experience been and i believe it's over a number

of years hi luna yes i joined the group when there was 100 members after I became ill from the toxin in 2016. And I'm now an admin of the group, and we have grown exponentially over the years. And we now sit at over 28,000 members, many of them from the UK. And we are seeing people coming in every single day with these side effects, some of them extremely severe. People don't know where to turn, what to do.

They often... And I'm just going to stop you there for a moment because I'd like to know just in concrete terms what those effects are. What happened to you, for example? Okay. I had my toxin treatment and developed flu-like symptoms for the first few days. And then all hell broke loose. anxiety, panic attacks, internal shaking, head pain, insomnia, tinnitus, blurred vision, dry eyes, dry mouth, facial twitching, extreme neck pain, body weakness, numbness.

I had my bladder wouldn't work properly. I had bowel issues. I mean, that's just to name a few. A few. I mean, that is so many, Janaye. It was absolutely terrifying. And put this in context for me then. You were, I understand, getting injections for a number of years before you had this reaction?

Yes, I've been having toxin treatments for over 10 years without issues. I had a slight sort of runny nose or minor side effects after previous injections. And in 2015, that all changed. And how are you able to connect that to the injectable? Well, in the beginning, I didn't connect that. And that is a problem for a lot of people.

I didn't know what was happening to me. At first, I thought I had food poisoning or bad flu. And eventually, I hopped onto the internet and found a website which explained to me about side effects. I then joined the group and saw that I was definitely not alone. Well, let me throw that back to Ash. I mean, you're hearing Janaye's story there. I know you have carried out these procedures. Is some of the things she's talking about there familiar to you?

Yes, you can get some of the issues, particularly aches, pains and issues to do. Sounds like we think maybe it's autoimmune related. But as I said, the first stage of this study was just to look at the problem. And again, this is a small snapshot of the problem. After the problem is kind of looked at and visualised, then we can go back and actually look at the causes and the reasons for it. Because you know,, there has always been this criticism, and I see more in the paper this morning, actually, about the lack of regulation around the injections.

But reading from your survey, 80% of those who carried out the treatment for these patients that had adverse effects were healthcare professionals, from doctors to nurses and in the study 78% refused to support their patients with complications. How do you understand that, Ash? Well, that's, you're right and that's surprising and 40% of them were doctors,

40% were nurses and interestingly only 50% of the procedures were done in clinics. So around 50% of the procedures were done in clinics. So around 40% of procedures were done elsewhere. And again, that is hard to explain. And just because it's done by health care professionals, not all of them are necessarily aware of these issues and aware of advising patients how to get them to report their side effects. Because most of the doctors actually probably won't know that toxins can also be reported as opposed to any other prescribal medications.

Because we've often heard with other medications, the yellow card that you, the MHRA, the regulatory body, that that's where you're reported. But you're trying to push healthcare professionals to report when they come across adverse side effects like this. Yes, it's not just healthcare professionals that can report it. Patients can also self-report as well. So we need to just make sure that people are aware. If they have any problems, report it.

Once they reach a certain threshold, and if MHRA regularly inspects this, they will just do an alert or start doing things about it. Because once we don't know what's going on, then we can't really look at it. Do you think this study will change that? Well, I hope it actually does something to make people think and to do something about it. And to for certainly this is a academic study, hopefully the health care professionals who do read these kinds of things and programs like yours will help to promote the fact that there is a way of reporting this. And once we reach a level that it's required by MHRA we investigate it

further and hopefully protect the patients. Jenny you talked about those horrific side effects that you had are you through them now have you recovered? Yes pretty much so I still have some lingering neurological side effects but but I can manage them well. And considering the condition I was in after my treatment and how I am now eight years later, I'm very happy with the progress I've made thus far. Would you ever do injectables again? No, never.

Never. I mean, you could ask anybody in our support group who's had significant side effects would say exactly the same thing, it's a living hell Ash you do treatments whether on the NHS and also privately because I mean

we talk about Botox, we talk about botulinum toxins being used for aesthetic processes but do you, have you had patients in those categories that have had adverse effects? I haven't had the adverse effects that we looked at in the study and Janaye was reporting. But, you know, it does happen. We know from the report that it does happen and and this is this this survey looked at only the aesthetic market yes of course toxins are used quite extensively for medical reasons as well

and we haven't really looked at that yeah because even when i was looking this morning it came up for headaches it came up for ms at times it came up for excessive sweating, a number and that's just a few at first glance because you would imagine if you are raising concerns in the aesthetic field that surely you would need to think about them in other fields as well Yeah absolutely and I think it's just

a matter of people thinking about that this is a medication and like any medication can have adverse effects and thinking about it will hopefully initiate people doing something about it and advising people if they're having some symptoms that they haven't had before just report it coming back to you jenna i mean are people reporting it in your group and i know any summer in the uk which relates to the mhra yes they certainly are we have a post up in the group which we to the MHRA? Yes, they certainly are. We have a post up in the group

which we refresh almost daily, advising people where they can report their side effects. But it seems that there's a discrepancy between what we see in the MHRA data and how many of our members are reporting side effects. So there's a possibility that the forms may be difficult for some. And what I would like to see is that if somebody is having side effects, they go back to their practitioner and go through the form together so that they can get important information like batch numbers, amount, placement, etc. Because a lot of people aren't told that and they don't know. And they come to fill out the form and they cannot fill half of it in. So that's interesting.

So what you're trying to do is create a trail of accountability. So if one batch was a bad batch, for want of a better term, it's not used on somebody else or that they can connect the dots. Absolutely. And that's why I believe that all practitioners should be licensed so that there's a proper database. Before I let you go, though, Janaye, your practitioner was licensed, is my understanding. Yes. Yes. And for me, it was a different story. You know, I was told what to do and I had a good amount of support.

But for the vast majority of people in our group, that is not the case. Really interesting. Thanks to both of you for joining us. That's Asha Masahebi and also Janay Ashok, who took part in that survey. Dr. Alison Cave, MHRA Chief Safety Officer, said that the Yellow Card reporting scheme is a robust and well-established system for the collection of information on the safety of medicines and defective or fake medical products, enabling our assessors to rapidly identify emerging safety signals. Information on reporting is included in patient leaflets and the scheme is regularly promoted by the agency as part of our yellow card strategy. The MHRA encourages the reporting of suspected side effects to authorise botulinum toxin products via the yellow card scheme. These products can have rare but serious side effects and should only be administered by

physicians with appropriate experience. Interesting because as we're hearing so many of those that did administrate were health care professionals even with those with the adverse effects. Right I want to move on now because over the weekend there were many tributes as you might have seen paid to the former Labour MP Anne Clid, who has died at the age of 86. Not only was she Wales' longest serving woman MP, she also became known as a passionate human rights campaigner, committing herself to many causes, including the banning of FGM, female genital mutilation, in the UK. In 2003, she introduced the Female Genital Mutilation Act, making it illegal to take a girl out of the UK to undergo FGM in another country. Hebo Wadere is an anti-FGM activist and author of Cut, a book which details her own experience of FGM and her fight against it. Hebo, welcome to Woman's Hour. Thank you so much for having me.

Thank you very much. Well, let's talk about Aunt Llywyd and that FGM Act of 2003. Do you remember how you felt when you heard about that for the first time? It was unbelievable because they were, you know, parents weren't held accountable. They could take their daughters out, you know, parents weren't held accountable.

They could take their daughters out, you know, cut them out and mutilate them, circumcise them, whatever you want to call it, bring them back into UK. And even if they were found out, they weren't held accountable. Why? Because they've done outside UK. And the whole fight was, no, these are, you know, innocent kids. These are British kids. They need to be held accountable no matter where they have taken them.

Why is it different to any other child abuse? If it happens abroad, parents will be held accountable. So why is FGM different? So Anne took that and ran away with it. And she was a diamond in bringing this law about and getting approval from all sides. What sort of impact do you think it had? We're talking about 20 years later.

Yeah, it has a lot of impact. Just remember that, you know, 20 years later and before that, people didn't talk about FGM yet. It was illegal since 1985 in the UK, but nobody knew about that. It's survivors like Leila Hussain, Ninko Ali, myself, that are very vocal, that have actually brought this life to life, actually, and brought other laws in terms of that as well. So it was a very, very hard work that made these laws actually come true in terms of UK girls being protected. Yeah, it's interesting. I was reading there's

only been one prosecution. That was back in 2019. How do you understand that? And I think, first of all, that prosecution came from my own barra, Walton Forest Barra, which have done amazing work in terms of FDM. And the reason we are lacking of what you call a prosecution is it's the way it's documented. It's the way the professionals among themselves for example like the social workers to the police to the teachers there's a lack there's a you know

there's a lack of information flowing through them there's a lack of how to report this properly even now as we deliver training left right center there's a huge gap in that and that is the huge gap that we are we are working on to you know to cap that one up and then get the results that if any child is mutilated that needs to be done. So what do you think Ibo because you're so immersed in that world I know I'm talking about one prosecution but do you think yeah the mindset and perhaps even more importantly, the actual cases of girls being taken out of the country for FGM, do you think that has changed? I think it does has changed slightly, not that much, slightly. But during COVID it's actually accelerated that. We have articles from Somalia that said, you know, cutters were going door to door, offering 50% for the girls.

We do know FGM happens here on UK soil. That girl that was three years old, the case 2019 has actually showed it's actually happening here. It's underground. It's, we can't hide from that. We can't ignore that. It's a matter of having to work,

all of us jointly, the police, you know, the social workers, the teachers having to work all of us jointly the police you know the social workers the teachers it's all about us connecting together so that we can see results in terms of cutting the perpetrators why do you think that communication isn't happening then because you've mentioned that a couple of times now that the flow of information isn't there i mean this is a couple of decades we're talking about that it has been in the public consciousness. You'd be surprised of how some of the professionals are afraid to talk or to tackle FGM because they think, for example, if the teacher is white and she feels like there's something weird going on, she might feel like, you know what, I am white. They might think I'm

racist. They might think that I'm discriminative, that today still is happening. And then we have the social workers who are overworked, and sometimes don't see the whole information in one go. And there's a lot of things that's happening. And for me, that is why we're not seeing enough, you know, prosecution or anything else being done. Because as long as there's that that discommunicationscommunication between the professionals, it's going to be very hard. Police who are absolutely afraid by the communities that would not let them in. And I don't think police also do a lot of work in terms of building a trust with the community either. You're the education lead for the charity Educate Not Mutilate.

Yes. So how do you go about then, you know, breaking through some of those barriers that you've just described? Yeah, I wholeheartedly, number one, believe in education. I believe in our youth today are the ones to end FDM, period. And this, you know, our charity Educate Not Mutilate, we're doing so much work with the help of the National Lottery grant, with the help of friends and

other people who support us. We have seen intake. We are inundated with work from all over UK, not only London only, but all over it. And we're travelling quite a lot. And we have seen education, how impact it has on our youth

but what are you what are you educating what are you trying to to get across to people because it's been made part of the phsc since 2021 it's part of a secondary school teaching it has become that the teachers have to teach a teacher's already got loads of things to teach on top of that so we do come in in that sense and deliver the work for them. But we also are engaging communities as well, health professionals, police. We engage in everyone that we can think of

or anybody who contacts us. We are always, always willing to do work with them. I'm just wondering though, particularly coming back to the mindset again, because this is about girls being taken out of the country and at times also happening on UK soil, as you as you mentioned. How do you speak to families that are perhaps very traditional, still believe in the practice? How do you change their minds? One of the things that we talk to the families like that is to make them understand you have to understand these families however traditional they are they actually do

understand their human rights yeah they understand what are their rights and for me I always come through the human right back door and I tell them well the child on UK soil have rights too just like you do even much more than you do actually. This child has a right to be protected from all sorts of harm. That includes, you know, FGM, that includes physical violence, that includes, you know, psychological emotion. So I make sure that they understand the child has rights to a new care, which they never understand that much. They don't think the children have their own sets of rights. So for me, I always talk about that and, you know, tell them if your rights were violated,

which you absolutely see as it's your must to be protected from all sorts of violence, why do you think this child isn't entitled to that? So for me, it's all about, you know, coming through the human rights law and teaching them about the law on how it stands in UK time. Do you think that you will see FGM eradicated? Absolutely. Wholeheartedly believe with my heart, yes.

As we continue to educate our youth through our work, through AENM work, we actually are seeing that. We are seeing, for example, I'll give you a quick example of a young man who argued with me, said there's no FDM. I've never heard of it. I come from Somali community, this and that. And in the same evening, I get an emotionally, you know, emotionally emailed talking about how he talked to his mom, how his mom disclosed she was cut. But he was also angry that his mom was cut by a man doctor. Forget about that.

She was mutilated. He was angry on that set as well. So education is having an impact, just like the Chinese footbinding ended through education. I wholeheartedly believe it's through our youth. It's through the community, but mainly it's through our youth and educating them in school, which UK government has done an amazing job by saying yes to secondary school. I'm very, very grateful to that and we will see end of it. I wholeheartedly believe it. Hebo Wadare, anti-FGM activist. Thanks so much.

Talking about FGM now as we think about the legacy of Anne Clewitt that had introduced that act to make it illegal to bring a girl out of the UK for FGM. Now, one of our favourite times of the year will be coming up in the not too distant future. Listener Week begins on the 21st of August. It's all about you and what you want to hear. So get thinking, start writing down your notes. Maybe you have a powerful personal story or maybe I don't know something unusual as a pastime that you want to share could be on anything

could be careers or dating or science something you'd like to put to an expert maybe you want to nominate somebody the inspiring story

somebody who got you through a particular challenge could be your family your community I'm just throwing these things out to get the creative juices flowing so we want to hear your ideas. Maybe you'll be with me here in this studio, the Woman's Hour studio, sharing it in a number of weeks.

So get your thinking cap on and don't rule out the frivolous. Just let them kind of, I don't know, percolate there and get in touch with us. On text, it's 84844. On social media, it's at BBC Women's Hour. Or indeed, you can also email us through our website. It's my first time doing Listener Week, so I'm really looking forward to it

and looking forward to seeing your ideas. Now, how long, while you're percolating your ideas, how long would it take you to photograph every single item you own? And what about then classifying them by colour, material and frequency of use? Well, the photographer Barbara Yvonne spent four years documenting the, get ready for it, 12,795 objects in her home. And not only did she discover unexpected possessions, but she also discovered quite a bit about herself and that emotional attachment that we attach to belongings.

Barbara calls herself a neurotic, a neurotic, let me get the word out, a neurotic collector and is joining me now. Hi, Barbara. Hello, hello. So good to have you with us with this you know we threw this out to our listeners and already i'm seeing so much we were particularly zoning in on something that reminded them of their mother or of them being a mother themselves and the reason i asked that is because you said you were driven by a desire to see the representation flat on the ground of a mother and her children. Tell me a little bit about that.

Yes, indeed. Well, actually, I was going to a divorce and I had moved a lot. I think in my life, 11 times. And I think I was moving from Amsterdam to Brussels with my three children. I was kind of exhausted, honestly, to packing, to pack all the time, all these objects. And I'm not a hoarder. I don't have especially plenty of things. But come on, each time, I was fed up.

And realistically, all our objects are always hidden in drawers or in boxes. And so they're not visible. So you continue, actually, you purchase all the time. So I was like, okay, I need to be honest there. We're all the time speaking about overconsumption, but we're always speaking about the others. But in a way, we are all the others. So I wanted to know, what is it actually?

A woman with three children, what is it? So I was like, well, I want to see black on the ground, which is, of course, impossible. So I decided, well, I'm going to photograph every single object I own. So that was the beginning. And so you did. I mentioned there you had the indexing and classification system. I mean, that boggled my mind. And this don't know, in the beginning, I didn't think of classifying these objects,

but I think in the beginning, I thought it would be self-centered on overconsumption, but the way of progressing in this project, it was becoming more and more personal. And so actually I was like, okay, I want to see all these statistics to know how I'm using these objects, which objects are painful. For example, I hate being in a kitchen.

I can't cook at all. For example, photographing all these objects, these specific objects was terrible, while others, more objects that are representing souvenirs or people, these ones were very important. Yes, I have to say the end result is beautiful. I love the order of it, of each object lined up. Yes, I just I love the, I suppose, procedure and process that you've created out of that chaos of all the objects that all of us have. Can we talk about some of the items that you had strong memories about? There was a trench coat I read about. Do you want to tell me about that? Yes, indeed, because I decided also the fact that it became actually more a biography. I have taken 50 stories related to objects.

And for example, there is a trench coat. It was actually because my ex-boyfriend was in the hospital. And so I was like, well, I'm going to throw a little risque surprise. It was the first time I decided to do that. I decided to wear a trench coat completely naked to the hospital. I was actually more giggling and I was like a bit, am I gonna dare doing it? And so I went outside to go take the subway to go to the hospital and I became one more secure. And actually, I was like, well, it's actually quite funny.

But then suddenly I felt like a tickle of air on my thighs. So I touched my back and I was like, oh, my God. Actually, the trench was open. There was a split actually completely open. So actually, I was walking for 10 minutes. Yes, with my butt visible to everybody so that's actually a story of my life I think I'm gonna be sexy and I'm being ridiculous but voilà so that's these kind of stories and I think they happen to all of us. You kept the trench? I do, of course. Yes, because I did see that there was like 99% of the items at the end of the day.

You felt you didn't need to hold on to them. Of course not. That's the crazy thing is that actually there was only 1%. But for me, actually, what was actually quite interesting is that more an object has a utility. Do you say that? Yes. The less I care about, like a phone, a computer, all the objects that you can replace. I don't care at all.

But all the objects that are linked to the past, nostalgia to people, these ones I really want to keep. To hold dear. Let's listen to some of our listeners, Barbara, who got in touch. They were inspired by you. Let me see. I have kept a little book of books to remind me of my mum. She was an avid reader and wrote little notes each time she read a book. I'm trying to read the well-starred ones.

And talking about kitchen items, I've got my mum's rolling pin and pastry board, which were also her mum's. In fact, they might even go further back than that. I wish I'd checked with her before she died. But every time I use them, I feel a beautiful connection with the matriarchs in my family over the years. I love all the scratches and indentations,

what stories they must have to tell. Here's another from David. My mum's Porsche, it was hers for 30 years. It's a member of the family. My mum crossed Europe in it with small children and no sat-nav, a tangible reminder of my mother's strength and style. Here's another. On a high shelf, I have an empty bottle I used to have for making my mother her coffee. After she passed away, I never got rid of it. It was part of our mornings together, just as was listening to your show.

Oh, that is so lovely, Stuart. Thank you. Here's another one from Helen. I've kept the last thing which my mother bought me, a box of pear and blackberry drops. They're a type of sweet, a type of candy. Unfortunately, my husband found the box and helped himself to them. Oh, no, Helen. I'm sorry to hear that.

And one from Elaine, a rose quartz budda. She kept it on her bedroom dresser with her makeup. I never knew who gave it to her or where she got it. It just sat lovingly with her. And now it's in my office on its own peaceful shelf. What about those stories? They're beautiful, actually. Yes, everybody has them, I think.

Everybody has them. And what would you say now about what you've learned about yourself from the possessions? Well, actually, that's a thing is that it's a little bit pathetic what I'm gonna say but um I think um it's such a chaos in my head and I believe life is in a way absurd and chaotic and I have no control in it you know like people can leave people can die but in a way with objects I've always had this sense of protection the stability like the inertia of objects, you know, in a way, they're always going to be there. It's a bit sad, because I believe I would love to be a traveler who doesn't care about things and who could, you know, leave in two seconds to a country and who would not care.

But I'm not like that. I, in a way, I have the sense of, yeah, sense of protection, I think. Yes, it is interesting because objects often live on after us, even though we can't bring anything with us. But sometimes they hold dear memories, as we're hearing from our listeners, about people who have passed. Anything you didn't want to photograph? Anything you left out?

Actually, and it's not what everybody thinks, like sex toys and stuff like that. That I don't care. I believe everybody has them. Well, women or men, whatever. But no, it was actually the mold of my teeth. It's a horrible... The mold of your teeth,

like that you'd have for the dentist for a retain retainer, or to stop you grinding your jaws. Yes, not in plastic, like in stone. And I don't especially like my teeth. And I have to be honest, when it came, it was in my bathroom and I was like, ooh, am I going to throw that away so nobody sees it? But come on, I have to be honest. So, well, I had to photograph it. You did get rid of lots of the items afterwards.

If somebody is listening now and they want to do what we'd call a cull, a serious cull of everything, what's your advice? To throw everything away. No, no, no, I'm kidding. No, no, I don't know. Actually, I would not advise to do it because it has been terrible and I would never ever do that again uh and I'm not a Marie Kondo that's what I realized also um is that uh I would actually not advise a person to do so

why was it terrible just before I let you go to To do this project? To photograph every single picture? Because it was extremely exhausting and extremely boring in a way, but it was interesting for sure. But if any person would ask me to do it in his house, I would, of course, refuse. Barbara Yvonne,

it's a real pleasure to speak to you. Thank you so much. You can find Barbara's objects and stories in her book catalogue, 84844, if you want to get in touch. Let me move on now to the Women Deliver 2023 conference.

That was one of the largest global convenings to advance gender equality. It's just come to an end in Kigali in Rwanda. It's the first time it's been held on African soil. And it addressed the issues impacting girls and women. So from climate change to gender based violence to unpaid care work. Rwanda has shown a commitment to gender equality, placing women in high level decision making roles in government. Over 60% of women are in its parliament.

52% hold cabinet positions. But what about the wider challenges facing women and girls in the country? Well, I'm happy to welcome to Women's Hour, Victoire Ngabire Umahosa, who is the leader of the opposition in Rwanda. She has been attending the conference, so speaking to me today live from Kigali. Welcome, Victoire. Thank you for having me but I did not attend the meeting because they refused to invite me.

You were not at the meeting forgive me that is my oversight. Let me turn then to some of the issues that come up with Rwanda because many who were attending the conference, they point to over 60% of women in the Rwandan parliament for example. They talk about Rwanda as a model for other states to follow, particularly African

countries. Is that something that you would agree with? Yes, you know the government of Rwanda had made efforts to improve women over the past two decades. For example, we have laws that protect women in Rwanda.

Today, the women have the same right as men, for example, to property. A large number of women have been placed in a high-level public positions. However, there's achievements. The majority of ordinary women I meet and speak to from across Rwanda say there is still a long way to go. For women to achieve a level of influence and decision-making, that can lead to the change they want. And what's standing in the way then, Victoire?

Because if you have education, health care, role models, what's standing in the way? Yeah, you know, the problem is that even if the Rwanda government is praised to have many women in the parliament, but it's more for his image and it is a kind of window dressing. The majority of those women in the parliament of Rwanda comes from the ruling party, of the party affiliated by the executive are not deeply scrutinized, including how the problem that affected most women. But because the U.S. Sorry, go ahead. Give your example. So I will give the example. For example, it is known that in Rwanda, a woman or a girl to find a job, a good job, has to sleep with the manager.

You can read this in, it is a kind of corruption. And this is published in the report by International Transparency Rwanda. And I never heard those women in parliament talk major against this kind of a sex abuse of women. And are you talking about their victoire, for example? You're saying that some women would need to sleep with people in order to get ahead. Are you talking about informal work arrangements? What sector are you talking about? Not all sectors, all sectors. Because I don't have anybody here to push back on that, but I'm sure there's so many that have their careers in Rwanda that have made great strides

that would disagree with what you're saying and say that they made it on their own without any sexual favours or any interactions like those that you're describing? I don't remember. I think the last time there was a meeting, the political meeting of the Wurundjeri Party, where the child person is President Kagame Serif. He told that he knows this abuse for women, this sex favor that the women have to use to get jobs. He condemned that.

It is something that is known in Rwanda. It is not exaggeration for someone in opposition, but it's the reality. And they talk about the report published by International Transparency Rwanda. It is something that you can find the facts and the evidence that the problem is there. So you feel it's something that's recognised in Rwanda. So I understand that is one point that you put across. And you also talk about Rwanda not being scrutinised. But, you know, others would say the US and the UK do scrutinise it

and they will at times point to human rights issues, but they have decided they want to partner with it. They have talked about it as a model for the continent of Africa. Now, you know, there is a different report of

British government. For example, there is a report from published by UK Foreign and Development Office, where they say that there are human rights concerns around the lack of freedom of expression and the targeting of opposition leaders and the civil society organization. This is a report published in 2017 by British government.

And I think in 2020 also they published the other report where their information about the opposition candidate who had harassment, threat or intimidation. So the British government knows the problem we have in Rwanda. They know that Rwanda is not a free country. And there is, let me be clear, as my listeners will know, so much debate at the moment, particularly because of a policy where the UK

would send migrants and asylum seekers to Rwanda. And I can get to that in a moment. But, and there's a difference of opinion, should I say, between the government and many other groups on that in the UK but you are a leader of the opposition you did spend eight years in prison from 2010 after being convicted of genocide denial and conspiring against the government there are still you were then released after eight years I think the term actually was 15, that you were sentenced to. Tell my listeners a little bit more about how that time has impacted you. Yeah, that was a hard period in my life where I spent, you know, I come back in Rwanda to participate in the presidential election 2010.

And when I had, I was hoping to register my political party and run for presidential election later that year in 2010 when I come back. And on the day of my arrival to Rwanda, I visited the genocide memorial center and gave a speech urging unity and reconciliation. At that moment, I criticized the government's policy for not being sufficiently inclusive. That is why I was accused to have a genocide ideology. So I was sentenced for 15 years and I made an appeal to the African Court and the Human Rights People's Rights. And 2017, my name was cleared. But I spent five years in isolation confinement.

In confinement, yes. It was in the cell where the windows were painted in black. There was no light inside the cell. In confinement, yes. always to serve the rest of my sentence along with the other in a minute. But if I know who the President Kagame giving me the pardon, it was in September 2018. But this pardon are with the condition. For example, I can't live in my country without the authorization of the Minister for Justice. What I tried to do many times, I asked the authorization to visit my family, because my family is still in the Netherlands, where I was in exile. And my husband is very sick since 2016.

I asked the authorization to visit him, but the government refused me. So you have not been able to go home. And I know you had young children when you left originally, when you went to run. And of course, the family being separated by that prison term, and also with these following restrictions. And you talk about freedom of speech, I'm wondering when it comes to the planned UK Rwanda asylum plan, as the illegal migration bill in the UK was passed last week, what is your reaction to the fact that migrants could be deported to Rwanda? I know I am against this deal between both governments. You see that different reports have consistently shown that Rwanda is not a free country.

Civil liberties and political rights are not respected. This deal between both governments, if you like, the Refugees Convention, which is created that nobody should be sent in the country where his life or freedom would be threatened. And if Rwanda is not a free country, how you will send the people who have fled persecution in their country, how you will send them in the country where they can suffer the same mistreatment. Now, Suella Braverman, she did visit Rwanda for two days in March. She said Rwanda offered a blessing for migrants

as the country would provide these vulnerable people with a prosperous future. No, that is not true. They know that is not true. Rwanda is a poor country. It is important to note that despite the praise that Rwanda received for achieving economic progress, Rwanda remains categorized among last developed country by the United Nations.

And Rwanda is ranked among 25 poorest country in the world. How you can say that the refugees are blessed and they will have a well-being in Rwanda? It is a poor country. I know that in the not very bad between Rwanda and the government, Rwanda promised to offer their jobs to

refugees, but you should know, you have to know that among Rwandans youth, the majority has no job. They are jobless. The employment rate, the government stats say it's 16 percent, increasing to 21 percent for 16 to 30 year olds. No, it is not that true. I have to leave it there, Victoria. I'm so sorry to cut over you.

I understand that you do not agree with those statistics as you see them. We'll have to talk a little bit more about Rwanda in future interviews, but I want to thank you so much for joining us today, Victoire. Ngabira Uma Hosa, the leader of the opposition in Rwanda, speaking to me today from Kigali.

Thank you so much. I just want to go to a message that some of you have been getting in touch about stuff you've kept. I have a straw stuffed lamb from my mum from 71 years ago when I was in hospital, age four, as well as her red beret and her red shoes.

That message ending at this edition of Woman's Hour. That's from Suzanne. Thanks so much. And I'll talk to you tomorrow. That's all for today's Woman's Hour. Join us again next time. You know the problem with technology, right? We've made it too complicated.

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