An afternoon walk home from school brought an abrupt end to 14-year-old Hirut Assefa’s childhood. Before she could reach her destination, a 29-year-old farmer abducted Hirut to make her his bride. In a scenario all too familiar to generations of African and Asian women, Hirut was expected to submit to her abductor and marry him under a practice known as “telefa,” defined as bride kidnapping or abduction into marriage.
An ancient tradition still practiced in some parts of Central Asia and Africa, telefa was legal and common in parts of Ethiopia in 1996 when Hirut was taken. At that time, telefa affected more than 40 percent of Ethiopia’s adolescent girls. To solidify the marriages, men would often rape them until they became pregnant. Under Ethiopian law, the men could then claim the girls as legitimate brides.
But Hirut fought back. She shot and killed her abductor in an effort to escape and return to her family. Her bravery did not free her. Instead, she landed in prison for murder. Hirut’s claims of self-defense fell on deaf ears, but led to a media firestorm that brought Ethiopian attorney and activist Meaza Ashenafi to her defense.
To carry out her work as a champion of poor and abused women, Ashenafi had struggled to avoid the attention of the Ethiopian government. But she decided to risk everything to save Hirut’s life and forever change the violence practiced against women in her country.
Eventually, Hirut was acquitted. The battle took six years. Her trial galvanized public support to change Ethiopia’s penal code to criminalize not only telefa, but also genital mutilation. For the first time in the country’s history, gender-based violence was deemed a formal crime.
Storytelling as Medicine
Hirut and Ashenafi’s extraordinary David and Goliath tale is the subject of a film titled Difret, which was executive produced by actress Angelina Jolie and produced by Mehret Mandefro, MD, MSc, AB, through Mandefro’s organization Truth Aid. The film won the Sundance Film Festival’s 2014 Audience Award: World Cinema Dramatic and the Audience Award at the 2014 Berlin International Film Festival, Berlinale. The film’s title—Difret—is a complex word that reflects the challenges Ethiopian women face. It has two meanings: In its most common usage, it means courage, but it also refers to the act of being raped.
“Our film chronicles the precedent-setting legal case that led to the criminalization of marriage by abduction—which was a form of naturalized violence against Ethiopian women,” says Mandefro, a physician, filmmaker and Robert Wood Johnson Foundation (RWJF) Health & Society Scholar program alumnus (2007-2009). She founded Truth Aid with the help of an RWJF grant.
"[Difret] is a story that gives hope for Ethiopia's future and for other countries where countless girls grow up without the protection of laws that shield them and their bodies, and shows how the courage of brave individuals can awaken the conscience of a society," Jolie said in a statement to the Hollywood Reporter.
Film may seem like an unusual bully pulpit for a physician like Mandefro, but she sees it as an ideal channel to bring powerful, potentially life-altering stories like Difret to the broadest possible audience.
As a former White House Fellow, Mandefro is acutely aware of the often lengthy process needed to translate health policy into action. “In public health, we frequently talk about structural interventions. But studies have found that it can take as long as 20 years for interventions based on research to make their way into practice,” explains Mandefro, who has produced two other films and has a third in process.
“I started making films because of the Robert Wood Johnson Foundation,” says Mandefro, who was working in primary care when she became an RWJF Health & Society Scholar. “I used the award to study film and carry out the outreach for a film I made in residency—All of Us. It is a documentary about African Americans and HIV/AIDS. That project really opened my eyes to what you could accomplish through the medium. You write a paper and a few people read it. You make a film and it has a much broader reach.” All of Us was featured on the Showtime network in 2008.
Mandefro, an adjunct faculty member in the department of health policy at the George Washington School of Public Health and Health Services, combines her expertise as a medical anthropologist, public health researcher, and former clinician to create what she calls “visual medicine.”
“I think Difret says a lot about the legal determinants of health,” Mandefro says. “The legal system can have a tremendous impact on people’s lives. We also do not train physicians to think about violence and its huge impact on health.”
Underscoring the media’s ability to give a voice to the voiceless, she adds: “We often talk about the haves and have-nots, but we must also talk about those who are safe and unsafe. When it comes to violence against women, it is a global public health issue. Across all cultures, approximately one in three women consistently face some type of violence or sexual abuse. I think the film helps raise awareness of these issues.”
Mandefro’s next project, the film Little White Lies, focuses on the connection between social identity and well-being. It will air on PBS’ Independent Lens in 2015. “Being part of such large global events like Sundance and Berlinale offers an ideal opportunity to mainstream concerns about the social determinants of health and reach the non-converted,” says Mandefro. “That’s why I love making films.”
Learn more about the RWJF Health & Society Scholars program.
For an overview of RWJF scholar and fellow opportunities, visit RWJFLeaders.org.