She was pregnant almost every year. She needed a choice — and the power to protect her island

You take a boat — over an hour across Lake Victoria, the world’s largest tropical lake. It feels like an ocean. When the weather is bad, this journey is dangerous. The crew stops talking. Passengers huddle together, away from the waves.

Thankfully today, the sun shines brightly as the beach comes into view, and you see this unique place for the first time.

Bussi Island is a proud community of fishers and farmers.

8 out of 10 people in the Lake Victoria Basin rely on fishing and agriculture for their survival and income.

Amidst natural beauty, families are struggling to survive.

People here are among the poorest and most food insecure in all of East Africa. To make matters worse, overfishing and environmental degradation have contributed to a steep drop in the native fish population — a decline of 80% since the 1970s.

Women are especially vulnerable. Their reproductive health and rights are at risk.

Almost half of pregnant women said their pregnancy was unwanted — or they wished it came later.* Nearly 70% of women of reproductive age on Uganda’s islands are not using an effective method of contraception.

Najjuuko Fausta, who first spoke to us in 2014, believes these challenges are all connected.

“Because I was always pregnant, I was sick all the time. Too tired to leave home and work.”

At 15, Fausta gave birth to her first child. By 23, she had four. Like many girls on Bussi Island, she felt pressure to marry young and grow her family fast.

“I had trouble caring for my family,” she said. “I needed to support them, but I couldn’t.” Her family had to rely on whatever income her husband, Paul, could earn off the lake or land.

At times, they didn’t have enough food — just black tea during the day and one meal at night. Fausta worried about another pregnancy.

What happens when we run out of money? When there are not enough fish? When the drought gets worse and there’s nothing to harvest? How will we afford to educate our children?

Fausta has one daughter, 5-year-old Maria. “I thought…she’s a girl. I may not send her to school.”

This is not the life Fausta wanted. But she didn’t believe she had a choice about pregnancy. “Our husbands didn’t want us to use family planning,” said Fausta. “They believed using family planning meant we were going to go with another man.”

And she’d heard terrifying things — misinformation about how contraception could kill her. That it gives a woman cancer. That a contraceptive implant could travel from your arm through your body — and pierce your heart.

Fausta needed accurate information and the power to change her life. Thanks to your support for our work, she’s getting it.

Let’s take on 11 challenges at once

In 2015, the United Nations unveiled its Global Goals for Sustainable Development — to address the world’s most urgent challenges. From “empowering women and girls” to “combating climate change,” this to-do list requires all of us to think outside the box. We believe we’ve done it.

We’ve partnered with environmental experts, East African governments, and communities like Fausta’s to unlock a formula for addressing 11 of the world’s biggest challenges — all at the same time.

The answer lies in combining reproductive health, management of natural resources, and economic opportunities into a single groundbreaking project. It’s called “The Health of People and Environment in the Lake Victoria Basin.” And it’s laying the groundwork for healthier people and ecosystems for years to come — starting with Fausta.

“The project is amazing. It has benefited my life,” Fausta says today.

Through the project, Fausta takes part in trainings on contraception, sustainable fishing and agriculture practices, nutrition, and sanitation. She’s joined other women on the island to form a nursery co-operative — to earn an income and create a better future for herself and her family.

“I’ve learned that our lake is our main resource, and we should use it sparingly…not to rely on fishing as our only source of income,” she says. “And I’ve learned the truth about family planning.”

She brought this knowledge home to Paul. The couple talked about how hard it was to support their family and decided together that they could not afford another child right now. They decided to use contraception.

“Family planning is the greatest thing,” she says.

Our Future Depends on Women’s Empowerment

You can hear the sound of women working, sinking their hands deep into the dirt and ripping out weeds. They are focused.

Fausta says women and families have gotten a lot from this nursery.

“We have been able to earn money. And more income changes everything. My husband and I were able to buy a plot of land. We built and own our first home. We can take better care of our children. Afford better food.”

 She smiles when she talks about how she uses the money to give her children whatever they need for school. All of her children.

“I have sent my daughter to school,” Fausta says. “I’ve realized how important it is…Even me—as a woman—now I know I can earn. I can take care of myself. That makes me happy. I am so happy.”

Where women are in danger, new allies emerge in the fight for contraceptive choice: men and religious leaders. Explore our latest from India.


The Health of People and Environment in the Lake Victoria Basin project is made possible through a close partnership between Pathfinder International, Nature Kenya, and Ecological Christian Organization. Funders include USAID via the Evidence to Action project, John D. and Catherine T. MacArthur Foundation; David and Lucile Packard Foundation; and the Barr Foundation.

*Bremmer, Zyoleff, and Pricope, Using New Methods and Data to Assess and Address Population, Fertility, and Environmental Links in the LVB, 2013

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