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US bishops’ international aid agency implicated in scheme to teach African girls to contracept

Catholic Relief Services is implementing a program in African countries that promotes contraception and condoms
Wed Apr 15, 2020 - 4:26 pm EST
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WARNING: The following report contains information and an image of a sexual nature.

April 15, 2020 (Lepanto Institute) – In at least four African countries, Catholic Relief Services (CRS) is implementing portions of a project called Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe women (DREAMS).  CRS’s implementation of the DREAMS project is separate from 4Children, but as an OVC project, there does tend to be some intersectionality where the projects overlap.

The problem with CRS implementing the DREAMS project is that a large portion of it involves the promotion of contraception and condoms.  The overall success of the program is built around knowledge and provision of contraception and condoms, which means that CRS’s involvement can only assist in facilitating that end, regardless of the degree of involvement CRS may claim to have or not have.

The video report here is a shortened version of the much longer and more detailed information published below.  This information proves, beyond any doubt, that CRS both knowingly and willingly implemented a project that was designed to introduce young girls to contraception indoctrination, and that CRS was obligated to refer their young female clients to those contraception-pushing components.

Background

DREAMS was launched in 2014 by Deborah Birx, United States Global AIDS Coordinator and United States Special Representative for Global Health Diplomacy.  In a 2015 document published by UNAIDS on the Millennium Development Goal #6, Birx explained the purpose, means, and goals of the DREAMS project.  Explaining the purpose of the DREAMS project (page 342), Birx said:

“The goal of DREAMS is to reduce new HIV infections among adolescent girls and young women in up to 10 sub-Saharan African countries. Countries that are eligible for funding under the DREAMS partnership will implement a core package of programmes for adolescent girls and young women, including programming that strengthens their families, mobilizes their communities and reduces the risks posed by their sexual partners.” (emphasis added)

As will be explained later, this core package of programmes includes the promotion and distribution of contraception and condoms.  The point here is to illustrate that the core package existed from the very beginning of the project, which means that CRS would have been fully aware of what it was and what it contained when it agreed to implement DREAMS.  And as Birx explained a few paragraphs later, this core package would be intended to “reduce unwanted pregnancies,” which means contraception.

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“Because of the interventions in the core package, DREAMS could transform lives in many ways: by decreasing HIV incidence, reducing unplanned pregnancy, increasing economic mobility, reducing violence and raising the status of women and girls in their communities.”

In 2017, PEPFAR published a document titled, “DREAMS Core Package of Interventions Summary.” In this document, PEPFAR provided a brief background of the DREAMS project, indicating that it is a $385 million initiative built through its partnership with Johnson & Johnson, Bill & Melinda Gates Foundation, Girl Effect, Gilead Sciences, and ViiV Healthcare.  Page 2 of the Core Package of Interventions Summary provides a list of four categories for these interventions.  Number 1 on the list is “Empower Girls and Young Women” stating that these interventions are aimed at “empowering girls and reducing their risk for HIV and violence.”  Page 4 of the document identifies six goals for these interventions, including “Increasing Contraceptive Method Mix.”  Under this heading, the core package of interventions says:

“Adolescent girls and young women in low income countries experience high rates of unplanned pregnancy due to an unmet need for voluntary family planning, which increases their risks for pregnancy-related morbidity and mortality and affects lifelong education and economic opportunities. Unplanned pregnancy is often cited as the reason for adolescent girls dropping out of school. The promotion of dual protection, in which condom use is combined with another modern contraceptive method, is a critical component of family planning/HIV services and will help reduce the risk for HIV infection as well as unintended pregnancy. Increasing the variety of contraceptive methods available to women will also help keep them HIV free.” (emphasis added)

DREAMS is currently being implemented in 10 different African countries: Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe.  Of these countries, CRS is responsible for implementing DREAMS in Kenya, Lesotho, Uganda, and Zimbabwe.  While little is known about CRS’ involvement in the DREAMS program in Zimbabwe, we know that in Kenya it is called the MWENDO program, in Uganda it’s called the SOCY program, and in Lesotho it’s simply referred to as DREAMS.

Throughout the course of our research, it was completely undeniable that the promotion and spread of condoms and contraception throughout the project areas was at the very heart of the program itself.  In July of 2018, BMC Public Health provided an in-depth look at the DREAMS Core Package of interventions in a 15-page document titled, “Evaluating the impact of the DREAMS partnership to reduce HIV incidence among adolescent girls and young women in four settings: a study protocol.” Beginning on page 2, under the heading “The DREAMS Core Package,” the evaluation states:

“The DREAMS Partnership supports a core package of interventions targeted at AGYW, their families, wider communities, and men characterized to be the sexual partners of adolescent girls and young women (AGYW). The package is comprised of evidence-based interventions shown to address HIV risk behaviours, HIV transmission, socio-economic vulnerabilities and gender-based violence (Table 1).”

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The table following this passage shows very clearly that the promotion of condoms and contraception are specifically identified in this Core Package.  What this means is that, even if the promotion of condoms and contraception was not directly facilitated by CRS, CRS nonetheless participated in a project whose stated goal was the propagation of these things.  It’s a little like being the spring in a mousetrap – while the spring is not the object that hits and kills the mouse, it’s active participation in a mousetrap facilitates the goal of killing mice.

Beginning on page 4 is an explanation of the theory behind the DREAMS program, stating that the promotion of condoms and contraception is directly intended for the increased use of these things, stating:

We hypothesize that DREAMS will reduce incidence of HIV among AGYW through three related pathways of protection (Fig. 1)

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Figure 1 shows a flow chart moving from the DREAMS Core Package to the expected outcomes.

In Figure 1, the DREAMS Core Package indicates that “condom promotion” and “contraceptive mix” are included for Adolescent Girls and Young Women, and that “condoms” are included for “their partners.”  Under “Outcomes,” “use of condoms” and “delaying first pregnancy” (indicating that the condom use is intended to act as a contraceptive as well as an HIV preventative) are intended for both AGYWs and their male partners.

In March of 2015, PEPFAR published a foundational document which established the overall strategy and plan for the DREAMS project.  There can be no denying that the promotion of contraception and condoms was established from the very inception of the project itself.  The document, titled, “Preventing HIV in Adolescent Girls and Young Women: Guidance for PEPFAR Country Teams on the DREAMS Partnership,” provides complete details on the promotion of contraception and condoms in the DREAMS program.

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Beginning on page 20, under the heading “Rationales for Interventions,” the document explains that it is “unethical” to refuse condom distribution in “high risk populations” and suggested capitalizing on a woman’s desire to avoid pregnancy as a means of increasing condom use:

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On page 21 the document provides the rationale behind increasing the contraceptive method mix, indicating that increased access to and use of contraception leads to “lifelong education and economic opportunities,” and achieving “fertility goals.”

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Table 1 on page 35 provides even further insight into the Core Package of Interventions for DREAMS, indicating the strategies for condom provision and promotion:

The same is found for Expanding and improving contraceptive method mix on page 38.  Of particular note is the indication in this table that TABLE 7 illustrates what can and cannot be funded with DREAMS funds.  While it makes clear that DREAMS funds should not be used to purchase contraception other than condoms, Table 7 explicitly states that DREAMS funds can be used for the promotion of contraception.  It says:

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DREAMS funds should not be used to purchase contraceptive commodities (with the exception of male and female condoms). Contraceptive commodities are often funded by USAID (non-PEPFAR funds), UNFPA, or other bilaterals. DREAMS funding can be used for all other aspects of expanding the contraceptive method mix (i.e., outreach, training service providers, etc.)

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And lest Catholic Relief Services claim that its involvement with DREAMS included abstinence-only education, the chart of page 50 spells out that Abstinence-Only education is an intervention that should NOT be done:

Perhaps the most detailed chart on the inclusion of contraception and condoms in the DREAMS project is found on page 33.  Page 11 explains the information found in the chart, saying:

DREAMS follows a logic model that should guide how programs are monitored and evaluated (Figure 12). The model lays out the epidemiological context that puts AGYW at additional risk of infection, the interventions proposed to address these contextual factors, the expected outputs and outcomes of these programs, and the overall impact of those outcomes in combination.

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The chart establishes the logical progression of the thought-process behind DREAMS, and positively confirms that condoms and contraception are a foundational aspect of the overall project.

Given that the promotion of contraception and the provision of condoms is so integral to the overall project, it’s clear that Catholic Relief Services could not have morally participated in the project, even if its participation was not directly involved in the contraceptive components.

As will soon be shown, it seems that CRS anticipated this concern by attempting to extricate itself from direct involvement in the contraception and condom promoting elements of DREAMS.  But this attempt is only a further indictment of CRS’s complicity.

CRS Role in DREAMS

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In 2019, through the 4Children project, CRS published a case study of its 4Children-DREAMS program in Lesotho.  The report, titled, “TWO PLUS TWO EQUALS TEN: MULTIPLICATION EFFECT OF SEQUENCING LIFE SKILLS AND SOCIAL ASSET INTERVENTIONS,” indicates that “the contents are the responsibility of the Coordinating Comprehensive Care for Children (4Children) project” and bears CRS’s copyright.

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The following image, found on page 3 of the document, shows a diagram breaking down the various components of DREAMS’ Core Package of interventions, and 4Children’s (CRS’) role in those components. The diagram acknowledges that condoms and contraception are an integral component of the DREAMS program, while the area shaded blue appears to exempt CRS/4Children from those elements.

The inclusion of the promotion of contraception and condoms in the chart proves that CRS knew about the goals pertaining to sexual immorality when it agreed to participate in the project.

That it cordoned off a blue-shaded area to indicate that the CRS/4Children’s participation in DREAMS did not include the promotion of condoms or contraception is a clear indication that CRS anticipated concerns or criticisms about its involvement with the DREAMS project at all.  But given the promotion of condoms we have seen in various CRS/4Children documents already, it is not unreasonable to wonder if CRS’s participation in DREAMS was actually as isolated from the promotion of sexual immorality as the chart appears to indicate.

In December of 2018, the Office of the US Global AIDS Coordinator and Health Diplomacy published a document titled, “The DREAMS core package of interventions: A comprehensive approach to preventing HIV among adolescent girls and young women.” Page 8 of this document establishes Principles for the Implementation of DREAMS.  These principles show that DREAMS requires that all implementing partners work to “layer” the Core Package so that enrolled girls get the ENTIRE program.  In other words, even if CRS is able to recuse itself from direct involvement in the promotion of contraception and condoms, the very fact of its participation in DREAMS at all means that it has to ensure that the girls for whom CRS is responsible are exposed to the contraception and condom promoting components as provided by other agencies.  This requirement proves CRS’s direct complicity in the promotion of contraception and condoms through the DREAMS program.  The document says:

DREAMS seeks to reduce HIV risk and increase agency of AGYW using a layered approach. The layering of interventions is a fundamental principle of DREAMS, based on research from related fields demonstrating that addressing multiple needs of young people will have greater impact on risk behaviors than any single intervention. At the individual level, layering is defined as providing multiple interventions from the DREAMS core package to each DREAMS recipient. While PEPFAR programs were overlapping some interventions in the past, especially through the OVC program, layering of this type and scale was not occurring for vulnerable AGYW. Layering in DREAMS has required multiple agencies, implementing partners, and technical areas to collaborate more intensely to ensure that AGYW get the right interventions layered to meet their diverse needs. The exact package of interventions that should be layered depends on three factors: 1) which interventions and services are included in the country’s DREAMS program (there is some variation based on context, laws, and policies—see Table 1); 2) age of the AGYW (10–14, 15–19, 20–24); and 3) needs of the AGYW (e.g., is the AGYW sexually active, has she experienced violence). In addition to the individual level, layering also takes into account contextual level interventions that are not delivered directly to an AGYW but from which she may benefit such as community mobilization/norms change programs and parent/caregiver programs. Layering also goes beyond simple referrals to ensuring actual linkage from one intervention to another. (emphasis added)

It must be noted that this same document also states on page 8 that “abstinence based” education is deliberately not included and (on page 9) that work should be done so that governments should legalize contraception.

In some instances, important policy, structural, and system reforms within the current health, education, and judicial systems are necessary to ensure the sustainable impact of these interventions. For example, government policies/regulations ensuring universal access to secondary education, ending restrictions on contraception access, increasing access to comprehensive HIV prevention education in schools, prosecuting perpetrators of gender-based violence, and prohibiting child marriages can all be leveraged as part of a partnership with the government in reaching DREAMS goals” (emphasis added)

According to a fact-sheet produced by CRS’s 4Children project, “4Children operated a total a 72 DREAMS Hubs as part of the project.”  The document, simply titled “DREAMS Hubs: Connecting Girls With Each Other and With a Better Future,” explains that 4Children’s DREAMS participation is being led by CRS:

4Children increases access to an array of basic services, tailored to the individual child’s needs, so that each girl will become Determined, Resilient, Empowered, AIDS-Free, Mentored and Safe – the DREAMS approach to HIV Prevention among adolescent girls. Project implementation is led by Catholic Relief Services (CRS) in partnership with AVSI, FOSREF, Maestral, and Plan International USA.

Explaining what adolescent girls and young women are exposed to through the DREAMS Hubs coordinated by 4Children, the document specifically indicates the inclusion of “reproductive health services,” which according to DREAMS documents includes condoms.  The DREAMS Hubs document says:

The girls who participated in the project learned about prevention and treatment of HIV and sexually transmitted infections (STIs); gender and power; their rights to education, reproductive health services, and a life free from violence; and about where to go for medical, psychosocial and legal support.

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Now, given that CRS acknowledges that the promotion of condoms and contraception is a key aspect of the Core Package of interventions, and that DREAMS has established that its Core Package of interventions requires implementing agencies (like CRS) to ensure that clients receive the entire core package, we can conclude from the chart found on page 7 that CRS has been directly complicit in the promotion of condoms and contraception.  We have underlined the countries in the chart where CRS has been identified as a Prime Implementing Partner of DREAMS and boxed in the indicators showing that the promotion of condoms and contraception were included in the Core Packages for those countries:

In January of 2018, PEPFAR published its latest version of the “Monitoring, Evaluation, and Reporting (MER 2.0) Indicator Reference Guide” regarding the DREAMS project.  This reference guide provides technical codes for various aspects of the DREAMS initiative, and indicates certain requirements under each code.  What is indicated in this reference guide is that condom provision and the promotion of contraception are requirements for DREAMS initiative implementation.

On page 17, under the heading “DREAMS SPECIFIC GUIDANCE,” the reference guide provides the following information:

In addition to required MER reporting, it is essential that all DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) and DREAMS-like countries ensure that all implementing Partners in DREAMS [subnational units] SNUs report their results for and use data from all DREAMS-related indicators and their required disaggregations. DREAMS countries are encouraged to monitor interventions progress using custom indicators for program components that do not have existing MER indicators (e.g., contraceptive method mix, condom promotion and provision). Appendix 3 includes a full list of the DREAMS-related indicators reported for MER 2.0 and the required disaggregation for each indicator. Please note there are also specific reporting requirements for DREAMS narratives.

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  • DREAMS countries: Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe
  • DREAMS-like countries: Botswana, Cote d’ Ivoire, Haiti, Namibia, and Rwanda (emphasis added)

Beginning on page 27 is the code “KP_PREV,” and is described as “Number of key populations reached with individual and/or small group-level HIV prevention interventions designed for the target population.”  On the next page is a chart indicating the interventions included under this code, including condoms and lubricants.

On page 30, explaining the Direct Service Delivery (DSD) or Technical Assistance for Service Delivery Improvement (TA-SDI) for KP_PREV, the reference guide reinforces the fact that condoms and lubricants are included as interventions for this code.  It says:

Provision of key staff or commodities for KP receiving HIV prevention services include: ongoing procurement of critical commodities such as test-kits, condoms, lubricants, or funding for salaries of personnel providing any of the prevention package components (i.e., peer navigators, outreach workers, program managers). (emphasis added)

Beginning on page 31 is the code PP_PREV, and is described as “Number of the priority populations (PP) reached with the standardized, evidence-based intervention(s) required that are designed to promote the adoption of HIV prevention behaviors and service uptake.”

Under the heading “Package Interventions,” the reference guide says the following:

Package of interventions: Together with the IP, the country team designs a set of interventions for each of the priority populations. In a defined catchment area for the specific priority population, all prevention interventions may not be offered by one IP. However, all required intervention must be available in the catchment area for the priority population.

In other words, the listed interventions for this code are required aspects of the overall project.  And listed among the “Package of Interventions” is condoms, which means that the promotion and distribution of condoms is codified by PEPFAR as a condition of receiving funds for the project itself.  While this paragraph does indicate that not all implementing partners are required to provide all interventions, any implementing partner participating in the project plays an integral part in the overall implementation of all interventions.  Because of this, CRS either directly or indirectly is absolutely participating in the promotion and/or distribution of condoms as indicated in this reference guide.  It says:

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“The table below lists the interventions that must be offered in addition to HTS (or HTS referral).”

The codes KP_PREV and PP_PREV in PEPFAR’s reference guide both indicated that condoms were required interventions for the completion of the DREAMS project.

Given this information alone, there can be no denying that CRS played an integral and complicit role in the promotion of grave sexual immorality through its work in DREAMS.

Lesotho

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A DREAMS Overview sheet published by PEPFAR identifies CRS as a “Prime Implementing Partner” of DREAMS in Lesotho, and provides statistical context for the various aspects of the project.  On the second page of the sheet, PEPFAR indicates that DREAMS was promoting and providing condoms to 63,000 young girls, and promoting an increase of contraceptive use to 25,000 of them.

In the “Two Plus Two Equals Ten” document we referenced earlier, CRS admits that all girls receive all interventions in the core package, and that the implementing partners ensure that this happens.  On page 3 of the document, CRS states:

“The DREAMS Partnership was initiated in Lesotho in January 2016. In Lesotho, DREAMS interventions are delivered by four implementing partners: Jhpiego, Population Services International (PSI), AIDSFree — John Snow, Inc., and 4Children Lesotho delivered by CRS. Each partner is responsible for distinct elements of the core package of services, and for ensuring that all adolescent girls and young women who are enrolled in the DREAMS partnership receive all services.”

In short, CRS is fully admitting that it played a direct role in ensuring “that all adolescent girls and young women who are enrolled in the DREAMS partnership receive all services,” which includes contraception and condoms.

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At the bottom of page 4 of the “Two Plus Two Equals Ten” document, CRS/4Children indicates that 4Children Lesotho and its partners are implementing various curricula, including a series on sexuality under the heading “Go Girls.”

On page 5 of the document, CRS/4Children explains the Go Girls curriculum, saying:

Each week for eight weeks, girls attend a weekly two- to three-hour session that combines: …
social assets intervention drawn from two evidence-based curricula. Go Girls! was initially developed in Malawi(4) and adapted for the Lesotho CRS context in 2016. Sessions include looking at who we are and what we want to be, gender norms and gender equity, communication skills and speaking up and sexuality. The sessions are adapted according to the ages of the girls in the group.

Footnote 4, right by the word “Malawi” contains the following information:

4    Johns Hopkins University Center for Communications Program (2011). Go Girls! Community-based Life Skills for Girls: A Training Manual. https://www.thecompassforsbc.org/sites/default/files/project_examples/GoGirls_English_Final_Rev1.pdf

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Before we dive into the Training Manual for Go Girls!, it is important to address the statement in the “Two Plus Two Equals Ten” document, which says “Go Girls! was initially developed in Malawi(4) and adapted for the Lesotho CRS context in 2016.”  CRS’s defense for using the curriculum will be that it was adapted, possibly claiming that the adaptation included the removal of all references to condoms and contraception.  But this immediately raises the question about why this curriculum was being implemented to begin with.  CRS has its own curriculum called Faithful House, and other supplemental materials which could have been suitably adapted to meet their needs without resorting to “adapting” grossly immoral material.  But, as it is, CRS provided a link to the training manual, indicating that it is the one they used.  Even IF the manual was adapted, CRS will not be leading this initiative in perpetuity, and implementing a truncated version of an evil program simply opens the way for its complete use by another organization coming in behind them. To put it succinctly, one cannot adapt Planned Parenthood’s textbooks for Catholic classrooms.

As indicated above, CRS plainly stated that sessions titled “Sexuality 1” and “Sexuality 2” were taken from the Go Girls!, linking directly to the Go Girls! Training Manual.  Go Girls was developed in 2011 by Johns Hopkins University through grants from both USAID and PEPFAR.  The introduction to the manual indicates that it was designed “for girls ages 13 – 17, who are not enrolled in school or live in very vulnerable situations.”

Beginning on page 59 is Session 11: “Preventing Unintended Pregnancy.”  The session description says the following:

“Participants discuss the advantages of planning their family, and learn about different types of family planning methods as well as where they can get them. This is important information for girls who are abstinent as well as for girls who are sexually active.”

Under “Facilitator Preparation,” the facilitator is directed to do the following:

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  • Invite a local midwife, nurse, peer outreach person or staff from an NGO working on family planning to come to talk about family planning methods and where participants can go to get them. This guest will lead Activity 4 below. Share this session plan with the guest so that she/he will know what is expected. Invite her/him to attend the whole session.
  • Collect sample contraceptives from a local clinic, pharmacy, or ask the guest to bring them.
  • Make copies of Handout 3: How to use a Condom and find out where other contraceptives are available in the community.

Handout 3, “How to use a condom” is found on page 63, and it provides the following graphic explanation as to how to use a condom:

On the page 60 is “Activity 2: The Pros and Cons of Family Planning.”  This activity discusses various forms of contraception, weighing various reasons why or why not to use it.  But this is immediately followed by “Activity 3: I Know It’s Good For Me But…”, found on page 61.  The entire point of this activity is to convince young girls that using contraception is as normal as “brushing our teeth, eating vegetables or doing homework.”

The wrap-up for the session instructs the facilitator to:

  • Remind the participants that although pregnancy is normal having children by choice, not by chance, is best for the mother, the baby, the family and the nation.
  • Remind the participants of places in the community where they can access contraceptives.

And after reminding participants of where they can obtain contraceptives, the practice activity, which is essentially a homework assignment, is simply this:

“Between now and the next meeting, find out: Where do people get condoms and pills in your community?”

Session 8 in this manual, which is titled, “My Body Is Changing – Am I Normal?,” actually recommends masturbation as a means of relieving sexual tension.  Activity 2 of this session, found on page 44, is titled, “Puberty: Is it Normal?”  Point 3 of this activity provides the following instructions to the facilitator:

Tell participants that now you would like to share with them some basic information about puberty. Share the following puberty messages with the participants:…

A few ways to handle sexual excitement may include masturbation, fantasizing, physical activity such as football, or putting the mind on something else. Sexual excitement does not mean that one has to have sex. Nothing bad will happen if you do not have sex. (emphasis added)

There are other portions of the manual that are equally morally reprehensible, but the point is that CRS is using this manual as a part of the 4Children DREAMS project in Lesotho.  It is inconceivable how or why CRS would even consider this program for implementation, adapted or not, but as we pointed out earlier, the real danger is that the manual was introduced at all.  Supposing that CRS is indeed using an adapted version of this program, removing all of the immoral aspects, there are two very important things that one must consider:

  • These manuals would have to have been purchased, which builds upon the expanded use of the manual in its entirety.
  • Once introduced in a truncated form, whatever organization comes to the area in which CRS is operating is under no obligation to continue using the truncated form, and may introduce an unsuspecting population to the evil elements.

One last point concerning CRS’s participation in the DREAMS project in Lesotho is that CRS fully admitted that “Each partner is responsible for distinct elements of the core package of services, and for ensuring that all adolescent girls and young women who are enrolled in the DREAMS partnership receive all services.”   This is to say that, once again, even if CRS was not directly facilitating the promotion of contraception and condoms as found in the Go Girls! Training Manual, CRS was responsible for ensuring that the girls under its care through the DREAMS program received such promotion from its partners.  There is simply no way CRS could have participated in the DREAMS project in Lesotho without being guilty of participating in the promotion of contraception and condoms.

Kenya

MWENDO is a $70 million, USAID-funded project being implemented by CRS in Kenya from 2017-2022.  In a 2-page flyer on MWENDO, CRS states:

MWENDO increases access to health and social services for orphans and vulnerable children (OVC) and their families, strengthens the capacity of households and communities to protect and care for their OVC, and strengthens child welfare and protection structures and systems for effective responses in targeted communities. By 2022, MWENDO is expected to deliver services to at least 326,000 vulnerable children from approximately 90,000 households in counties with the highest HIV prevalence rates in Kenya.

Using approaches and tools validated through CRS’ global 4Children project, MWENDO uses comprehensive case management as the foundation and entry point for an evidence-based and informed program of interventions.

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While not specifically a 4Children project, MWENDO is identified with the “tools validated through” the 4Children project.  In May of 2019, CRS provided USAID with a document titled “Innovations in Case Management: Picture Impact Journals.” On page 7 of that document is a flow chart titled, “Picture Impact Case Management Tools,” indicating that these tools were being implemented in the MWENDO project.

4Children’s document titled, “Pictorial Tools for HIV-Sensitive Community Case Management” expressly states on page 6 that “the toolkit was first developed with 4Children in Kenya through the Mwendo program.”  Throughout the document are images showing the very same tools indicated in the flowchart above, such as the Household Action Plan, the Activity Card Deck, etc.

Earlier in this report we examined the 4Children SOP for Case Management and the Activity Card Deck and showed how they promoted condom use as a “good practice.”  What this flowchart and the “Pictorial Tools for HIV-Sensitive Community Case Management” document indicate together is that MWENDO is not only using but helped develop the condom-promoting toolkit we identified in the first chapter of this report.

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In 2016, PEPFAR published a brief summary of the DREAMS project in Kenya, showing MWENDO as one of the Prime Implementing Partners.

It is worth reiterating what we’ve already covered in this chapter, indicating that in every place where DREAMS is being implemented, the condom-promoting components have all been indicated as requirements.  There is very little on record regarding CRS’s implementation of DREAMS through MWENDO, though we have been able to verify that CRS has indeed been implementing DREAMS through a series of job announcements.

In the Spring of 2019, CRS announced that it was looking for an OVC Service Delivery Specialist whose job description is as follows:

“The OVC Service Delivery Specialist will manage, coordinate, oversee, and monitor capacity strengthening activities and relationships with local implementing partners (LIPs) and other MWENDO project stakeholders to assist in OVC Service delivery (HIV services, Education, Psychosocial Support, Adolescent services including DREAMS,) strengthening case management systems and referral networks, advancing Catholic Relief Services’ (CRS) work serving the poor and vulnerable.

His/her project management skills and technical knowledge in HIV care and treatment and OVC programming will ensure that CRS Kenya delivers high-quality programming and continuously works towards improving the impact of the MWENDO project.”

Under “Job Responsibilities,” CRS’s ad specified:

Lead Project technical team to work with and create linkages with stakeholders involved in Adolescent service delivery with a specific focus on MWENDO Adolescent girls receiving top up and or service layering in line with DREAMS service delivery.

In September of 2019, CRS took out a job advertisement for a “Project officer – Adolescent/DREAMS.” The job summary was very straight-forward in stating the intention to manage the implementation of DREAMS interventions:

The Project Officer (PO) Adolescent/DREAMS will provide technical and management oversight to Local Implementing Partners (LIPs) to ensure efficient implementation, M&E and reporting of adolescent/DREAMS initiative interventions and their integration in the respective counties.

The first specific responsibility identified in the ad is the following:

Support the coordination, implementation, and monitoring of all assigned Adolescent/DREAMS MWENDO project activities as outlined in the detailed implementation plan in line with CRS program quality principles and standards, donor requirements, and good practices.

Another responsibility deals with DREAMS’s comprehensive services for adolescents:

Work with CHMT, health facilities and community partners in the respective DREAMS Counties to ensure coordination with other programs and stakeholders for quality and comprehensive services to adolescents.

While all of this is couched within terms related to “CRS program quality principles and standards, etc.” the fact that CRS cannot escape is that DREAMS, as a program, is designed specifically for the intention of spreading contraceptive and condom promoting programming to young adolescent girls and women.  Whether CRS is directly facilitating that particular messaging is irrelevant, since they are introducing a project whose aim is to do so.  As indicated in the background information on the DREAMS project itself, not all implementing partners are required to provide all services and messages, however all implementing partners are to work together to ensure that the entire project is completed in all phases in each place it is implemented.

This is yet one more case where CRS has been working with full knowledge of the evil designs of a federally funded project and facilitated the implementation of that project.  The fact of the matter is that the implemented program called DREAMS will remain long after CRS has departed the project, and even if CRS had nothing to do with the promotion of contraception and condoms at the time, it created the beachhead for DREAMS to do it in perpetuity long after CRS leaves.

Uganda

In Uganda, Catholic Relief Services’ OVC project is called Sustainable Outcomes for Children and Youth in Central and Western Uganda (SOCY).  A 2-page flyer on SOCY, published by CRS, gives some statistical data on the project, indicating that it is a $45 million project funded by USAID, spanning from 2015-2020.  One of the stated goals of CRS’s SOCY project is “Improved Coordination of Community-based Clinical and Socio-Economic Services.”  Under this heading, CRS explains the incorporation of DREAMS as a part of its work:

For adolescents and youth, SOCY implements a program designed to help adolescent girls and young women ages 10–24 develop into Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) women. DREAMS’ regulated peer-to-peer discussions help young women build their confidence and equip them with skills to combat societal threats, such as HIV infection. In addition, DREAMS participants receive the vocational entrepreneurship skills training and have the option to join SILC groups to support their economic independence. Lastly, the DREAMS curriculum includes Parenting for Lifelong Health or Sinovuyo trainings targeting adolescents ages 10–17 and their caregivers.

Listed under “Key Results” for the project as of September 2017, CRS boasts that it has provided the “core package of services” of DREAMS to nearly 17,000 adolescent girls and young women.  We’ve already shown that the DREAMS core package includes the promotion and distribution of condoms and the encouragement of increasing the mix of contraceptives, so there is no doubt that CRS’s implementation of DREAMS in Uganda incorporated those aspects of the core package in the SOCY project.  A DREAMS overview sheet published by PEPFAR in 2017 actually provides the number of girls and young women who were being targeted with condom promotion and supplies and encouraged to use additional forms of contraception in the regions CRS was implementing DREAMS.

In 2017, CRS posted a job advertisement for a Project Officer for its DREAMS project. The description for the Project Officer provides certain details which confirm that CRS was either directly or indirectly through its network of implementing partners, ensuring that all required aspects of the DREAMS project were being implemented.  As we indicated in the background information on the DREAMS project, the promotion of condoms and the promotion of the increased use of different contraceptives were requirements for the implementation of the DREAMS project.  The description of the Project Officer position is as follows:

The Project Officer DREAMS will provide technical leadership to the design and roll out of the SOCY DREAMS expansion strategy to all program districts with the aim to improving the health and social lives of AGYWs, families and their communities.  Based on SOCY lessons learned from the original three SOCY DREAMS districts (Mityana, Gomba and Rakai), the Coordinator will support CSOs to develop DREAMS implementation plans and budgets, identify trainers and manage the training process in all relevant DREAMS packages at different levels. The DREAMS Coordinator will work collaboratively with the Referrals and Linkages Officer to ensure that beneficiaries receive comprehensive interventions as per DREAMS requirements, the Monitoring and Evaluation Unit for tracking and reporting of DREAMS interventions and with the Education Subsidy Officer to ensure DREAMS is supportive of retention and completion of school especially for adolescent girls. The Coordinator with support from the Services and Linkages Technical Manager will facilitate vertical collaboration between the three program result areas to maximize existing program interventions for effective delivery of services. The Coordinator will be required to actively participate in all relevant USG, IP and LG stakeholder meetings, as well as District DREAMS coordination/planning meetings. The Coordinator will be expected to travel to the districts frequently to provide on-site technical assistance to CSOs to ensure effective, timely and high quality program implementation.  (emphasis added)

In the job description, CRS identified that SOCY DREAMS districts were Mitryana, Gomba, and Rakai.

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On page 2 of PEPFAR’s Uganda DREAMS Summary for FY-2017, CRS is identified as a prime implementer, and the target numbers for condom and contraception promotion for CRS’s 3 DREAMS districts is provided.

Once again, it is abundantly clear that CRS is implementing the DREAMS project in Uganda, which means that the Core Package of Interventions of condoms promotion/provision and increased use of contraceptive mix were implemented along with it.  Whether directly or indirectly, it is undeniable that CRS is complicit in the promotion of contraception and condoms through the DREAMS project in Uganda.

Zimbabwe

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The only thing known about CRS’s involvement in the DREAMS project in Zimbabwe is that CRS is identified as an implementing partner in a 2016-2019 overview sheet.

Despite having any additional information, if CRS was indeed an implementing partner for the DREAMS project as is indicated in this sheet, then as with the other locations, CRS would have been required to play some part in the promotion and provision of condoms while encouraging an increased use of contraceptive mix among young women.

Conclusion

Catholic Relief Services is directly responsible for leading the implementation of the DREAMS project.  The DREAMS project requires that all aspects of the project be implemented, even though not every partner is responsible for implementing every one.  What this means is that CRS is implementing a project specifically designed with the goal of increasing the use of condoms and other forms of contraception, specifically and deliberately omits abstinence-only curricula, and requires that the contraception-promoting components be implemented.

CRS routinely denies that it participates in any way in the promotion of condoms or contraception, but the fact that it is leading the implementation of DREAMS proves that this is completely untrue.  Because of this, we reiterate our call for a thorough, independent, third-party investigation of Catholic Relief Services and its projects.  We also continue our call for bishops to withdraw all support from Catholic Relief Services until CRS is brought into full conformity with Pope Benedict XVI’s motu proprio On the Service of Charity, which states:

“the diocesan Bishop is to ensure that charitable agencies dependent upon him do not receive financial support from groups or institutions that pursue ends contrary to Church’s teaching. Similarly, lest scandal be given to the faithful, the diocesan Bishop is to ensure that these charitable agencies do not accept contributions for initiatives whose ends, or the means used to pursue them, are not in conformity with the Church’s teaching.”

Until such time as Catholic Relief Services is no longer allowed to accept funding from USAID, PEPFAR, the Global Fund, the Gates Foundation, and other similar contraception-promoting agencies, no Catholic can, in good conscience, provide funding to CRS.

Reprinted by permission of the author


  catholic relief services, contraception, lepanto institute, us bishops

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